This is a good time for us to talk about social isolation and loneliness. During the festive period, many people will have been alone and thinking about what the year ahead holds, and given what we heard during our inquiry into age and social isolation, we know that, for many people, there will be nothing to put in the calendar for 2016. We also know about the terrible impact that that will have on their physical and mental health.
The Equal Opportunities Committee agreed to launch its inquiry into age and social isolation because we had already heard about the isolation that is experienced by both younger and older people in Scotland. We had an idea of who might be at risk of social isolation, but we had not expected to hear about the extent of the problem or the terrible health impacts.
Our inquiry led us into communities where people are working hard to combat isolation in both urban and rural settings. We visited Easterhouse and Islay, and I thank those communities for their valuable input to the inquiry. We realised as a committee that, for all the people who are in touch with projects and services, there are many who are not being reached. For those people, loneliness is a long-term issue that has no end in sight, and they also have to contend with the stigma of loneliness. They were ashamed to admit their situation and had lost the confidence to do anything about it. Many reported to health services such as general practitioners and accident and emergency departments when professionals knew that the underlying problem was loneliness.
We discovered many important things about people’s experiences, but what I would really like to mention before I move on to the detail—and what everyone should remember about this topic—is the terrible effects of extended loneliness. We have to stand together and say that it is not okay for anyone to suffer this kind of isolation no matter what their age is, and we must acknowledge the impact that it has on our communities and our health and social services.
Jane Kellock of West Lothian Council explained how important it is to think about how services are provided. She said:
“When systems break down in such a way that we disconnect from others, or when life circumstances come along—we might lose people we are close to, for instance—we need to be able to respond to that in a human way, rather than stigmatise people or further isolate them by treating them as if there was something wrong with them as individuals.
All the agencies in the partnerships around the country need to be responsive to that and to consider the structures of how we deliver services, how we make contact with people and how we speak to them on an individual basis. That is all very important for keeping our communities connected.”—[Official Report, Equal Opportunities Committee, 23 April 2015; c 7.]
I cannot emphasise enough the issue of the health consequences of spending time alone without contact with others. We took very seriously Age Scotland’s point that the
“need for contact is an innate human need in the same way that feeling hungry or thirsty or tired or in pain is.”
The health consequences of isolation are shocking. Michelle McCrindle from the Food Train told us:
“Research has found just over 10% of over 65’s are often or always lonely with that figure rising to 50% for the over 80 age group. Similarly, research has also found that just over 10% of over 65’s are at risk of or are malnourished”.
The member mentioned stigma, but she has also mentioned just how widespread the problem of isolation is. Does she agree that it is a very widespread problem, that it is common right across Scotland and that we need to take it very seriously?
Yes, I totally agree with the member on that. The problem is widespread across Scotland and covers all age groups.
Ms McCrindle also said that the Food Train does not think that it is a
“coincidence that the same number of older people are affected by malnutrition and loneliness,” and that in the Food Train’s experience
“the two are interlinked, which also means they can be successfully tackled together.”
We heard from the Institute for Research and Innovation in Social Services that people who are lonely are more likely to have health issues such as high blood pressure, poor sleep and depression. For older people, there are proven links between loneliness and poor health, including dementia rates. We also heard that, on average, socially isolated individuals are twice as likely to die prematurely and that they make poor choices on, for example, inactivity, smoking, alcohol use and diet. The Health and Social Care Alliance Scotland told us that people who experience loneliness are more likely to visit their GP, have higher use of medication and a higher incidence of falls, undergo early entry into residential or nursing care and use accident and emergency services more.
I have mentioned the commitment to tackle the loneliness that we uncovered, which is so important. Instead of finding that everyone was ignoring the issue or did not believe that it was important, we heard about many initiatives to tackle it. However, we felt that even more could be done, because all the projects and services told us that there were many people who, for a variety of reasons, they did not manage to reach. Without national prioritisation of the issue, we feel that there cannot be the large-scale improvement that we need to see. We recommended a strategy because we recognised that the issue of isolation has to be integrated into planning and services for things to really change.
We have noted the Scottish Government’s response to our recommendation that a national strategy should be developed. We recognise, as the Cabinet Secretary for Social Justice, Communities and Pensioners’ Rights stated in his response, that it is important to strengthen individuals’ connections and resilience and that that work rests on the skills, trust and obligation of front-line workers and ordinary citizens. The Scottish Government considers that that work is very hard to manage from the centre and that, consequently, a strategy might not have the impact expected.
However, as a committee, we are committed to ensuring that there is a response to what we see as a worsening situation that has such a huge impact on so many members of our society that it is difficult to see how we can achieve better outcomes without a strategy. I take some reassurance, however, from the Scottish Government’s commitment to take more evidence on what works in addressing social isolation and loneliness, and from the fact that it is looking to build that more explicitly into public services.
Yes, I totally agree with that. It is also important that the Equal Opportunities Committee continually keeps an eye on the situation later.
Mapping is also important, as is the work that is being done to look at prevention and the links between statutory and third sector services under the work that is being done to support community planning partnerships. We know how important prevention work is. In fact, what we tried to promote in our report could all be seen as prevention work. That is why we see it as so important.
The Equal Opportunities Committee should have a role in engaging with the Scottish Government on how those developments will help to keep the issue of social isolation and loneliness at the forefront of services and how people in those services respond to the needs of lonely people. The Scottish Government has said that it does not want to bolt anything on to existing policies. It will be the work of the Parliament and any future Equal Opportunities Committee to ensure that work is taken forward and to find out what has been achieved at a strategic level. We cannot stand still. The response to our report and the level of engagement with the committee on the issue make it important for us to listen.
The committee thought that a national publicity campaign was important because of the stigma that is associated with loneliness and to show what communities can do. We heard from witnesses that people were so ashamed of their lives that they had lost the confidence to seek help. Services have encountered that.
We also wanted Scotland to have a national campaign so that we could tackle existing perceptions. As a society, are we prepared to accept that so many people are alone and are not able to participate in society? Do we think that it is acceptable for people to be so lonely that their mental and physical health is badly affected and that so many people are not reached even by established services?
We need a lack of acceptance—zero tolerance—of social isolation so that we can change our thinking and tackle the problem. Best practice has shown us that lives can be changed, sometimes with very small, but intelligent interventions. The Scottish Government has told us that it will work with stakeholders to consider what innovative approaches it can use to raise awareness of issues around loneliness and the role that communities can play in addressing it. As a committee, we can only encourage that work. We hope that the Scottish Government will keep us informed of progress.
I turn to the situation that many young people face. The committee thought it very important that we should not just focus on isolation and loneliness for older people. We had already heard about extreme isolation during youth homelessness work, and some of the informal sessions that we used to set up the inquiry left me with stark evidence about what early isolation can do to a young person.
There were three very important areas of evidence for young people. First, bullying because of a person’s identity can cause social isolation that endures well into their life. It can deskill them and isolate them from many positive experiences. Discrimination starts a chain of events in a person’s life that affects confidence and reduces the chance of positive outcomes in later life.
Secondly, unacceptable behaviour around people’s identity should be explained to the perpetrators. That might sound obvious, but we heard from front-line youth workers that smart work needs to be done to explain to those who harass and exclude the terrible impact of their behaviour.
Thirdly—this leads on from that point—peer-to-peer support and initiatives are key. That came through in evidence, particularly from Enable and Roshni, in which it was clear that, if steps to tackle social isolation are to be taken seriously, they should begin with young people working with other young people to skill them up and support the connections that many of us have taken for granted.
I was glad to see in the Scottish Government’s response that it supports anti-bullying work and that it agrees that much stems from that. Enable highlighted with us the importance of staff confidence in schools. Things need to be tackled head on. Equalities training is very important for staff, and it is important for children to know their own rights. We look forward to the revised anti-bullying guidance, which is due to be published this year.
One of the most important areas of work that we explored was the idea of a link worker system in which someone is able to signpost people to services that might support them. We believe that that link between services and projects in communities is essential to moving things forward and building connections for people.
Advances have been made in social prescribing, by which a general practitioner can refer patients to local services as an alternative to treatment or statutory support. We were greatly encouraged by the work of the deep-end link worker project, which allows a link worker—who is often from a community development background—to be based in a GP practice. We were very glad to hear that that programme is being evaluated by the University of Glasgow, and we look forward to the Scottish Government sharing the final report.
There are many individuals who clearly made their mark in the committee’s inquiry. I want to quote from two of them directly. Contact the Elderly told us about its monthly Sunday tea parties and said that the event was sometimes the only entry in a person’s calendar. One client told them:
“I’m really looking forward to going to the tea next Sunday. I haven’t been out for 7 weeks.”
Who Cares? Scotland told us about a young person who used its service. He said:
“I have seen other people who have left the care system end up in tenancies where they have ended up being all alone. The loneliness has meant they haven’t been able to keep up a job or have become homeless after losing touch with those they used to be close to. When they started preparing me for leaving care I was really worried about ending up with no one. I have seen how devastating this has been for people I know.”
We believe that our inquiry has been the first of its kind by any Parliament anywhere in the world. Many of us were moved by the evidence that we heard and persuaded of the need to address the social consequences and health implications of loneliness and isolation. I stress that this is not a lightweight report to be politely noted and then put on the shelf. There is a compelling case for change, and it must be heard.
That the Parliament notes the conclusions and recommendations in the Equal Opportunities Committee’s 5th Report 2015 (Session 4), Age and Social Isolation (SP Paper 816).
I thank Margaret McCulloch and all the members of the Equal Opportunities Committee for their inquiry into age and social isolation. This is a great opportunity to respond to it. It was a very positive exercise and is a very welcome contribution that is also timely, not least because of the festive season, as Ms McCulloch’s highlighted in her opening remarks.
The report has raised important issues about how widespread social isolation has become across all levels and ages in society, including how it can affect and damage a person’s sense of belonging, their empowerment and their contribution to society. Alienation is a word that is often used in the context of discussions about Jimmy Reid’s contribution and Harry Burns’s sense about work, but it also applies to society, with the same risks.
To its credit, the committee has been praised for its inquiry, with what Age Scotland has called the first parliamentary inquiry to be carried out specifically on isolation and loneliness anywhere in the world. I would join in that praise.
Alongside the constructive recommendations and evidence in the Equal Opportunities Committee’s report, there is a strong moral case for tackling the issue. We are social creatures. A lack of social contact hits people across the board with poorer health and a shorter lifespan, and it makes it harder to follow through on good lifestyle choices that could have beneficial impacts.
There are not any quick fixes—let us agree on that. Everyone in Scotland has to be committed to addressing social isolation and to taking tangible, measurable actions against it.
To begin, we must consider the differing needs of age groups in society. For example, there are the implications for and complex needs of our ageing population, which are only projected to continue. Twenty per cent of children born today—I repeat, 20 per cent—will live to be 100 years old, the statisticians tell us. Our young population has a whole range of ways of communicating and interacting socially that previous generations did not. Among the young there is a strong emphasis on technology and virtual contact, but it can have negative and positive impacts on social isolation. Changing working patterns, family patterns and social patterns also cause our forms of interaction to change, as indeed they always have over time. What we must do is adapt.
