Living longer is good, but an ageing population has problems

THE annual report by the Registrar General for Scotland has highlighted two problems which confront the nation, one a persistent one and the other emerging: the continuing health inequality which plagues this country and the potential strain on the state of a growing proportion of elderly people.

It is, without doubt, a scar on the nation that life expectancy in Scotland remains lower than in many European Union countries. Life expectancy has, it is true, increased greatly over the last 25 years, but Scottish men and women are not keeping up with the longevity of their European counterparts.

Despite many years of efforts by governments of different political hues, it is a matter of grave concern that only Eastern European countries such as Hungary, Bulgaria and Slovakia have lower life expectancy rates than Scotland.

We are coming out of a period of high public spending on areas which should affect longevity - in health and local government - and it is hard not to conclude that the spending of this money has either been wasted or misdirected.

Related to this trend, are the continuing differences in life expectancy within Scotland with poorer areas of the country registering continued lower life expectancy than that better off areas and with little sign that the gap is closing.

In considering both of these phenomenon it is important to recognise that thanks to improvements in our health services people are living longer, but it is worrying there are few signs that the gap between rich and poor is narrowing, and that the gap between us and other comparable countries has not closed.

Whilst health inequality is an important issue in itself, the publication of these figure throws up another problem facing Scotland - how the growing demand for public services which older people need can be paid for by a smaller working population, and indeed whether some or all universal services can be maintained?

It is difficult to see how the inevitable increased demand can be met by the current system which gives large numbers of older people services free or charge, or at a very reduced rate, whatever their income. There is also a political problem. If Scotland retains the block grant from Westminster and her politicians at Holyrood continue to fund universal services, which may disappear south of the Border, the tension within the Union will increase.

However, if Scotland were to have a higher degree of fiscal autonomy would it be able to afford the level of care services for older people it currently offers without imposing far higher taxes on everyone - not just the richest - in the dwindling working population? If a more financially autonomous Holyrood were to do that it would make Scotland a less attractive place to live and work?

Whilst it is true that we are blessed to have healthier people, living longer, and we should celebrate that, we must also not lose sight of the problems which this creates, problems only our politicians, taking bold decisions, can solve.