The Generation Game: Spending priorities for an ageing society
We are now entering a key period in UK politics, the outcome of which will shape the health and welfare landscape for older people for the next five years at least – and possibly for a lot longer. The party conferences of 2015 fall between an election, at which gaining the older vote was a target for all the parties, and the autumn spending review, which will set in stone the priorities revealed in the recent summer budget.
In terms of the final shape of that review, interestingly, one of the key pillars of the future welfare terrain – the ‘living’ wage – wasn’t mentioned in the Conservative party’s pre-election manifesto. Something that was promised – the implementation of the key element of the 2014 Care Act, the ‘care cost cap’ – has subsequently been postponed for five years. Whatever structures replace this will define the content and shape of health and social care in England for many years ahead. Obviously as the post-election euphoria fades and the harsh reality of restrictive spending limitations hits home, there is still much to play for in achieving the right balance between supporting both working age and older people.
The spending review should reveal just how the new government plans to fairly balance the needs of older people against other sectors of society. It needs to show
just how it plans to finance the support people require to prepare properly for later life, including incorporating the new pension freedoms. It needs to show how it will help people manage the risk of needing care, and provide access to the right guidance and advice about how best to plan for and prioritise the range of different costs faced in old age.
It is to be hoped therefore that in framing the review, the government will look closely at the full extent and trend of pensioner poverty. For while the top-line figure of pensioner poverty has fallen, pockets of extreme poverty in this group, particularly among those who are entering old age with a pre-existing disability, remain. They also need to strike the right balance between resolving both pensioner and working age poverty and prospects, especially among disabled people, under 25s and single mothers.
Another issue which should be a significant driver for the review is how the government plans to address the need for people to work longer into older age as part of its goal to resolve the challenge of skill shortages in certain sectors of the economy. The issue of training and re-skilling at all ages, but particularly for older people in terms of employment retention and recruitment, is critical. So too are the ramifications of an older retirement age, along with its implicit corresponding reduction in ‘grandparenting’ opportunities. Thus working age parents risk being forced out of, or denied, employment because of lack of available childcare.
In the review, the joining up of health and social care and the management of long-term chronic conditions, including dementia and end of life care, also require further underpinning, together with an associated improvement in both retaining good health and in prevention of ill-health at all ages. The hope is that the government fully understands the scale of the current crisis in health and social care and uses the spending review to seek to resolve both the short-term pressing issues and to begin the development of a long-term sustainable solution to the funding of both the lifestyle and health needs of people in later life.