Oral evidence: Demography of Scotland and the implications for devolution, HC 746Monday 18 April 2016

Oral evidence, 18 April 2016.

Witnesses

Keith Dryburgh, Citizens Advice Scotland, John McAllion, Scottish Pensioners Forum, Derek Young, Age Scotland, and Owen Miller, Alzheimer Scotland, gave evidence.

Chair

Can I first of all welcome our guests to the Scottish Affairs Committee? We started this inquiry today with a wonderful presentation from the National Records of Scotland and we have had our first formal evidence inquiry this morning too. We are at a very early stage of this inquiry and report. We are looking to you fine people to help us shape up some of the things that we want to look at and we are hopefully going to have an interesting conversation—hopefully it will be more of a conversation, given the layout of the table today—about some of the issues that you are feel are important that this Committee looks at in the course of its inquiry. What we will do is go around the whole table, which is unusual for us because we usually only ask the guests. We will start with me and then we will go to Margaret. I am Pete Wishart. I am the Chair of the Scottish Affairs Committee.

Margaret Ferrier

Margaret Ferrier, MP for Rutherglen and Hamilton West.

John McAllion

John McAllion from the Scottish Pensioners Forum.

Keith Dryburgh

I am Keith Dryburgh, Policy Manager at Citizens Advice Scotland.

Mr Hepburn

Stephen Hepburn, Member of Parliament.

Derek Young

I am Derek Young. I am a senior policy officer with the charity Age Scotland.

Chair

I forgot that you need to press that little button there. It is mainly for recording because we can all hear each other perfectly adequately here, but if you would remember to press that. I think we have got everybody covered as I went round but I will go to—who are you again?

Kirsty Blackman

I am Kirsty Blackman. I am the MP for Aberdeen North, Pete, not south.

Chris Law

I am Chris Law and I am the MP for Dundee West and not east.

Owen Miller

I am Owen Miller. I am a policy officer for Alzheimer Scotland.

Chair

I am grateful. You have seen the remit of this inquiry, the type of things that we want to look at. Do any of you have any particular opening statements that you would like to give this Committee to get things started a little bit? I am looking round to see if there is anybody. We will go straight into it, yes. This morning we had quite a number of very interesting—and almost quite dramatic—issues to do with Scotland’s population and demographics and new terms, like dependency ratio, were a feature of some of the things that we got today. I think we got a good context for the type of things that we are going to want to look at, so could I kick this conversation off, and colleagues feel free to jump in with anything you want to hear expanded or emphasised. How has the changing nature of Scottish demographics impacted and affected the work that you provide? We will start with you, John, if you do not mind.

John McAllion

We are not a service provider. We are a campaign organisation that tries to give voice to pensioners across Scotland on issues that affect them. We are political campaigners but not party political, completely non-party. All we are interested in are the issues that affect pensioners and we try to give a voice to those issues.

Chair

Keith, in what way are the changing demographics impacting and affecting the work and services that you provide?

Keith Dryburgh

I have prepared a quick summary of our statistics for the Committee just to show how the demographics are impacting on our services. About one third of CAB clients are aged between 45 and 59. We are actually slightly under-represented in the 60-plus, but we think that maybe those 45 to 59 year-olds will bring in their issues and carry on seeking advice at the bureau. Older people tend to seek advice on energy. The average age of somebody seeking advice on energy is 55. They are more than twice as likely as other clients to seek advice on energy. They particularly seek advice on consumer issues, transport issues and health and community care issues. There is already an impact in that those are the trends, but you can see that developing next to the years and also the issue of single adult households, which is another growing demographic trend. About 60% of the clients who come to the Citizens Advice Bureau are a single adult in their household. It is not just single pensioners. It is mainly single people of working age. That is something I wanted to bring to the Committee.

Derek Young

We combine both the roles of Citizens Advice, being an information advice provider and a service provider in other ways at Age Scotland, and also, being a campaigning organisation much like the Scottish Pensioners Forum, we see some impact on the services that we do provide because of shifting demographics. Keith has already mentioned the growing numbers of older people living alone, so increasingly there are issues of social isolation and loneliness that are being recognised by national decision-makers and policymakers that are of great importance. Equally we are also aware of shifting patterns of demand for other services—notably statutory services, health and social care—in the campaigning work that we do. It is a complex picture and it does not always accord with perceptions that you often find. One of the key additional elements is the nature and the tone of the public debate around ageing. It is something that we play a—

Chair

Can you talk a bit more about that?

Derek Young

Sure. It is not at all uncommon—either in national debates in Parliament or especially in media coverage—to see what has sometimes been described as apocalyptic demography or voodoo demographics. You very frequently hear the word “burden” when hearing about debates around the shifting demographic patterns and in particular population ageing. In fact, there is a lot of evidence that is available publicly and we plan to submit a written submission for the benefit of the Committee’s inquiry as well—and we will make reference to some of this—which says that, over the piece, the contribution economically that older people make and the benefits that they draw, broadly speaking, even out. There is a lot of very intense and dramatic language around shifting population that very often is not borne out by statistics or at least not to the extent that the debate can portray that.

Chair

Owen, I think you were in for the session earlier when David Bell was saying a quite staggering figure of 30% of over-90s would expect to have Alzheimer’s or a related illness.

Owen Miller

Yes. At the moment in Scotland there are 90,000 people with dementia across the country. About 3,000 of those are aged under 65, which gives you a sense of the scale of the number over 65 who experience the condition. That is not including their families and their carers, who also need additional support. That number, as you may have seen in various media reports in different ways, is expected to double over the next 20 to 25 years. By 2050 in western Europe it is expected that figure Europe-wide will double. I should point out that Alzheimer Scotland is similar to Age Scotland. We have a sort of policy role and influencing role as well as the services that we deliver. The services that we deliver are primarily aimed at living within community settings; so, we provide support through our link workers, but we also offer day care services and sensory enhancement services to provide support for people with dementia. But we are beginning to look towards the future at what else we need to do. As those numbers grow, as expected, quite quickly and as people are being moved into community settings, we are beginning to look towards: how do we make changes in those areas where people are living to help improve their lives? A lot of the work that we are going to do is especially with dementia-friendly communities, because we are realising that if we are going to have this shift away from acute settings, which is welcome, then you need to have the services and you need to have support in communities to keep people within their realm.

Chair

Could I just say that Mr Young has come up with the phrase of today, which is “apocalyptic demography”, which is a very elegant phrase. If we could have you, and perhaps John, look at this a bit more. I think what you said is it is always defined as something that is counterproductive, which is an issue, a difficulty and a problem. Is there any way that we could get beyond that type of assessment about these things and look at this much more positively?

