Published: 17/03/2005, Volume II5, No. 5947 Page 21

Steve Ainsworth, Halifax

The latest national population projections show the UK population rising from 59.6 million in 2003 to over 60 million in 2005. By 2031 the population is predicted to reach 65.7 million. Over that time it will become progressively older, with the median age expected to rise from 38.4 years in 2003 to 43.3 years by 2031.

In 2003 there were around 700,000 (6 per cent) more children under 16 than people of state pensionable age. However, from 2007 onwards the population of pensionable age is for the first time projected to exceed the number of children.

The number of people over state pension age is set to rise from 10.9 million in 2002 to 12.2 million in 2011. Sixty years from now that figure will have risen to over 17 million.

One potential guide to demands on the NHS is the number of people over the age of 60. Currently around 12.5 million, the number of over-60s is set to rise to 19.5 million by 2031, and to 22 million by 2071 - nearly one third of the population, compared to 21 per cent today.

How does a nation cope with such a large proportion of its population retired, drawing pensions and creating a vast increase in demand for health services?

Something - perhaps several things - will have to change.

Women's retirement age is being put up to 65; NHS staff pensions provision is now being reviewed.

And NHS spending is increasing.

The future looks set to be one of political conflict between ageing voters, who will seek to secure decent pensions and healthcare provision, and workers - youngsters who will demand relief from an ever more punitive level of taxation to support their elders.

Some point of balance will need to be found, and that point is certain to involve later, smaller pensions - and a much more costly NHS that is less beneficial for the average patient.

There may even come a point where it becomes accepted that increasing longevity, although good for the individual, is not necessarily good for society. If that point is reached, a fall rather than a rise in life expectancy may become an acceptable NHS performance measure.