HOUSING FOR THE ELDERLY

HC Deb 03 March 1961 vol 635 cc1929-2016

11.6 a.m.

Mr. Gordon Matthews (Meriden)

I beg to move, That this House welcomes the recognition given in the White Paper on Housing in England and Wales to the urgent and increasing need far more housing and other accommodation for old people; and, while recognising the progress being made in providing it, calls on the Government to see that this progress is maintained, and to take further steps to ensure that the accommodation provided for old people is really suited to their special needs. I am very grateful for this opportunity to call attention to the most pressing need facing elderly people today. The White Paper on Housing is, I feel, a very encouraging one. It is good to see that there certainly is no complacency in the wording of it. In more than one place it refers to the urgent need for something to be done about accommodation. More is needed for old people as well as for young.

It is useful at a time like this to take stock of the position and to look back over the last few years to see what progress is being made in helping the old. In 1940, when the National Old People's Welfare Council was formed, there were, I understand, only 44 local old people's welfare committees. Now, twenty years later, there are 1,630, and, in addition to these, 62 regional and county committees. I give those figures as evidence of the tremendous progress that has been made in the last twenty years. In the last ten years there has been an increase in the amount of building devoted to old people. Ten years ago only 7 per cent. of our building was devoted to this purpose. Now it is in the neighbourhood of 29 per cent.

Eighty thousand people are now living in welfare homes provided under Part III of the National Assistance Act, 1948, and every year a further 3,000 places are being provided. There are 70 geriatric departments in hospitals for the rehabilitation of elderly people and the number is growing all the time. Under the Mental Health Act, 1959, this work has made great strides. It is saving elderly people from ending their days in mental hospitals.

Neither should we overlook the tremendous progress made in the development of domiciliary services, the increased number of health visitors and nurses. The number of home helps has been trebled since 1951. Boarding-out schemes have been approved. Then we have ventures like Parnham House, the residential home for 42 elderly ladies suffering from mental infirmity. I believe that the W.V.S. has a similar scheme in contemplation. As we all know, these elderly ladies present a growing problem to the community. In attempting to secure suitable care for them, we have to make rather special efforts. This is what is being done by the National Association for Mental Health.

I cite those cases as examples of what is being done by voluntary effort throughout the country; but still we have a long way to go. We welcome particularly the prospect outlined in the White Paper of increased subsidies for old people's homes where the local authority is able to satisfy the test of financial need. We welcome also the promised relaxation of the rule in regard to one-bedroom dwellings. Above all, I think, we welcome the further encouragement which is to be given to approved non-profit-making housing associations. The signs of urgency expressed in the White Paper are encouraging.

In this respect, I wish to quote from page 10 of the Annual Report of the National Old People's Welfare Council. Referring to housing associations, it says: There are now 638 housing societies"— another 12 have been added since the Report was issued— affiliated to the National Federation of Housing Societies, of which 209 provide accommodation solely for elderly people. However, even this welcome improvement is not nearly sufficient as practically all these schemes have long waiting lists, and vacancies when they occur can be filled many times over. Later in the Report it is said that In some areas housing societies providing accommodation for the elderly work closely with the local old people's welfare committee, and each body is represented on the other's committee. This is an ideal arrangement because, through this co-ordinating link, information regarding welfare services can be made available to the tenants. Further, the two organisations together can obtain a better picture of the accommodation needs of the elderly in the district. North West Kent and Hampstead are examples of two such areas where this co-operation exists. I hope that my hon. Friend the Member for Nottingham, South (Mr. W. Clark) will be able to add to what I have said with regard to housing associations.

We are all aware of the immense problems created because we are an ageing population. According to the Report of the Phillips Committee on the Economic and Financial Problems of Provision for Old Age, Cmd. 9333, the percentage of elderly people in our population back in 1911 was only 7 per cent. Ten years later it had risen to 8 per cent. Ten years later it was 9 per cent. Ten years later it was 12 per cent. By 1951 it had reached 14 per cent., double what it had been in 1911. By 1965 it will have reached 15 per cent. By 1979 it will have reached 18 per cent., nearly treble the proportion in 1911.

This rate of change, fortunately, we are told, is likely to be much smaller during the next twenty years, but I do not think that we have reason on that account to be complacent about the need for more housing for old people. We all know the reasons—the decline in the birth rate and the increasing expectation of life which old people enjoy nowadays. We welcome the latter, of course. Let us make it possible for them to live even longer than they do now.

The House will know that many of the private homes provided for old people are very much below standard. Several of the best homes are accommodated in converted Victorian mansions, many of which were already worn out before they were converted. Voluntary bodies are stretched to the limit of their financial resources, and there is immense pressure on beds in mental hospitals owing partly to the disruptive effect of having living in one's home someone who is becoming senile.

On 17th May last year, Mr. Peter Townsend, Lecturer in Social Administration at the London School of Economics, contributed an article to The Times on the subject of private homes for old people. He said that most local authorities are allowed, under certain conditions, to pay the costs of maintaining residents in voluntary Homes. This power has been increasingly used, because of the pressure on local authority accommodation and the shortage of funds for new buildings, but there are signs that it cannot be extended much further. Voluntary associations lack the funds, and to a large extent the incentive, to open new Homes. He went on to point out that the geographical distribution of these homes is extremely uneven, saying that there are no homes in 48 of the 146 local authority areas, principally in the north of England, Wales and the Midlands.