Derek Young

First, I cannot claim credit for that phraseology myself. I took that from an article in the British Medical Journal, and that will feature in the written submissions that the Committee eventually receives. You can delve back into lots of history of humankind to understand that most financial provisions for older people and for care responsibilities existed within families, and in traditional societies and developing countries that is still very much the model. As that starts to be shifted at least partly towards the state, that is where we start to see some of the change in tone. We have had to cope with this type of population ageing for a very long time. It has been a persistent and gradual change since probably the 1840s. In fact, the only interruption to that constant increase was the two world wars. So, although it is a profound social shift with economic consequences, it is actually quite a predictable one. Of all the social changes that policymakers have to grapple with, such as the digital revolution, changing attitudes to LGBT, for example, this is one that we have been able to predict to a much greater degree and that does allow you to plan for financial provision and for service provision. But when old-age pensions were introduced in 1908 the first qualifying age was 70. That was at a time when very few people in the population would live to that age. Also, it was not treated as an entitlement. There was a character test imposed, so if you were a habitual drunkard, for example, you would not qualify for an old-age pension when it was introduced. We have adapted that and we have changed our expectations and our models in relation to shifting demographics before, and there is nothing altogether out of order, surprising or difficult about the challenges we face today.

Chris Law

Just listening to you, Derek, talking about how it has been fairly constant—and we have known for a hell of a long time, frankly, what the predictions are likely to be for demographics long term—what is your view about that fact that pensioners today, many of whom were born after the Second World War, who believe that they have been paying into a UK pension pot actually have no UK pension pot?

Derek Young

I wasn’t here for the earlier evidence session you heard with David Bell, but I did catch some of it on the live stream and I know that he addressed that question too. It is certainly the case that many older people regard the state pension as a contribution-based system, even if that does not accurately reflect the way that the policy has developed and has been organised. There wasn’t a formal contribution to the state pension through national insurance until the National Insurance Act of 1946, which obviously came a lot later than the introduction of state pensions, but that is certainly how it is regarded. When you talk to older people, for example, they say, “Well, I have paid my fair share and I am entitled to draw on that.” If we were in a position where there was a state pension fund/pot, I think the character and the tone of the discussions we would be having would be a lot different, because there would be an identifiable sum of money that you could point to that people had made a contribution to and was allocated. The difficulty with meeting all current state pension liabilities from current revenue is that there is always this tendency to try to match what current income is against what is affordable, as opposed to the perceptions that people have, especially when they see that as an entitlement and certainly do feel that way.

John McAllion

My generation certainly believe there is such a thing as a national insurance fund and in fact, if you look at the National Pensioners Convention, which is a UK-wide organisation, they have traced this national insurance fund and they have identified it as having a £35 billion, £36 billion surplus every year. The Government do not treat it as a pension pot and it does not meet the costs of the pensioners and so on, but it is used to meet the general Government expenditure. That is because successive Governments have done that. That is not the way the 1946 Act was originally sold. It was sold to pensioners as something that you contributed to and then it was you who were paying for your own retirement at some point in old age. I would like to reinforce very much what Derek was saying. People forget that pensioners are taxpayers, both at a national and a local level. They are pouring in lots of money, spending power, into the local economy through volunteer and childcare cost, for example. Many grandparents look after grandchildren to enable their sons and daughters to go out to work. It is not the people in work who are supporting pensioners. Pensioners support the people in work to go to work, because they are providing free childcare. It is the same when you speak about caring for older people. I was at a party last week for a woman in Dundee who was 101. It happens to be my mother-in-law. There was another person there who was 100, or she will be 100 in July. The principal carers of those two women, 100 and 101 years old, were 74 and 65. Older people are looking after older people and without them the state would be in a very bad position indeed. We have to get away from this idea that older people are the problem; they are not. Older people are part of the solution to the problem. I think if you take that kind of perspective it would greatly improve the kind of work you did.

Margaret Ferrier

Just before going on to the question I was going to ask, John makes a very good point. I certainly would not have been able to go out to work after having my child if it had not have been for my mother taking over the childcare, because at that point it was going to be very difficult to pay for childcare and go to work as well. It was not going to be worth my while, so that is a very good point in the round. A lot of people rely on their parents to look after the children. I think many of you around the table will be aware too of the WASPI campaign, which is Women Against State Pension Inequality, where they are being expected to work longer. That is all right maybe if they are in good health, but the argument behind it is that these women, who were born in the 1950s, have done their time. They have done their work. A lot of them started work at, say, age 15, 16, so they feel that they should be able to retire now and get a pension without having to wait.

Mr Hepburn

We are all aware of the issues. I wondered about the individual roles of your organisation and the additional services you are going to have to provide in the future to cater for the changes that are coming ahead. For example, John, the Pensioners Forum—I addressed the north-east pensioners convention—is a brilliant organisation, as we know, throughout the country, but when I was younger that sort of thing did not exist. It has developed throughout the years and I wonder how it is going to develop on. There are more and more courses going on in the community to make people aware of Alzheimer’s and help to spot it. Parliament is drawing up an Alzheimer’s awareness policy at the moment, so that staff and everybody can be aware. These are tremendous changes and for the better. How do your individual organisations see your roles and services changing in the future?

Owen Miller

The integration of health and social care services was mentioned in the evidence session this morning—it was just touched on briefly—but I think, in terms of a broader picture and how Alzheimer Scotland can play out its role as well, it is looking at the bits that can be provided that are not necessarily statutory services. Alzheimer Scotland does provide services that it is contracted to do through local authorities. However, the example you mentioned of dementia-friendly communities work is a collaborative effort. Alzheimer Scotland did a lot of work, but the first place that we did it in was in Motherwell and it was done along with NHS Lanarkshire and North Lanarkshire Council as well, and we went to local businesses and said, “Here is what you can do.” Some of their staff took dementia-awareness training. They were also given the small dementia-friendly communities toolkit to make changes to their businesses as well. I know that in other areas across Scotland it is now beginning to go well. I know that in Hamilton the South Lanarkshire Council has been heavily involved in piloting some of the work, especially in relation to community services such as the library, which is now dementia-friendly because some of the services we run are done there. They are not huge changes. They do not require a massive transformation. It could be something as simple as making the signage easier for people to read so that they can navigate their way about. It could be making it more accessible. I think there is a way. Collaboration and partnership working is really key, and just another aspect of that has been the 8 Pillars model of community support that Alzheimer Scotland developed and has now been piloted by the Scottish Government. We are working with health boards and local authorities in the care sector across Scotland to look at a different way of delivering services for people who are living in the community, so if they need access to HP support or different services, they will get that through the main dementia practice co-ordinator. But again it goes beyond that. It goes into looking at what the connections are, what peer support is out there, what other groups, and how people can be supported to continue to do what it is they want in the community. It really is about looking at how you can work together, both in terms of statutory services and community assets. That is one way.

Margaret Ferrier

Owen, you mentioned earlier in your briefing that I think you said there are 3,000 people in Scotland who are suffering from dementia who are under 65. Have we any reasoning behind that? That is obviously a massive issue. Dementia is a massive issue that will only get worse as we go forward and we need ways to deal with it, but I am interested in why that would be in the under-65s.

Owen Miller

Simply because there are so many different types of dementia. It does affect predominantly older people, but for some people—depending on the condition that they have—it does naturally develop earlier on in life. One of the things we hear about that quite often is the need for greater services for people who are under 65 as well, because so many of the services that are available out there now are targeted to above 65, simply because that is where the numbers are. But it does mean that people who are under 65 who experience dementia don’t always have access to some of the services that they might.

Chair

One of the new phases that emerged this morning—one that I had not thought of before—was that we talk about greater life expectancy, we are also making this distinction between healthy life and this period that we could only characterise as unhealthy retirement. I don’t know that I found that distinction particularly helpful. Then when we asked how this figure and how this divide was determined, it was voluntary—people were saying, about their quality of life, whether it was healthy or unhealthy. Do any of you have any thoughts at all about how we look at these issues?

