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2. Setting the scene - Background information
1. Introduction
Scotland is changing. Uniquely amongst the other nations in the UK, Scotland's population is not growing, it is more or less static - in fact it has remained at around 5 million for most of the last century. However the age structure of the population is changing significantly. As a result of lower birth rates and greater life expectancy, there will be many more older people in Scotland, and fewer younger people.
The ageing of the population is unprecedented, however Scotland is not alone. Ageing populations are a worldwide phenomenon, from Japan to Italy. They come about because of a combination of reducing birth-rates, increased longevity, and the impact of earlier peaks in birth rates. Longer lifespan is testament to the success of public health measures, improved physical health, and a more prosperous society. It is something to be celebrated, not feared.
2. Why a strategy is needed
This poses a challenge for us all - how to ensure that Scotland is a fit place in which to grow old?.
Faced with the challenges of an ageing population, it is essential to change the outdated mindset which characterises older people only as a drain on resources. Older people already represent a considerable resource for Scotland, and by removing barriers this can be further enhanced. Older people (over 50) have the potential to help grow the Scottish economy, by greater economic engagement. They also have a key role to play in creating stronger safer communities. Greater local participation improves both the perception and reality of local safety.
Releasing more of the potential of older people is an integral part of a wider strategic approach to Scotland's ageing population. Such an approach, which will impact on most areas for which the Scottish Executive is responsible, is needed to ensure that we are equipped to meet the challenges which an ageing population undoubtedly poses.
This involves more than looking only at the needs and aspirations of today's older people, important though those are. Issues such as economic activity over the life course have a significant impact on inequality, health and social inclusion in later life and need to be incorporated into our strategic thinking. The old boundaries between working age and retirement age are becoming less and less clear; and a flexible view needs to be taken of what "older" means and of the traditional view of what constitutes "older people's issues". Scotland needs to ensure that its services, buildings, transport, structures and society are fit for purpose and responsive to the needs of the population.
This is why the Scottish Executive is developing a Strategy for a Scotland with an Ageing Population, which will be published by the end of 2006. This is an opportunity for you to contribute to discussion on what the key issues are for Scotland's ageing population.
3. Aim of the strategy
The aim of the strategy is to provide a long term framework for:
- Access to opportunities for older people to make a continuing contribution, including:
- Identifying and removing barriers to opportunities;
- Establishing effective and diverse ways to involve older people in their communities and with government;
- Promoting equal opportunities;
- Promoting social inclusion;
- Combating stereotypical views of ageing.
- Effective integrated services for older people;
- Promoting and maintaining health and wellbeing;
- People living in accommodation and environments which continue to meet their needs and wishes as they age.
The Strategy is being developed within the context of existing work and initiatives of the Scottish Executive and the UK Government.
The need to respond to the ageing population lies not just with the Scottish Executive, but with local authorities, health boards, professions, the voluntary sector, the private sector, communities, and individuals.
Some issues, like pensions, benefits, and discrimination legislation, are the responsibility of the UK Government. The Scottish Executive works closely with the UK government on these reserved matters, for example to promote better take-up of benefits. The Scotland Act 1998 gives the Scottish Parliament power to encourage equal opportunities, including in relation to age.
4. Objectives of the Strategy
The objectives of the Strategy are:
- To address the challenges and opportunities of an ageing population in a sustainable way within an integrated and evidence-based framework;
- To realise the potential that an older population can bring, and to recognise the contribution that older people already make;
- To maximise older people's future involvement and contribution, including promoting active and healthy ageing, and to support those older people who wish to continue to work;
- To provide a context within which to review and develop existing policies to ensure that they adequately respond to the challenges and opportunities of an ageing population; in particular to set a direction of travel, identify gaps and ensure that priorities are right;
- To set a framework to help others develop their own plans for action and for future services, and engage with the challenges and opportunities of an ageing population.
This paper sets out some of the issues within which a Strategy for a Scotland with an Ageing Population is being developed, and highlights some of the areas which will need to be considered.
5. Demography
The demographic trends are well known. Scotland has an ageing population, and the change in age structure has very significant implications for the future of Scotland's economy, for family life, and for the planning and delivery of services.
By 2024 there will be 2.2 million people aged 50 or over and more than half a million aged 75 or over. The largest percentage increases will be in the oldest age groups. Alongside this, there will be fewer people in the traditional "working age" age group, and fewer children. The average age of people in the workforce will be higher due to both population change and the impact of UK policy to extend working lives. The impact is much greater in some parts of Scotland than in others. Dumfries and Galloway for example has a projected fall of over 30% in the 30-49 age group over the next 20 years (2004 to 2024), while they have a 75% increase in the 75+ age group in the same period.
Table one shows Scotland's changing demographic profile from 1901, projected to 2041.
Table 1 Scotland's Past and Projected Age Structure 1901 - 2041 (in five year groups)
Source: GROS 1901 census, 1951 and 2001 mid-year estimates and 2004 based projections
The Scottish Executive is already undertaking work on aspects of demographic change, including the Fresh Talent initiative. However, we also need to plan for the fact that irrespective of future levels of migration and fertility there is an absolute increase in the number of older people, an increase which will continue for many years to come.
6. Access to opportunities for older people, in all their diversity, to make a contribution
The current generation of older people can face obstacles and difficulties in many aspects of their lives. Whether it is someone in their fifties being turned down for jobs for which they are qualified, or a ninety-year old being neglected in a care home, the underlying reason is the same: a lack of respect for older people, their value, and their contribution; in short, ageism. Although these two are a generation apart, and their life stages and experiences are very different, they are both experiencing prejudice because of their age.