Later in his most interesting article, when referring to an extensive survey he had carried out, he said: …"a substantial minority of residents in private homes were dissatisfied and quoted restrictions on their movements and freedom of choice. In two-fifths of the Homes small personal articles of furniture were not allowed. Sometimes residents were not expected to leave their rooms during the day. In a few Homes visiting hours were narrowly restricted…In two we found bolts outside bedroom doors.…Altogether a third of the homes…could be said to be seriously deficient in their amenities. I think I have said enough on this point to convince the House that there is need to consider the position of the private home. I hope that my hon. Friend the Member for Barons Court (Mr. Compton Carr) will be able to deal with the matter more fully later in the debate.

The National Assistance Act, 1948, Part III, introduced a new duty on local authorities to register and to inspect homes for disabled persons and the aged, but in the absence of Ministry of Health Regulations for registered homes there appear to be no standards to work to and no statutory powers of enforcement in cases where disputes arise. There seems to be a lack of uniformity in the approach of local authorities to this problem throughout the country, owing, to a certain extent, to vagueness in the wording of the Act and a lack of enforceable regulations. One hears of cases where district public health inspectors have worked to various standards, some according to lodging house standards, some according to Ministry of Health institution standards, and others according to hotel standards. We hear also of proprietors of old people's homes who, while specialising in accommodation for old people, decline to register because they call their establishments guest houses or boarding houses. Regulations on sanitary facilities, the number of people to be accommodated, fire precautions, means of escape and other matters of that kind would greatly simplify the procedure and save time.

What can the Government do apart from tightening up regulations of this kind? We must be clear about the extent of the need, and it seems that there is considerable scope for further research. The needs of old people vary very much. At the risk of oversimplifying the case, I shall, for the purposes of my argument, divide old people into three groups. First, there are the chronic sick, the bed-ridden and the senile, Who are mostly housed in acute hospitals, mental homes, private nursing homes or, perhaps, in their own homes. Second, there are the ambulant and geriatric cases, who need stimulating, many of whom are living in welfare homes established under Part III of the 1948 Act, in voluntary homes or in registered or unregistered private homes. Lastly, there are the hale and hearty living at home with their families, or it may be living alone or boarded out.

The personal needs of all these groups differ considerably, and each has to be dealt with on its merits. All of them have one thing in common: the wish to preserve their independence so long as they possibly can, Which is absolutely vital for old people. The majority are far better off in the care of their own family than in the best of community homes.

There is a lack of reliable statistics, but so far as one can tell we have to face the fact that approximately one in ten of old people of pensionable age are bedfast or confined to their home. About one-sixth of the remainder are lonely, desperately lonely, and many of them are not even today contacted by the welfare services. They are the most isolated people in society; 25 per cent. are unmarried or Childless and desperately need friends and visitors. About the same number are living at home but imposing a very severe strain on their families because of their continuing infirmity, incontinence and difficulties of that kind.

One hears of so many cases where an aged husband is valiantly trying to nurse his sick wife, or of a married daughter with a large family who is heroically endeavouring also to keep her old mother happy, or of an elderly daughter who is herself getting on in years having to look after an old parent. I am sure that we could all cite numerous cases of people living in most tragic circumstances even in this modern age.

Then there is the last class. I suppose that approximately two-thirds of our old people enjoy a reasonable degree of security and live with their family, which is where most of them ought to be and where they can be happiest. But they are an expensive problem. Many are housebound and handicapped. I feel that too little detailed attention has been given to the problem of these chronic cases, in contrast to the enthusiasm we see in certain quarters for helping the able-bodied and active by the provision of social clubs, day centres and the rest of it.

It does not seem to me that there has been co-ordination of effort in studying the various needs, such as professional nursing attention, help with dentures, hearing aids, spectacles, laundry services, hot meals, chiropody, recreational facilities and the rest of it. A great deal is being done by various voluntary associations and by local authorities, but it seems to me that the whole scheme needs co-ordinating. There is no doubt that people of 70 or over who live alone—and many of them are living alone—need supervision. Too little attention is being given to what the Rutherglen Report calls the overwhelming dislike of enforced retirement.

The recent Bethnal Green Report pointed out that to many working-class men retirement is a social disaster. I should like to refer to that later in connection with the need to bridge the gap on retirement, in order to keep them mentally and socially active. There is no time adequately to cover this immense field—I can only treat the subject sketchily—but I should like to outline a scheme which has been in operation for many years and which seems to me almost an ideal arrangement. I refer to the Linen and Woollen Drapers Institution and Cottage Homes, of which I have been a member of the board of management for several years.

This wonderful Institution is maintained completely by voluntary contributions. It runs two estates for old people, one at Mill Hill, where there are 200 residents, with an extension for another 50 in hand, and another estate at Derby, where 150 old people are accommodated. A third is being planned in Glasgow. Those estates provide adequate facilities, not only for the people to live in independent cottages so that they retain their independence so long as it is humanly possible for them to do so, but also for social intercourse. They also deal with the medical side of the problem, which seems to me to be the crux of the whole matter. There must be medical and nursing facilities available on the spot.

If a community is organised consisting of 150 people—perhaps 180 is about the ideal number—and if provision is made —as is done at Mill Hill—for bungalow cottages for the able-bodied, with a little garden to keep them interested in active pursuits, and an assembly hall in the middle of the estate for their social gatherings, whist drives, concerts and the rest, there is then provided, I think, everything necessary for an old people's home. In addition to about 88 of these little bungalow cottages there is a block of flats at Mill Hill—there are two at Derby —for widowed ladies and spinster ladies who do not need a cottage. They could not cope with and would not want a garden and are better housed in a flat. These little flatlets have two sitting-rooms, a separate kitchen and bathroom and a little spare bedroom further along the passage, so that the occupant can have a visitor—it may be a younger person—to stay with them from time to time.