The good news is that we are together on the need to bring about greater community. That is a very helpful place to start. From the Parliament and its members, the passionate people who contributed evidence to the committee’s report, those in public services, communities and the ordinary and, frankly, extraordinary people who, with good will, are trying to make a difference, there is already a collective sense of willingness, commitment and social obligation to tackle the issue. Leaders, organisations, communities and individuals want to work together to capitalise on what they are already doing that is good; they also want to learn from that and to share it more widely.
I want to outline our strategic approach to the committee’s recommendations. We will endeavour to build this strand of work into all of our on-going, broader programmes and the frameworks that are already in place—I am referring to the Government’s purpose and objectives, the national outcomes and the overarching approach to public service reform—because we recognise the issues that have been raised. Community planning partnerships and the health and social care partnerships, which Margaret McCulloch highlighted, have an important role and will be included. We can create an integrated approach to the specific issues of age and social isolation, as with all the other things that those partnerships have been set up to tackle. They exist to tackle the problems that no one service can tackle on its own, and they have developed considerably in their efficacy over the years for which they have been in place.
Under the Christie principles, we recognise the need to alter the balance of public services and to move away from crisis intervention towards more preventative approaches. That is an article of faith around the Parliament, and I am glad of that agreement. Tackling isolation before it leads to further harm is a perfect example of preventative action. Around Scotland, we have an ever-clearer view of what works in public service design and delivery and the challenges ahead. In all our work, we will drive things forward through a Scottish approach, which involves working in partnership rather than having experts who are detached from lived experience dictating from on high. That approach itself recognises the value in relationships, networks and the input of people who make up the communities. Health and fulfilment lie in attachment to others, to society and to having a life with purpose, but that attachment also informs what we do and it should inform good policy making.
The findings of the Equal Opportunities Committee’s report will be included in our fairer Scotland discussions and the subsequent social justice action plan. People with direct lived experience of various forms of exclusion are helping the Government to shape the way in which we deal with social justice. That will be true in respect of the literal form of exclusion that we are discussing, just as it is true of financial or any other form of exclusion. The people who have lived the challenges that we want to solve are the ones who are best placed to tell us the answers.
As we go through some of the main recommendations in the committee’s report, several jump out. A key recommendation is that the national social isolation strategy should be “integrated within all policy”. We completely agree that the changes that are needed for mainstream services to respond to isolation in a human way must be embedded in the approach and planning of a wide range of services, including health, education, housing and transport. We want our social justice action plan to have that same broad reach, and I believe that our forthcoming action plan can fulfil that role by making social connectedness an important element.
In connection with the two recommendations on the need for more evidence, we have committed to commissioning research and publishing findings in summer 2016 on how widespread isolation and loneliness are and on identifying those who are most at risk. That will include analysis of the association between social connectedness and a wide range of important physical and mental health measures, which will provide further rigorous evidence on which to base further action. As well as recognising what the problem is, as I think we all do, we must try to get insights into how we can start to tackle it and what works. In December 2015, NHS Scotland published a review on social prescribing in the context of mental health problems that looks at the benefits of linking systems much more widely.
I want to move on to the issue of a publicity campaign to raise awareness of social isolation. We certainly intend to work with our stakeholders and partners to consider what approaches we can use to raise awareness across communities and to tackle the stigma. A documentary called “The Age of Loneliness” that is to be shown on BBC 1 on Thursday night sets out to present the issue and will do so to a wide audience. I would love to claim the credit for that timely presentation on the television but I cannot, which again goes to show that the Government does not have the arm to reach into telling the BBC what to do.
Indeed—and long may that remain so.
On the ground, there has been a surge of willingness from third sector stakeholders to be involved and to share good practice in this area. There has also been a momentum, which has been highlighted by the festive season in particular, behind the idea that no one should be isolated socially.
We were also asked to share what has been learned from the deep-end evaluation and to include link worker systems in a national strategy. The University of Glasgow is evaluating the programme and we will share the final report at the end of 2016. We will consider very seriously expanding our approach once we have seen the evaluation. That is the sensible approach to take—to look at the evidence and to refine practice on that basis.
There is a lot more to report on what we are doing and what we are committed to doing on volunteering, transport, housing, health, health and social care partnerships and digital inclusion—and whatever anyone else cares to name. It is a big topic that is hard to sum up in 10 minutes, but it is a worthy one to which to devote an afternoon’s debate, so that we can explore all the issues.
The time is right to take action. The inquiry is timely. It has given us a substantial challenge and we want to continue our partnership approach to share some of the great work that is out there and to get more of that happening. It is a chance to ensure that Scotland is different, to tap into the groundswell that is out there and, through concerted actions, to ensure that vulnerable, socially isolated people, regardless of age, have the support that they need to be connected to the services and communities around them.
I am a minister for two areas, one of which is community empowerment. I want to ensure that everybody can be part of a community, so that those communities can be empowered.
I thank the committee very much for its inquiry and all the clerks and members for their work. I will start by picking up a strand that the minister threaded through his speech about Scotland being different as regards social isolation. I perhaps misinterpreted what he said, but I am sure that social isolation in our communities, and certainly in my community, is not specific to Scotland. We may want to take a much more innovative approach here with the powers in this Parliament, but I am sure that such isolation is not particularly experienced in this country alone. However, it is, indeed, a sign of our society.
In the lead-up to and over the Christmas period, I was taken by, first of all, John Lewis’s television advert, which pulled at people’s heartstrings and got to the point of social isolation and loneliness. However, it was Age UK’s campaign on the back of that advert that most struck me. The campaign appeared on my Facebook newsfeed. I noticed that friends of mine and people across my community in Dundee were signing up to go and visit elderly people in their houses. I then began to wonder about the societal bonds that have meant that it takes such a campaign to instigate such action by people. It took me back to years ago, to when I was a young child and my father took me to visit some of the elderly parishioners in our church and how delighted—I think—they were to get a visit from a young family in the parish. That led me to think about the bonds of inclusion. Those are very much alive in our churches, our trade union movement and our political parties. Such organisations bind together people of all ages and form networks and events for people to attend. I was glad to see that the campaign was so successful and that it had used social media to foster those bonds again and to get people returning to a routine of visiting and going into peoples’ homes.
I am very much looking forward to the short election campaign in April. Every member across the chamber, I think, will recognise as I do that one of the great privileges of campaigning is, as a candidate, going to someone’s door, especially that of an elderly person, and being invited in, and seeing that they are glad of that five or 10-minute visit.
That gets to the nub of the debate, which is about how we achieve the infrastructure in our communities that allows people to feel free and willing to do such things. The Facebook campaign showed that a lot of people want to do such things; we need to provide the infrastructure, which I think—if he does not mind my saying so—is what the minister meant when he talked about taking an innovative Scottish approach.
One of the things that jumped out at me from the Age Scotland briefing is the sentence that says:
“Though the State is not primarily responsible for the quality of people’s personal relationships, it does often have to deal with the consequences where these break down or are absent.”
That is where the budget implications and the human cost come from. As I said, the state is not primarily responsible for relationships, and I do not think that people want it to be primarily responsible for them, but it needs to support the infrastructure that allows people to have stronger bonds in their communities.
When I prepared for the debate, a figure jumped out at me from the Office for National Statistics and a longitudinal study of ageing that says that 34 per cent of those aged 52 or over say that they feel some loneliness. Among those aged 80 or over, that figure rises to 46 per cent. Nearly half of our citizens who are over 80 say that they feel often or always lonely and cut off from society.
Does the member recognise the issue, which the committee addressed, of the difference between isolation and loneliness? Isolation can be measured to an extent, but loneliness is much more difficult to pin down.
I absolutely agree with John Mason, who sat on the committee and heard the evidence. As I said to the minister, the Government has a role in supporting the networks and mechanisms that ensure that people are not socially isolated.
I was coming on to the committee’s recommendations, some of which are very good—
I am glad that Alex Neil has responded to the recommendations and put the focus on services and budgets. We need a commitment from the Government—I think that the minister was going in this direction—to providing the infrastructure that will give support.
I am glad that we are having the debate. Health and social care integration provides an ideal opportunity. The multidisciplinary teams that work in our GP practices, which follow up patients once they pass a certain age and which try to prevent a lot of ill health, can really have a role in addressing social isolation. I look forward to the rest of the debate.
All the razzmatazz of Christmas has come and gone. Some memories will fade, as with some presents, such as the jumper that gets lost at the back of the wardrobe, but other images will stick with us. Like Jenny Marra, I found poignant the television advert that features an elderly man on the moon who is alone in the festive period. A young child sees him and sends him a telescope so that he can share in the young child’s Christmas. Ultimately, that is an image of someone who is isolated and alone.
Professor Mima Cattan defines social isolation as
“an objective, measurable state of having minimal contact with other people, such as family, friends or the wider community.”
That is a chilling definition that should trouble everyone in the Parliament.
It is our duty in the Parliament to always have an eye on how we can go one step further. Can we go further than the child in the TV advert? The Equal Opportunities Committee has already gone one step further and it is an impressive step. I thank my committee colleagues, our excellent clerks and all the other participants for contributing to such a useful and powerful report.
I hope that the member recognises that to be alone is not necessarily to be lonely. For a small minority of people, being alone is a choice that they prefer to make.
That point is well made and is acknowledged in the report.
I return to the significance of the report. Age Scotland considers that the committee is the first ever to set up an inquiry into social isolation, which demonstrates that the Parliament is taking the issue seriously and that, together, we are attempting to understand it better.
Sadly, social isolation exists all year round. It can affect everyone, regardless of age, background or mental or physical health. It can have a corrosively negative impact on lives, particularly among older persons, looked-after children and groups that face prejudice because of their ethnicity or disability. Social isolation is this century’s new malaise; it is a contemporary disease. It is usually invisible, depressingly widespread and progressively debilitating, and it is as prejudicial to health and wellbeing as many diagnosable clinical conditions. It does not affect just one group but impacts on the lives of many, and for those whose lives are so blighted there are multiple consequences.
In our communities, there are now patterns of lifestyle that were unknown even 20 years ago. Individually and collectively, those contribute to weaker social engagement and social coherence. However, although that may explain why social isolation is a significant social issue, it can never be an excuse for it. We can develop positive measures to help those who are at risk, and we owe it to them to do that urgently. The Parliament must be proactive.
In 2014, 16 per cent of the Scottish population was aged 65 and over. When we factor in that 80,000 of those who are aged 65-plus in Scotland describe themselves as often or always feeling lonely, we can predict that social isolation will increase in the future unless we act now. There is and will be intensifying pressure on our national health service and social services as a consequence of the condition.
In Parliament, we have all agreed to the health and social care integration plan, and we agree that general practice needs to be reformed to accommodate the changing demographic. Those are two vital developments in seeking to identify and combat social isolation. However, Audit Scotland has repeatedly raised concerns about the progress of the development and implementation of the integration of health and social care, and I do not think that we can ignore that flashing red light.