Derek Young

One of the things that these two statistics do point up is the size of the gap. Although healthy life expectancy is largely self-defined, there are more objective criteria, such as whether people have one or more life-limiting long-term health conditions. That is covered in things like the Scottish household survey and so on. What it points up in a Scottish context is that, although we do not do too badly by comparison with the rest of Europe in terms of our life expectancy, the gap between healthy life expectancy and life expectancy is greater. I think that points to some of the very deep and structural health challenges that Scotland has. I know that some of the written evidence that has already been submitted refers to the regions of the UK where life expectancy is lowest. A lot of those are based in urban west central Scotland, which is where you find the highest levels of relative deprivation, for example. That is obviously very closely related to quality of health and then life expectancy too.

John McAllion

I think it is in the evidence that has already been given to this Committee—by the national registers or somebody. It points out that the gap between the least deprived quintile—the top 20% of the population—and the bottom 20% is 18 years of healthy life expectancy.

Chair

That is what we heard in the evidence today, yes.

John McAllion

That is nothing to do with some individual making the wrong choices; it is where those individuals are born and the circumstances into which they are born, the environment into which they are born. We know for a fact that in more deprived areas there are problems with smoking, alcohol and drug abuse. Mental health problems predominate to a much greater extent. When you are talking about things like raising the state pension age or making people work longer, you have to take these factors into consideration. Some people are not able to work into their 70s and the 75s and so on. That cannot become the norm. We have to find a system that takes their position into consideration.

Chair

Another thing that came out very clearly in the evidence we secured this morning was health inequality and pension age. I think it was Professor Bell’s example of taking a train from Jordanhill to Bridgeton and contrasting it to a similar journey from Canning Town to Westminster. Not only was there an inequality between Jordanhill and Bridgeton but there was a massive discrepancy between that specific journey and the one made in London. Now that we are on this, do our guests have any views about this health inequality? Have you seen anything in public policy that has helped to challenge some of these huge inequalities that we have seen in the course of the past 20 years? You will remember Sam Galbraith, the first Health Minister, who very much evangelised about health inequalities. Have we moved any further forward? I know we have greater life expectancy but that seems to be across the board. Is there any sense that we have managed to tackle some of the inequalities?

Derek Young

I don’t know if they plan to make submissions to this inquiry, but the Glasgow Centre for Population Health and the Joseph Rowntree Foundation have done a lot of research work linking health inequality with income levels. That is at a very profound level. Governments for generations now have tried to make efforts to encourage better health promotion. The American President’s Council on Physical Fitness was created by John F Kennedy in the 1960s. There is a lot of health advice and we are an information provider ourselves. I know that Citizens Advice do something similar, encouraging people to remain fit, to abstain from smoking, to limit their alcohol intake, to get some exercise, to eat well, but that has a partial and limited effect on the quality of your health. You also have to take account of social factors that have been referred to in the other discussion and the points that John has made.

John McAllion

I came across one suggestion, which I think was in the report made by the Scottish Parliament Committee that looked at this same problem a couple of years ago. They were calling for national indicators to be available to show the progress that was being made year by year in reducing health inequalities. I don’t know to what extent that has ever been adopted, either by the Scottish Parliament or the Westminster Parliament, but clearly that would be one policy that you could measure. I know when the Christie commission was published, the late Campbell Christie made the point that with the state devolution there had been no progress in reducing health and income inequalities in Scotland. Setting up the Scottish Parliament is not enough. Both the Scottish Parliament and the Westminster Parliament have to follow the right policies to make an impact. I am not blaming you: I was there for a long time myself, so I am as much to blame as anyone else. We are not making enough progress as a society and we are going to have to find ways of measuring how we are making that progress. I don’t think we have done that so far.

Chair

That is a really helpful point and I think we will hold on to that one just in terms of how we will take forward our conversations about that.

Margaret Ferrier

We heard earlier that Scotland has an ageing population. A report by Derek’s organisation, Age UK, stated that people aged 65 and over actually contribute to society; in fact, last year in the UK contributed £61 billion through employment, caring and volunteering. Much of the discussion concerns the financial impact and challenges of supporting an ageing population, however many retired and older people contribute to society. Can you give us some more in-depth examples of how they do that, Derek?

Derek Young

I will try. I am very pleased, Ms Ferrier, that you referred to the £61 billion figure. Age UK is technically a sister charity, but we are obviously closely connected and work closely with them. We have used that £61 billion figure to try to address some of the challenges we find in the public debate around ageing and the contribution that older people make. I think it identified £37 billion was the contribution through employment and taxation, £6.6 billion through childcare, £11.4 billion through informal caring for spouses and other relatives and £5.8 billion through volunteering. It might have been the Royal Voluntary Service that produced the statistics that between one in four and one in five older people do regular volunteering within their local communities, and there are many third sector organisations and charities who would not be able to fulfil their functions or achieve what they can without the contribution that older people make through volunteering. Age Scotland is an example of that. There are lots of anecdotal bits of evidence about grandparental childcare but that is something that in terms of policy we could begin to look at a bit more closely, because there is an increasing number of children who are getting a mix of grandparental childcare and also more formal sources. In more formal sources in Scotland, once you reach the age of three you are tied into the Curriculum for Excellence, for example, so there are very specific outcomes that formal childcare provision is directed towards. What the evidence does also suggest is that although you might have more structured educational outcomes from formal childcare, children who have at least some childcare from their grandparents benefit from better socialisation, earlier and more developed communication skills, things like that. That is something we could do more work to quantify. There is already a degree of this that points to a contribution that, even if not economic through earning, has a very defined economic impact.

Owen Miller

Just on a similar point about the involvement in activity of older people, Alzheimer Scotland is very engaged with its membership, but also there is also the Scottish Dementia Working Group. It is mainly for people who have dementia, who have had a diagnosis and a lot of whom are over 65. It is a key group for pushing the policy agenda and making sure dementia remains a priority across the UK. We have local groups as well at a more local level—so, there is one in Dundee, one in West Dunbartonshire. These groups are engaging with their local health boards and with the local authorities and saying, “Here are what our priorities are. We have a lot of experience. We know what people with dementia need within the locality,” I think they have a huge contribution to play in that way by taking a human rights-based approach and involving people. Involving the carers in those decisions is hugely important. It is often assumed that a person gets dementia and that is it. They don’t have a contribution left to make, they don’t have anything to offer. Nothing could be further from the truth. I think that these involvement groups are a real testament to that.

Kirsty Blackman

No matter what is said about the fact that older people do contribute—they absolutely do—in terms of concerns about making sure that there is a balance, the Government have to pay the state pension and these kinds of softer contributions in financial terms. Which types of people choose to stay and work beyond the state pension age, which the Government is probably keen to encourage because they are making a hard financial contribution today? Of those people that do, do you think the Government should be providing an incentive to ensure that more people choose to stay in work beyond the state pension age and, if they do, what kind of incentives could the Government provide to encourage folk to stay in work longer?