So much for the younger of our able-bodied and active old people. But what happens when they become too old to look after themselves? It is inevitable that then they lose some of their independence. It is then that we are ready to take them into what we call the rest home, it is a kind of hostel, where each resident has a bed-sitting-room and there is a common lounge and dining-room where they can all feed together if they are well enough. Their cooking is done for them and they are cared for in every way.

Then comes the crisis case, and this is the crux of the problem. What happens at the average old people's home when an old person has a stroke or becomes bedridden, or a helpless chronic case? What happens then? We all know the dreadful story. They go off down the road by ambulance with the feeling that they will never come back.

In our little community we have a nursing cottage, a hospital, right in the middle of the estate. Before they ever get to the stage where they have to go to this hospital themselves, the old people have been in the habit of visiting their friends in the nursing cottage, taking them flowers from their gardens, having little chats with the patients and keeping on friendly terms with them. When the crisis comes for them the uprooting is minimised. They are quietly transferred to the nursing cottage which is already familiar to them. The whole thing is quite different from going to hospital. There all the attention they need can be provided. It seems to me that it is extremely important to minimise, so far as possible, this dreadful, almost fatal uprooting which occurs when old people are taken seriously ill and have to be removed to hospital.

Another advantage of an estate of this kind, where we have 180 people congregating together, is that it greatly facilitates the necessary supervision of the old people and the means of providing help when it is needed. The residents have little cards which they put in their window if they are not feeling well, and if when doing morning inspection the matron sees a card she at once goes with an offer of help. The more chronic or dangerous cases are sometimes linked with a bell.

There we have a scheme which is the result of very careful planning. It certainly is not a new idea. The original cottage homes established at Mill Hill were started by Mr. James Marshall of Marshall & Snelgrove at the end of the last century. So this idea is nothing very new. It is the result, however, of careful planning and experience. I think the effectiveness of this integrated pattern of home life and welfare services is proved by the fact that the residents are quite definitely happy. We have only to see them to know that. They live, on the average, about ten years longer than other old people.

From the practical point of view, maintenance costs are very low in comparison with what they are in their own homes. I have recently been studying the annual report for the year ended 31st December, 1960, from which I see that the cost per head per year for the free accommodation provided—that is to say rates, central heating on the district system, lighting, cleaning, salaries of nursing staff and domestics, gardens and gardeners, residents' coal, of which they are given a free allowance in addition to central heating, repairs and maintenance, insurance and all sundries—amounted on the estate at Leylands to £137 per resident and at Mill Hill to £116.

The difference in the cost is due to the number of residents, which suggests that at Derby it is not quite enough to be economic while at Mill Hill we have about the right number. That number of 180 appears to be right. It is a cost of about 45s. a week, which, the House will agree, is a very reasonable figure for providing such accommodation. It does not, of course, include personal housekeeping expenses, food and clothing or, for that matter, the cost of an electric fire, which is provided by means of a meter in the cottages.

I claim that this is an almost ideal arrangement for elderly people. The accommodation is of bungalows and flatlets and a rest home. There is a separate rest home for the men who, perhaps, are not quite so self-reliant when living alone. More has to be done for them than for the women. There is also an assembly hall and a nursing home on the spot. It is the most convenient scheme that we can devise for health visitors and others who have to work among old people.

I have to admit that there are certain drawbacks, one of which is the high capital outlay for an estate of this kind. We are aware that bungalows desirable as they are cost 20 per cent. to 25 per cent. more than houses. We also have to take into account that an estate of this kind takes up a very large area and would not fit in with some of the problems in the need for higher density. We also have to realise that sometimes on an estate of that kind they may be sited too far from the old people's old homes. They do not want to be uprooted and taken a long way from their family surroundings. It is very difficult to persuade them to move in those circumstances. I suggest that these drawbacks can be got over in the crowded areas, first by more efficient methods of construction, but mainly by building flats on top of old people's accommodation. The old people would have the first claim on the ground floor level, as is done in Camberwell.

A lot can be done by siting colonies for old people in the middle of new housing estates. It was interesting to read in this morning's newspapers about a scheme at Hillfields, Coventry. There was an illustration of a big housing estate with a block of 30 storey flats, three blocks of 17 storeys and eight with 11 storeys. That is on a new housing estate which is to provide accommodation for 1,810 dwellings linked by footways for pedestrians, a shopping centre and so on. However, nothing is said in the enthusiastic description of that housing estate about the needs of old people. When we work out the population figures and find that 18 per cent. of the population by 1979 will be old people, we find that on that estate there should be 325 dwellings for old people. That is the equivalent to the whole of the big 30-storey block.

Nearer my home, at Walsall, in Staffordshire, there are what are called "granny annexes" built to provide houses where old people can live a semi-independent life, independent of their families but so near to them that they can be supervised and taken care of. One likes to think that in an estate such as that in Coventry there could be an old people's health centre in the middle of the estate among the younger people and providing special accommodation for the old. There should be great possibilities there. When one considers the practical problems of erecting such homes, I suggest that we should learn from the experience of the consortium of local authorities who have done excellent work in the building of schools.

The House will know that local authorities of Convetry, Derbyshire, Durham, Glamorgan, Leicester, Nottinghamshire and the West Riding of Yorkshire have combined in co-operative efforts to carry out research and development into the building of schools. Their building programmes have been co-ordinated on a major scale and this has brought about considerable improvement in costs in design and finish. The aim is a rapid assembly on the site with factory produced components which are rather like the "Meccano" with which we used to play as children. There is the smallest range of parts and the biggest batches of production. This system is known by the initial letters, C.L.A.S.P. and has resulted in bulk buying and considerably reduced costs with higher standards of design and finish.