Having said that, it would be wrong to suggest that the integration of healthcare and social care is the complete answer—it is not. The committee found that an holistic approach is needed to tackle social isolation because health, housing, education and transport can all play a vital part in providing solutions. That is why the committee called for a national approach.
The Scottish Government has rejected such an approach. It may surprise the Government to learn that I have some sympathy with its view because I believe that a one-size-fits-all approach has its weaknesses. Nevertheless, the Scottish Government must explore how we can deploy our resources within an holistic approach. The Government may not want a national strategy or a national advertising campaign, but I think that we need an holistic approach if we are to find solutions.
We need to work much more closely with the third sector to develop crucial local services. We also need to look at transport issues and the impressive field trials, which we were made aware of, that could be introduced to general practice not only to identify those who may be socially isolated or at risk of becoming so but to inform and educate those people about the services that are available to them. However, that assumes that they can get to the GP or health centre and that they can access the services once they are aware of them.
In conclusion, I think that an holistic approach is required to tackle social isolation. I am fairly flexible about how the Scottish Government wants to interpret that, but increasing our understanding of what is effective in this crucial area is of the utmost importance.
We have taken the first step in holding an inquiry and having a debate. I think that that will provide a positive and fruitful contribution to how we approach the issue and anticipate what we may bring forward in the future to support those who find themselves socially isolated. Further steps are urgently needed to alleviate this devastating condition, but I detect that there will be a willing political consensus in the chamber to support such initiatives.
I am delighted to have contributed to the Equal Opportunities Committee’s inquiry into age and social isolation as a full member of the committee, and I add my thanks to all those who participated in the inquiry, including the clerks and the Parliament staff who participated in the launch of the inquiry report. That was a fantastic and important event, which the media attended. I also thank those individuals and organisations who made oral and written submissions to the committee.
“We have not been able to find another inquiry at any other parliamentary institution anywhere in the world that has specifically considered isolation and loneliness.”—[Official Report, Equal Opportunities Committee, 26 March 2015; c 17.]
It is right to repeat that, as we should be proud of it.
Annabel Goldie touched on that fact. She said that she was glad that our strong parliamentary system delivered this kind of proactive inquiry, which in turn will strengthen our society and our urban and rural communities. Sometimes the value of Parliament’s committees can be questioned, but it is important that we can do different kinds of work, such as proactive inquiries like this, to see what kind of society we are and what kind of society we want to be.
We looked at the impact that social isolation and loneliness has on people’s lives in modern Scotland. We acknowledged first how much organisations, groups and individuals are doing already to tackle social isolation and loneliness across our rural and urban communities. We met many young and old people on our travels and spent a few days in Islay. I truly fell in love with the place. The welcome that we received was tremendous and, when the weather stopped us going to Jura, the people of Jura came to us.
Reading the report, members can see how much of a challenge it is for young and old people to live remotely, and they can also see how some of our more remote communities deal with that challenge. Joan Richardson told us how the Jura Care Centre group started in 1996 and told us about the impact that it has had and continues to have. It helps older people to join in socially, attend clinics regularly, go to the GP surgery with ease and mix with people of different ages, which is important. It is now the focus point for the community. If members want to know how it has become that, I encourage them to take a trip to Jura.
Members could also take a trip to my town of Westhill, a few miles from Aberdeen. Westhill was the first community in Scotland to adopt the Australian model of a men’s shed. There is no gender balance when it comes to social isolation among older people: generally women have a better circle of friends outside of work and are better at socialising. However, best practice is out there and is replicated across the United Kingdom. The example of Westhill Men’s Shed is now followed everywhere. It is a great concept. Maybe more important, it is proof that the people who suffer from loneliness and isolation are themselves the best people to create and develop solutions to tackle the problem. From the start, Westhill Men’s Shed was created and delivered by the people who use it. They needed support, of course, and they got it from the community, Aberdeenshire Council and other organisations that offered it.
Let me be clear: empowering people is the answer to the problem. Westhill Men’s Shed applied for one of the first community asset transfers in Aberdeenshire, to use a disused building as its new home. The minister is right to say that the new Community Empowerment (Scotland) Act 2015 is bringing together public authorities and community bodies to work on action to improve local outcomes and reduce inequalities. It is important to see how that can work in urban settings as well as rural settings.
There is a lot of good practice and there are a lot of good ideas out there. I am pleased to say Aberdeenshire is leading the way. We heard from Karen Nicoll, the chief officer of Aberdeenshire Signposting Project, which is an interesting model that provides a link to services and receives a range of referrals, including from GPs. We have heard already in the debate today about the importance of social prescribing. GPs are now referring patients to local services as an alternative to treatment or statutory support. That is so important: GPs used to treat illnesses; they went on to treat patients; and now they are treating people. Things are very much people centred now, and that progression will help tremendously to change attitudes around social isolation and loneliness.
In my mind, our role as politicians and as a Parliament in tackling social isolation and loneliness must be about how to design the society in which we live. I truly believe that, in the past 50 years, we have stopped planning for our villages and towns to be the best places to live and, instead, we let promoters and developers shape our homes, our streets and our communities. It is so important that we tackle that issue of planning the best places to live.
I am proud that the Parliament is, so far, the only Parliament in the world that has specifically considered isolation and loneliness.
I accept John Mason’s point that social isolation is objective and loneliness is subjective, but we all realise that there is a big overlap between the two and that those who actually seek social isolation, whom Stewart Stevenson referred to, are surely a very small minority.
Social isolation is a problem and, if we look at the numbers, we can see that it is a very big problem. I was struck by a recent headline in the Edinburgh Evening News that said that more than half of Edinburgh people never have a feeling of loneliness, with the article saying that that is better than anywhere else in Scotland. However, what struck me is that that still means that an awful lot of people in Edinburgh have feelings of loneliness. We should accept the figures that Margaret McCulloch gave that 10 per cent of over-65s and 50 per cent of over-80s—fortunately, we will have more and more of them in the future—often or always feel lonely. There is a big problem.
We know about the emotional and psychological dimension, but I was struck recently by the impact on physical health. There has been lots of evidence on that. In fact, just yesterday, I retweeted a tweet by a consultant cardiologist who was highlighting the issue in terms of stroke and heart disease and referring to other illnesses. We have to take account of that aspect of the issue.
Sticking with older people, it is clear that the issue can be triggered by the loss of a loved one or even by retirement and the loss of social networks as a result. It is a problem that we have to address, and it is important that we have lots of community initiatives to do so. I will mention two good examples in my constituency. One is the Pilton Equalities Project, which focuses on older people. It provides a great deal of accessible transport to take older people to activities and it has a befriending service, five day care clubs in north Edinburgh, a weekend resource group for people over 50 who are feeling isolated, and a visiting and information service to take the community to older people who are otherwise unable to access community facilities.
I emphasise that organisation because of the work that it does and because it is facing a 15 per cent cut next year. We do not want to turn the debate into one about local government finance, but we cannot ignore that reality.
Many of the excellent voluntary sector initiatives that address the issue are funded by local government. Another one in my constituency is the Leith community connector project, which is based at the Pilmeny Development Project in Leith. A community connector is a supervised volunteer who works with appropriately matched socially isolated older people for a time-limited period in order to facilitate social connections.
That is a key idea. Recently at the cross-party group in the Scottish Parliament on health inequalities, we heard about the community connections project in Glasgow, which is funded under the new integration arrangements and which connects vulnerable older people to services.
We have also heard about the deep-end GPs in Glasgow, who have link workers who link people to services and initiatives in the community. This is a crucial area of activity for the new health and social care partnerships and, as the report from the Equal Opportunities Committee emphasises, appropriate housing is an important part of that. It clearly should be part of the work of the integration authorities.
The issue is not just about older people so, halfway through my speech, I will move on to children. Loneliness is a major issue for children, as ChildLine told the inquiry. One of the saddest comments that I came across in reading the material in the report and the evidence was Margaret McCulloch’s reference to the fact that some children have American accents because they relate to their computer rather than to anybody in their family environment. That is a very sad situation.
Prevalence studies tell us that loneliness peaks at adolescence, and young people in care are particularly affected. Therefore, there is a crucial role for schools. Obviously that involves addressing issues such as bullying, but it is wider than that. Schools really have to be sensitive to young people who are socially isolated. Those young people suffer mentally and physically because of that, but I am sure that it also has an effect on their education.
Social media is relevant. I certainly appreciate its positive elements but, as the committee reminded us, we must also consider the negative aspects. In relation to young people, we are all aware of those. Cyberbullying is the extreme example, but we must examine social media carefully from the perspective of social isolation.
Of course, social isolation affects all age groups, not just the young and the old. Vulnerable first-time mothers can experience feelings of loneliness, which is why projects such as home start are important. Migrants in particular can experience them, and projects such as living in harmony in the Pilton area of my constituency are important in addressing that.
The issue can affect everybody. That is why building up social networks and social capital in the community is crucial. The voluntary sector is at the heart of that. Volunteering is critical to it because volunteers can connect with people who are isolated. They have an important role to play. I must refer to funding, because much of that work depends on funding, particularly from local government.
The committee makes important recommendations on
“a national strategy … integrated within all policy considerations”, which I am sure everybody supports, and about research and the publicity campaign. I welcome what the minister said about those. We look forward to what the research tells us about identifying the people who are most at risk and the relationship between social connectedness and the health issues that have been referred to. I hope that the publicity campaign will be modelled partly on the see me campaign in terms of addressing stigma but will also highlight the contribution that people can make to addressing the problem.
One of the first challenges that we had in the committee was to come up with a definition of isolation. Members can see in paragraphs 5 and 6 on page 1 some of our thinking about that. For example:
“Professor Cattan considers that whilst it might be possible to measure social isolation, the feelings of loneliness are personal and individual and therefore more challenging to measure objectively.”
However, we found that some witnesses used the terms interchangeably and, for the purposes of the report, we decided to consider both.
As Stewart Stevenson suggested, one person can enjoy their solitude while, in similar circumstances, another person can feel lonely. A minor example of that is, when the committee went to Islay, most of the members and clerks stayed in hotels but I stayed on my own in a tent. That was because I enjoy that and love being on my own. We all got together at certain times.
In recent years, there has been a strong commitment to keeping older people at home and providing them with the care that they need there. Most members across the parties support that concept. However, one of the lessons from the report is that one size does not fit all and home is not always the best place for someone to be.
My mother is 88 and getting quite frail but can still get out under her own steam to the hairdresser and some of the shops, and friends and family visit regularly, so I agree that the best place for her to be is still at home. However, there can come a stage when someone cannot get out at all and they perhaps have very few visitors because their friends are elderly or no longer with them and family may live at quite a distance. In that case, it may be best for an older person to be in a care home or similar setting where there is more company at hand and care provision is also nearer by.