Derek Young

Who is staying in work beyond the state pension age? It tends to be people who have good health. That would be the first thing. It tends not to be in what we could say are manual or physically demanding occupations. That is a wider point about the increase in the state pension age too. Ms Ferrier mentioned the WASPI campaign. We run the national telephone helpline in Scotland for older people. We have received calls from women who were unaware that these changes were taking place, and they may work in demanding service sectors, like hospitality or catering, where they are anticipating and looking forward to their retirement a great deal. To find that the time at which that is due to happen has changed is a very strong emotional blow for them, particularly when they feel they have not had time to adjust to these changes. The Turner report in 2005 recommended that whenever the timetable for state pension age changes there is meant to be a 20-year advance notice period, which I think is a reasonable balance. The Work and Pensions Committee in the House of Commons is conducting an inquiry into intergenerational fairness at the same time. I know that Steve Webb, the former Minister of State for Pensions, said that the Government Actuary’s Department is going to give evidence to the regular review of the state pension age, that is now happening every five years, to point out where the balance lies between two-thirds of your adult life spent in work and one-third drawing a state pension. That might be a sustainable basis on which to look at it. That was taken very strongly into account by the independent review now chaired by John Cridland. It tends to be people who are in productive forms of work—work that they enjoy, work that is more cerebral or relationships-based: these are the types of occupations where you would tend more often to find people deferring their state pension or claiming it later. What we don’t yet know, and we will probably need more evidence on, is if greater private provision through occupational schemes is encouraging people to defer their state pension. Auto-enrolment, which has now been introduced in the last year or two, might have an impact on that, but we are not likely to see the effects of that for a couple of decades.

John McAllion

If you go back to the early 1990s, I don’t think there were any national pensioner organisations. The Scottish Pensioners Forum grew out of the Scottish Trades Union Congress older people’s committee. There is now the Scottish Pensioners Forum, the Scottish Seniors Alliance, and the National Pensioners Convention, Scotland. These three bodies came together to support a Scottish Older People’s Assembly, which is now forming itself into a national movement like the rest of us. None of them wants to see the state pension age changed from 65—that is it: everybody. They have a big voice now. Pensioners organisations are politically on the move across Scotland and they don’t think people should be forced to stay on at work beyond 65. None of them accepts that, because most of them come from working class, trade union backgrounds. If you are a film star or a Larry Grayson or somebody you don’t want to retire, but that is different, isn’t it? If you have to go to work 9 to 5 and it is hard work and it is stressful work, everybody wants to give it up and have a good retirement. Everybody has a right to that.

Keith Dryburgh

I should have come in on what Derek said earlier, that the Citizens Advice service absolutely would not exist without older volunteers. They saved the service and I think they do have a positive role to play right across society. I want to take up Kirsty Blackman’s points about support for older people, whether it is to work longer or to stay in employment. I think there was an argument made a couple of years ago that if the Scottish Government did not have the devolved powers available, that could have an impact on outcomes for older people. The devolution of social security, employment support, parts of the fuel poverty programmes and so on means there are those policy levers within the Scottish Government and in Scotland, and particularly in partnership with the UK Government, to provide that support. The devolution marks an opportunity to support older people, whether it is to stay in employment or whether it is a carers allowance or attendance allowance. I think there is much greater scope to improve public policy in that regard.

Chair

There is absolutely no doubt there will be more policy levers available to the Scottish Government in the next year when the full devolution is—and I think that is something that this Committee will be interested in looking at. I am sure we are going to ask people along. If you have any views at all about that—this is an ongoing, open inquiry—please let us know if there is anything that you have observed.

Margaret Ferrier

I would like to get the panel’s thoughts on how Government policy support can older people to be more active and enjoy a longer period of good health in their old age. Would any of you like to answer that one first?

Owen Miller

I think there is some good work going on. Again, I am taking this from a dementia perspective, but there is some good work being done around this already, particularly the Scottish Government’s guarantee for a minimum of one year post-diagnostic support for people with dementia. That year is spent working with people with dementia with an interlink worker who comes and creates a personal plan with them. It is done to build the resilience of a person, to find out what they like to do, what they want to keep doing within their communities, and works with them to explain how they can do this, what is available in the community to support them to do this. It is to help them come to terms with the diagnosis but also to plan for the future so that they are able to do that and are able to play healthy and active roles. We know that where this is done well people really value it. The shock of a diagnosis of dementia can throw people and they think they cannot participate anymore and they often don’t know what services or supports are out there. When they have this one year to work with a person—as I say, a minimum—they have told us that it is invaluable and that they are able to plan for the future. In a lot of cases there are peer support groups that they can go along to. They can speak to people who have dementia or who have been through this already, and it is important to do that so that, as the illness progresses, health professionals are supporting them and know what it is they want to have support on.

Margaret Ferrier

Thank you, Owen. Just one point that has probably not been touched on yet is how that affects the partners of people with dementia going forward and how it changes the relationship that they have.

Owen Miller

Absolutely. That is definitely one of the key things when we are working with a person with dementia and especially with the 8 Pillars model that I referred to earlier on. It is a specific element designed for carers to make sure that their needs are being supported as well, whether that is a carer support peer group or making sure that there is respite care available or day care services available, so that it gives them a bit of time off in the care-giver role. We have been really clear on that and especially with services, as much as we are absolutely determined that people with dementia will be involved, we are the same for carers as well. We want to hear their experiences and make sure that their experiences are fed into health and social care professionals, because as you say it impacts on them almost as much as it impacts on the person with dementia.

Derek Young

I have now had time to collect my thoughts on this, which is useful. The Scottish Government at the moment have an active and healthy ageing action plan and that is in the process of being refreshed, but there are a number of different strands to it. First, there is a greater encouragement of people to manage their own long-term health conditions—which, if they can do to a greater degree, will not just encourage them to be able to manage their health, whether they have dementia or sensory impairment or any other type of condition, but will also mean they have a much more positive outlook in managing that circumstance. Social science is pointing to that as being a very critical factor. If you have a positive outlook, if you believe that you are valuable and valued, that greatly increases your quality of life and your self-perceived health, especially since that reflects on the healthy life expectancy statistics. You begin to see an effect there. A number of different local authorities are investing in what is called re-ablement. People have an identified, firmly assessed care need. They are encouraged to develop their capacities over time so that their care need shifts and becomes more manageable. There are a couple of good examples that Age Scotland supports, which I will mention to the Committee. Both of them relate to men and it is sometimes difficult to get men to access services if they are reluctant to actively seek them out or to join local social-based community groups. The first is walking football, which is now being developed with a walking football network in Scotland with the SPFL Trust. This is football where you are not allowed to run, so it is much like the Olympic walking tournaments. It is very popular among men aged 50 and over. There is an annual festival now in Scotland and we are looking to develop as many clubs and associations around Scotland as we can. Equally, we have the Men’s Sheds movement. This started in Australia over a decade ago and there are now 900 sheds. These are community spaces where very often there is joinery and carpentry and fixing things—especially popular with men who used to work with their hands, but they are also able to access information and health advice there. Sometimes men have gone to these sheds and talked about the fact that they are not able to do things as well with their hands as before, and it has led to an earlier diagnosis of arthritis, for example. As I mentioned, there are 900 in Australia. If you take a population equivalent per capita basis, there would be 225 in Scotland, so that means every community in Scotland that wanted one could get one.

