Full details of the event are available here: http://www.ilcuk.org.uk/index.php/events/ilc_uk_and_the_actuarial_profession_debate_public_service_and_demographic_c The live blog for this event is available here: http://blog.ilcuk.org.uk/2013/04/23/live-blog-public-service-and-demographic-change/

1. Public Service and Demographic
Change
23 April 2013
This event is kindly supported by Joseph Rowntree Foundation
#readyforageing

2. Welcome
Baroness Sally Greengross
Chief Executive
ILC-UK
This event is kindly supported by Joseph Rowntree Foundation
#readyforageing

3. Lord Geoffrey Filkin
Chair
House of Lords Public Service and
Demographic Change committee
Ready for Ageing?
This event is kindly supported by Joseph Rowntree Foundation
#readyforageing

4. Ready for Ageing?
Lord Geoffrey Filkin
Chair, House of Lords Public Service and Demographic
Change committee

5. Ready for Ageing?
“Government is woefully underprepared for ageing…which
will have a huge impact on our society and public services”
1.Opportunity and Challenge
2.How to support a longer life
3.Living Independently and Well
4.Fairness
5.Government and Political Parties

6. 1. Opportunity and Challenge
Progress – a success and an opportunity
Two big and certain social changes will affect us all:
• Much longer lives - 50% of girls born now will live more
than 97 years
• Many more older people - see below:
Increase 2011 to 2021 Increase 2010 to 2030
65+ 24% 51%
85+ 39% 101%

7. Major challenges to individuals, communities and attitudes
Perhaps the biggest public policy challenge we face
We looked ahead, to next decade, 2020 to 2030
Rapid, cross party holistic review - the first
We should expect such an analysis by Government

8. 2. How to support a longer life
Many people are unaware, unprepared, underfunded
Trusted information needed
Three priorities for action:
I. Longer working
II. Pension reform
III. Equity release
What is government doing to address these issues?

9. I. Longer working
Rises in the State pension age were right and will continue
So later working will be necessary for many
There are many benefits
This needs public debate and actions to make it possible:
- End cliff edge retirement to allow winding down
- Abandon fixed age retirement
- Challenge employers to change
- Help re-skilling
- Change incentives to retire early

10. II. Reformed pensions
- A serious pension and savings problem already
- Compounded by denial and justified scepticism
- UK’s pension policy is unusual – neither compulsory
pensions nor savings
- Flight of employers from DB and pensions wherever they
can
- Pension position of many will be much worse than in
past

11. - A longer life exposes the gaps and increases our risks
- Single tier pension is progress
- Auto-enrolment will at best generate a pension worth
only 8% of salary
- So many risk finding themselves much worse off than
expected
- Defined contribution pensions are a broken product
- Has to be addressed

12. III. Equity release
Many have substantial assets which may need to be used
Property wealth – prudence and thrift – or windfall gains?
Cannot expect others to pay to keep them sacrosanct
Moving house – one way to release
Equity release should be simple, safe and fair – it’s not
Needed to fund social care, adaptations and income support
Government and financial services must deliver this

13. 3. Living Independently and
Well
Living independently and well is what most hope for
Four big challenges from an ageing society:
• Increased demand for care
• Increased costs of care
• A radically different care model is needed
• Housing supply and services to support independence
Has government assessed and addressed these?

14. i. Increased demand
We did not find a DoH analysis of this
Many more older people with longer lives and long term
illnesses
Predicted increases from 2010 to 2030 for people aged 65+
- 45% more with diabetes
- 50% more with arthritis, CHD and stroke
- 80% more with dementia
- 90 % more needing social care (moderate or severe level)
- Much more informal social care
The increases to 2020 are less but are still dramatic
Where is the analysis of this by government?
Where is the plan to address it?

15. ii. Increased costs
So a big increases in number of older people with LTC’s
But LTC’s generate 70% of NHS costs!
So there will be a big increase in cost of NHS and social care
Where is the DoH’s medium term cost forecast?
Nuffield forecast a shortfall of £54 billion for NHS England by
2021/22
Or a £34 billion shortfall if massive productivity
improvements

16. Base expenditure NHS England in 2010/11: £107 billion
In addition there is a current funding crisis for social care
Dilnot Commission and government’s response did not
address this
Public spending on social and continuing care may have to
rise from £9.3 billion in 2010 to £12.7 billion in 2022 – a 37%
increase
How address great increases in demand and cost coming
now?
Where is Government’s analysis of the issues and the
options?
We need to debate these issues

17. iii. A radically different
model of care
The challenge is much more than more money - ageing
demands a different system
NHS prioritises acute and emergency conditions – 47% of
total spend
Yet these are not the priorities for an ageing society

18. Experts told us we need a radically different model to manage
long term conditions:
- More prevention, early diagnosis
- Integrated around the individual, personalised, home centred,
not hospital based
- Avoid unnecessary hospital admissions – far too many frail
elderly there
- Shift funding from hospitals to community and primary
- Address the fragmentation and the wrong incentives:
- “It’s institutionally fragmented between health and social care,
mental and physical health and primary and secondary care”
Norman Lamb, Health Minister 2013.

19. This will require massive system changes irrespective of
funding issues.
Do ministers agree this?
If so, where is the plan to do so?

20. iv. Housing
Suitable housing is crucial to preserve independence but we
found:
- Patchy care and repair services
- Poor new supply market
- Lack of support services
- No coherent plan or drive to address it
Central and local government need to address urgently

21. 4. Fairness
Big increases in spending on health and social care and
pensions
How finance this – public/private and between
generations?
Welfare state – younger pay for old initially
But we cannot shunt too many costs down the line
Gender fairness
Social class fairness
Geographic inequities

22. 5. Government and Political
Parties
A major and certain social change affecting everyone
No coherent pan-government consideration
Left to Department to address – departmentally!
Not considered from point of view of public
An existential challenge to NHS and welfare system

23. Focus on short term – election, economy, cuts
We should expect more:
- White Paper
- Manifestos
- Two commissions on:
o Income in later life and equity release
o NHS and social care system and its funding
How do we get them to address this?

24. Justin Russell, Director - Ageing Society and State Pensions,
Department for Work and Pensions
David Sinclair, Assistant Director, Policy and Comms, ILC-UK
Claire Turner, Head of Team (An Ageing Society) , Joseph
Rowntree Foundation
Deborah Cooper, Member of the Institute and Faculty of
Actuaries’ Council and member of the Institute and Faculty of
Actuaries’ Pensions Board
Panel Discussion
This event is kindly supported by Joseph Rowntree Foundation
#readyforageing

25. Panel Debate and Q&A
• What would your one single priority be for
Government action in terms of responding to
demographic change?
• How can we create a public debate on ageing?
• Does anyone think any country is in a position
where it has successfully begun to respond to the
challenges of an ageing society?
This event is kindly supported by Joseph Rowntree Foundation
#readyforageing

26. Public Service and Demographic
Change
23 April 2013
This event is kindly supported by Joseph Rowntree Foundation
#readyforageing