The UK health secretary has admitted that there is a shortage of both doctors and nurses. This is a problem that could have been foreseen some years ago, and will only get worse due to Brexit. And there is another looming shortage in the shape of social care workers.
The context of these issues is that we are all living longer. For most of us that is good news, provided that we have taken good care of our health and protected our investments. But the downside is that those provisos are not always easy to follow, and old age can be a difficult time even for the very rich.
In addition, demographic figures often hide nasty surprises, such as falling birth rates. This has already happened in Japan, with 25 per cent of the country’s 127m-strong population now aged over 65. Low birth rates compound the problem. Japan’s health ministry forecasts the population will shrink by as much as a third by 2065, while the old are living longer. As a result, this ratio of over 65s to the total population is expected to rise to more than 40 per cent.
Changing work demand
There are an increasing number of ‘super-aged’ countries in the world, for whom at least one in five of the populace is aged over 65. The US and UK are among them. The average age of an American nurse is nearly 50, and that of a construction worker 40. The UK, just like Japan and the US, is also fast running out of young workers.
Yet of the 30 fastest-growing occupations across the Atlantic, as forecast by the US Bureau of Labor Statistics, nearly half are some version of nursing – and especially social or care workers.
However, these are some of the lowest paid and least esteemed of all working categories. Andy Burnham, a former minister for health and now mayor of Manchester, recently reported on the 17-hour shift of one such worker in the UK: 48 visits, with the shortest at only two minutes, and no time for compassion, conversation or care. Furthermore, 50 per cent of these workers are paid less than £7.50 an hour.
The problem is more than demographics. It is also capitalism, which works by ‘scaling up’ an individual’s capacity: a warlord through an army, a lawyer or accountant through trainees but increasingly through computerised libraries or procedures, and a company boss through factories and distribution systems.
But a nurse or care worker cannot be scaled-up. Good or bad, an individual can only work so many hours, offer an honest day’s work, or skive off and still collect a day’s pay for bad service. The employer cannot obtain more profit, except by cutting wages, insisting on more and shorter visits, and otherwise reducing the quality of the service. Austerity worsens the problem but is not its cause.
The coming of the robots
The Japanese hope to resolve this problem through the use of robots. They have been aware for several years of a shrinking workforce, rising demand and cost of social care, hampered by the lack of sufficient recruits. Their quest has been aided by domestic popular culture: childish and friendly anime characters that first came to prominence in the 1960s have helped society conceive of a less threatening type of robot.