I used to work for a group of care homes. It was not unusual for an older person’s health to improve when they came into a home and got more company. As a by-product, it often took pressure off family members.
I hear what John Mason says about the appropriateness of people staying at home or going into care but does he agree that there is another group of people who could be sustained in their homes with suitable care? It does not have to be a massive care package, but there is an issue about care being so threadbare that we are driving people towards the care home option or the other alternative, which is being lonely and uncared for.
Johann Lamont raises a valid point because there may be some people in care homes who should be at home. There are also some at home who should be in care homes.
I was glad to see that in the Government response, under recommendation 2, it talks about supporting people to live well
“at home or in a homely setting”.
I thought that that was quite a good way of putting it. The point has already been made—I think by Jenny Marra—that we are very dependent on volunteers, family members and the third sector. It is just not possible for the public sector to provide befriending and care for every single person in this country.
The other side, perhaps, to what we have just heard is that when I visited a care home in my constituency a little while ago, the staff said that, in effect, it was being used as a hospice by Glasgow City Council, with admission only taking place when the older person was towards the end of their life and was in too poor a state to really benefit from the care home setting.
Finances are clearly part of the whole equation, because being in a care home is not cheap. I strongly contend that we must live within our means, but I think that we are seeing cases where some older people are being kept at home for financial reasons and as a result they are isolated and are not in the most appropriate setting.
One of the visits that the committee carried out was to Easterhouse in the east end of Glasgow and the convener and I also went with the Food Train on visits to Shettleston and Dennistoun. We met an elderly couple who lived three storeys up and they were struggling a bit with walking up the stairs but they did not want to move—they wanted to stay where they were. The kind of support that Food Train provides is ideal and essential for keeping people in their homes.
As the name suggests, Food Train is primarily about buying and delivering shopping for people. That is absolutely great, but it struck me and the convener that the volunteers were also able to spend time with people as they delivered the shopping, which was very much appreciated by those people.
We have to accept that paid care workers are very much under pressure with multiple visits and perhaps cannot spend a lot of time befriending and chatting. However, Food Train and other befriending services can give more of that time that people need.
Housing has to be part of the answer to all this and a range of housing must be available. I still have too many people in my constituency coming to me who everyone agrees are in the wrong type of housing—for example, an older person who is up a close and cannot manage the stairs—yet there are very few ground-floor flats and sheltered or very-sheltered housing is just not available. The Finance Committee looked at that issue a little while ago.
I think that I am running out of time so I will cut out one or two bits from my speech.
We need to support all types of housing and we need to think about whether we should be investing more in housing generally or whether we should be making a more specialised investment in things such as sheltered and very-sheltered housing.
I think that we all learned from this study. In one sense, we all knew that isolation and loneliness existed but carrying out this study and reporting on it as we are today has underlined, for me at least, that it is not just a minor side issue; it is a real and serious issue that must remain firmly on our agenda.
I thank the committee for its hard work and for the development of the report that we are discussing.
On the one hand it is motivating that the Scottish Parliament is one of the first Parliaments in the world to be discussing old age and social isolation, but on the other hand it is concerning that the issue has been allowed to take such a grip on our society. Nonetheless, by taking this first step into a public discussion, I hope that we can raise awareness about isolation and loneliness and explore how to reshape our current policies to tackle those issues.
The main theme emerging from the report is that isolation is not unique or exclusive to one group of people. Young people, old people, lesbian, gay, bisexual and transgender youth, ethnic minorities and people in rural and urban areas can experience it.
The report makes specific reference to the difference between social isolation and loneliness. Although one is not more important than the other, social isolation can be measured while loneliness can be experienced in a very personal way and can be more difficult to address.
That is why community care, which will be integrated in just a few months, as well as social groups and other channels of socialisation all have a crucial role to play in reaching out to people who are at risk of being both lonely and socially isolated.
The report notes that social prescribing can be an invaluable source of ideas that can be taken forward. Some are already in place and it would be wise, and in fact it is recommended, to take the lessons from those projects and develop them further.
I note that the committee heard the repeated mentions of the importance of general practitioners. Food Train hit the nail on the head on GPs and the important part that they play in people’s lives:
“In many cases, a lot of older people won‘t be in contact with any other service, but the one service they will usually have some interaction with will be their GP.”
For older people who receive home care, especially in remote and rural areas, the Royal College of Nursing notes that physical and virtual connectivity, greater support for the role of advanced nurse practitioners and support for independent living can contribute to more information being shared and a better connection to the community. Providing adequate information is invaluable for those who have limited exposure to the services that provide it. As the report recommends, a national campaign to raise awareness among those who need information on social isolation and loneliness is most welcome.
Before the Scottish Government develops such a campaign, we need to have more information on the true scale of social isolation in Scotland. The Scottish Government is urged to commission research, as the report notes, because the full extent and prevalence of social isolation for younger and older people is still unknown. We need to answer those questions before engaging in an attitude-changing campaign.
Social participation and inclusion affects mental health and promotes good mental health. With demand for mental health services growing, and supply simply not being enough to address everyone’s needs, we need to be bolder in our efforts to provide people with alternative options to medication.
The Scottish Council for Voluntary Organisations was clear. It is concerned that
“We are heading in the wrong direction. The sums of money that are spent on prescriptions vastly outweigh the sums of money that are available to support the kind of initiatives that would make a difference to people’s lives.”—[Official Report, Equal Opportunities Committee, 26 March 2015; c 22.]
The third sector also brings up the question of how to achieve a more joined-up approach in working together to inform GPs and service users about their services and areas of work. That is a matter of concern. The approach of social prescribing can help people to get in touch with other people and become more active members of society. In turn, reduced medication can help people to gain more self-confidence, as well as save money for the NHS. The Royal College of General Practitioners also calls for more information and for social prescribing to be developed further in GP practices, based on the experience of the community links practitioners.
As I mentioned, the problem of social isolation is not exclusive to old age. The committee makes it clear that young people, particularly those from ethnic minorities or LGBT groups, can face bullying, which harms their self-confidence and pushes them into isolation. The serious long-term effects that early discrimination can have on young people are particularly concerning. Each and every young person has the right to develop his or her identity. Inclusion and understanding of differences must become the norm, and I would welcome the inclusion of that aim in the campaign against isolation.
I will end by pointing to a very important recommendation by the committee that the Scottish Liberal Democrats have been voicing for some time. Reducing social isolation and loneliness is not a policy that can operate in a silo. Just as good housing is conducive to good health, good health also requires that normal social activities are part of an individual’s daily life. We must look at this as a problem potentially affecting people from many social, ethnic, and age groups, and one that has wide consequences.
As a non-member of the committee, I welcome the opportunity to contribute to the debate.
Reading the record of the evidence-taking sessions, two points struck me about the cabinet secretary’s evidence in June last year. The first was his comment that all the answers cannot come from Government. Often, he said, it is about interpersonal relationships and issues that are well outside the control and remit of the Government, although he recognised, of course, that isolation and loneliness can lead to other problems, not least with mental and physical health. I entirely agree with that. The second point was his highlighting of the fact that loneliness and isolation can affect anybody of any age and of any social or economic status, in any circumstance. Again, I agree. Loneliness is clearly not just an affliction of the elderly. As Susan Hunter of YouthLink Scotland told the committee:
“social isolation has an effect on young people’s confidence, their self-belief, their anxiety levels, their ability to know that services are there for them and their ability to meet people for the first time.”—[Official Report, Equal Opportunities Committee, 5 March 2015; c 3.]
Loneliness is potentially universal, but it is also complex, and someone’s ability to cope with loneliness is a personal reaction, the long-term consequences of which can be considerable.
The period after Christmas and new year is undoubtedly a good time to highlight the issue of loneliness. As Marco Biagi said, tomorrow night, BBC television will broadcast a programme on precisely that topic. It will be interesting to see the reaction to the programme.
As the committee’s report makes clear, the full extent of the prevalence of social isolation for younger and older people in Scotland is not known. Much reference is made to one set of Age UK statistics, particularly the reference to the fact that half of all people aged 75 and over live alone and that 17 per cent are in contact with family friends and neighbours less than once a week. However, as many organisations have pointed out, there is a lack of comprehensive information about the prevalence of isolation and more particularly its health impacts. Although loneliness would seem likely to increase the risk of depression, for example, we really do not have much information on that, so more research on the links between social isolation and health needs would be welcome.
In relation to just one area of policy—housing—the link to social isolation is clear. Sheltered housing and care homes need a community room and facility. I was encouraged by the evidence that was given to the committee by the North Ayrshire health and social care partnership that a major refurbishment programme for sheltered housing facilities will incorporate a community hub. However, as that same evidence session made clear, the issue is not about day centres per se, but about providing focused activities. With regard to physical immobility, it means that the community in the widest sense must come to the individual and that facilities must be available for that interaction to take place. In relation to those who are able to get out and about, we should not forget the importance of transport—particularly public transport—in tackling isolation. That is why the over-60s free bus pass is important, as it helps our older citizens to feel less isolated.
Alternative models of housing, such as the one for co-housing that is promoted by the Vivarium Trust, are to be encouraged. One such project is being run in my constituency, in conjunction with Kingdom Housing. Co-housing is a concept that was promoted in Denmark and involves homes that are designed for the individual but which exist within a community that contains communal facilities that are based on the preferences and needs of its members. Communal facilities are often in the form of a common house that contains areas for leisure, socialising, office space, gardens and workshops.
Ideally, we should strive to avoid creating ghettos of old people. Let us also recognise that, for example, although a young single mum might be glad of housing, her house might be a long way from family and friends. Too often, young mums can feel isolated because of the sheer pressure of time and lack of money that too often arises.
As many speakers have already suggested, the integration of health and social care provides an opportunity to build tackling social isolation into that change, but it cannot all be about integrating budgets. It ought also to be an opportunity to ensure that, while we prioritise care at home, which might well have a profound economic impact, the need for social interaction is not forgotten in relation to helping to build more fulfilled lives.
It is also clear that carers frequently become more socially isolated because of the very demands of caring. That is an isolation that respite care will not necessarily solve. And what of the young and minorities of different types? I think that the committee is right to see the link between anti-bullying strategies and social isolation. Schools, in particular, have a key role to play. Although rates of suicide are declining, we must recognise that there is a group of young men whose isolation in the widest sense from the community places them at risk.
That perhaps brings home the fact that social isolation comes in many forms, which means that a one-size-fits-all strategy would have clear drawbacks. Indeed, any comprehensive strategy would have to be extremely nuanced.
Although I was pleased to note that the committee received a lot of submissions on the benefits of social prescribing or signposting people to services that might benefit them—all eminently sensible—I have a lot of sympathy with GPs. The Food Train might be right to suggest that the one service that a lot of people will have some interaction with is their GP. However, there are already substantial demands on GPs, so it is vital that, at the very least, clear information about local support services is made available to GPs and that GPs are not required to go out and look for it.
I welcome the committee’s report and the debate that it has stimulated.
