What are we going to do about all the old people? A modest proposal for our times by Fringe playwright Robert Dawson Scott

The percentage of the population that is aged 65 or older has increased by 26 per cent in the last 40 years. It will be a quarter of the population by 2045, perhaps sooner, as life expectancy extends, health care advances and life-shortening activities, such as smoking or working in heavy industries, continue to diminish. We may not have a mining industry any more, but at least we’re not seeing many new cases of pneumoconiosis.

Meanwhile, the birth rate, at 1.8 children per woman, is showing signs of an uptick from a low of 1.6 in 2001 (largely thanks to the immigrant population, but let’s not get side-tracked by that argument just yet). However, it is still well below the developed nation replacement rate of around 2.1.

You know all this, right? We have been hearing about the demographic time-bomb since the 1980s. Margaret Thatcher was one of the first to refer to it publicly. You can draw any number of conclusions from the figures. The one that interested her, and the one that lies at the heart of my new play, Assessment, is how the nation, be it Scotland or the United Kingdom, is planning to support this ageing population.

The UK pensions bill today is £241 per year per head of population and there are fewer and fewer people to pay it. There are currently 3.2 people of working age for every person of pensionable age. By 2040, the Old Age Support Ratio, to give it its Sunday name, will have fallen to just 2.8. (The main impact of last week’s announcement, according to the Cridland report which recommended it, will only become apparent after 2040.) If 2040 seems a long way off, it is as far in the future as the opening of the Channel Tunnel or the release of Four Weddings And A Funeral are in the past. So – stop all the clocks.

Yet when the Conservative Party put a relatively modest proposal into its recent manifesto, suggesting that those who could, might have to pay for social care in future, it was immediately dubbed the “dementia tax”. The manifesto included other age-specific measures such as ending the triple-lock on pension increases and means-testing winter fuel payments. Between them, they were widely considered, even by the person who wrote them, to have lost the Conservatives their parliamentary majority and indeed, in the face of the new Westminster arithmetic, they have, for the moment, been abandoned.

That manifesto writer was Nick Timothy, the Prime Minister’s former chief of staff. Timothy wrote a frank but unapologetic “mea culpa” in the Spectator magazine a few days after the election, headed, Where We Went Wrong. Among other things, he said this: "The biggest complaint was about our social care proposals. You can criticise the policy but we need to be honest with ourselves ... Somehow, we have reached a point where older people with assets expect younger, poorer people to pay for their care. With Britain's demographics, that is not sustainable."

Pausing only to thank Nick Timothy for putting my play slap bang in the middle of the political agenda just as its premiere approaches, I have to admit it was not the demographics that first started me thinking about this subject. The immediate prompt, a couple of years ago, was the viciousness of the now notorious Work Capability Assessments being carried out on certain welfare recipients by the French company Atos. As it happened, I had a doctor friend who was sitting on one of the in person, medical appeals panels at the time. She and her colleagues were upholding around two-thirds of the appeals. (The UK average, including paper appeals, has hovered around 40 per cent.) Even without the individual tragedies that were being regularly reported, any assessment system which is being overturned that often is clearly not fit for purpose.

It did not take an imaginative leap much beyond “What will they think of next?” to come up with the Pension Exchange Scheme, which is the "assessment” of the play. In the very near future, a company very like Atos has won a contract from a government which has decided that all these old people are a luxury the country can no longer afford. The contract is to deliver a pilot scheme aimed at a particular group of pensioners. They are being invited to cash in their remaining state pension entitlement for a lump sum. In return, they have to guarantee, in an, shall we say, irrevocable way, to make no future claims on the state. It is not too much of a spoiler to say that sales are not going well.

Film buffs tell me this all sounds a bit like Logan’s Run meets Cocoon. But at the risk of heading straight for Pseuds Corner, my reference points were both older and more literary, going all the way back to 1729. That was the year Jonathan Swift published his famous essay, A Modest Proposal, perhaps the greatest sustained piece of satirical writing in the English language.

To give it is full title, it was a modest proposal "for preventing the Children of the Poor People From being a Burthen to Their Parents or Country, and For making them Beneficial to the Publick". In short, he suggested that the Irish poor might ease their economic woes by selling their youngest children to the rich people to eat.

There is no eating suggested in my play but the solution on offer is, I daresay, nearly as distasteful.

Ongoing Government pension liabilities are calculated using actuarial tables based on life expectancy. The projections are recalculated all the time as actual figures emerge. You may have noticed last week's news reports that the rate of increase in life expectancy has slowed recently. But anyone living beyond their allotted span is a headache. For a man in Scotland today, that span is 77.1, a couple of years below the UK average, much lower in certain pockets of deprivation. (Women do rather better, partly because fewer of them die violent deaths in their 20s.) So I have set the play on the 77th birthday (you can’t really have a 77.1th birthday) of the central character, one Alan McDonald.

