Learning from Japan and Sweden could help improve the UK’s care system (Image: Getty)
Britain should launch a “national mission for ageing” and create a universal social care system, a major report has recommended. Experts warned that the UK is on track to have a “super-ageing population”, defined by the World Health Organisation as more than 20% aged over 65. This means there will be a smaller proportion of people in work to provide and pay for care.
A major report has called for the United Kingdom to embark on a “national mission for ageing” and establish a universal social care system to address the country’s rapidly ageing population. The report highlights that the UK is on the path to becoming a “super-ageing population” — a term used by the World Health Organization to describe nations where more than 20% of the populace are over the age of 65. This demographic shift poses a challenge as it results in fewer working individuals available to fund and provide the necessary care.
The study, conducted by The King’s Fund and the International Longevity Centre UK (ILC), draws comparisons with countries like Japan and Sweden, recognized as global leaders in elderly care. The findings suggest that the UK stands out negatively for the number of people who are excluded from publicly funded social care, leaving many to either cover the costs themselves, depend on family and friends, or go without adequate care.
Simon Bottery, a senior fellow specializing in social care at The King’s Fund, emphasized the need for increased financial investment in the sector. “Both Japan and Sweden operate under universal systems, ensuring that everyone requiring social care receives some level of state support,” he explained. “While there might be some personal contribution required, the support is available to all — something that is lacking in England. We currently restrict public funding access based on financial means, excluding many who are deemed to have too much money.”
Bottery stressed the importance of bridging this gap and improving the quality of care, which would necessitate greater financial allocation to the system.
Japan was specifically examined in the report due to its current demographic makeup, which mirrors where the UK is heading. In Japan, 31.7% of the population is aged 65 and above, in stark contrast to the UK’s current 19%.
A national conversation was sparked in the late 1980s when Japan’s fertility rate dropped to 1.57, dubbed the “1.57 shock”. This led to major reforms to the delivery and funding of social services for older people. Japan now tops the ILC’s global rankings for health span and life span.
Meanwhile, Sweden has a similar health system to the UK but scores much higher on measures of healthy ageing. It has focused more on prevention of ill health through interventions such as “health meetings” for older people.
The report found both countries crucially had a “sense of mission” when it came to confronting the challenges of an ageing population. Mr Bottery added: “[In the UK] we’ve got a kaleidoscope of different initiatives and attempts to to recognise and tackle the challenges and opportunities of an aging society, but without that sense of national mission, where it’s led by the government, the Prime Minister.
“Japan had a wake-up call about 35 years ago, realised the curve they were on and were determined to do something about it. You also see in Sweden this determination to improve aging and not to allow complacency to slip in. That’s what the UK needs to do.”
The report concluded that ministers should create a national strategy for ageing and take bolder action to deliver on promises to boost prevention and move care closer to home.
It also recommended creating a universal social care system and developing a workforce fit for an ageing society.
Report co-author Luca Tiratelli, a senior researcher at The King’s Fund, said: “As the realities of our demographic future begin to materialise there will be fewer people in work relative to the population and more people needing support.
“So far that conversation has not received the focus it needs and other countries are proving to be both more ambitious and more successful in their attempts to address it.
“Without [a sense of national mission], our already creaking health and care system risks collapsing and the prize of a population that can enjoy healthier and more independent lives for longer will be missed.”
A Department of Health and Social Care spokesperson said the Government was “focusing on preventing ill health and enabling people to live longer, healthier lives”.
They added: “We’re prioritising prevention and personalised care to support people to make healthy food choices, boost physical activity and access financial and employment advice that will improve health and wellbeing and help people get back into work.
“We are also progressing towards a National Care Service with higher quality care, greater choice and better integration between services — backed by over £4 billion additional funding for adult social care by 2028-29.”
Lessons from Japan
The Express travelled to Japan in 2024 to experience its superior social care system. On visits to nursing homes in Kawaguchi City, just north of Tokyo, we found a strong focus on preventing ill health through daily activities designed to keep the brain and body active.
The country’s revolutionary Long-Term Care Insurance (LTCI) system means every worker pays insurance premiums from the age of 40. When they need support, those over the age of 65, or younger people with age-related conditions, undergo an assessment and receive a care budget.
They are asked to contribute a small amount depending on their income, while the rest of their costs are covered by state funding and insurance.
Yuichi Sakamoto, Kawaguchi City’s director of social welfare, told us a typical pensioner contributed around £250 per month. He said the reforms had created a much fairer system because “society as a whole has started to take care of the elderly, whereas before it was the family.
Mr Sakamoto said the new insurance model initially faced strong opposition. He added: “There was also deep-rooted criticism that it would not work because it was creating something that had not existed in the world before.
“But if the UK is going to create a system, I think it will be easier to persuade those who oppose it, because they can see the results from the Japanese precedent.”
