Intergenerational equality - what does it mean for the NHS?

According to the Social Issues Research Centre, the over 50s in the UK now own approximately 80 percent of the nation's wealth.

One must always be sceptical about assessments of wealth ownership. People are notoriously dishonest about declaring how much they have. Nevertheless, the number has a ring of plausibility about it. Assuming that it is true, it raises a troubling issue - intergenerational inequality.

If one respects property rights, one can only grumble quietly about the fact that a disproportionate share of wealth is concentrated in the hands of a minority of ageing hippies. Nevertheless, this group has a claim on the nation's income that goes beyond property, shares and bonds. This group is also making a pitch for a disproportionate share of future government expenditure.

Over the next 20 years, health and pensions expenditure will take up an increasing proportion of the government's budget. Both these items are essentially expenditures on the over 65s. As the UK ages, pensions and health expenditure, as a proportion of GDP, will reach astronomical levels. Based on our current system of free health care and comprehensive pension entitlements, this would imply a further intergenerational transfer from the young to the old.

Somehow, I can't see that happening. Sooner or later, taxpayers and by that I mean the young, will demand comprehensive reform of social expenditure. In fact, this process has already begun. By international standards, the UK pension system isn't terribly generous.

However, the NHS has managed to escape any substantive adjustment. For practical purposes, healthcare remains free at the point of delivery. Successive governments have tried to restrain expenditure by rationing and cost control efforts. These efforts have reached a logical limit. A horde of grey-haired chronically patients are about to swamp the nation's hospitals demanding free healthcare.

The demand for intergenerational equality will inevitably lead to the demise of the NHS in its current form. There is something rather ironic about that. It was an institution created on the promise of delivering equality. It will be also destroyed by the demand for greater equality.