It’s a fair bet that Sir Paul McCartney did not look forward to his 64th birthday, which took place last Sunday. He was still young when he wrote the famous ditty musing on the humble pleasures he’d enjoy in a happy, coupled-up retirement. Doing the garden, digging the weeds, mending a fuse, babysitting the grandchildren, scrimping for a rented cottage on the Isle of Wight, staying out till a quarter to three, being fed and being needed — this was all he could picture himself wanting when he reached the ancient landmark of 64 years.

He must have realised, as the date loomed, that the comparison with his current circumstances would be gleefully made. And the contrast with the modest happiness he’d dreamt of as a working-class youngster really is movingly stark. The wife with whom he’d have happily spent a quiet, simple old age is prematurely dead, and her glamorous replacement’s reputation is being trashed in the red-tops. His baby daughter — who is even younger than Vera, Chuck and Dave — is being torn between her parents as the divorce battle gets more lurid, or if you prefer more entertaining, by the minute.

There is good news, though. McCartney won’t have to save for a holiday on the Isle of Wight, since he could probably buy the place and still have change. And he is fitter, healthier and more youthful, even without the dye job, than he could have expected to be when he wrote When I’m 64 some 40 years ago. Because at that time, men and women who reached their sixties really were old. Growing up, McCartney would have looked at his own grandparents and seen worn and tired folk for whom life held few comforts.

It has become a lifestyle cliché of the past decade to claim that 60 is the new 40, but when you compare the expectations of modern sixty-somethings with those of their parents, it is actually the truth.

We’ve better health care, longer life-expectancies and less physical wear and tear upon us than the post-war generation. And thanks to cosmetic procedures, pensioners need look no older than people in their mid-forties. Advertisers and marketing strategists target the “grey euro” on the assumption that sexagenarians with mortgages paid off, kids reared, and a fortune’s worth of equity sitting in their neat suburban semis have money to spend on life’s luxuries, and energy to match. Lots of businesses, in fact, rely on the custom of senior citizens to turn a profit, which is why hotels offer cut-price midweek rates and hair salons give discounts to pensioners off-peak.

Meanwhile older people benefit most from positive discrimination, while enjoying legal protection against negative discrimination.

Those protections and benefits are well-earned and sensible. The wisdom and experience of years would be lost to the workforce if ageist discrimination was acceptable. Just as youth is no guarantee of mental acuity or health, passing 65 doesn’t mean an instant decline into feeble senility.

But anti-ageism measures amount to little more than lip service while we retain mandatory retirement ages in so many areas. If there was to be a mandatory retirement age for rock stars, for instance, wouldn’t you factor in the lifestyle toll and instruct them to hang up their guitars and settle down to watch television (rather than flinging them through hotel windows) somewhere around the age of 38? And yet Mick Jagger is about to qualify for his bus pass and butter vouchers, and McCartney, at 64, is said to be planning a world tour. The idea of ordering fit and talented people to give up jobs they perform well and enjoy, just because they’ve reached a certain age, seems laughable in the rock-star context — so why do we accept it for ordinary folk?

Patricia Comer was one of the first women to set up a GP practice in Ireland. She was widowed in her thirties and, with three young children to care for, had little option but to take over her husband’s practice. She’ll be 70 on August 1 and she’s been told by the Health Service Executive (HSE) that she can no longer treat her 500 medical-card patients after that date. She is not planning to go quietly. Already a petition signed by 400 of her patients has been sent to the HSE asking for a review. Ironically, if any of them want to keep seeing Comer privately they’re perfectly free to do so, but the state won’t pay for patients to be treated by a 70-year-old GP.

What’s at issue is the right to make choices — not just Comer’s right to keep on working after the state tells her she’s too old, but the right of her patients on medical cards to make the same decisions as those well-heeled patrons of her surgery who can opt to stay in her care because they have the money.

No doubt a new patient would be slow to pick a 70-year-old GP, but many of Comer’s patients are second- and third-generation. She knows them and their families and their histories with a depth that the most thorough case notes couldn’t match, and they’re entitled to that continuity of service as long as she’s up to it. If they develop concerns about the quality of Comer’s care, if they worry that she might not be up to speed on new developments or keeping up with her reading, they can always take the course that the HSE is forcing on them now — to find another doctor.

If 60 is the new 40, then Comer is a perky 49-year-old with at least another decade of active service ahead of her. In the past few years we’ve seen a number of tragic cases of medical incompetence, negligence or plain malice, none of them involving an especially elderly doctor or nurse. If age brings a presumption of medical incompetence, then the corollary benefits those lazy, arrogant or reckless young doctors who can’t see further than the end of their text books. Comer suggests regular competency tests for all doctors regardless of age and, at a time of great pressure on A&E departments and a shortage of GPs, that seems like a perfectly sensible proposal.

Touchingly, she says she’d be “lonesome” if forced to retire and “would probably die of boredom” — a common fate for active people obliged to slow down before their time. With a more flexible HSE attitude, and regular monitoring of performance, she could continue to treat her patients, ease some of the strain on the medical service, and enjoy social and mental stimulation that would make her golden years worthwhile. As Sir Paul himself sang, who could ask for more?

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