Chair

I will bring John on in a minute, but one thing that also strikes me is what can be done in terms of positive health interventions. If you think of the generations now who have hip and knee replacements, that is one thing Government has responded to in policy development with what has been described as an ageing population. It has a health benefit for this healthy retirement we talk about. Also with mobility issues there are mobility scooters available and all the other means that allow people to enjoy full access to facilities and community resources. We are interested in the sort of things that can be done positively by these types of interventions by Government.

John McAllion

I would endorse that. Just recently the Dundee pensioners organised a walking football tournament in City Square in Dundee as part of International Older People’s Day. Remember the free bus pass? It makes a massive contribution towards overcoming isolation and depression among older people, enabling them to lead very healthy, active lives and the people who attack it time and time again should try to think about what the consequences of removing that bus pass might be for older people right across Scotland. In the end that may prove to be more expensive than maintaining it as it is at the moment. The other thing that I think is very important is the Scottish Government are integrating health and social care for older people and they are setting up joint integrated boards to run this new system. There has been a persistent demand from older people’s organisations to have an older people’s representative on that board, which has been consistently refused. Involving older people in making the decisions about how their care and treatment is organised is a very important aspect of the future. I think the authorities should be encouraged not to try to keep older people at arm’s length and let them come into the decision-making process.

Margaret Ferrier

I am very interested to hear you mention Men’s Sheds. I was speaking to somebody yesterday about the Men’s Sheds when it had been mentioned on the television the other evening, and I think it is possibly the way to go because men are not quite as sociable as women and may become more isolated at home. On the health side, which goes back to my original question, again men are not as good at going to the doctor if they are unwell, and prostate cancer is an early intervention and can be treated, as can things like bowel cancer. It is very important that men do access healthcare as well as women.

Chair

Hold your thoughts a minute. I see Steve Hepburn wants to come in.

Mr Hepburn

I was in favour of the ban on smoking in clubs and enclosed places. I think it is a great thing, but it did mean a lot of older people, single people and older men, did not get out, because they went out for a cigarette and a drink or whatever. They are now isolated in their homes. Do you think when these policies and changes in the law are brought about for the benefit of people there should be more consideration of keeping older people more included?

Derek Young

I very much think that and that leads itself to a consideration of whether we should have a more strategic approach to an ageing population. I think that John previously mentioned that since 2007 the Scottish Government have adopted an approach of proven science. There is a national performance framework with dedicated national outcomes and so on, one of these being that we live longer, healthier lives and that people are able to enjoy their independence while they get older for as long as possible. Prior to 2007 there was a strategy for Scotland with an ageing population called All Our Futures and one of the ambitions of that was to effectively test the impact of other policy decisions on older people as a community. You might also cite, for example, the regulation of bus services. If local transport has to be run on an economic base model, it is unlikely that it will make a great contribution, except by accident, to social objectives. If you have an ambition to allow older people to get out and about, that is something that you ought to factor into that type of system, and similarly with the pattern of Post Office provision or local library services around the country. There are lots of locally-based public services and also shops, but that is less within the sphere of public, which make a great contribution to older people’s interaction with other people. That ought to be considered when these decisions are being made.

Chair

I am keen to move on, because I have a few more questions, but I know Keith has wanted to come in for a while and then we will maybe take a question from Kirsty.

Keith Dryburgh

Thank you. I just wanted to come in with what support the Government can provide. I think it is important when you consider the ageing population that it is not just people who are aged 60 or 65 and over now; it is the people who are going to be aged 60 or 65 in 20 or 30 years. When people, say, lose their jobs in their 40s and cannot get into the labour force, that may be the main factor of their health when they are in their 60s rather than what happens when they reach the age of 60. I think it is crucial that you support people in middle age or older to get back into employment. We see a number of clients who are in their 40s and 50s lose their jobs and, because they do not have online skills, suddenly they are excluded from the labour market and they are out of work, and that has an impact on what it is like for them in old age. Equally, if support for people with disabilities works, it keeps them in work, keeps them healthy. I think financial advice is important. If people have saved, if they have their finances in line, they have proper financial advice in their 50s, it makes their 60s and 70s much easier. All of those things need to be in place for when somebody becomes older. When they are older, things like fuel poverty are crucial—that is the main thing that people come for advice on—and also that people claim their entitlement. Attendance allowance has something like only 60%-odd claim rate and I think it is because older people do not claim. It is a really important thing that older people feel that they can claim and the support is clear

Owen Miller

I know you want to move on, but just to follow on from the points that have been made, it was mentioned that men can be quite isolated, especially in the older age. There has been a lot of work done on football reminiscence projects, which has grown arms and legs, and rugby reminiscence projects, and it has gone on to a whole range of other things as well. I did want to make a point—about dementia, but it is also for other carers as well—which is that dementia is a particularly gendered disease. It affects women far more than it affects men. The people who are carers of people with dementia are also women. They have a much higher percentage rate of supporting people with dementia than do men. Although I take your point, and it is absolutely well made, that there are issues around isolation for men, there are for women as well. That comes to the fore when you think that the carer has to give up work to care for a person with dementia, or for anyone else for that matter, and they can find it particularly difficult to get back in and find themselves very isolated. That is the point I wanted to make. In terms of inequalities for pensions and for income more generally, that has a huge impact, especially if they have had to take time out to care for a person.

Kirsty Blackman

Before I ask my question, I wanted to ask a question of Keith, because he mentioned the rise in single adult households. Not so much for older people but in general, do you think the Government should be making policy changes or at least taking that into account when they are making policy for the future?

Keith Dryburgh

I think maybe it is an overlooked point as part of the demographic of Scotland that 35% of households in Scotland have one adult. That is more than the number of households that have two adults, and that is across single pensioners, single adults and single mothers. I think something like 1.15 million households in Scotland by 2030 will be single-adult households, and by far more than any other household type. Looking at the Scottish Government statistics, they are the group most likely to be in poverty. If you live on your own as an adult, you have a 21% chance of being in poverty, but here a single parent with a child has a 16% chance of being in poverty. Not having a child makes you more likely to experience poverty, which seems a bit strange. That is reflected in our statistics, particularly for men. I think 40% of our male clients live on their own and it seems that it is a good predicting factor of the kinds of problems that people seek advice on, particularly things like food banks and housing that people in a single adult household seem to have problems with. I think it is worth bearing in mind. I do not have future predictions, but I think it is something that is maybe being overlooked in the demographics of Scotland, whether it is single pensioners or single people and single working age people.

Kirsty Blackman

That is really interesting, thank you. I know that one of the food banks that I visited has an increasing number of single males coming through the door, and they say that is their highest group. Moving back to pensions, what impact will the recent changes that have been made to the state pension have on future generations of pensioners coming through?

