Bill Johnston – 11th August 2022
In our book “All Of Our Futures” (2021) Craig Dalzell and I set out the elements of a new Social Contract for Scotland’s Ageing Population as a contribution to the debate on what an independent Scotland should be like. We offered strategies to counter ageism, improve pensions, renovate workplace relations, create better housing and promote healthy ageing.
We also discussed how the impact of ageing can be better managed via decision making at key points in our lives by planning and taking pre-emptive actions to improve outcomes. Such a system would cover a range of basic aspects including:
- Pre-emptive health checks.
- Financial checks to prepare for retirement.
- Career stage reviews to support extended working lives.
- Housing reviews to identify options for introducing assistive technologies or relocation.
Whilst elements of a system currently exist, they are not joined up across different social groups. A social system designed to increase use of this approach could, for example, contribute to closing the gap between ‘normal’ life expectancy and healthy life expectancy, or at least to reduce the impact of declining health on quality of life and overall wellbeing.
This article is aimed at encouraging folk to explore the MOT idea and suggest ways it can be improved and implemented.
The MOT Model.
We have developed the concept of a Life-stage ‘MOT’ to illustrate a planning mechanism for individuals. Ageing would be supported by systematic reviews at key decision points in the life course, which could be embedded in formal settings like education, workplaces and health care thereby spreading the benefits across society.
The key processes are:
- Informed support and guidance.
- Practical interventions to implement any desired changes.
The implication is that individuals would create a record of their MOTs, digital and hard copy, to carry and develop through life. This could be imagined as a personal ‘passport’ to healthier ageing, enhanced lifestyle, and better social and economic outcomes.
Introducing such an organised mechanism to support individual decision-making would have a ripple effect across society and could begin to deliver the promises of independence for a better society.
The MOT Territory
Let us look more closely at key areas of life, which could be better managed using an MOT model and process. The vehicle for delivery may well depend on the extent of the various MOTs and need not be a single one for all of them (a health MOT and a financial MOT require the attention of very different specialists to administer, and a workplace MOT will almost certainly require on-site inspections of the workplace).
The following selected summaries are expanded and developed in chapter 9 of All Of Our Futures.
A financial and pension MOT
The 2017 Cridland Review recommended the concept of a Mid-Life MOT with respect to financial planning stating that for many people financial choices were a consequence of lifestyle changes rather than an aim in themselves and that this may leave some with insufficient time to properly plan for the financial consequences of ageing and retirement. This idea has been taken up by several insurance, investment and pension firms and calls for more support throughout a working career to identify potential issues such as gaps or fragmented work that may compromise saving for a pension, being overworked to the point of being unable to train, develop skills or otherwise progress one’s employment and general unawareness of how best to save for retirement.
Apart from identifying principles, little work has been done to develop the practice of such a financial MOT but the roll-out of auto-enrolment in pensions combined with more fragmented careers means that much more support is needed to enable forward planning for a secure future.
A workplace MOT
The concept of a workplace MOT is one that would allow employers and employees to work together to adapt jobs so that employees can continue to lend their increasing experience and knowledge to the workforce. Ideas such as tapered retirement allow people working towards the end of their career to move to part-time work which reduces the ‘cliff-edge’ of suddenly stopping at ‘retirement age’ and avoids the sudden disconnect of what could be both an entire way of life and a significant portion of their social structure (not to mention the loss to the employer of sometimes decades of experience in the sector). During our research for the book we spoke to at least one person who witnessed older colleagues being transferred from active, public-facing roles to desk-based office jobs without their full consent and described the change in role as “psychologically devastating” for the people in question.
An initiative along these lines would challenge the negative influence of neoliberalism on workers’ rights and require substantial trade union involvement to develop union objectives for better paid and more secure employment.
A health MOT
When considering a Life-Stage MOT, the first and most obvious assumption would be that this would primarily involve familiar health-related matters. This should be a primary, though not the sole, purpose of such an MOT as it is increasingly recognised that pre-emptive health checks and action are more effective, more efficient, and better for outcomes and wellbeing than reactive healthcare. If widely used the health MOT would be a practical and significant addition to a national healthy ageing strategy.
The Scottish NHS already offers many kinds of proactive and pre-emptive health checks aimed at specific demographics (screening for various cancers for people deemed vulnerable to them, particular health screens for people over a certain age threshold etc.). Whilst widespread and reasonably well targeted, the Scottish system could be better branded under a comprehensive “Health MOT”. Enhancing people’s Health Literacy and creating public information and educational programmes would support such a rebranding.
One thing should be noted though. The purpose of the Health MOT should be for pre-emptive healthcare and to allow people to plan for issues that may become a problem in the future. It should not be seen as a means of ‘patching up worn out workers’ to squeeze another few years labour out of them or to enable the state to further increase state pension age.
Implications for the Independence Movement
It may be that the novelty and creative potential of the comprehensive MOT idea would be an attractive feature of an independent Scotland by introducing a tool for enhancing the individual life courses of Scottish citizens.
An MOT ‘guarantee’ should be a core element of citizenship in independent Scotland allied to a citizen’s human rights. The MOT process could be a tangible means whereby every citizen knew that independence was benefiting them directly and was not simply a different constitutional form wrapped around the same old neoliberal inequalities and lost opportunities presided over by a largely unchanged, self-perpetuating elite.
An MOT guarantee would be a powerful reason to vote for independence as a positive choice rather than as a protest at the decline of the UK in its present inequitable form.
Many of the specific tasks required for this kind of Mid-Life MOT are already in operation in Scotland – particularly within healthcare and, to a lesser extent, in workplaces and financial planning – but more can and should be done to enhance and knit all these disparate sectors together so that they cross-link, complement each other and, most importantly, spread the benefits across the whole population.