I was a member of the Equal Opportunities Committee when it undertook its inquiry into age and social isolation. I thought at the time that our work could point the way to new models of local service delivery and a new awareness of the true cost to society in health, social and economic terms when people feel isolated and lonely.
Loneliness takes no account of age and is not unique to older persons. It is prevalent among people of all ages in society, with a particular focus on the young and the old. Misconceptions about social isolation are only part of the picture, and we must continue to examine not only the reasons behind its causes but the practical solutions to tackle it where it occurs.
“We have not been able to find another inquiry at any other parliamentary institution anywhere in the world that has specifically considered isolation and loneliness.”—[Official Report, Equal Opportunities Committee, 26 March 2015; c 17.]
Although we live in a world that is increasingly interconnected, isolation and loneliness still exist, and it is important that work is undertaken to examine why that is the case and what we as a Parliament can do to address the issue. I thank the numerous charities, local authorities, health boards, health and social care partnerships and individuals who have been working tirelessly on the campaign. It is through their dedication and hard work that we are discussing the issue today in Parliament. I welcome the recommendations in the committee’s report, and I hope that we can collectively agree to work together to ensure that tackling isolation and loneliness is given the attention and political will that is required.
Social isolation is unique to the individual who is experiencing it. It is a complex issue, with many subjective elements. Many people perceive social isolation as pertaining to life in remote communities. Although that is sometimes the case, many people experience social isolation in some of our biggest cities or in the same house as members of their family.
A young person said in evidence to the committee that they often felt isolated in their bedroom when everyone else was in the house, but that experience was unique to them in their situation. Amazing work is undertaken by various organisations throughout the country, but we need a national strategy to integrate the issue with all policy considerations in order to both understand and tackle the concerns across Scotland.
To achieve that aim, we must work with local communities and existing local networks and build from there. We need to understand the individual, and often different, concerns affecting communities where people are experiencing social isolation. From examining that information, we can begin to build a model that will tackle the issues and ensure that those concerns are taken into account at all stages of further policy development.
At this stage, I should highlight the impact that the cuts to council budgets across the country will have on social isolation. The small and often community-based support services that are often funded by councils should be a paramount concern. Many older people rely on those services, and it is often the case that the return on the investment that is required to provide them is more than matched by the reduction in the impact on other services. It is not always easy to conduct that kind of cross-sector cost benefit analysis, but government at all levels must get better at that if we are—in the spirit of the Christie report, to echo the minister’s comments—to deliver services that deliver the maximum outcomes.
Many voluntary organisations are trying their best to continue through this difficult period. I was privileged to have some contact with one of the organisations that gave evidence to the committee last year when I opened an art exhibition staged by the Impact Arts craft cafe. The craft cafe is a creative workshop programme, with support from an artist in residence, for residents of sheltered housing. I met some of those people when I opened the exhibition and found out about the work that Impact Arts undertakes. The craft cafe is a place where they can learn new skills, renew social networks and reconnect with their communities. That is the kind of work that challenges the stigma of loneliness and highlights the importance of social contact for everyone, no matter what age they are.
I agree with the committee’s recommendation that the issues of social isolation and loneliness should be built into the plans and strategies of health and social care partnerships across Scotland. We must understand that health concerns change over time, and isolation is increasingly becoming an established health concern for the people of Scotland. We must tackle it, as we would any other health or social concern that impacts daily on the lives of citizens.
Understanding the root causes of social isolation and loneliness is a difficult process due to the subjectivity of the problem. However, some things come up consistently when we discuss the issue, one of which is access to appropriate and affordable transport. That comes up time and again in both urban and rural settings and for people of all ages.
When I used to work as a policy officer in the accessible transport team in Fife, I spent a lot of time talking to people who used public transport and people who did not, to try to find ways of improving our services. Too often, older people would tell me that they did not have a transport problem, saying, “It’s okay, hen, I never go out.” When I asked them where they would go if they could, I soon got a different answer. They mentioned all the things that people with good access to transport and good mobility take for granted—shopping, social visiting, leisure, health and work.
The lack of access to appropriate transport is one of the factors that contribute to social isolation and it requires co-ordinated partnership effort and action by providers of transport services, local government and the voluntary sector. Such partnership working will underpin any progress that we make on addressing social isolation. It is the connections between services that make the difference, and that is most effectively managed and encouraged at a local level. I look forward to seeing the committee’s report having an influence on this on-going area of work.
I found both the Equal Opportunities Committee’s report and the Government’s response to it very interesting. Colleagues’ speeches today have shown just how wide-ranging the report is. However, when we move forward on this, as we all appear to wish to do, it is important that we note the clear difference between loneliness and social isolation. I worry that, if we use the terms interchangeably, we might take away from the importance of tackling social isolation and what we can do about it. I understand the committee’s decision to use the links between the two things to inform its recommendations, but we must recognise that personal loneliness cannot always be addressed by strategies or public service practices.
I firmly believe that there is a role for public services to play in helping to alleviate some forms of loneliness, but much more so with social isolation. After all, as the Cabinet Secretary for Social Justice, Communities and Pensioners’ Rights points out in his letter accompanying his response to the committee’s report,
“Evidence shows that where ... people have strong, supportive social networks ... benefits are ... higher on a range of socio-economic and health inequalities measures”.
He also mentions something that I feel strongly everyone in all the public services should strive for in all that they do—wellbeing.
I note the committee’s recommendation of a national strategy. I am not yet convinced that that would be the best way forward, but I could be convinced. The other recommendations include that much more research is carried out, and I note that the cabinet secretary, Alex Neil, has committed to reviewing the existing data, with a report being due by the summer this year. I am particularly pleased that research on what we call social prescribing and the linking of systems will form part of the report, because it is incredibly important that we have joined-up approaches, as others have mentioned.
The integration of health and social care is a start, and we should recognise that it is about more than home care and freeing up hospital beds. It is about the promotion of wellbeing and the associated benefits to the individual and the community as a whole.
Another recommendation from the committee is that there be
“a national publicity campaign to tackle stigma on loneliness” tied in with anti-bullying and so on. I can see the need for that, and we should link it with training on good practice and joined-up approaches in public services. Too often, people can feel stigmatised by those agencies and organisations that are actually there to help. I believe that we are all guilty—I certainly am—of judgmentalism to some degree, and I am afraid that, too often, those who are already socially isolated can be made to feel more so by attitudes that are encountered when they come up against what they perceive as authority.
A lot more can be said about that and about other interesting subjects in the committee report. For example, there is the availability of community transport, which Jayne Baxter just talked about. Community transport is incredibly important for allowing people to have social links, and it ties in with the great shopmobility scheme that we have in East Kilbride—I know that Jayne Baxter has been heavily involved with the shopmobility scheme in her area. The scheme gives people the ability to meet in the local town centre, particularly in new towns such as East Kilbride, and pass the time with friends.
In tackling the issue of social isolation, we should also look at housing development and design, and take note of the importance of landscaping, the environment and the sense of place, as well as models of occupancy and housing allocation policy.
I will finish by talking a wee bit about the voluntary sector and volunteering. In terms of countering loneliness and social isolation, volunteers and the voluntary sector in general do a fantastic amount of work, but they do not always get credit for it. However, I want to record what Calderglen high school in East Kilbride does through a befriending scheme. What I think is wonderful about it is that the whole sixth year ties in with the befriending scheme. They visit elderly people in their own homes who feel lonely and isolated, and they invite them to the Café Clare project to interact with others.
What is really important about that befriending scheme is that it works for both sides and is not just about young people turning up to do their duty and tick off the volunteering box. I am finding that real friendships across the generations are being made through the scheme. What is also important is that it is not just about the elderly people feeling that the young people are paying them a visit; the elderly people also feel useful because they are imparting their knowledge and experience, so the friendships are working in that sense. If people feel useful, that goes a long way towards having a sense of well-being and avoiding social isolation and loneliness.
I look forward to further discussions about this subject as we move on.
I thank the committee for its report and I congratulate the convener, Margaret McCulloch, on outlining in her speech the detail of how the committee addressed the issue.
I welcome the fact that members across the chamber are clearly interested in addressing the questions involved. However, I say to the minister that, although his contribution to the debate was very thoughtful, I think that it is a mistake to exclude the possibility of a national strategy at this stage. I think that Alex Neil has described such a strategy as a bolt-on solution, but that is not how I perceive it. A strategy would allow more than just the Government to ask, “How do we address social isolation? Are we doing things through our policy that make the issue worse?” It is about mainstreaming thinking about the consequence of Government decisions as well as active policy in the area.
It is clear that I am not the only one who was touched by the John Lewis Christmas advert, which symbolised the sense of loneliness and isolation that is felt by some older people by placing an elderly man on the moon, a world away from the happy celebrations of families on earth. However, the John Lewis message cannot be just for Christmas, to be discarded along with the wacky and usually ill-advised jumpers. The reality for many who look forward at old age is fear of two things in particular. The first is the fear of dementia and loss of capacity and self. The second is the dread of loneliness: outliving contemporaries, with families far away, and being left with little to do, few to see and only rare opportunities to be involved in the events and occasions that enrich our lives. Healthcare, detection of dementia and effective care services and support for those looking after their loved ones must continue to improve, shaped by the experience and understanding of those who know best the impact of dementia and its consequences.
Tackling loneliness and isolation is important because they have such an impact on health and wellbeing; and their cruelty surely ought to speak to the need for compassion for those who suffer. We know that loneliness and isolation are no respecters of person or class, although living in poverty makes the challenge of isolation more difficult still. We all know of elderly people who have retired, lost the routine and camaraderie of their workplace and fallen into a lonely life. We know of elderly people who have been widowed and left after many years of caring and are very isolated because of their caring, which excluded them from maintaining friendships and connections. I commend the south-west Glasgow carers centre in my constituency, which not only supports people in a caring role but keeps the doors open and welcomes them when they are bereaved as they cope with the loss where the caring was before. We all know many people who are in those circumstances.
Jenny Marra and, indeed, the Government are right to say that this is not just about the role of the state in spending money, but there are choices that we can make and decisions to take that will make lives better and address the blight on too many lives. It has been acknowledged that the job of the Government is not simply to wring its hands. If we want to address isolation, we should do something basic. We should start with the person and follow with action. The challenge is huge, but there is a simple question for the Government. We do not expect it to do everything, but is it making things better or worse through what it does?
How many elderly people in some of our poorest communities rely on GPs who are busier and under more pressure and have access to fewer resources than their peers in better-off areas? As doctors in my constituency have told me, although those people need time from their GP, the funding settlement allows doctors to spend huge amounts on drug prescriptions while denying them the means to tackle underlying problems, which are often not medical ones at all. It is ironic that an elderly person from a more affluent area who suffers from loneliness and isolation is more likely to be given time by their GP than someone who comes from a poorer area. That simply cannot be just.
This is not a theoretical argument about funding formulae. The Government must address the fundamental injustice in the division of spending for GPs, as it not only fails to tackle health inequality but exacerbates it.