Derek Young

We do not explicitly take the same attitude as the Scottish Pensioners Forum, in that we are not overjoyed about the fact that the state pension age is increasing, but it seems to be a reflection of reality, particularly this one-third, two-thirds principle that is applied. What it will increasingly mean, of course, is that the definition of working age is going to change. You heard a lot of evidence earlier on about the dependency ratio—which I must say is terminology that we decry completely, given the evidence you have already heard here about the contribution that older people make and they certainly do not regard themselves as dependants. There are academics in the University of Edinburgh—again, we can submit this in writing—who say that the dependency ratio has fallen. It does not compare the number of people who are economically active to the ones who are dependent, not just in terms of the financial provision but also in health and social care costs and so on. There are other tools that you could use to quantify that much more successfully. However, it would be difficult, for example, to have a situation where people who are in different types of occupations reach their pension age earlier than others. First, there might not be a great deal of public support for that idea, but also people change jobs quite frequently. They change employers certainly much more than they used to do, so they have to evidence what was the situation where someone would qualify for an earlier state pension age. What you could do is link certain means-tested benefits to healthy life expectancy. If there were people who were more likely to suffer particular health conditions as a result of their working pattern throughout their working lives then there might be forms of support that did have some qualification process, but which were not either the basic state pension or now the single-tier state pension. Lots of older people like the fact that it is a universal service offered on the same basis.

John McAllion

It is the state pension in general, not just the pension age. With the new pension you have to have 35 years national insurance contribution to qualify for it. The majority of future pensioners will not have that, because of the nature of work nowadays and so on, and will not get the full pension. It is not clear whether they will still qualify for housing benefit and council tax rebates and so on if they are on that £155 a week. Some people estimate that the majority of the future pensioner population will be worse off because of the pension changes that have been introduced. On the question of age, we already have firemen and policemen retiring earlier than anybody else, for a very good reason, but they do not get the state pension until 65. I do not think anyone in the pensioner movement wants to see the pension age increased to 70 or 71. The life expectancy of the bottom quintile of males is 71 years. If you raise the pension age to 70, they will not get the pension after contributing to it their whole life. You cannot really have that. That is a massive injustice. A different way of looking at it is that in one of the latest studies that has come out of the National Pensioners Convention at the UK level, they argued for a state pension that is based upon 30 years’ residency. You have to be resident in the United Kingdom for 30 years to qualify for the state pension, but it does not matter about contributions. They now probably recognise that the contributor principle has become a myth because of the way Government have treated it over many years. I think that may be a way forward, and the only means-testing that would then be allowed would be for people who did not qualify because they were latecomers into this country and so on and may need some kind of means-tested benefit. To increase means testing would be resisted by all the pensioners’ organisations across this country. It is the one anathema that the pensioner movement has. They do not wish to see any means test of pensioners in order to qualify for a pension.

Chair

Thanks for that, John. We have a couple of other questions on pensions. I know Chris wants to ask a couple.

Chris Law

John, you have touched on the very thorny topic that I have next, which is about raising the state pension age. A couple of things I have been looking at is the House of Lords Committee on Public Service and Demographic Change and their report in 2013 called “Ready for ageing?” Their own recommendations and those of the Turner commission have not been agreed by the Government. In fact, the Government are moving slower on raising the state pension age than was indicated in that. One other thing I am just looking at here is that the National Records of Scotland stated that there is projected to be an increase of 20% between 2014 and 2039 in Scotland, which leads me on to the thorny question: when do you think the age of state pension will next have to be revisited?

John McAllion

By law I think it has to be revisited in every Parliament at the moment, but any idea of increasing the state pension age would be resisted. I think one of the problems is you have to think these things through very carefully. There will be some pensioners who are fitter, healthier, living much longer in much better, healthy conditions. Do you want them competing with young people in a job market that is dominated by zero-hours contracts, low wages and low-skilled jobs? That does not help young people. It probably squeezes young people out of the job market if you get more pensioners working on and taking jobs that should be going to younger people who have not had the chance to work and so on—plus the fact that even in the working population I think almost a quarter suffer from some kind of disability: 40% of the pensioner population suffer from illness and disability. You cannot impose upon these people by raising the pension age so that they are going to have to work longer. That is not the answer. It is a very complicated situation, but we need more thought given to it and what the implications of any change may be. I am very much in favour of some kind of requirement on Government at UK level and Scottish level taking into consideration the demographic consequences, the implications for the different sections of the population of any policy change that is brought in. If you are going to make pensioners be in the job market longer, what is the implication for youngsters leaving school who do not have many skills? Pensioners will have skills.

Chris Law

My next question revolves around the figures that came out from the Scottish Government that suggested that pensioners in Scotland will get £10,000 less for men and £11,000 less for women than in the UK as a whole because of the differences in life expectancy. The Scottish Government suggested looking at lowering the state pension age in Scotland. What do you think the positive consequences of that could be and are there any potential negative ones?

Chair

Differential pension ages. It was mentioned during the last general election campaign because of the lower life expectancy in Scotland. Do any of you have views about that?

John McAllion

I think one of the consequences would be that the rest of the pensioners in the UK would be very upset. It would certainly be welcomed in Scotland.

Chair

I think that would be almost certainly the case. I know you take a different view from the Pensioners Forum when it comes to these things. What is your general view about particularly Turner and all the conversations that are going on now about raising the pension age, and this life expectancy issue that was thrown into the general election campaign last year?

Derek Young

There is a point about process and there is a point about substance. The process point is that when the Scottish Government first mooted the idea of differential pension ages it was in the context of the independence referendum and if Scotland were to be independent in the future, that sort of decision could be made quite straightforwardly. I know Professor Paul Spicker, who used to be at Strathclyde University, has started to do some work about whether the additional welfare powers and putting the discretionary powers that are available to supplement existing benefits, which would include pensions, could be used to make additional pension provision. I think one of the parties that is currently campaigning in the Scottish Parliament elections has talked about addressing the WASPI problem using the devolved powers that are coming in under the Scotland Act 2016. As far as the substance is concerned, there are a variety of options. It would be important for the Cridland review, which is the review that is taking place every five years, to take into account differences between the nations and regions of the UK and what the impact of an increasing state pension age might be. I know that Age UK, our sister charity, is doing some modelling about some of these options with the Pensions Policy Institute and I think that will be available to the review. The information and the feedback we received from older people during the independence debate was that there was not a lot of support for the idea that the state pension provision should be different across the UK. That might well be something that changes over time if there was evidence presented about the differences in healthy life expectancy and life expectancy north and south of the border. That might have an impact, but certainly that is the strong feeling that we received as we were consulting older people around the referendum time. As an organisation that I am representative of, we want to try to reflect that and our interactions both with the independence debate and also with the Government policy as it is developing now.

Chair

A question I asked Professor Bell in the earlier session was that there is much more to Government policy for pensioners than the pension. It was suggested that the Budget that was presented a few weeks ago was much more in favour of older people and it was at the expense of younger people, and that was the way that a few commentators have characterised this Budget. Do you have a particular view about the politics behind support for older people? There is this idea, which is probably true, that older people tend to vote more than young people, so they have a bigger impact on democratic outcomes. Are Government right to look at demographic profiling of things like the Budget as they are making these announcements, because there is quite a lot of grey power, as it is called, in terms of maybe forcing the Government’s hand when it comes to policy?