The same method could be adopted for old people's homes. It would have the advantage of reducing costs and giving us much more for our money. However, before this could be done, considerable research is needed into design, layout and equipment necessary for efficient old people's homes, the problems of space and water heating, fire and home safety precautions and sound heating insulation. We all welcome the leaflet produced by the Ministry of Housing and Local Government entitled "More Flatlets for Old People." We look forward to the report of the Central Housing Advisory Committee on standards of design and equipment. We could do with more bulletins such as the Ministry of Education has issued to outline the design of model day hospitals and also for model day centres with workshops for the able bodied such as those at Shrewsbury, Letchworth and Camberwell and for suitable accommodation for women and batchelors.

I appeal for more research into the attitudes of old people themselves. What they want is perhaps not what the officials and other welfare workers consider that they ought to want. In this connection I quote from the report of the Tenth National Conference of the National Old People's Welfare Council held in Blackpool in 1960. In a talk at that conference, Dr. Mark Abrams said: We need many more straightforward enquiries into the living patterns of elderly people…There is need for much more information about such topics before it is possible to get down to practical policies…I should like to see development of much greater concern with measuring old people's own attitudes…in regard to what they feel about the narrowing of their interests…we should systemmatically enquire how far old people want peace and quiet, how far they want activity…the sort of company they want. We lack evidence on these things. We live in an atmosphere of change and experimentation. Our success in this very important sphere depends, to a large extent, on central and local government and on the voluntary workers who are doing wonderful work under most difficult conditions in some cases. But it also depends on the willing co-operation of the old people themselves. The planners and the architects have a vital part to play, but the old people must also play their part. Instead of carping about their pensions, as, I am sorry to say, some of them do, if they would count their blessings and express gratitude for the good things which are coming their way, it would be a great help to some of us who are trying very hard, through voluntary means, to help them.

This business of growing old is still clouded with prejudice and conventional Victorian beliefs. Women no longer wear black dresses, mob-caps and shawls at the age of 40. But there is still a narrow limited outlook on the problems of old age. The age of 40 is only the beginning of a second innings in life. Let us look at it in that way. Old age develops a creative urge and a power of its own which we have seen demonstrated and proved by several leading Members of this House. Powers of judgment and discrimination increase. We are told that at 60 our minds reach their maximum maturity. At 70 we should be entitled to do what we want to do.

We will all be old one day. Let us realise that there are great possibilities through science, medicine, and all the knowledge that we have these days of providing a glorious future for the old people and, incidentally, for ourselves.

11.43 a.m.

Mr. A. E. Hunter (Feltham)

I wish to congratulate the hon. Member for Meriden (Mr. Matthews) on his success in the Ballot. On Fridays, we have often debated the needs of the old and elderly people. The hon. Member has shown by what he has said, not only about housing, but about other welfare services necessary for the old people, that he has sympathy with them. I congratulate him on selecting this subject for discussion today. As he was speaking, he reminded me of a very old saying, "As we get older together the best is yet to be". I hope very much that those words will come true.

The Motion is mainly concerned with housing. It is one of the great social problems of the present time, especially in Middlesex, London and our great cities. All local authorities have long waiting lists of applicants with many urgent cases. The Motion calls attention to the need for housing for the elderly.

I am sure that the Parliamentary Secretary, who, when he was a back bencher, made a study of the needs of the old people, will agree with me when I say that the housing needs of the aged can be solved only by the local authorities. The majority of retired people can afford only a moderate rent, and private enterprise building is not likely to satisfy their requirements. I know that private enterprise is building bungalows on the south, east and north-west coasts, for elderly people, but the requirements of the majority of retired people, whether it is for houses, bungalows or flats, must be met by the local authorities.

We have approximately 5½ million retired people and the number is increasing each year. Therefore, the subject raised by the Motion is an urgent one. The problem is likely to increase in the coming years. In my constituency, the local authority has paid attention to the needs of the old. We have excellent old people's bungalows and flats. In fact, when we have had visitors from abroad to see housing estates in England some of the old people's bungalows in Felt-ham have been selected for them to visit. A certain percentage of them have been built on housing estates so that the old people are linked with the younger generation. Although they are excellent bungalows, and are very much liked by the old people, especially be- cause they have gardens, radiators in the bedrooms, modern kitchens and bathrooms, many more are required.

Because of the shortage of land in the London area, Middlesex and around our big industrial cities, the future development is likely to be in flats. These can be designed in a modern way which can be comfortable and pleasing to the old people. I have seen some of the booklets issued by the Minister of Housing and Local Government, and they give good examples of what can be done for the old people.

I suggest that the best policy of the Ministry is to include old people's dwellings in housing estates with the rest of the community. I do not think that it is a good thing to put old people on separate estates. I think that they like to be with the younger generation and to see the children go by their garden gate or by the ground floor of their flat. I hope that the Ministry will pay attention to that point.

The Ministry has issued a White Paper from which, I understand, the subsidy in respect of old people's dwellings is to be increased. This will help the general housing problem. I often find on the waiting lists of local authorities the names of old people who are living in two or three-bedroom council houses because there is not an old people's bungalow or flat available. If they were transferred to old people's dwellings, this would make units available for families. Therefore, by helping the old people we will also help to solve the general housing problem for other people.

Old people's dwellings should be near the shops and buses. The old people like to do their own shopping, but they do not want long walks. Also, they want to go into the town. If there is a bus stop near, the old people can mix with the rest of the community, do their shopping, and go to a cinema, Darby and Joan clubs or other places of entertainment without a lot of inconvenience. I hope that that point will be borne in mind.