Does the member agree that more deep-end practice link workers and social prescribing, as recommended by the committee, would be one way of tackling what she sees as people from deprived areas not being treated proportionately?
I recognise the particular work of link workers, but there is the fundamental question why GP practices with more people with more problems and more need of a GP are given less money than GP practices in more well-off areas. No matter the size of the cake, we need to look at how that money is currently being distributed, because that means that people in poorer communities who need to talk to somebody are less likely to get that than people in better-off areas.
On transport, how many isolated older people have a bus pass but no bus to take them safely and easily to the shops? In my constituency, for example, many routes have changed and two buses are involved, whereas there would have been one bus in the past. Faced with that, some have chosen to go out less, and increased isolation is the consequence.
One small step that has already been referred to would be community transport having access to the bus pass scheme on a fair basis and funding being directed to communities that would most benefit from effective bus services. In addition, of course, there should be understanding in bus route planning of the need for older people, particularly women, to feel safe. That means more direct routes to key areas rather than routes that involve two or more buses.
If we understand that opportunities to meet others and go to lunch clubs and to be supported to go to the library or the church can be the difference between thriving and simply surviving in our homes, what follows? If we understand that connection, how do we support volunteers, who are often the bridge into an active life, when voluntary sector organisations face cuts? Why disproportionately cut local government with the consequence that support services that are not statutory but can be life enhancing disappear and the lifeline away from isolation that they represent is withdrawn?
In conclusion, if we all responded to the man on the moon because he hit a nerve, we must all individually look at what we can do, but those with the privilege and responsibility of power can do much more. Let the money follow need. If we have a conversation about that, Labour members will support the Government. Otherwise, I fear that we will continue to isolate politics from the real world. That is a bleak future for all in Scotland and particularly those who live with loneliness and isolation.
In her contribution, Johann Lamont said something very important indeed, on which I want to anchor my remarks: we must start with the individual.
In its response to the committee’s report, the Government says that the report
“usefully acknowledges the responsibility of citizens, public services and the Scottish Government in taking any action forward.”
That is pretty much self-evident.
I will say one or two things about the approach that the committee has taken, but before I do, I say that because it is the first parliamentary report on such a subject, we have no point of comparison with predecessor reports. It is clearly an excellent piece of work; it is thorough in its scope and analysis and in its drawing of conclusions. However, for next time, there are one or two things that we might think of doing.
As Winston Churchill and others have said, predicting the future is particularly difficult, so I will not try to do it. That is a matter for committees.
I say seriously that it is in many ways a first-class report, but let us look at who gave evidence to the committee. Of the written evidence, slightly less than 10 per cent came from individuals, and every single person who gave oral evidence represented an organisation and had a job title. I recognise absolutely that when the committee went out and engaged communities, it talked to what I might call “real people”—which may sound patronising, although I do not intend it to be. It is a fundamental challenge for us in Parliament and in committees to get beyond the institutions and to talk to the people who are actually involved. I want to talk a little about that.
In the 13 recommendations that the committee made, the word “people” occurs only twice. It occurs properly but it occurs—
I will come back to John Finnie if I may, but I want to develop my point. One recommendation says that the Scottish Government should identify a
“typical profile of people who are at risk”, which I think would be entirely right. The last recommendation talks about technology and people.
The reason why I use people as an anchor is that I am one of the older participants in the debate—I will be 70 later this year—and a number of my friends from a long time ago are now affected by the very issues in the report. It is a great report in that it will equip corporate Scotland, the third sector, the Government and councils to respond even better to the problem. However, I am not sure that it reaches the point of empowering individuals who have no status other than being, for example, the friend of someone whose mental capacity is diminishing. One thing that is absolutely necessary in interacting with a person who is still able to communicate but is suffering from the early stages of dementia, is knowing how to interact and how to give them something from the experience, when one visits them. I have a small circle of friends whom I visit who have some degree of mental incapacity. One of the key things to do, for example, is to talk about things that happened 30 or 40 years ago, because generally such memories endure, while short-term memory is often the part that decays. Perhaps I am privileged, because I come from a medical background through my father, to have that understanding, while others may not. We need to be sure with our responses that we equip people to do that.
I intervened on Annabel Goldie on social isolation versus being alone. I think that people find it more difficult to make friends as they get older. It is easier to keep or to refresh the friends that one has, and one way of doing that is through technology. Some of the old technologies can be quite good. This year I decided not to send Christmas cards and instead sent letters; each letter was personalised. There were quite a few people of my age with whom I have been exchanging Christmas cards for the past 25 years without our necessarily ever meeting. That was a pretty purposeless interaction, to be blunt. I have been amazed to suddenly get responses by writing just a couple of sentences on the back of a circular letter. There are things that we could be doing as individuals and as corporate Scotland to help others to understand the sort of things that can be done.
As people’s mental faculties decline and their memory becomes less effective, we need to focus on their partners, because they are socially isolated in their own homes and often find it difficult to live all the time with the person to whom they have been married, or with whom they have lived, for decades. They, too, need support.
On social interaction, I have previously talked about reducing taxation on bingo, and I make another plea to the Government to do that, because there is medical evidence that bingo is one way of keeping people mentally alert.
In rural Aberdeenshire—and, I believe, in Dumfries and Galloway—there is a particular problem in getting high-speed broadband to individual homes because of the technology that phones in those areas use to connect to exchanges: the use of exchange-only lines means that a big proportion of homes cannot get connected to fibre directly. The social inclusion that results from using Skype, for example, and from being connected electronically would help. That is another little thing that could be done.
The report is excellent and I commend the committee for it, but next time we should perhaps move on to look at what individuals can do, rather than at the corporate response.
I would like to thank all the contributors to the report and the staff who were involved in preparing it. Those contributors were very real people—that is what I wanted to say to Stewart Stevenson. No slight is intended, but they were very real people whom I had a coffee with in Easterhouse, and they were very real young people whom I saw give Christian Allard a hammering at pool at the youth centre on Islay. I understand the point that Stewart Stevenson made, which was about the general nature of the people who come to Parliament to give evidence. At the ceilidh—the good news is that I did not dance—we met very real people; we sat and had cups of tea with them and got to understand them.
I want to touch on an issue that a few members have mentioned—the definition of “social isolation”. Talking about the definition might seem like a very dry place to start, but it was actually extremely helpful. It was important that people said what they understood the term to mean, but we wanted some form of evidential basis, and the definition that we got from the academic Professor Mima Cattan was about what is measurable and what is personal. It is not a case of saying that one is more important than t’other; it is simply a case of contrasting those two aspects.
The issue of contrast also applies to the locations that we went to—Easterhouse and Islay. In Easterhouse, we heard from Food Train about the wider role that it undertakes, which is typical of the extra value that we get from the third sector. That was compelling evidence to hear.
We had planned to visit the Jura Care Centre, but we were unable to go because of the weather. That gives members a flavour of community isolation: especially in recent months, Islay and Jura have had significant issues with that. I had the good fortune to visit the centre during the summer recess, and it is an excellent model that is often held up by people who are aware of social care, which is about sustaining people in their homes in the community. As people get older and frailer, they gravitate towards the centre, where there is a respite facility. It is excellent and I commend it.
There was commonality in the issues of the two communities that we visited, relating to housing and transport, for example. I hear what Johann Lamont said about buses; she mentioned people having to take two buses. The challenge of getting suitable transport in urban settings came up, but the contrast there is with the many parts of rural Scotland in which there are no buses. Nothing negative is inferred by that, but there is a challenge in getting about at all in some rural areas, not least because of the dearth of bus services.
The people whom we met were very real people, and I am grateful to all of them for their contributions. In some cases, it was a very soul-searching experience and we dealt with some very sensitive issues. The legacy of gangland culture came up in Easterhouse, and we also heard about the challenge of dealing with school bullying, and all the various relationships that go along with that, in an isolated community.
I will comment on the Scottish Government’s response, in which it spoke about what it sees as the challenges. It mentioned the challenge of “rising expectations”. I know that the Government did not mean that entirely negatively, but if our communities have rising expectations, that is a good thing.
The Scottish Government also said that the challenges include
“pressure on resources and living standards, public health issues, an ageing population”— what a great news story that is, with all the statistics about how much longer we are all going to live—
“and the impacts of multiple deprivation”.
I add to that list the impacts of rural deprivation—especially fuel poverty, which is a significant issue.
The Scottish Government’s response said that it
“has a clear view of what works in public service design.”
The public do, too. The Government also assured us that its approach to reforming public services
“places the needs and aspirations of people at the centre of all that we do.”
That is reassuring.
The response mentioned plans to realign services to meet the new challenges. It also alluded to a number of positive initiatives—not least of which is the recently commissioned research into design for ageing.
Age Scotland was a significant contributor to our inquiry. I am grateful for its briefing, which expresses disappointment about the Government’s response that
“a national strategy might lack impact”, not least because there are
“34 specific strategies the Government either has adopted or is developing, with 12 of those in the health field alone.”
The landscape may be cluttered, but social isolation issues are not going to go away.
Another thing in Age Scotland’s briefing that I will talk about, and to which Jenny Marra alluded, is the idea that, although
“the State is not primarily responsible for the quality of people’s personal relationships, it does ... have to deal with the consequences where these break down or are absent.”
That is true, but the state is statutorily responsible for provision of education, health and care. We forget that at our peril.
I am concerned about how the profit motive in social care, housing and transport affects social isolation. Housing has been mentioned.
I want also to mention another issue in the Scottish Government’s response, on comments that were made by the then chief medical officer, Dr Harry Burns. It said:
“Dr Burns was clear that the fundamentals of human well-being that underpin health and fulfilment lie in attachment and in lives with a sense of coherence and purpose.”
Clearly, that is what we all want.
I am grateful to have had the opportunity to participate in producing the report. There is talk of additional research, which would be helpful. I am sure that Parliament will revisit the topic.
Good afternoon, Presiding Officer. I am delighted to take part in today’s debate on the Equal Opportunities Committee’s inquiry into age and social isolation. The Scottish Government has a lot to do in this area of equality, because people who are living with terminal illness and their carers and families can often experience social isolation.
I have been contacted by several constituents and community groups that are suffering from local authority cuts and the huge increase in the costs of attending day centres for the elderly. The cuts that our elderly people face are creating real hardship. Many older people’s voluntary organisations and groups are being shuffled around in a bid to accommodate them and cut their expenditure, but that has totally failed, particularly in Glasgow.
In its submission to the Equal Opportunities Committee, Glasgow City Council said:
“Glasgow is Scotland’s largest city. Outside London, Glasgow is one of the largest concentrations of economic activity ... The city and its surrounding area, the Clyde Valley, make a significant contribution to Scotland’s economy. Glasgow ... has a high level of citizens living in single occupant households”.
The council appreciates that
“not every one of these people will feel or consider themselves socially isolated but living alone is considered a large factor in isolation and loneliness”.
More than 30 per cent of households in Glasgow, which is nearly 87,000 households,
“have one single occupant under the age of 64”.