Derek Young

Yes, I am willing to comment on that. The appropriate phrase to use and the right attitude to have is one of intergenerational fairness, so it is very welcome to see the Work and Pensions Committee and your colleagues on it taking that attitude. I think some of the evidence they have received is that there are some common perceptions about intergenerational unfairness that are simply not borne out by the facts. Putting that on public record contributes to a better public understanding of what cost, benefit, contribution and withdrawal from the system mean. Policy can encourage greater intergenerational interaction, things like the integration of health and social care services. There is a lot of provision, especially around preventative health, that could be done by community-based organisations that might have young people in them. I know that digital inclusion was mentioned already. When older people are learning basic online skills that they maybe do not have, they tend to have those skills encouraged and taught to them by younger people. That is a form of interaction inter-generationally that can encourage far better social relations. That is what we should be aiming for. I do not wish to add comment on whether or not that was achieved in the last Budget. If that is a principle that we establish and we can make visible signs of showing that we are working towards, including things like inheritance tax, which would be another to take into account, that would start to at least pressurise a change in the debate that we see.

John McAllion

If there was anything in the Budget that discriminated in favour of older people, it would be richer older people, because I think that is the kind of Government that we have at the moment. There is a pensioners’ parliament held in Blackpool every June, where pensioners’ organisations from all over the UK go and debate pensioners’ issues. The main theme at one of the most recent ones was intergenerational solidarity, with each side promising the other that they would not allow politicians to divide them and to play one group off against another. Dundee, for example, is well known as sanction city in Scotland because young people on benefit are continually having their benefit stopped. They are often thrown back on to their guardians, who are expected to look after them when they do not have any money. It is that intergenerational solidarity at the grass roots that still exists. Young people do not want to see older people deprived of their bus pass or get their pensions cut or be made to work longer. They do not want that and older people do not want to see young people exploited through sanctions and all the other things that go on. They want to see everybody come up together, and I think we should resist any attempt to play one age cohort against another because we, the older age cohort, will resist it as long as we can.

Chair

Thank you very much for that. I have a couple of questions to round off. I do not know if it was you, Derek, who mentioned the Scottish Parliament’s Finance Committee inquiry into demographic change. Was it John? A very good report it was too, which has helped shape up some of the things that we want to ask. What they called for—and I think we have seen it in the integration of health and social care—was a bigger collaborative working process between the health providers and local government and social care, and we now have that. The question is: does there need to be a greater collaboration between these areas in the DWP when it comes to pension policy? As well as having health and social care, are we now having to look at bringing health and social care and pension provision integrated into a bigger collaborative sphere?

Derek Young

I was going to recommend the Finance Committee’s report to the Committee in its deliberations, so it is good to see that is already on your radar. Interestingly, in the Scottish Government’s response to that report they cited not just financial provision and health and social care, but they touched on things like housing provision for older people and public transport. What is increasingly becoming better understood is that there is a range of different services that older people interact with and need in order to have a sustainably good quality of life. It would be good for Government to treat those as connected. I know that a number of the integration joint boards who are implementing integration are looking at the impact that patterns of other service provision have not just on quality of life but on the ability of older people to access services. We would be quite keen, in the strategic and local planning that goes on, for people to also assess social factors that are social determinants of health, such as loneliness and isolation, and the impact that they are likely going to have on demand for services going forward. The more that you can have a joined-up approach, the better. The Scottish Government would argue, and have done, that the national performance framework leads to that strategic approach. We would also like to see a refreshed and renewed version of the “All Our Futures” planning for Scotland with an ageing population and trying to deal with some of the consequences as well. Both of those can have a positive impact certainly.

Owen Miller

I wanted to make a bit of a follow-on from that. It is about drawing in all of those aspects but keeping it for a person with dementia to have a single point of access to go to for accessing the different services, housing and HP support or other interventions. One of the things we did when the Scottish Government consulted on the devolution of social security powers to Scotland was highlighted the research on fragmentation in the system. People have to go to their local authority for their housing benefit or housing, they have to go to the health board for their treatment, and they have to go elsewhere to get different services. There are examples within Glasgow, I think, where people can go and it is almost a one-stop shop to apply for all these things, and they have a person who will work through all the different benefits and ensure that they get income maximisation. The point that I think Keith made earlier was that a lot of people do not get the benefits that they are entitled to and they do not get the full range of support. There is something there about ensuring that the benefits system works with the health system that works with the social care system and there is not this artificial divide. For the people down on the ground, especially those with dementia and their carers, that is a really difficult system to navigate. They do not know that there are all these artificial Chinese walls between all the different organisations. They just see the process taking forever. I think a real benefit of that would be encouraging the agencies, regardless of whether it is Westminster or the Scottish Parliament or the Scottish Government, who are in control of these things, the people in charge of setting the direction, to work together. That would be a really positive step forward.

Chair

Thank you for that. This inquiry is looking at issues of demography as well. We are very grateful for the way you have helped us out in understanding some of the issues to do with the older population of Scotland but we are also looking at population issues and would like to get your thoughts on some of the broader points that we are looking at. We have issues where Scotland’s population is not expected to grow as quickly as the rest of the United Kingdom. What does that mean for Scotland in terms of how we provide for our services? I know you do not like the phrase “dependency ratio”, but there will be fewer working-age people in Scotland as a proportion of all the people than there is in the rest of the United Kingdom, which will have an impact on the way that we deliver services and the ability to pay for these services. Do you have any closing views about both the different population as regards the UK and a higher dependency ratio, even though it is a phrase that we have decided we do not particularly like around here? Are there any thoughts or closing remarks about that?

John McAllion

I was talking to somebody recently who was heavily involved in delivering health and social care for older people in Dundee. They made the point that the system would collapse without migrant workers who had moved into the city. Dundee’s future is based very much on its universities, which are attracting thousands of foreign students into the city and have turned the city around in a very short space of time. It has been a very positive addition to Dundee’s population. They make a massive contribution to looking after people in Dundee. I would be very concerned, for example, if there were cuts to migration because this would start to stretch services, public services especially, which depend to a great extent on workers who come into Scotland from elsewhere.

Derek Young

The key drivers for population change are migration, fertility and longevity. We are probably not qualified to talk about migration and fertility to any great degree, but it is clear that Government action can have an effect on longevity and can extend lives. There is nothing absolutely certain about the fact that we have doubled life expectancy between 1850 and 2010. There are public actions that have been taken to improve environmental conditions, better medicine, technological change, avoiding mass warfare, for example, and better disease control. There are many elements of these that have public elements to them and so we should look at the fact that longevity is increasing as one of the main achievements of civilisation. I would like to put that on the record and hope that the Committee would endorse that as a statement. When you talk about the dependency ratio, which is a phrase that we do not like, I know there is a different view from the Scottish Pensioners Forum. The last UK Government, the 2010 to 2015 one, had developed a policy of extending working lives where people felt able to and wanted to do that, and that is an important qualification, so that John does not jump down my throat. Increasingly there are people who see that they can continue to make a contribution and want to do so and there are policies that have already been adopted such as abolishing the default retirement age, introducing the prohibition of age discrimination in 2006. We do not yet know what full effect those will have, but what we can do is encourage employers to adopt practices that will allow people to work on where they want to, perhaps in slightly different roles, or encourage people to work with more flexible working patterns. All of these types of changes should be considered, so long as they are not imposed on people against their will. They do allow for older people who can continue to make a valuable contribution, who do have skills, who have an ability to coach their younger colleagues, for example, and share their wisdom and life experience, so that the numbers as you have depicted them, and as I mentioned are sometimes presented apocalyptically, do not have to play out that way.