The great need is for more accommodation at moderate rents. As I have said, there are 5½ million retired people and the number is increasing. I think that a minimum of 1¼million of retirement pensioners are on National Assistance, so that we can see that the policy must be to provide accommodation for elderly people in which the rents are moderate. This is a point which I feel hon. Members on both sides of the House will support. The majority of retired people are living on limited incomes, and, therefore, we should do all we can to see that the accommodation is let at rents which they can afford.

The Parliamentary Secretary to the Ministry of Housing and Local Government (Sir Keith Joseph)

The hon. Gentleman is making an exceptionally good speech, but I hope that he will allow me to point out that the National Assistance Board does meet the rent, where it is a reasonable one, in addition to the basic allowance.

Mr. Hunter

Yes. I am glad to have the hon. Gentleman's interruption. I know that the National Assistance Board meets the rent in some cases, but there is a balance of about 4 million people, who have only their retirement pension or perhaps a small pension from a local authority or firm, or other small income, who fall between the two classes. Therefore, we must keep the rents down to what they can afford.

The hon. Member for Meriden mentioned other types of accommodation. We all know of cases in which old people living in bungalows or flats become bedridden or infirm, and who, even with domestic help, need special attention. In support of the hon. Gentleman's plea that there should be more accommodation for old people, I suggest that there should be wings of hospitals as special accommodation for old people. It is very difficult to get old and infirm people needing treatment properly cared for, and I hope that the Parliamentary Secretary will try to link his policy to the suggestion that wings in hospitals should be devoted to old people who cannot look after themselves.

This is a matter that should be pushed ahead with all possible speed. The hon. Member for Meriden has mentioned the welfare services, meals-on-wheels, the Darby and Joan clubs, which render a great service to old people. But housing is one of the main problems for the 5½million retired people whose number is increasing each year. This is a problem which brooks of no delay, and I hope that when the Parliamentary Secre- tary replies he will give us some hope that the Government will push ahead with the problem dealt with in this Motion.

11.52 a.m.

Lady Gammans (Hornsey)

I, too, am very glad to have this opportunity of saying a few words in support of this Motion. This is a subject which is above party politics. It is something which all of us, on both sides of the House, have very much at heart. As my hon. Friend the Member for Meriden (Mr. Matthews) has said, most of us will one day be old, and most of us have either elderly relatives or friends, and we all have a duty to see that these people, at the end of their lives, live in reasonable comfort and happiness.

In China and Japan, in the old days, there was a special status for one who attained retirement. At a certain age, the head of the household would retire in favour of his son, who would then take over all business responsibilities and the responsibility of looking after the family unit. When the father retired and arrived at that very honourable status in the old China and Japan, he was looked up to and revered by the community, and his advice was sought and listened to.

It seems to me that, in our crowded and very hurried lives today, there is a special need, perhaps, to think not only of the material benefits that we give to old people, but also of their happiness, their independence and their peace of mind. I know, of course, that a great deal is already done, both nationally and also locally, and by private enterprise, but there are still so many old people who seem to fall between these nets, who do not seem to be catered for, and so many of whom are unhappy and lonely.

A lot of that has come about because members of some families have emigrated —certainly, a good many have in my own constituency—and have left the old people to break up their own homes and find rooms in overcrowded houses, in which, perhaps the landlord did not want them. Perhaps the landlord intimated to an old lady that he wished her to go, when she had no intention of doing so, if she could help it. It seems to me that there are so many people who really need our help in that way.

My own borough, I am very glad to be able to say, has been a pioneer in work for the elderly. We have many different schemes in Hornsey which are very admirable indeed. We have many homes for old people, we have clubs of all kinds, in which they can get together, have hot meals, where they can sit in the afternoons and have opportunities not only to talk, but use their hands in an effort to keep away boredom, because boredom kills as much as anything else. They feel that they are living in a community and have the benefit of community services. A great deal has been done by these clubs.

I am thinking more especially of one in my own borough, where there is a residential annex, which is there for the benefit of formerly active people who eventually find that they need to be looked after. Most of these clubs and homes have been supported by voluntary effort. We have another rather exceptional scheme which is called the Housing Trust, by means of which property is bought and rooms are rented to old people at very reasonable rents. There is also a visitor, who goes round to look after them, see what their needs are, and that they are not ill or lonely, because so many people die alone in lonely, cold rooms at the tops of houses.

There is an Old People's Welfare Committee, and wonderful work is done by its visitors. There is literally nothing which these visitors cannot do to help these people. They help them by collecting their prescriptions, by paying their insurance premiums, by making sure that their furniture is all right or attending to it if it needs repair, and looking after their health. They do another valuable service by looking after those who are mentally afflicted, who, though not ill enough to be taken away, are unable to look after themselves properly at home. After they have been fed, clothed and looked after when mentally ill, when they recover, they are taught how to take up the strings of life and how to live again.

I have no intention of making a long speech, but I should like to say a few words about a few things that I should like to see, done in the future. I realise all that has been done and is being done, but I should like to see more boarding-out for old people. If they could be taken into kindly homes, just as children have foster parents, so these old people could be boarded out to families who would look after them. They would need to be placed with sympathetic families who would care for them and make them happy.

As has already been suggested, there should be blocks of flats, and in each one of them there should be somebody in charge, like a matron, to see that the old people are helped. They should be mixed flats, not just flats for old people, but flats for old people and young families as well, so that the old people will feel that they are living in a community and leading normal lives.

