This is my first speech in the House after 15 years' absence. During those 15 years, in my endeavours to get back to this honourable House, I visited many homes in many parts of the country, and it was brought home forcibly to me that there remains a tremendous problem in the need for more care of elderly people. Many hospitals are facing the problem of obtaining accommodation for old people in local health authority or voluntary service homes.
Unfortunately, adding to this problem are cases where old people are held in hospital after treatment because relatives refuse to take them home and accommodation cannot be secured. I am sorry to have to introduce this point, but it is regrettable and very true.
The shortage of local authority Part III beds and the consequent delay in transferring patients accepted for admission is resulting not only in people remaining unnecessarily in geriatric units but also in a backlog of patients blocking general medical, surgical and orthopaedic beds.
There is an obvious lack of co-ordination between the hospital service and the public health service in this matter. Patients in hospitals waiting for admission to old people's homes should be given absolute priority over others. The present division between hospital and public health service in the care of old people should be bridged by bringing such people under the care of one authority, or at least bringing in a greater measure of co-ordination.
There is an obvious need for more old people's homes to be built. I have the great honour to be the senior Member for the City of Norwich, and in that city new homes are being provided by the city council. They are fine examples of modern design with every need being met, both at Alderman Clarke House and on Heartsease Estate, on the outskirts of the city. In each case bungalows for more active couples are grouped around the home, and assistance is available when required.
This is indeed an ideal arrangement. These homes are more like modern private hotels, and are a startling contrast to the old institutional concept. It is far better to build homes like this than to go in for expensive conversions of old houses which were not originally intended for the purpose.
Getting away from the care of old people in local authority homes and hospitals, I think we would all agree that the care of these old people in their own homes is vitally important. Adequate care of old people in their homes saves public money, creates greater happiness, and maintains health. To achieve this—and we fall seriously short today—we must have a greater extension of the home help service, home nursing, and night attendance service, allied to such excellent voluntary services as the meals on wheels service and various social service units. At the moment the standard of service varies greatly throughout the country.
Amongst the social service units which are growing up today are old people's clubs. They are springing up in great numbers, and do a great deal to ease the problem of loneliness. In Norwich we have excellent examples of these clubs. The three main clubs are called M.A.G.N.A. clubs, which is short for Mutual Aid Good Neighbour Association. These clubs were pioneered by Alderman Ruth Hardy of Norwich. They are available for use every day, and are comfortable, warm, and friendly.
What is more important is that we bear in mind that old people are independent. These clubs are run by the old people themselves, with a membership of 6d. a week. There are fund-raising efforts to provide further funds and also£and this is interesting—a grant of £70 per annum for each club from the Friends of Old People Organisation. An important and very interesting point is that senior schools are being linked to these clubs, thus providing a link between the old and the young.
Another very interesting voluntary effort which has been started in the city, is called the Friends of Old People Organisation. It was started in 1956 by the then Lord Mayor to provide support for old people's clubs in the city. Employees in various firms in the city provide 1d. per week voluntarily from their wages. There has been a splendid response. Last year it brought in £2,359.
Starting from that, a new and very interesting development has just commenced, called the V.E.P.s scheme—Visitors to Elderly People. A voluntary corps of visitors each adopts two or three old people for regular visits. At the moment about 180 V.E.P.s visit about 400 elderly people. This organisation is still growing. In this connection, great practical help is being received from the students of the city college, the East Anglia University and many youth clubs in the city. As a result of the success of this scheme a new one is to be started for young people, called Junior Friends of Old People. In both these fields of voluntary organisation there exists complete and valuable co-operation between the city council welfare department, the National Assistance Board and these organisations.
Another development which is taking place in various parts of the country is the development of Youth Social Service Units. I happen to have a boy's grammar school in my area where a social service unit was started by the sixth form, quite spontaneously and without any prompting from the masters. Already this unit helps old people by doing odd jobs, running errands, and providing general friendship. Here at home is a great challenge to youth, which I am sure will receive great response if a national appeal is made by my hon. Friend the Parliamentary Secretary or the Minister. Old people like young people, and a move on these lines, together with a development of the Norwich Friends Scheme, will do a great deal towards easing loneliness in old age.
In a few words I have tried to outline a great human problem, where voluntary service can and does achieve a great deal. Time does not permit me to give the House many examples and a great deal of the details that I possess, but I can give them to the Minister later. I trust that he will be able to assure the House that the maximum encouragement will he given to such efforts, combined with an increase in the facilities to which I have referred.
The question before the House at the moment, after the great foreign affairs debate that has taken place, is a homely one. It can be summed up in the question, "Who cares?" I should like to end by reading an extract from a letter which I have received from Alderman Ruth Hardy giving me details of the scheme for M.A.G.N.A. Clubs. She says:
The day after the first Club was opened a most unkempt and uncared for man looked hesitantly in the door. I went to him and asked him in and sat with him for tea. He later turned up washed and shaven and asked if he might come in any time. He was admitted as a member. He told me later that when he looked in the club door he had meant to commit suicide that night. He could no longer endure the utter loneliness after his wife's death … and being completely alone in the winter ahead. Not only did he become an active and acceptable member but he married a widow member and lived happily ever after.