Owen Miller

First, to follow up on and agree with what Derek said about keeping people within the workplace, especially people with dementia as their illness progresses. They want to keep working because it offers them income and socialisation. They may not be able to continue doing what they want to, but a lot of them will still continue working until they cannot anymore. That point should also be made for carers. As we have said, with the number of people in the future who are going to require care from their family, their employers are going to have to begin to think about how they accommodate that, be it through flexible working patterns or compressed hours. In a number of different ways employers are going to have to change their thinking about this, because we know from what carers tell us that at the moment they do not always get the support, so it is either work with what you have been doing or resign. A lot of the time there is no support for the middle ground. Just to round off, I think going forward prevention is going to be the big issue for future health and social care services and housing and others are going to have to come together to put in place preventative plans, because that is how you avoid crisis points. The most expensive health and social care interventions are the ones where a person hits crisis, whether it be life-threatening or they cannot cope with the situation they are in at the moment, whereas if you build the resilience in people, if you build hope and you build and plan for the future, you can either offset that or you can push it so that people do not reach these crisis points. I think with the demographic changes going the way they are predicted to, that is going to be absolutely essential.

Keith Dryburgh

I second what has already been said about maximising the potential of everybody and their contribution. I think public policies can manage any demographic change that comes. I would just emphasise as well that there is no one set of older people and it differs right across the country. We cannot just talk about older people in Scotland; it is older people in Dundee, it is the whole population of Dundee, it is what Dundee needs, what Edinburgh needs. There is a particular issue in rural Scotland in that there is an older population in rural Scotland and younger people tend to move away to the city, so the changing demographic in rural Scotland is quite different to the rest of Scotland. Bear in mind that no one size fits all. Equally, if you follow the mantra of maximising potential and giving people opportunities, everywhere can benefit from the changing demographics.

Chair

I think your comment about the movement of people is important and valuable. We have looked again and have been presented with some of the trend about how people move throughout the course of their lifetime, like university, coming and studying and moving away in their 20s and going to retire in areas of retirement, so I think these are things that we will want to pick up on in this Committee. Anything further that you have on that that would help us in reporting and inquiring would be really helpful, so that we get a bigger and better sense about how all that works and impacts on services. Have we managed to get most of the issues from you or is there anything else that you feel we have not quite touched on? Are there any questions from my colleagues on the Committee that we have missed out?

John McAllion

I think it was the Cabinet Finance Secretary for Scotland, John Swinney, who pointed out that between 2010 and 2020 the Scottish Parliament’s budget would be reduced by 12.5%. During this period we have embarked upon the most ambitious changes to the National Health Service we have ever seen, with health and social care being integrated. The idea that that can be achieved properly with less money really is not realistic in the Scottish Pensioners Forum’s point of view. There is a massive underfunding of the changes that are taking place, and that has to be taken into consideration.

Chair

Thanks for that. I think it is really important to hold on to these things too. Derek, did you want to say something?

Derek Young

Two very short points. First, Audit Scotland has recently published a report on the initial plans for health and social care integration and they have talked about the fact that it will take five years anyway. Even if everything goes perfectly and it is all planned brilliantly it will take five years before you start to see some changes in people’s outcomes because of the streamlining and better co-ordination of services. That is if everything goes to plan. The second point is that one of the Committee’s terms of reference talked about resources around the UK and I know that the Barnett formula and so on was all considered this morning. If you were to move to a needs-based formula, which would be an alternative to Barnett that is obviously about predictability and equalisation, then demography would be one of the factors and ageing within demography would be one of the factors to be balanced against things like population dispersal, deprivation and so on. You should certainly take into account the point Keith recently made, which is that older people are not a homogenous group. There are a huge variety of circumstances that they face and these change over time as well. Although you can predict to some degree what future need might look like because as I mentioned ageing is predictable, everything that is a projection has a degree of uncertainty about it. If you were to move from the situation where you are looking at current population to one where you anticipate what you think the population might turn out to be, Barnett is already the subject of quite contentious public debate. If it is then based upon things that are closer to estimates rather than hard data, I think that might colour the way that resource-sharing debates happen around the UK.

Chair

There is a very important debate to have around this and you probably saw a little bit of that earlier when we had Professor Bell before the Committee. These are the sort of things that we will want to look at, some of the economics that are behind all of this and some of the assumptions that are made about needs-based analysis vis-á-vis the Barnett formula, so it is very kind of you to remind us about these things. It is certainly within the scope and remit and on the horizon of this Committee. Is there anything further, colleagues, before we round up?

Owen Miller

Just a short point: it did not really come up over the course of the discussions and it is very health-focused, but in the context of an ageing population, the older people get and then come towards the end of life, there is going to be an increasing demand on our palliative care services and the support for people at the end of life, so that their decisions can be supported and to have the end of life that they would want. That is inevitably going to change with the increase in chronic conditions, dementia being one of them. Something for the Committee to maybe consider as well is that as the population age increases, there is going to be an increasing demand on services.

Chris Law

I am going to wind up on a reflective point, because across the day we have been talking about the impact of demographic changes and life expectancy. Going backwards, back to talking about just after the Second World War, do you think where we are now, given we are at such critical stages, that any future planning needs to be long term and future proof, rather than the kind of ad hoc policies we have made over the last 50 years or 60 years regarding pensions?

Derek Young

It would be definitely advantageous for people to have adequate notice of changes that are made to the state pension. I mentioned before the Turner report in 2005. I think that is a principle that is still very valid and when you do not follow that type of pattern you have seen with the WASPI campaign what that can do in terms of the public reaction. It is probably also true that we will continue to have public policy debates in this country and elections and people will continue to want to make choices about how services are delivered. While there is probably a valuable ambition to have a degree of consistency, equally things happen that you have to react to. There was the Equitable Life pension scheme collapse, for example. That was something that eventually, after a long campaign, there was a public policy response to. We ought to retain the capacity to be able to reflect on what we see as shifting need and react to it, but have a principle-based approach in which you identify what are the outcomes that you want to achieve, what you think is a fair intergenerational settlement, and then always try to work towards that end.

Margaret Ferrier

You mentioned there Equitable Life. Just to clarify that there are still outstanding payments for a lot of these people and, rightly, they are very angry. There are the two strands, the new WASPI campaign and then these people who have been fighting to get what they deserve from the Equitable Life scandal.

Derek Young

I agree.

Chair

Thank you everybody. I think there have been important salutary lessons for this Committee on our terminology and the way we go forward in using some of these phrases. We are really grateful for you all turning up today. I have to say I think this worked. It is more of a conversation than a straightforward evidence session. Thank you for being our guinea pigs today for the Scottish Affairs Committee when we attempted to do this, but I think it is something we will probably do again in the future. As we say to everybody when we are just starting an inquiry such as this, there is not going to be any end to the requirement for further information and evidence. If there is anything that you observe as we take this forward in the sessions that we have, or anything that you feel needs to be clarified, it would help the Committee in drawing it up and you have also seen the terms of reference. Please get in touch with us again and we would be quite happy to accept that. Can I thank you all for coming along today? I thought it was a fantastic and very interesting conversation and we are very grateful for you turning up today.