The strategy must address some of the barriers to opportunities for older people to make a continuing contribution; and it must also ensure that the contribution already made by the oldest people is recognised and valued. The strategy needs to establish effective and diverse ways to involve older people in their communities and with government, it must promote equal opportunities and social inclusion, and it must combat stereotypical views of ageing.
Older people are not passive recipients of services, but are active consumers with important spending power, particularly those on comfortable pensions, with no mortgage or dependent children. Even those living on low pensions will spend their income, contributing to the economy.
The contribution of older people to their communities is immeasurable. Older volunteers provide essential support to the vast network of large and small voluntary organisations up and down the country. They are not just the cared for, but are often carers themselves, taking on the responsibility of providing intensive care for their own family members. As grandparents, many provide essential childcare, enabling parents to go out to work.
However despite this, too often older people are denied the opportunity to contribute to or participate in society - ageist attitudes and policies, a society which writes them off, and sometimes, their own lack of self-esteem - all contribute to a waste of talent, experience and ability.
The Scottish Executive is seeking your views, and examples of good practice, on these issues. Please use questions 3.1 and 3.2 of "Age and Experience - What do you think?" to give your views.
7. Effective integrated services for older people
The Scottish Executive has made major commitments to improving services for older people. Free personal and nursing care, free central heating, and free local bus travel have all been well-received and have contributed to improved quality of life for older people; and the commitment to extend free bus travel to a nationwide scheme takes this even further. The work on Joint Future and other ongoing work addresses the issue of providing joined up services. These initiatives, and the development of future policy, must be set in the context of a wider strategic approach to ensuring that all older people experience high quality, joined-up services that meet their needs.
Older people's services are diverse, as are service providers. Service provision is a complex interplay between local authority, health service, voluntary sector, and private sector provision; between housing, residential care, transport, community care, and health care; as well as services such as advice and information, libraries, and leisure. Not only that, but informal care and services are an important part of the overall package of services that older people use. While the Scottish Executive can directly influence the statutory services, there is also a role for providing a strategic framework within which other service providers can develop to meet the needs of an ageing population. Future services are likely to be influenced by the impact of new technology and the development of new models of integrated service delivery, as well as changing consumer expectations and the desire of many older people to make active consumer choices.
The Scottish Executive is seeking your views, and examples of good practice, on these issues. Please use question 3.3 of "Age and Experience - What do you think?" to give your views.
8. Promoting and Maintaining Health and Well-being
Perhaps one of the most feared and publicised consequences of an ageing population is the possible increased burden on health services. Greater life expectancy does not automatically mean a proportionate increase in demand on health services. There is evidence to suggest that as people live longer, they are living healthier. Also the greatest demand for health services tends to come in the last few years of someone's life - regardless of what age that happens to be. However with a greater proportion of older people in the population, there is likely to be a greater demand on health services - just as there was a greater demand for schools when the baby-boomer generations were of school age.
The report 'Building a Health Service Fit for the Future' by Professor David Kerr has set out a vision for a health service that is much more focused on the needs of an ageing population, proposing significant changes to the way the health service operates. The report emphasises the need for preventative, anticipatory care rather than reactive management; and for services to be delivered predominantly in local communities. The Scottish Executive response 'Delivering for Health' re-enforces the need for change as proposed by the report. These policy documents have already provided much of the strategic direction for health services for an ageing population, and the development of the ageing population strategy must sit with these, and other policy initiatives.
However health and wellbeing is far more than the delivery of health services. The issues of isolation, loneliness and poor mental health are very real, as are long term health problems. People's housing, social status, income, diet, level of physical activity, social networks, and employment status can all have an impact on people's health and well-being in later life, and the strategy can consider issues that will promote health and well-being in later life.
The Scottish Executive is seeking your views, and examples of good practice, on these issues. Please use question 3.4 of "Age and Experience - What do you think?" to give your views.
9. People living in Accommodation and Environments which continue to meet their needs as they age
An ageing population poses particular issues for the physical environment in which people live. The housing that is being built today will still be here in twenty, thirty or forty years time - and in all likelihood, much of it will still be lived in by the original residents. Many of today's generation of older people are living in the same homes they've lived in all their adult lives. This means that housing and physical environments - streets, pavements, availability of shops and local services - should be able to respond to the needs of an ageing population. For those people who choose to move to different accommodation as they age, they will want to find housing which meets their needs based in their own communities. The ageing of the population possibly poses the biggest challenge for planners and developers - physical infrastructure is much harder to adapt to changing circumstances than services.
There are opportunities too - the development of new technology opens up opportunities for housing responsive to the needs of its occupants, and may enable people to live for longer in their own homes. There are opportunities for providers of housing and services to develop products that meet the needs of an ageing population - particularly a generation that is used to exercising its consumer power, and with higher consumer expectations.
The Scottish Executive is seeking your views, and examples of good practice, on these issues. Please refer to question 3.5 of "Age and Experience - What do you think?" to give your views.
10. Conclusion
There may well be other issues that you think that the Scottish Executive should take into account in developing its Strategy for a Scotland with an Ageing Population. Please refer to question 3.6 of "Age and Experience - What do you think?" to give your views.
The challenge of an ageing population is great. The challenge of developing a strategy to enable Scotland to respond appropriately to its changing demographic is almost as great - but the development of this strategy provides a real opportunity for all sectors of Scottish society to influence future policy, and to ensure that Scotland is a place in which we are happy to grow old.
Scottish Executive Older People's Unit
March 2006
This paper is available on request in alternative formats and languages. Please contact Jess Barrow on 0131 244 0718 or email jess.barrow@scotland.gsi.gov.uk
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