Alderman Hardy concludes by saying:
That one case more than compensates for the work put in to establish these clubs.
That one club is a justification for voluntary effort which can be co-ordinated and encouraged particularly amongst our young people, and no words of mine can add to the appeal that is contained in that extract.
I feel that I am being almost condescending when I compliment my hon. Friend the Member for Norwich, North (Mr. Wallace) on the thorough-going survey he has given of the problems of elderly people. I wish to draw the attention of my hon. Friend the Parliamentary Secretary to one aspect which was highlighted so very well in the account given by my hon. Friend of the elderly gentleman who finished up by marrying the widow and who lived happily, if not for ever after, at least for a considerable time.
We are speaking of the problem of isolation in ald age, and of so many of the consequential problems which arise. It is particularly difficult to deal with; and I speak as one who is confronted with the problem from time to time in my professional life. By virtue of the fact that elderly people are isolated, they are difficult to discover.
I have for long harboured the hope that an enterprising local authority, or perhaps even the Government, might introduce a scheme whereby people who retire through ill-health, or who reach the age of 60 or 65, could have their names entered on a register in much the same way as we register births. They would then be available for an initial visit by a representative of the local health authority, preferably a health visitor or a representative of the Old People's Welfare Council, where that exists. In this way, having made contact with the isolated old person, it would be possible to maintain the contact and develop it.
I hope that my brief intervention will give the Parliamentary Secretary an opportunity to deal with the matter.
I welcome the intervention of my hon. Friend the Member for Wandsworth, Central (Dr. David Kerr). It is the experience of those who have worked in this sphere that there are plenty of people willing to help. The problem is that we have no knowledge of the existence of old and lonely people at the time when there are those available who are ready to help. The experience of my hon. Friend would be very welcome indeed and I hope that something will come of it.
I am sure that the House will join me in welcoming this opportunity to deal, however briefly, with a topic of such interest to all hon. Members. I am grateful to my hon. Friend the Member for Norwich, North (Mr. Wallace) for raising it and for his courtesy in giving me prior notice of some of the points he wished to raise. They are of general importance and I am sure that he will forgive me if I deal with them generally rather than referring to his observations about his own constituency and the great city which he represents.
I wish to give some prominence to two points which my hon. Friend made. The first need of old people is for a home of their own where they can manage their own affairs and keep contact with their friends and relatives in familiar surroundings of their own. The first object of the services should be to enable them to do this. Secondly, though there are statutory services which make a vital contribution, not all the load can be carried by them and there is a great need for voluntary help.
What are the stautory services? My hon. Friend has referred to some of them. The home help service is an invaluable aid which has been steadily increasing in recent years. We hope it will go on increasing. In 1963, about 355,000 cases were assisted and, of these, 266,000 were elderly people. The home nursing service supports the general practitioner with visits to the home. Of 840,000 patients nursed in 1963, nearly 450,000 were elderly. Besides these there were supportive visits by health visitors to over 250,000 old people and a great many more by other officers of local authorities on one service or another. More than 5½ million meals are served to old people in their own homes or in clubs, mainly through the agency of the Women's Voluntary Service.
"Their own homes", for an increasing number of old people, means, as my hon. Friend said, special flatlets and bungalows designed with the needs of old people in mind and provided by housing authorities or housing associations. Often community facilities are provided and these houses and flats are grouped with other housing so that the elderly keep in touch with the life around them. This is particularly important. There is a rapidly growing trend to appoint a resident warden who can keep a friendly and watchful eye on old people's needs without intervening in their daily lives.
My hon. Friend may like some figures to illustrate what is being done. There are 35,000 to 40,000 old people now living in warden-serviced housing. On present plans, the number will rise to about 140,000 over the next five years. We will have constantly in mind ways in which services can be improved and adjusted to meet the needs that further research will reveal.
It should not be supposed. however, that old age is itself a disability, or that 65 years represents a specific watershed, after which a man loses his capacity for helping himself or helping others. There are too many examples around us, in the House, in particular, for us to fall into error on that score, Indeed, when I recall that my birthday, on Christmas Day, will allow me to reach the age of 65, and that the great playwright Sophocles, wrote his greatest play at the age of 95, I feel extremely young and encouraged.
It is with those on whom infirmity has fallen earlier than the normal age of retirement and those of much more advanced years with whom our statutory services are most concerned. These are the minority, though their numbers are growing as more people live to a greater age. But there are many more to whom infirmity alone is not the burden. The essential burden is, as my hon. Friend said, isolation or loneliness. These people, too, the statutory services can help, and any visits paid by the members of these services help to maintain social links.
It would be wrong to overlook the valuable support given by the National Assistance Board officers in the course of their visits to elderly people. For those who can get about or can be brought together by car, there are thousands of clubs and day centres provided by local authorities and various voluntary organisations throughout the country. Where day hospitals are provided there is also an important social element.
