Institutional changes, both within social security policy and implementation, and in policy interaction with other areas like health and employment, will have contributed to the growth in caseloads. However, the question remains whether the increasing numbers of recipients of disability benefits reflect a rise in numbers of people who have developed an impairment, or simply an artefact of the way that benefit rules have been framed and applied. For instance, how significant is the ageing population and worsening health? Certainly, since the chances of developing impairment increase with age, one might expect – other things being equal – an ageing population to be associated with a higher incidence of impairment. The difficulty is that other things are seldom equal and, as has already been discussed, social attitudes towards disability have changed markedly over the last 30 years, measurement has changed and improved, and people have possibly become more prepared to exercise their right to provision.

An ageing population

A key characteristic in the ageing of Britain's population since 1971 has been the 44% increase in the number of people/pensionable age, over a period when total population increased by less than 7% (Chapter 2). Not surprisingly, therefore, the most obvious impact of an ageing population can be seen in the increased numbers of people of pensionable age who are in receipt of benefits to cover the extra costs associated with disability (largely Attendance Allowance – the increase in numbers of older people continuing to receive Disability Living Allowance was considered in Chapter 11).