One of the greatest challenges facing Scotland is its poor health record.
After years of government initiatives to improve health, people in Scotland are still likely to die younger and be disabled by ill-health earlier than their counterparts in the rest of the UK. Scottish males typically live two years less than their UK counterparts and their disability-free life expectancy is markedly lower.
Behind those depressing figures are hundreds of thousands of people struggling with a compromised quality of life, but the human cost is not the only cost. A new report by the think tank the International Longevity Centre-UK, warns of the economic impact of ill-health on productivity. Drawing on ONS figures, it highlights that the working age population in Scotland is due to shrink by 3.5% by 2037, when over the same period England's will grow by 5%. At the same time, the retired population will grow. Over the next 20 years, the ratio of those who are not of working age to those who are is expected to increase by 40%, compared to 30% for the UK as a whole.
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There will be many more older people to be maintained and cared for but fewer working people to maintain them. The report warns that an independent Scotland could not rely on oil and gas revenues to fund the shortfall, not when the Office of Budget Responsibility is forecasting much lower tax yields from the sector over the next 25 years compared to the last 35 years. Instead, it stresses the importance of economic growth, maximising the productivity of the workforce and extending people's working lives for as long as possible, including paying significant attention to improving people's health.
How crucial this is. Keeping people healthier for longer would have multiple benefits for the country. Not only would it enhance lives and boost government revenues; it would also relieve pressure on the NHS. The Herald campaign, NHS: Time for Action, has highlighted the growing pressures on the health service from the ageing demographic. Even with changes to the way elderly people are cared for, it is increasingly clear that the system will struggle to cope and that a debate on increasing NHS funding will be required. What if the situation continues unchecked? The ILC-UK warns that, in an independent Scotland, higher taxation would likely prove necessary, echoing a report by the Institute of Fiscal Studies last year warning the SNP's more generous proposed welfare system, including its funding of the state pension, could not be achieved long term without tax rises or public service cuts.
The Scottish Government is aware of the challenges and says they are manageable. Independence would give ministers the power to tailor immigration policies to attract skilled migrants of working age, which would help, as would sustainable economic growth, the Holy Grail of any government. But these are no easy fixes. Ending the woeful situation where employees in their thousands are unable to work until retirement age due to ill-health must be a top priority.