Pre-eminently, however, there is scope here for voluntary service. I was delighted to hear my hon. Friend strongly stress the part that voluntary service can play. There are many whose contacts are inadequate, either because they cannot often get about, because they have become infirm or just because they are too timid or shy. Often they are without relatives and sometimes they have outlived their friends.
Systematic good-neighbourliness can be of immense benefit. Often neighbours can perform small services that make such a difference. To give a small but important example, it can make a crucial difference if someone ensures that an infirm old person is warm by getting in the coal and making up the fire.
There are, of course, long-established organisations whose object is precisely to help those who need support. It seems invidious to mention only some of these organisations, but the best known are, perhaps, the National Old People's Welfare Council, to which more than 1,000 local committees are affiliated, the Women's Voluntary Service, pre-eminent in meals service, and the British Red Cross Society. However, still more friends are needed, not only for those who plainly have some need which they cannot satisfy themselves but for those who have no special claim to make except that they are lonely and alone.
My hon. Friend points particularly to the help the young can give and do give to the old. My Department is studying ways in which the much that is already being done can be further stimulated. I do not think it is realised how much is going on unpublicised. Every major local authority has the task of stimulating youth activities and can well act, with local voluntary bodies such as councils of social service, in stimulating the interest of young people in this sphere.
King George's Jubilee Trust published last year an excellent pamphlet on "Opportunities for Service" which I commend to hon. Members, and other people who are interested. It describes some of the activities carried out, some of them organised by schools, some by youth organisations. A good deal of interest has recently been stimulated by the activities of Task Force 64, whose founder, Mr. Steen, is tapping the exuberant energies of youth clubs in the service of the older citizens.
All this is welcome evidence, if we needed it, that the overpublicised delinquent or prematurely affluent do not represent the true quality of our young people or their willingness to discipline themselves in the service of others.
I turn to the second main issue raised by my hon. Friend. When health fails or infirmity prevents the elderly from caring for themselves adequately at home, the hospital and welfare authorities provide—or rather aim to provide—an alternative home. Some 55,000 or 60,000 elderly people are likely to be in hospital at any time—apart from those who are acutely ill—and some 80,000 or 85,000 in welfare homes. There are plans to expand the numbers of places in both as the elderly population grows, and to make good the deficiencies in various areas. These plans will change and develop as time goes on and certainly should have high priority.
My hon. Friend, however, really draws attention to a problem within the problem. The number of the elderly who survive to greater age—the eighth and ninth decades—is increasing. As it does so, their numbers in hospitals and homes grow disproportionately. A broad band of patients and residents are seen to have similar needs and the hitherto broadly accepted functions of both types of accommodation come into question.
To some, the answer lies simply in transferring people from one place to another. But this could often be inhumane to those who have learnt to live in an accustomed way and might and could merely lead to deterioration. And to what end? To others, it is simply a matter of transferring the whole responsibility from one body to another. With what prospect of success in the measurable future?
Nor is my hon. Friend's suggestion of a separate old people's service under a unified management really as attractive as it sounds, for it would tend to divorce the geriatrician from his specialist colleagues, to the detriment both of the doctors and their patients, and the local services for the old from local services in general. If nothing else, economy of staff would be unlikely, and that would be a problem. Clearly both the hospitals and the local authorities are in a real difficulty.
My Department has been studying the possibility of further guidance which will help to resolve it. There is no easy answer. Whatever help can be given, it is certain that local solutions will have to be found, and not central ones. I stress this, because in many areas I have no doubt the right kind of co-operative relationship is already established, and hospitals and local authorities work their way patiently and conscientiously to a settlement of consistent policies and plans. I know that my hon. Friend appreciates this point. This is needed in all areas—not central intervention.
Finally, I pick up a point my hon. Friend used in writing to me. It is true, as he said, that many old people stay in hospital until they die. I must add that many also live out their last years in welfare homes. The implication is that they do so alone. Despite the devotion of the staff many must indeed feel friendless.
I make no apology for saying again that here as well as in the community there is great scope for voluntary help, including youth service. Every hospital has or can have a link with the community through the Leagues of Hospital Friends which can do immense good in this way, besides helping to provide amenities as they always do. Many welfare homes now have similarly organised groups of friends linking up with old people's welfare committees. Both kinds of organisation will surely welcome the help of young people who can be just as helpful there. Hospitals and homes also can provide opportunities for the project type of help which may particularly attract young people and enable jobs to be done for the benefit of patients and residents who otherwise have to wait too long.
I give two examples. A group of school children in the Wirral, with help from a Territorial Army unit and hospital staff, have cleared waste land at a hospital in a series of one-week camps to provide a small park for elderly patients. The second example is that a group of police cadets worked on an access road to an old people's home to enable the old ladies to get out to town more comfortably. I could quote scores of such instances and I know that every hon. Member could also do so. Therefore, I assure the House that my right hon. Friend and I are very much alive to the issues which my hon. Friend has so cogently put before the House tonight and we are grateful to him that he has done so.