This article was originally published on "The Quint" in 2019 and my views on the subject have changed slightly, now in favour of subsidized at home elderly care along with the provision of subsidized training for such care providers. The original article can be accessed here.
India is a young country. More than half of its population is under 25 years of age, 65 percent of its population is 35 or under, and the median age of the country is just about 29. Naturally, this is a matter of both great promise and immense anxiety for the Indian government.
The promise lies in the fact that at no other time has the country seen a larger number of young people becoming part of the workforce and the voter base each year. It is an apparent electoral and financial incentive. The concern and anxiety is that at no earlier instance in India, has there been greater risk of dealing with such a sizeable chunk of educated, yet unemployed, youth population – a dangerous mix for any country.
Are We, As a Nation, Ready to Deal With Such a Sizeable Ageing Population?
Whether the risks and rewards will be balanced, is a concern for another enquiry, but the pursuit of dealing with the urgency of the issue of youth deeply engages the government and the Indian policymakers, owing to its urgency. James Freeman Clarke, the American theologian, once observed that: “A politician thinks of the next election. A statesman, of the next generation.”
The logic is simple. The median age of the nation is 29 years. Thirty years down the line, this means that a large section of the Indian population would be nearing its sixties. Demographic trends already show that between 2000 to 2050, the population of people in their 60s will have increased by 326 percent, ie, nearly 324 million people. Add to that the 48 million people who will be above 80 years of age. That is a fifth of the Indian population in the senior citizen bracket by 2050, compared to nearly 8 percent in that age group now in 2019. Are we, as a nation, ready to deal with such a sizeable mass of ageing population?
National Policy on Older Persons : Old Wine, New Bottle?
The National Policy on Older Persons (NPOP) was announced by the Government of India in the year 1999, and it depended on the strategy to “encourage families to take care of their older family members”. Dr Susan Paul and Dr Matthew Asirvatham, in their research on the efficacy of the geriatric health policy, concluded that the “implementation of this policy … has been negligible”. The second instalment of a geriatric policy came in the form of the National Policy for Senior Citizens in 2011.
This too, quite unequivocally stated that it will consider “institutional care as the last resort” and that the “care of senior citizens has to remain vested in the family”. Even though it talked about productive ageing and multi-generation bonding as relevant areas of intervention, it did not pay much heed to the breakdown of the joint family system and the migration of the younger generations to urban centres, leaving the old behind.
Moreover, it only offered some lacklustre “old wine in a new bottle” genre of solutions, including, but not limited to, utilising the “Indira Gandhi National Old Age Pension Scheme” (originally launched in 1995), the public distribution system, income tax benefits, and the establishment of a number of agencies such as a Department of Senior Citizens under the Ministry of Social Justice and Empowerment (MoSJE), directorates of Senior Citizens in states and union territories, a National Council for Senior Citizens, as well as National and State Commissions for the Aged.
India Needs Leaders Who Can Think Beyond Elections
Without compromising on the need for family care, the long-term solution would inevitably comprise of institutional geriatric care. It will indeed be a monumental task to set up institutional care models given the limited financial resources of the country and moreover, by the time the demographic shift will move the ageing problem to urgency, the swift mobilisation of financial resources towards geriatric care would have already become an impediment, leading to inefficiencies.
Given these challenges, the need of the hour is a new generation of statesmen and stateswomen in India who can work in complex environments with the long term in view, and can design unique solutions that move beyond the insipid and inadequate solutions such as setting up of committees, banking on underfunded pension schemes, and offering paltry tax breaks.
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