Opinion
From pensions to health to social care, this government has done precious little to prepare for an ageing population
Let the bodies pile high in their thousands, Boris Johnson supposedly said. Not once but often, the Covid inquiry has heard that he was for killing off elderly people, obsessed with older people accepting their fate. According to the invaluable diary of the chief scientific adviser, Sir Patrick Vallance, our prime minister was saying thats natures way of dealing with old people as he complained we are destroying the economy for people who will die anyway soon.
It wasnt just him. The chief whip, Mark Spencer, allegedly said: I think we should let the old people get it and protect the others, to which Johnson replied: A lot of my backbenchers agree with that, and I must say I agree with them. So this was not one irritable remark, but a theme aired many times around tables where people didnt get up and leave the room: many are still in government, presumably including Rishi Sunak, the eat-out-to-help-spread-Covid chancellor at the time.
Members of Covid-19 Bereaved Families for Justice say the evidence they are hearing is even worse than they feared. Age UKs charity director, Caroline Abrahams, watching the inquiry equally aghast, tells me: The pandemic inquiry is laying bare just how ageist many senior decision-makers are.
Politically, the plan for a slaughter of the ancients was insane, since older people are the ones who vote Tory overwhelmingly, voted Brexit and voted in Johnson. The Tory problem is that they are dying out too fast, not too slowly, while young people no longer turn Tory as they age, the way their parents did. In every sense this is the dying party.
But for the sake of argument, lets take a leaf out of Jonathan Swifts satirical modest proposal for butchering children starving in the Irish famine to serve to English landlords.
Old people are very expensive and growing as a proportion of the population, as births of new children to pay for them fall. The government has done nothing to prepare for this long-foreseen demographic change, and now complains of the soaring cost of pensions, NHS and social care.
The state pension costs it more than 100bn a year, a cost that has risen threefold since 2000. An 85-year-olds health costs 5.6 times more than a 30-year-olds: there are 1.7 million over-85s, and this number is rising. Across the UK, 10% of health spending goes to those over the age of 85, with 32% to those aged 65 to 84.
Ahead, needs will rise as the government has reneged on its promised social care reform, now denied to many very frail people. The Health Foundation says adult social care in England will cost an extra 8.3bn over the next decade, and thats just to maintain its current decayed state. It would cost an additional 18.4bn to cover its full cost and to improve access to care.
So if the Tories want a smaller state, eliminating everyone of pension age could pay for luxurious tax cuts. Indeed Covid must have saved a fair bit, as Sir John Edmunds, a member of the Scientific Advisory Group for Emergencies (Sage), told Andrew Marr on LBC this week: If wed have moved the lockdown forward by a week, we would have saved thousands of deaths. Another saver: the poorest who cost the state more died at a far greater rate than those who were well off.
Johnsons delinquent Covid policy still has prominent supporters. Jacob Rees-Mogg said on GB News: Boris Johnsons instincts on lockdown and Covid policy were broadly right. The inquiry heard that the cabinet secretary, Mark Sedwill, suggested a herd immunity policy of deliberately spreading Covid, like chickenpox parties for children: that seems to have happened in care homes.
The idea that most of those who died were already at deaths door, or suffering terminal pre-existing conditions, was wrong. The average number of years of life lost by each Covid victim was 10.2. Those aged over 75 lost an average 6.5 years.
That is an important calculation, because healthcare is rationed by counting in quality-adjusted life years (QALYs): how many years of good-quality life a treatment will deliver. Thats how the National Institute for Health and Care Excellence (Nice) decides which new drugs give real value for money. A great many QALYs were needlessly lost through bad political decisions on Covid.
Although older people are now the group least likely to be poor, there are still many pensioners living very low-quality lives, without care, their day centres closed. About 850,000 pensioner households fail to claim the pension credit they are entitled to, in order to top up poverty incomes: presumably that suits the government, since it knows where every pensioner lives, and so could rectify this if it chose.
But inequality among older people is extreme. They are also the richest cohort. In 2018/19 79% of them in England were homeowners. One in five over-65s live in households with assets worth more than 1m. Meanwhile, the half of the population who are under 40 own only 3.9% of all wealth, says the International Longevity Centre UK. The Treasury did well out of Covid deaths, raising a record-breaking inheritance tax take.
The politics of social care and who should pay for it prove toxic: they did for Theresa Mays 2017 election campaign, and added to Labours troubles in 2010 when its social care plan was dubbed a death tax. The money is right there for the taking, in wealthy pensioners assets, for any government brave enough to redistribute some of that wealth. I doubt many older Tory voters will forget the terminal plans being hatched for them inside No 10, not just by Johnson but also by all those around him, who discussed them willingly. But it was far from the only Tory policy driving a wedge between generations.
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