Nearly 13 per cent of households, which is more than 36,000 households,
“have one single occupant aged 65+” and 14.5 per cent of households, which is more than 41,000 households,
“have an occupant who is a lone parent”.
Looking after our citizens is vital. People must be prioritised and looked after. It is crucial to have regular visits to the elderly by professionals, who should consider equality and cultural-awareness issues.
The best places to raise awareness of the opportunities and support that are available to people who are experiencing social isolation are the places where they tend to go most often, such as general practitioner surgeries, community nursing facilities, community groups and health centres. We require a national awareness-raising campaign that is backed by local information provision through, for example, GP surgeries and other organisations.
Cultural recognition cannot be ignored. The Government must reassure many people in our communities of its commitment to and determination about providing the best possible service. The delivery record must be monitored so that there is clear evidence that the services that are being delivered are fit for purpose. There is no point in having services if we do not record or monitor what people are doing.
When we give our pensioners free bus passes, we like to say that that is a job well done. I am sorry, but I disagree; we can do a lot more for our elderly and vulnerable people. Our pensioners should also get free off-peak cinema tickets and access to our sports centres, which lie empty all day. They should be able to use golf courses and all the other such facilities out there. Businesses should not get a free ride any more; they need to demonstrate that they care for elderly people in this country and they need to make a meaningful contribution. Local authorities and the Government should not have to pay bus companies for the free travel; if a company wants a licence to operate in Scotland, allowing our elderly people to travel free should be part and parcel of the licence conditions.
Such things would help to reduce isolation and to improve the health and wellbeing of our communities. There are many examples of good work that is being done, but we also need to examine the services that we are providing and ensure that there is no duplication. I do not know who monitors voluntary organisations that get grants and other funding; there is no record of how they are monitored and assessed and of whether they provide value for money. I want the minister to take it on board that we need proper monitoring in place to ensure that decisions are evidence based and that people get appropriate services.
Not being a member of the Equal Opportunities Committee, I begin by congratulating the committee’s members on an excellent report following their extensive and detailed exploratory work on the important issue of age and social isolation. I confess that, when I heard the subject of the debate, I assumed that it would deal exclusively with problems of social isolation in the elderly. However, having read the report, I have been forcibly reminded that any age group can be adversely affected by a sense of isolation and loneliness.
Social isolation also affects people from all backgrounds, including the full range of protected characteristics as defined in the Equality Act 2010. People with disabilities, people with a range of long-term conditions, people who are restricted physically, psychologically and socially in coming to terms and dealing with terminal illness, even when they are surrounded by family and friends, and unpaid carers—not least those whose caring role has ceased following bereavement—may all experience isolation and loneliness. That may—and often does—go unrecognised because it is not thought about as a possibility by people who are preoccupied with their own lives.
I have a little personal experience of social isolation that would nowadays be called bullying. As an only child growing up in the early 1950s, I was roughed up and called names because I did not speak in the broad Aberdeen dialect of my schoolmates, probably because my father had been brought up south of the border. I remember my mum telling me to put a brave face on it and to try to ignore the jibes. I eventually learned to cope by developing one language for home and another for the playground. However, the experience was difficult at the time, and without parental support it could have been devastating.
What stands out for me in the committee’s report is the importance of communication. If we fail to communicate and make proper contact with people, we will never fully understand the needs of the individuals in our communities and the sort of help and support that they may need to live a full, inclusive life whatever their age or physical status and whether they live alone or with the company of other people. It is telling that, in an age when so many channels of communication are available, there is still a significant problem with social isolation and loneliness in Scotland. The report gives us a timely reminder that it is everybody’s problem, that it should not be ignored or tolerated and that a change in attitude is required in our society if its impact is to be reduced.
It seems strange, given the widespread nature of the problem in the modern world, that nowhere else has the issue of social isolation been considered by any parliamentary institution. The Equal Opportunities Committee is therefore to be congratulated on leading the way. I hope that its recommendations will have a significant impact on the health and wellbeing of many people, not only in Scotland but further afield.
The 16 recommendations in the report are too numerous to deal with in detail, but the first two are, I think, particularly important. The first is:
“that the Scottish Government develops a national strategy on social isolation that ensures that the issue is integrated within all policy considerations so that the impact of isolation and loneliness is understood and tackled across Scotland.”
The second is
“that the Scottish Government ensures that the issues of social isolation and loneliness are built into the plans and strategies of health and social care partnerships across Scotland.”
I welcome the Government’s overall positive response to the report, which the minister outlined.
We are at a crucial stage in the development of the integration of health and social care. If the integration joint partnerships take on board the need to prevent and deal with social isolation, they can go a long way towards improving the health and wellbeing of many people in both urban and rural Scotland who are currently disadvantaged.
Communities need to be made aware that they have a major role to play in highlighting the importance of social contact for everyone in their area, regardless of age and background, and that local action can be taken to improve communication and let people know how to contact local services, which can improve the lives of people who are at risk of social isolation. We have seen an excellent example of such community spirit this week in Ballater and Braemar, in my region, in the aftermath of December’s devastating floods. That spirit of caring for neighbours is typical of those small communities.
The report highlights the importance of community and public transport and the need for health and social care partnerships to incorporate housing issues and links with housing professionals into service planning. Those are important aspects of the committee’s inquiry, as is the recommendation that the outcome of the deep-end project’s work should be shared across Scotland. It is clear, too, that research is needed to assess what is required to prevent and deal with social isolation issues across all age groups.
A large number of excellent projects and community activities to identify and tackle the widespread issue of social isolation and loneliness are already in place in many parts of Scotland, and I feel that I should mention one in my region. It is also mentioned in the report and has been cited by Christian Allard this afternoon. The Aberdeenshire Signposting Project works with people who are affected by, or who are at risk of developing, low to moderate mental health problems to increase their level of social contact and their usage of locally available leisure and educational facilities. It does that by putting those who have been referred to the project by GPs and others in touch with sources of appropriate support, help and advice. Such so-called social prescribing has been found to be beneficial by witnesses to the committee, and we have heard about a number of such innovative projects from members today in what has been an excellent and far-reaching debate.
Nevertheless, the recognition of the need for such activity, as well as its availability, is piecemeal and it is clear that there needs to be a co-ordinated effort to extend best practice across the country. That can be achieved only through Government involvement in developing a national commitment to mainstreaming the issues within all policy considerations. The excellent report by the Equal Opportunities Committee shows the way, and, once again, I congratulate everyone who has been involved in a pioneering piece of work that I hope will bear fruit in many places in the months and years ahead and will help to overcome the problems of the many people who face, or who are at risk of facing, social isolation in our communities.
I am grateful for the opportunity to close the debate on behalf of the Labour Party and I reiterate our thanks to my fellow committee members and, in particular, Margaret McCulloch, the committee’s convener, for the report.
I was not a member of the Equal Opportunities Committee when it conducted the inquiry, but I enjoyed hearing committee members’ perspectives on the evidence taken as the report was prepared for publication. The subject was broad and the issues raised are undoubtedly complex, but they are also very human. The chances are that all of us will have experienced loneliness at some time in our lives, for whatever length of time—although perhaps John Mason is slightly less vulnerable to loneliness, due to the benefits of his tent, as he explained. The power of the personal stories that the committee collected in the report has given importance to the debate and has resulted in the extensive coverage of the issues that the committee has achieved.
The committee has also achieved an understanding of the public policy issues raised by the loneliness of some of our citizens through its recognition of factors such as age, rurality and social isolation in a more comprehensive sense. As members have said throughout the debate, and as the committee’s report made clear, loneliness can be a consequence of social isolation, but not all socially isolated people are lonely, and not all lonely people are socially isolated. Social isolation can be a risk of rurality, but it is not exclusively so. Social exclusion can create the risk of isolation for those who live in our biggest towns and cities.
Although the committee was specifically interested in the vulnerabilities impacted on by age, notably among our older and younger citizens, it recognised that those things are risk factors, not causes, and that generalisation is not likely to be the best aid to an improved response from public services or society more generally.
The report recognises that we live in an era of technology. It highlights that technology can assist communication and sustain valuable networks, but that it carries a risk of minimising or competing with face-to-face contact, evidenced by the dangers of addiction to or unhealthy usage of technology. There is also the risk of technological solutions being pursued for cost or other good reasons, such as improving the coverage or accessibility of a service. In reality, such technological solutions might have the impact of reducing an isolated person’s contact with an imperfect but potentially more human form of interaction.
As I said, the great strength of the report is the human stories that it has unearthed from diverse witnesses who live in varied circumstances around the country, to whom many members have referred this afternoon.
In the time remaining to me, I will briefly touch on a couple of the committee’s recommendations. My party fully supports the committee’s conclusion that loneliness should be recognised as a public health challenge. It is a circumstance that has the potential to be life limiting, and mitigating it will have beneficial effects on other aspects of a person’s health and reduce the need for more costly or invasive interventions later.
From my own work in the field of promoting health-enhancing physical activity, I know that combating loneliness is taken seriously by a range of projects that seek to make a comprehensive difference to our lives in the roundest sense. The word “wellness” is sometimes used to describe that, which some people like and some people do not—Linda Fabiani was correct to use the word “wellbeing”, which is probably better. There is no doubt that there is no political divergence between the parties on the better lives that we want to see for our citizens. In his letter to Ms McCulloch, the cabinet secretary referred to the Government’s national purpose and broad indicators relating to quality of life. That is to be welcomed, and it is welcomed by Labour.
The committee specifically makes the case for a national campaign against the stigma of loneliness. Although the Government has not endorsed that call, I think that there is merit in examining the idea further.
It is a hardy perennial issue for those of us who serve on committees, particularly when there is an open inquiry on a complex and broad social issue, that there is a call for more data to be collected. I confess that I can find that a bit frustrating, because there will always be no end of experts who could examine an issue further for us but, at some point, a political choice needs to be made about whether the challenge is sufficiently serious for action to be taken, rather than just to have more data collected. To be fair, I am sure that the Government recognises that tension, which my colleague Johann Lamont raised earlier.
The Government’s response to the committee rightly tries to set the issue in the wider context of public service reform. Jenny Marra was right that we should not become too preoccupied with the role of social or other public services as the only means to improve lives versus other societal changes and the individual actions that we can all take.
I end by highlighting the particular circumstance of loneliness in the care environment, particularly for older people or those who suffer from a range of conditions, which a number of members have mentioned.
There is something that is often said but not as often meant in the chamber, but I want to say it and mean it: this has been a really valuable debate. A committee of the Parliament has identified a social problem and explored it and made recommendations, and the Government has weighed them and taken many of them on board. We are now debating it in an informed way, as a weighty issue, recognising the substance, putting forward perspectives, analysing the choices and trade-offs in a grown-up way and largely setting aside any synthetic partisan rancour. Every single speech today has been creditable. This is the Holyrood that the outside world never sees and, in truth, we do not often enough see it ourselves. As a soon to be former MSP, I really wish that we did.