Increasing numbers of pensioners carry on working – just under 12 per cent at present. Others again, such as senior civil servants, have generous final pension settlements and, as Timothy correctly identified, substantial capital assets.

Alan is not one of them. He has nothing but his basic state pension, currently £8,296 a year. He lives with his daughter and her two teenage sons in social housing. His wife has been dead these 10 years and he has a touch of arthritis in his fingers, which is one of life’s little ironies as he used to be a joiner and now can’t do much with his hands.

He is the kind of person I think would be targeted for such a scheme: poor, vulnerable and, because he is likely to live on for a good number of years and has no other means of support, expensive. Using the tried and tested back-of-the envelope method, taking into account the pension, sundry benefits and an element of healthcare, I came up with a notional figure for what Alan had cost the country since he retired. It came to somewhere north of £400,000, or £35,000 a year.

Multiply that across the nation, and it is not hard to imagine some bright young think tank jockey, tumescent with the thrill of a blue-sky-thinking-away-day-paintballing session, coming up with something similar. In fact, I’d be surprised if they haven’t. Nor is it merely satire. On a recent edition of the BBC Radio 4 programme The Untold, a well-spoken lady in her 80s from Somerset, not a spokesperson for anything, suggested that people like her should simply be culled at 75.

For Alan, in the context of the play, it is, of course, not satire at all. It is his reality. The impact of the initial proposition is to trigger a bout of introspection in him, wondering, as the slogan for the play has it, what his life is really worth. We generally take for granted that life is a precious gift. But as we all entertain the prospect of living longer, how often do we contemplate what kind of life we may be living?

In his compassionate but clear-eyed book, Being Mortal, Atul Gawande, the American-Indian doctor who was the BBC’s Reith lecturer in 2014, broaches the possibility that simply being alive should not be considered enough; that medical science, brilliant though it is, has led us down a blind alley of extending life if at all possible, regardless of the consequences. We need, he argues, to have “hard conversations” with our ageing relatives.

As a doctor, he is concerned principally with people who are ill or in pain, the sort of circumstances that Switzerland, with its Dignitas clinic, the Netherlands, or the US state of Oregon require before they consider that the deliberate ending of life may not be considered a crime. They are rare jurisdictions; the UK’s refusal to consider the possibility is regularly upheld in the UK courts, in even the most heartbreaking of circumstances.

The idea that anyone might simply decide enough is enough, without any great physical agony, is even further from the legislators' minds. Yet it is not hard to see why older people, in our current connected yet alienating culture, might not feel valued. A new report, The Obstacle Course, published last week by the charity Independent Age, draws attention to some of the difficulties. "Too many older people," it says, "have to fight to be heard and have their needs recognised. They can struggle to get the most basic support and can often feel like they are battling a system that is set up to complicate things and present barriers to getting help."

Not everyone sees the demographic time-bomb in such apocalyptic terms. Phil Mullan, the economist whose book cites Thatcher’s early adoption of the “timebomb” idea, goes for the jugular in its very title, The Imaginary Timebomb. He argues that it is all simply a way of justifying giving up on regulating the economy and curbing the role of the state. Thatcher in her time, and more recent commentators on the right, use the underlying figures to argue that people need to make better provision for themselves. Recent evidence that UK savings ratios are at their lowest level for 50 years (20 per cent of Scots have no savings at all) suggests that that idea has not gained much traction, which is why the new workplace pension scheme will become compulsory next year.

Both the Royal Commission On Long Term Care in 1999 and the later Wanless Inquiry Into Securing Good Health For The Whole Population, (2001-04) found that although people were living longer, they were also living healthier lives and therefore the costs of geriatric conditions and end of life care were more or less the same; it was just happening later. But these are objections more on the perceived impact on health costs rather than on pensions and related benefit costs. The more recent Dilnot Commission (you can’t say successive governments are not aware of all this) on the Funding Of Care And Support took a gloomier view (and mooted the kind of means-tested social care provision that eventually made its way into the 2017 Tory manifesto).

Theatregoers will be relieved to know that all this statistical tennis rapidly takes a back seat in the play. Alan, our hero, may be forced by the Assessment of the title, to confront his own mortality and circumstances. But he goes on to come up with solutions that are entirely his own. Obviously I’m not going to tell you what they are; for that, you have to come and see the play. Because in the end, the question is not what we are going to do about all the old people. We are all, barring accidents, going to be those old people. So if we don’t fancy being presented with a Pension Exchange Scheme of our own, or something similar, we had better start doing something about it ourselves.

Assessment is at the Gilded Balloon Rose Theatre in Rose Street, Edinburgh from August 2-28 at 2.30pm daily except August 15. Tickets: gildedballoon.co.uk 0131 622 6552 http://bit.ly/ASSESSMENTGB

All figures quoted are from the Office of National Statistics unless otherwise stated.