When we are making so many plans for the young today, as we certainly are, we should certainly think more than we do of the many old people whom we have in our midst. We owe to them a debt which we should repay, because it is really on the foundations which they have laid by the work which they have done on which we ourselves are living and from which we are benefiting.

12 noon.

Mr. John Mackie (Enfield, East)

When the hon. Member for Meriden (Mr. Matthews) said, early in his speech, that we had a long way to go, I felt that that was almost a masterpiece of understatement. However, I must straight away congratulate him on opening this subject this Friday morning because, like everybody else who has spoken, I consider it of tremendous importance today.

I said I thought the hon. Member had made an understatement. That is because of the size of the problem. In my own constituency we have a list of nearly 600 old people who have made applications for flats. Consider a Member of Parliament's problem. I am a new Member still, and perhaps I was more enthusiastic in the earlier days, eighteen months ago, but anyway at that time I had some luck in getting a couple of old people accommodation. No doubt the rumour spread that I had done so, because I have had queues, almost, of old people coming to see me about their needs for accommodation and with tales of their troubles which are really quite pathetic.

Consider the old people sitting in single rooms, which are usually upstairs. It seems to me so tragic that those rooms are always upstairs. They sit in a single room, with no bathroom, no hot and cold water, with the lavatory outside at the back of the premises. Those old people are as much as 82 and 83 years old.

This is why I have come here today to impress upon the Government that something be done, because I simply cannot go on month after month having my constituents come with these dreadful problems and having to turn them away without being able to help them. It is a dreadful thing to have to tell them that there is a waiting list of 600 or thereabouts and how long it will be before anything can be done. Fancy having to tell an 82-year-old lady that it will take ten years before she comes on to the list! She simply cannot bear to hear it, and I simply cannot do it. That is why I am pleading today that the Government should do something about it.

Poverty comes into this more than a lot of people think. Recently, my wife has been interesting herself in the plight of the old people and taking an interest in old people's clubs, and she has been amazed at how hard up some of these people are.

I was discussing this with an old person the other day, and she said to me, "It costs more to stay in bad conditions. If you want a drop of hot water you have to put the gas on and boil a kettle, and that costs more than if you are in a centrally heated place." Everything costs more. For one thing, people living in bad conditions tend to try to get out more than other people, to get away from their unhappy conditions, and that in itself is a factor which must be taken into account.

The hon. Member for Meriden covered the great width of the old people's problems and I was interested in what he said, but my interest today is chiefly in the question of houses for people who are prepared to look after themselves. I would, however, like first to say a word about old people's homes, because I think that they are essential for people who cannot look after themselves altogether.

The first thing is that there are not nearly enough of them and they are too far away from the areas where the old people living in them lived previously or were brought up and where their relatives still are. There is nothing worse for old people than being moved away from where their families are. It costs a lot to go to see them. Some of those who go to visit old people in old people's homes are themselves 60 or 70. It is common to see a man or woman of between 60 and 70 going to see his or her mother of between 80 or 90, and having to go to south London from Enfield and paying 5s. or 6s. in fares, which is hard on them as well. That is the first thing, that there must be more buildings, and to see that those homes are built near where the people who are to live in them previously lived.

I had an old employee. He was so long with me that he became a friend rather than an employee. He retired and ultimately went to an old people's home. He told me that it was really too well run for him. He was not even allowed to clean his own boots. That is a bad thing, to treat old people like that. This old gentleman—he was a real gentleman —was quite shocked at this, that they would not let him clean his own boots. It was quite extraordinary. I think that it is a good thing that the old people who can do it should be allowed to do things like that, to have things to do to keep them occupied, and to do everything for themselves that they possibly can do.

Now I come to the question of houses for people who are able to look after themselves, either single people or married couples. First, I would say that I agree with my hon. Friend the Member for Feltham (Mr. Hunter) that there should not be colonies of them. I am all against old people's colonies. I know that it is probably cheaper to build accommodation that way, probably with central heating and central hot water supplies, and so on, and with a central garden, but the drawback is that the people there sit watching one another's funerals, and that is a very bad thing.

Like my hon. Friend, I say that they should be sprinkled through the community so that they can keep in touch with young people. In old people's colonies the people see one another every day and, therefore, they tend not to go to meetings, to old people's clubs, and so on, whereas if they were to be sprinkled through the community they would. Old people's clubs are a lifesaver for hundreds of thousands of old people. We have them in Enfield and I am astonished at how much good they do.

Mr. Matthews

In my remarks about old people's clubs it was my intention to say that they should be the centres of the communities. The two features of the community I described are, on the one hand, the hospital, and, on the other, assembly hall, where the old people can meet for social gatherings. That is most important. I did not, I think, emphasise this enough in my remarks, because I was anxious about time. But I do want to stress its importance. The social centres help to keep the old people active. That is why I stress their importance.

Mr. Mackie

I appreciate the point. I was on a slightly different one. I was speaking of people living in a large community in single rooms without opportunity to meet enough people.

I speak now about the classes of houses. I have seen some buildings where, for each person, there is a single room with small kitchenette and bathroom. I think that a bad arrangement. I would far rather that there were a kitchen-living room and a bedroom where there could be a bed settee where, say, a visiting daughter could sleep on a visit overnight. Sometimes there is a small single bedroom, but that is more expensive, and is not always used a lot. It is far better to have a large living-room cum kitchen, with a screen which can be drawn across the cooker and sink, and a bedroom where a couple can stay —the daughter who comes to look after the old person if he or she is unwell. I am sure that that is a much better plan than the living room or bedsitting room and small kitchenette.