I go back to the speech from Jenny Marra, whose vignette about the conversations that canvassers at the door sometimes have was one of the many things that I heard that really struck a chord with me because of my personal experience. It illustrated in an evocative way the effect of loneliness that I presume we have all seen at first hand.
Jenny Marra also asked whether we think that things are different in Scotland. My answer to that is complicated. I have no evidence that the problem of social isolation is any greater or lesser in Scotland than in other countries that are experiencing the same changes in age structure, employment, household type, communication methods and so on. However, my intuition is that the countries that we seek to emulate by having better support for the elderly, more stable working patterns and stronger local communities might also have better performance on social connectedness.
I argue that we are distinctive because Scotland’s approach governmentally to public services—what we should do as the Scottish Government and the public sector—has connectedness at its heart. From “Throw open the doors” to co-production and the national standards for community engagement, we recognise as a matter of practice that connectedness means better government.
“that the fundamentals of human well-being that underpin health and fulfilment lie in attachment and in lives with a sense of coherence and purpose.”
Members have set that out very well. We recognise that connectedness means better society. We can argue about the difference between strategy and a strategy that has a glossy cover and can sit on a shelf, but what we are doing, and what I do as a community empowerment minister day in, day out, puts community and connectedness at the heart of the Government’s approach to creating a fairer country.
I hope that the fact that I am a community empowerment minister in the overarching portfolio of social justice shows our understanding that community has to be at the heart of how we make Scotland a fairer and better place and improve the all-round wellbeing of our citizens. The Harry Burns perspective is also our perspective. The point is not that the state should say goodbye or do everything; it is that the state should ensure that there is a space for discussion, deliberation and connection and then respond to the priorities coming from that process as a democratic body.
In community empowerment, that means that, if a community wants to take over something and deliver it itself locally, it can do that through an asset transfer request and, if it wants to guide the public sector to respond, it can do that through a participation request. That is the philosophy. It will be embodied in the social justice action plan not only in how we brought it about from the fairer Scotland work but in how we develop our solutions for the country.
I visited an Age Scotland group in Cupar, where everyone talked about how valuable the group was and how it got them out of the house. They had all heard about it through word of mouth but were clear that there were more people in the community who were not taking up the service. Such experiences are effective in connecting key decision makers with the people who directly experience the challenges that we want to solve. They create a richer contribution than simply receiving something on paper from a representative group.
When I launched our support for the big lunch and observed the line dancing at my local constituency big lunch—I did not take part; there are no photographs because I made sure that any were burned—somebody asked me what it had to do with community empowerment. I said that there had to be a community before it could be empowered. My first encounter with the concept was Robert Putnam’s “Bowling Alone: The Collapse and Revival of American Community”. He observed that, in America 20 years ago, the number of people bowling had been going up but the number of leagues had been going down. People were becoming more disconnected and he ascribed many problems to that.
It is fair to say that more people are living on their own. In the 1961 census, the one-person household was the least common type at 14 per cent of households; by 2011, it was the most common type at 35 per cent. We must accept that we need creative solutions to that. I saw a Guardian piece about purpose-built housing for young people with communal space. It was very Shoreditch and Islington but it seemed an interesting idea and there was certainly a demand for it.
I will always value public space and I very much value communities taking over its management themselves. That is a far cry from the attempts to privatise and fence it off in other parts of the world.
I go back to John Mason’s point on choice. The last time that I saw the inside of a tent was on a film screen and Heath Ledger and Jake Gyllenhaal were in it, so I completely respect John Mason’s ability to face up to the Islay environment in that way. The key is the choice. It was his choice to do that. The difference between solitude and isolation is choice.
Choices can lead to unforeseen consequences. One rural local authority once highlighted to me a phenomenon that it was encountering of old people retiring to the country and leaving behind family and support only to find that that led to difficulties further down the line. Perhaps that is a higher-income example—not everybody can retire to a wee house in the country—but it also shows that isolation cuts across class. When stigma is a big issue, we have to be very careful about how we characterise it.
Malcolm Chisholm referred to online issues. Again, we have to be sensitive in our characterisations of those. In some ways, online interaction may be shallower but, for the person who suffers identity-based isolation in a physical community, connecting online with other people with the same identity and knowing that they are not alone can be a lifeline. Poor characterisations of behaviours can themselves be isolating.
To go back to some of the language that we have used, we should recognise social isolation but never accept it. It is a scourge on our whole society and, taken to the maximum, threatens the existence of anything worthy of that name. Every person who is locked in their home alone for weeks, every person who is locked out from their surroundings more metaphorically because of the fear of harassment and anyone who is isolated from the warmth of human connection in any other way is a tragedy. We are right to debate the issue and we will have to work together to ensure that all individuals and communities in Scotland flourish.
I think that I speak for the whole committee—I certainly speak for myself—when I say that, when we embarked on this investigation, we had a wee bit of trepidation because we did not quite understand loneliness and social isolation. We had to look at the issue very carefully.
One of the other things, obviously, is that we did not realise that we would be feeling very worried about John Mason in his tent when it was so windy and rainy on our visit to Islay. I am sure that we can all agree on that particular point—we did worry, but John was absolutely fine and so were we.
I thank my fellow committee members, both past and present, who have worked on the inquiry, the many groups and individuals who took part, and the clerks and the staff of the Equal Opportunities Committee, whose sterling work enabled us to produce the report. They did absolutely fantastic work, and I am sure that our thanks go out to all the staff, some of whom have moved on to other committees but some of whom have stayed with us.
We have heard from evidence and from members’ speeches that loneliness and social isolation cross all age groups. Although the common perception was that older people were more likely to be affected, we know from the evidence that we received and from speaking to people that that is not always the case. Indeed, as we found out from our evidence-gathering visits to Islay and Easterhouse, which members have already mentioned, younger people—or indeed anyone, depending on their circumstances—can also experience loneliness and isolation.
Malcolm Chisholm touched on the example of the young family in Easterhouse. We were quite shocked that, because of a certain culture in certain parts of Easterhouse, the family was frightened to let their young kids go out and those young kids did indeed speak with American accents because all they did was play video games.
We also heard from the many volunteers in Easterhouse who were frightened to cross from one side of the road to the other because of the unfortunate prevalence of a gang culture, which shocked a lot of us. Knowing the area myself, I was quite shocked about that. However, the work that was going on with the young people was absolutely phenomenal, and we praise them for that.
As I say, the issue can touch everybody’s lives, not just older people. The convener, in her opening speech, went into great detail as to why the committee recommended that a national strategy be developed, citing evidence from Jane Kellock of West Lothian Council, among others. Jane said that all the agencies in health and social care partnerships need
“to consider the structures of how we deliver services”.—[Official Report, Equal Opportunities Committee, 23 April 2015, c 7.]
I have heard the minister’s reply on that particular issue, and it is one of the key areas that we need to tackle if we are to tackle loneliness and isolation.
I thank the member for all the good work that the committee is doing. I just want to re-emphasise my point about monitoring and measuring the level of success in tackling the issue. Will the committee take that on board with the continuation of its evidence gathering? Will that monitoring take place, and will the committee consider how we can truly measure the scale of success or failure?
I thank Mr Malik. I will come on to the point about monitoring progress because one of the recommendations related to it.
As I said earlier, I welcome the minister’s comments about looking at structures and how we deliver services. The convener also mentioned that the committee was reassured by the Scottish Government’s commitment to take more evidence regarding this particular issue. We have the Community Empowerment (Scotland) Act 2015, community planning partnerships, and health and social care partnerships, which are all designed to work with services to support vulnerable people. That is the issue that I was trying to raise—we have to work together on this particular social integration.
I reiterate the convener’s view that the Parliament should monitor how effective the approach will actually be. The monitoring aspect is very important. I welcome the Scottish Government’s assurances on that particular issue, but we still need to ensure that we monitor how effective the approach is regarding inclusion priorities in strategic plans. We can put forward strategic plans, as the committee has said in its recommendations, but we need to know that that is prioritised and how it turns out. I hope that that answers Hanzala Malik’s question. I would also like to think that that would be put into an Equal Opportunities Committee legacy document for the next parliamentary session.
I will touch on the committee’s recommendation for a national publicity campaign. I welcome the Scottish Government’s commitment to working with stakeholders on the issue. I have suggested previously that there could be a media campaign that goes along the lines of the see me campaign to highlight social isolation. The Scottish Government could consider that. Jenny Marra and other members mentioned the John Lewis campaign and Age Scotland, and I would like to thank a number of newspapers, particularly The Herald and Evening Times, which published articles on the issue and helped to raise the profile of isolation and loneliness.
We talked about gathering evidence for strategic plans, which I have already mentioned, and a publicity campaign. The minister mentioned the third sector, and I would like to reiterate that point. We need to make sure that the third sector is involved. It plays a fantastic and enormous role in the delivery of services. I take on board the minister’s comments about the third sector being involved in this issue.
I want to touch on the anti-bullying guidance. In response to the committee’s report, the Scottish Government supported the committee’s view that anti-discrimination and anti-bullying work is vital in tackling social isolation. Revised anti-bullying guidance will be published by the Scottish Government in 2016. I also know that the Scottish Government has given an undertaking to consider how it might enable greater use of peer education to tackle social isolation in schools and other youth settings. Like others members here and on the committee, I look forward to the publication of that undertaking, but I also look forward to seeing the greater use of peer education, how it will go about tackling social isolation and how that will be monitored.
We can get there in the schools by using the curriculum for excellence, peer monitoring and peer education to recognise and monitor loneliness and social isolation in young people. Some of the young people who we spoke to had great difficulty with speaking to others about themselves. I do not know whether it was because they were embarrassed, but they did not like to mention their isolation. Perhaps there was also a stigma factor. We really need to look at that aspect.
GPs at the deep end, link workers and social prescribing were mentioned by a number of members. Indeed, our recommendations 6, 7 and 8 all relate to the link worker system and the national strategy that must be involved. I welcome the Scottish Government’s response to those recommendations, and I look forward to report from the University of Glasgow in 2016.
Many members and committee witnesses raised transport. As Jayne Baxter said in her contribution, the issue covers all areas and ages. It is not just about older people. We heard evidence—and Johann Lamont raised the issue today—that it is all right for someone to have a bus pass but there is no point in having it if they cannot get a bus. There are concessions for older people, disabled people and younger people, but it is no use if the transport is not there.
Linda Fabiani talked about a local transport initiative in her constituency. Perhaps we could look at that to see how it works and whether it could be rolled out in other parts of the country. However, I reiterate the committee’s recommendations 11 and 12 on community transport: the Scottish Government should work with local authorities to improve the availability of community and public transport, and it should include transport policy as a strand in any isolation strategy.
In conclusion, I thank all members for their contributions. Like the minister and other members, I think that this has been a very good debate on an important subject that can affect any one of us at any time and certainly any of our constituents. The Equal Opportunities Committee has done a fantastic job in raising an important issue; it has carried out a very valuable piece of work that I hope will be a legacy to be carried forward during the next session of the Parliament.