Happy New Year to one and all.
I have been busy trundling to and fro to NHS hospitals. My mother is not so well. See earlier accounts here:
Above all, I am humbled by the diligence shown by the nursing staff as they try to keep their designated batch of elderly heavy wheezing largely immobile patients clean and tidy. All the more so when so few of them appear to be native Britons. Maybe it should be called the UK International Heath Service. One African male ward orderly told me how he came from a large Nigerian family: his father was a king in Nigeria and had had 20 wives, a policy that (he sighed) had proved too expensive for the family as a whole.
It’s a sobering thought to look at the expensive honourable care being given to old people in our society who long since stooped contributing much to the common weal other than tenaciously staying alive. Eeek. That’s me in 1000 weeks or so, if I live that long! How long will it be before the costs overwhelm the ability or willingness of the taxation system to cope? What are the intergenerational and other ethics of this situation?
No-one has the faintest idea. But the way forward has to lie in technology, robots and greater organisational flexibility.
Somehow. Or not.
More of the same. Some UK NHS hospitals are well past their best days, yet they keep going in their own scruffy way. I wonder when the idea emerged of covering every possible noticeboard with laminated badly designed signs, leaflets and healthy exhortations that are far too numerous to read. Who was that first fateful person to stick a notice to a wall or lift interior using sellotape?
And what happened to British nurses? In my many recent visits I’ve scarcely met a nurse that by language sounded native British. Not that there is anything wrong with what these non-native nurses do. On the contrary, their diligence in attending the needs of so many patients who are unresponsive or ungrateful or just confused/belligerent is awe-inspiring.
In many societies the number of old people as a proportion of the total is rising. And the absolute number of younger people to drive things along is relatively modest. But look at eg Nigeria (my emphasis):
Also, the population figure of infants within the age bracket of zero to four years, according to NBC and NBS, constituted the largest percentage of the population with 31,116,156, followed by the figure of those between five to nine years with a population of 27,549,964.
An analysis of the figures showed that Nigeria currently had an estimated population figure of 78,971,690 of those between the ages of 15 to 39.
This is a demographic tsunami:
Back in 1985 or so I wrote a speech for Sir Geoffrey Howe about demographic trends. It posed this question:
Take a country with a fast-growing population. It gets worried that its people may outstrip its resources and passes a law that limits families to a maximum of two children. The law is 100% obeyed from the day it is passed. When does the country’s population stop growing?
The answer, of course, is that in the absence of wars or massive calamity the population stops growing roughly around the time that the children who are born the day the law is passed themselves die of old age. In other words, the population growth juggernaut trundles on for some 70 years before the decline sets in.
A population grows each year because more people are being born than die. So if there are more many young people than old people, it has to keep growing until the current young people themselves reach the top of the demographic pyramid. As in Yemen and Tanzania now.
This effect also works in reverse – Ukraine and Russia are set to see accelerating demographic decline over this period as there are today too many old people dying and not enough new young people appearing.
All those 31 million Nigerian babies will in dues course have their own babies, and so on. Propelling Nigeria towards one of the top three population countries in the world a century or so from now.
In the meantime, we ageing Brits glumly wonder what the NHS will have in store for us in our own very old age. Somehow it will have to adapt to new technology as we all start having cheap gadgets that monitor key health indicators and send data straight to our doctors. The UK NHS is a classic example of an institution founded in the Age of Mass grappling with the new demands of the Age of Velocity. Its transition to something different will be unusually messy and dramatic – there’s no easy way to change course as the next wheezing patient arrives…