We need more than soundbites to solve NHS’s demographic problem

THERE is clear evidence to support the warning from health service workers that “things cannot go on like this” (“Staff warn future of NHS is not viable in long term”, The Herald, February 24) and the link they make with our growing population of older people.

The prevalence of complex health conditions, physical disability, and mental health issues (especially dementia), significantly increases with age, and so the projected 86 per centincrease in the population aged over 75, and 151 per cent aged over 85 years the next two decades threatens to overwhelm our health and care services and special forms of housing – not in 20 years’ time; it is already happening.

Just to maintain our current rate of services, already under severe pressure, home care services will need to be available to 54,000 more older people, with an additional 41,000 care home or care housing places required. That means a 50-place care home/ housing unit opening somewhere in Scotland every fortnight over the next 20 years, alongside equivalent increases in community health and hospital provision. And the cost : NHS and social care spending growing year-on-year, building to an additional £4.5 billion by the end of the next 20 year period.

The workforce implications are an additional 100,000 care staff and perhaps the same number of NHS staff – so, an extra 10,000 health and care staff every year from now. The projected reduction of four per cent in Scotland’s working age population over the next 20 years will have to be reversed through young people remaining, women returners to work, and a Scottish policy to secure substantial immigration.

Political offerings, such as Labour’s centrepiece promise of 1000 more nurses, and demanding A&E statistics, demonstrates a failure to grasp the enormity of the future pressures facing health, care and housing services. Meeting health and care needs related to demographic change amongst people of working age and older people raises issues about economic planning and financial management, fiscal policy and taxation, education, employment and immigration. We must build on existing Scottish Government and council efforts to deliver integrated health and social care and their 20/20 vision of improved NHS services. We need serious strategy and major investment rather than populist soundbite. Andrew Reid, The Old School, Dundas Street, Comrie.