A word about the question of heating and cooking. I know an odd lady who was shifted from the town, Where Ole had cooked by gas, to the country, where she found she had to use electricity. That may seem a strange thing—electricity instead of gas in the country; that may seem a strange way round; but that was how it was. Her utensils were of no use for the electric cooker. As she put it to me, "There is no low"—that is what in Scotland we call a flame—"for my pans." It is most important to see that when old people are moved they have equipment right for their new circumstances.

I come to the bathroom. I have experimented by getting into and out of a two-level old people's bath. They are an absolute menace, these old people's baths. I am amazed that we have not thought of trying to have a bath into which people do not have to climb, a bath one can get into from the side, with a revolving seat to sit on. A spray would be a good thing. It need not mean an expensive waste of hot water, for the bath could be plugged. The equipment in the bathroom is most important as people get older.

There is a great deal of talk about this general problem, but I should like to see some action. In my own constituency 600 old people are waiting for accommodation and at the present rate, as I have said, their need will not be satisfied for ten or fifteen years. That simply is not good enough. Borough councils cannot solve this problem themselves; it has to be done on a national scale. There must be a year to year plan of the maximum that can be done; a five-yeas plan, perhaps. I know that it is said that we must have a steady flow of building of all kinds and that we cannot switch building potential. I do not believe that.

A new office block has just been built in Enfield on a site which the Minister refused for house building and gave to a private firm. When this new 48,000 sq. ft. block was erected an enormous sign was put on it, which says, "To Le ". In other words, there is no demand for it. That building represents 120 houses for old folk. I am not saying that one could convert it. In advertisements in The Times, a month or two ago, there was enough square feet of office building to let to solve the whole housing problem of the Borough of Enfield. That is the potential that there is. I do not know what all the offices are being used for, but T am certain that in the position we find our old people today there is a better use for these sites. If the Government do not do something I suggest that the Tories are even worse than I think they are.

12.12 p.m.

Mr. Compton Carr (Barons Court)

After hearing so many speeches covering so many points, I feel that there is very little I can add to the debate. As this is a subject on which I, like many hon. Members, feel so deeply, I shall, however, take up the time of the House for a few minutes. I am not like some lawyers are reputed to be, namely, one of those people who find not solutions for difficulties but difficulties in every solution.

I feel that there are some matters which have been touched on already which we as a nation and individually in our official capacity as members of old people's welfare associations and local government bodies, really must face. I honestly believe that more old people are suffering today from cancer of the mind than there are people suffering from cancer of the body. This cancer has already been referred to by my hon. Friend the Member for Meriden (Mr. Matthews) and others. It is loneliness. It is something which is cumulative, something which takes away the will to look after oneself. It is something which takes away the will to do more than lie down and wait for the end which, nowadays, is sometimes a very long time coming.

There are gaps in the efforts which we are making at present. I am glad to see that my hon. Friend the Parliamentary Secretary to the Ministry of Health is here, because this problem is very closely tied with the problem of housing. It is one of the things which contributes to under-occupation. For example, old people often live in biggish premises and cannot bear to leave their old surroundings because it is all they have left. There is also a frame of mind which may sound rather peculiar to some people but which nonetheless is quite common. It is that as people grow older they have a great reluctance to move away from the district where their dead are buried. I so often hear old ladies saying, "No, father's buried here, I don't want to move away from him". That is something which we must bear in mind and something which arises out of loneliness. If they had other interests and other people interested in them that might not be such a factor. Local authorities have a greater part to play and, in some cases, private enterprise has a lesser part to play according to the effi- ciency of the two or the ability of the two to spend enough money to assist these people.

We have heard from my hon. Friend the Member for Meriden about the views expressed in The Times by Peter Townsend, of the London School of Economics. Following the letter which my hon. Friend read, hon. Members may remember he wrote two articles in The Times during May, 1960. I should like to quote a short paragraph from one of them which will make my feelings plain on the lack of assistance which private enterprise sometimes gives under the guise—perhaps with quite good intentions—of giving actual assistance. He said, having spoken of the good old people's homes that he had found, that At the other extreme was a dilapidated building for 21 residents. The bedrooms each contained three or four beds close together. They were uncarpeted and unheated. In one icy room a woman in her eighties was said to be dying. The beds had iron frames and lumpy flock mattresses. Some of the thin plywood doors could not be closed. Several floorboards were rotten; the stairs were very steep. There was no separate dining room and the lounge had insufficient chairs for all the residents. It had to be shared with the proprietress who had only one handyman, a cook and a mentally defective woman of 60 to help her. The charge was four guineas a week. The charge was not high, but that, I would submit, does not help at all. That is where local authorities must surely step in in order to help those who cannot afford to help themselves.

Finally, I feel we have to regard this to some extent as a three-pronged drive. First we must care for the lonely, homebound old people who have been mentioned already. Those people are, indeed, cared for already through meals on wheels, home helps, visitors from the old people's welfare associations, but there are still tremendous gaps.

I was once honoured by being vice-chairman of the Old People's Welfare Association in South-East London. We there had ability to give home help to homebound old people, but over the weekends there were no meals on wheels and we had to make a tremendous effort among people whom we knew were homebound—and they were a small percentage of the ones who surrounded us—,to supply even a Christmas dinner to those people. That was done on an almost completely voluntary basis. It is no use being over-sentimental about these matters, but we have to think of the case of the man or woman who is incapacitated to some extent and unable to get out and sometimes has not been out of home or room for years. We must think of these people sitting from Saturday lunchtime to Monday lunchtime literally waiting to hear the sound of a human voice addressed personally to them and waiting to taste hot food. That is something we have to do.

