HEALTHY DEMOGRAPHICS

HEALTHY DEMOGRAPHICS

By 

Sally Hughes

Scotland’s National Health Service was created in 1946, at the same time as the NHS in England, Wales and Northern Ireland.  They are all separate entities, fully funded by the taxpayers in the host nation.

They came into being on the back of 2 World Wars, and a Flu Epidemic, that turned the world’s powers on their ear, and were inspired by a previous model used in the Highlands and Islands of Scotland.

Scotland’s NHS is funded fully by her taxpayers, not subsidised by England’s as oft-times shouted.  Operating and Service Delivery differences between Scotland’s NHS and England’s are due to Political choices and Management decisions, not the generosity of Westminster.  

Of course medical cover does not stop at Gretna, if I travel to England and need medical treatment during my stay there, they will provide it…. But the bill gets sent to Tayside Health Board, for that is where I live and pay my taxes.  And the opposite applies to those travelling from England to Scotland.

However, what happens if a person retires to a completely different part of the UK from where they have been living, working and paying taxes for the last 30 odd years?

It is commonly expressed that old people run up high health bills.  This is not entirely accurate.  Specifically, the last 6 months of a person’s life will generally cost the most in health care, and this applies to children and young adults, as much as pensioners.

It’s just that by the time you get to your 80’s, wear and tear on the body will be a thing, and you won’t have as many ‘last 6 months’ in you, as you used to.

Since Scotland’s Independence Referendum 2014, anecdotally, people in Scotland have been talking about a marked increase in English people retiring to Scotland.  If true, in addition to changing the dynamics of areas, (pricing young workers out of the area), placing a higher burden on rural care services, it might have a considerable influence on any future vote for Scottish Independence.

For that reason, the reality of how Scotland’s NHS is funded when it comes to retirees moving into different Health Board Areas needs to be disseminated and addressed.

Every patient seen by SNHS is issued a unique patient ID number, it’s called a Community Health Index Number (CHI).   Different recording / Identity methods are used in England and Wales, they are non transferable.

Since it’s likely that those moving to Scotland on a permanent basis will sign on with a GP in their new home area, the possibility exists that these newly issued CHI numbers will provide a window, or dip test of changing demographics.

To this end FOI Request 2023-000075 was requested and asked the following:

How many New COMMUNITY HEALTH INDEX NUMBERS were issued/

generated for those aged over 50 in the following years:

2017, 2018, 2019, 2020, 2021, 2022

What is the distribution of these New Numbers across each of Scotland’s NHS 14 Health Boards – a total from 2017 to 2022 for each Board area would suffice.

The results for Non Transfer (ie Brand New) CHI numbers for each area is as follows:

For conciseness I’ve produced the figures for 2017, 2021, 2022, and a total for 2017 – 2022 including years ’18, ’19 and ’20.

I’ve taken 2017 as a base year, and compared it to the New CHI numbers in percentage terms for years 2021 and 2022.

Arran/Ayrshire              Y2017  516      Y2021  706 (+ 36%)      Y2022  667 (+22%)

Total Increase               Y2017 – 2022   +3344

Borders                        Y2017  461      Y2021  733 (+59%)       Y2022  499 (+8%)

Total Increase               Y2017 – 2022   +2958

Clyde                           Y2017  686      Y2021  1072 (+56%)     Y2022  783 (+14%)

Total Increase               Y2017 – 2022   +4500

Dumfs/Gall’w               Y2017  615      Y2021  1012 (+64%)     Y2022  781 (+27%)

Total Increase               Y2017 – 2022   +4355

Fife                              Y2017  450      Y2021  673 (+49%)       Y2022  489 (+8.6%)

Total Increase               Y2017 – 2022   +3035

Forth Valley                  Y2017  369      T2021  474 (+28%)       Y2022  468 (+27%)

Total Increase               Y2017 – 2022   +2212  

Grampian                     Y2017  959      Y2021  2318 (+141%)   Y2022  1846 (+92%)

Total Increase               Y2017 – 2022   +7986

Glasgow                       Y2017  750      Y2021  1459 (+94%)     Y2022  1530 (+104%)

Total Increase               Y2017 – 2022   +6230

Highlands                     Y2017  815      Y2021  1323 (+62%)     Y2022  1321 (+62%)

Total Increase               Y2017 – 2022   +5922

Lanarkshire                  Y2017  461      Y2021  706 (+53%)       Y2022  776 (+68%)

Total Increase               Y2017 – 2022   +3381

Lothian                        Y2017  1328    Y2021  2722 (+105%)   Y2022  2957 (+122%)

Total Increase               Y2017 – 2022   +11360

Orkney                         Y2017  125      Y2021  199 (+59%)       Y2022  115 (-8%)

Total Increase               Y2017 – 2022   +756

Shetland                      Y2017  59        Y2021  154 (+161%)     Y2022  129 (+118%)

Total Increase               Y2017 – 2022   +544

Tayside                         Y2017  534      Y2017  1143 (+114%)   Y2022  939 (+76%)

Total Increase               Y2017 – 2022   +4394

Western Isles               Y2017  108      Y2021  188 (+74%)       Y2022  105 (-3.7%)

Total Increase               Y2017 – 2022   +678

Of course the above tells us nothing of the nationality of those obtaining new CHI numbers, only that they are aged over 50.

It will be for others to speculate, or evidence, which demographic group/s they belong to.  Anecdotally I would suggest that the Eastern Europeans who used to grace our neighbourhood in Tayside, especially in summer, during the Berry picking season, prior to Brexit, were a lot younger than 50.

It will also be for others to work out if politicians in their area need to worry about such changing demographics…. Would a change of +4394 in Tayside affect the election of SNP candidates, for example?

Grampian +7986?   Lothian +11,360?

At least with this information, an argument can be made, that for our elderly, new Scots, come to retire to Scotland, for a lovely view, and the safety net of a functioning NHS, Independence could just be their healthiest option.

MY COMMENTS

Limited due to being on holiday. My thanks to Sally for this article.

I am, as always

Yours for Scotland.