Ageing population is not a drain on economy or NHS, says report

BMJ 2012; 344 doi: (Published 24 April 2012) Cite this as: BMJ 2012;344:e2934
  1. Zosia Kmietowicz
  1. 1London

Rising numbers of older people should not be blamed for economic problems or for increasing pressure on the NHS, says a report. The effects of population ageing on the health sector are limited because older people are staying fitter, and this group is likely to contribute a substantial proportion to the UK economy provided that they are well looked after, it concludes.

The report, from the School of Pharmacy at University College London, says that when the NHS was established in 1948 there were only 200 000 people in the United Kingdom aged 85 or over. Today the number is 1.4 million, and it is expected to rise to almost three million by 2050.

It is often thought that the ageing population will impose severe strains on the economy and that good quality welfare systems will become unaffordable. But improved life expectancy should not be unfairly targeted for economic woes that arise from other causes, says the report.

In the 1980s and 1990s the NHS budget grew by 3.4% a year, but the ageing population was responsible for only 0.2% of these costs.

Some projections estimate that the ageing population will lead to a rise in NHS spending of around 1% a year this decade or just short of £2bn (€2.5bn; $3.2bn) a year on top of the costs of social care. However, these “exaggerated claims that health and/or social care costs for older people are escalating unaffordably should not be accepted,” says the report. “Neither should suggestions that private insurance funded or independently delivered care would necessarily prove better value for money than that offered by well-run public services.”

Ensuring that older people stay active and healthy for longer can increase the competitiveness of economies and should be reflected in national health policies, which should include the availability of enhanced pharmaceutical services to support more effective use of drugs and preventive health services, says the report.

Drugs have already helped to reduce the disabling consequences of diseases such as atherosclerosis and diabetes; and in the future new drugs for arthritis, Alzheimer’s disease, and Parkinson’s disease and for reducing the effects of strokes and other diseases should help to improve life expectancy further and promote active ageing.

Jennifer Gill, a coauthor of the report, said, “All too often old age is seen as a time of increasing dependency, vulnerability, and frailty. But older people already contribute significantly to their families’ and wider communities’ wellbeing. In future decades, greater participation by people in their 60s and 70s in formal and informal work could, alongside additional decreases in the number of life years spent with major disabilities, increase national productivity by up to 10% of gross domestic product.”


Cite this as: BMJ 2012;344:e2934