The other part of the drive is that we must empty the hospital wards of those who are not sick but who are merely old. We must make arrangements for them. Sometimes they are merely incontinent and sometimes—and we must face the fact—they are merely a nuisance and no one will take them off the hands of the general ward once they get in there. This is not a huge problem but nevertheless it is part of the difficulty that we have to face.

In common with hon. Members who have spoken so far, and no doubt with those who will follow, I think that we must also work harder to house adequately those who are fit to live their own lives in their own homes, because those are the people on whom the burden can be placed of looking after themselves. They are the people who need less welfare as long as they have better housing. If we do that, as I believe the Government intend to do, and if we as private Members can exercise our duty in pushing the Government always a little faster than perhaps they might otherwise go, we shall have done something to remedy this very large problem.

12.22 p.m.

Mr. Roderic Bowen (Cardigan)

I am deeply grateful to the hon. Member for Meriden (Mr. Matthews) for moving the Motion. There can be no doubt that, while medical science is progressing in a way which involves an increase in longevity, we are not keeping up with that development. Almost every hon. Member so far as referred, quite naturally by reason of the constituency he represents, to conditions in towns and populated areas. One of my reasons for intervening in the debate is that I should not like it to be thought that the problem does not exist in the rural areas. In fact it exists there in a more acute form in many ways.

Some of the references made to hardship so far in the debate fade into insignificance when they are compared with some of the hardships that have to be suffered by elderly people in the rural areas. Many elderly people in my constituency live in isolated places, in substandard accommodation, with no electricity and no water except a well which often is a considerable distance away, and no sanitation. In some cases the nearest neighbour lives a mile away. Loneliness in those conditions develops a significance far greater than that of some of the incidents cited so far in the debate.

I wholeheartedly agree with the concluding statement of the hon. Member for Barons Court (Mr. Compton Carr). The problem could be eased considerably in the matter of residential accommodation and accommodation for the chronic sick if a greater effort were made to provide housing for elderly people who are fit to look after themselves. Economically, in the long run, it would be a far cheaper way of alleviating this problem.

On the subject of housing accommodation for elderly people, one or two hon. Members have referred to rents. It is all very well to say that if these people are in difficulty the National Assistance Board will pay their rent for them. The group of people about Whom I am concerned, and there are large numbers of them among the elderly, are people who are just outside National Assistance scales. In my constituency there is danger of reaching a situation in which elderly people of humble circumstances who have led frugal lives and have savings and resources of one kind or another find themselves just outside the National Assistance scales, with the result that the only persons who can afford to take council houses provided for the aged are those on National Assistance. The people just outside those scales cannot afford to live in accommodation provided by the local authority for elderly people.

There is also another discrepancy. Rents Charged for housing available in the rural areas of a sub-standard character are much less than the rents which these people would be required to pay if they moved into council house property. These elderly people are faced with the dilemma, therefore, of either remaining in sub-standard accommodation at less rent or moving into council houses provided for the elderly which will involve a substantial strain on their weekly incomes. This is a problem to which we have not yet given adequate consideration.

I do not apologise for referring to the position in Wales in particular, and the record in Wales in the provision of houses for the elderly is not one of which we can be proud. The latest figures that I have been able to obtain indicate that proportionately half as many more houses are built for the elderly in England than are provided in Wales. I know that the Minister is doing something already in this direction, but I hope that he will bring every possible pressure to bear on Welsh local authorities to hasten their programmes for the building of flats and bungalow-type dwellings for elderly people in the Principality.

One reason why Wales is behind England in this matter is that the housing problem as a whole has been so great and there has been such a demand for two-bedroomed and three-bedroomed houses. In the rural areas one of the problems is that housing authorities are usually exceedingly limited in their resources. There are demands upon them in other directions and this sphere of social welfare is in danger of not receiving the priority that it deserves.

In my constituency we are particularly proud of the efforts made to provide residential accommodation. The problem in the area has been accentuated by one factor which should receive attention. It is that a substantial number of the elderly people who are now provided with residential accommodation in what we rather unhappily call "homes for the aged" are chronically ill. They should not be the responsibility of the county council. They should be looked after by the hospital authorities. The present arrangement is unsatisfactory from the point of view of the county council which already bears a substantial burden in looking after the aged. It should not be required to bear this additional burden which should be borne by the hospital authorities.

This arrangement is also unsatisfactory from the point of view of the homes themselves. The fact that there are in the homes for the aged a number of people who are in the chronic-sick category places an unwarranted burden on the staff. There is some danger that if the staff, very rightly, devote their attention to the chronic sick they are not able to carry out the necessary services to people who are in the genuine old-age category. I hope that the Minister will look into this problem.

We could do with a great deal more accommodation for the chronic sick in Cardiganshire, and many people who are now in homes for the aged should be moved into that accommodation. I should like to see far greater attention being paid to the possibility of setting up establishments of a dual character, that is, a home for the aged combined with a wing for the chronic sick. Two authorities come into this, and I see no reason why they should not combine and co-operate to provide the accommodation on a joint basis. If there were people in the home for the aged who, for a period, went into the chronic sick category and one had much greater flexibility of transferance from one side to the other, it would assist both the chronic sick side of the problem and also the home for the aged side. I believe that this idea is in operation in a number of areas, and I should like to see far greater attention given to possibilities in that direction, particularly in rural areas.

I hope I shall not be thought parochial in making these remarks. I feel that they illustrate the rural area problem in most parts of Britain. I wish to give an illustration from my own area. An hon. Member referred to the objection which elderly people have to being transplanted from their own surroundings into entirely strange ones. This is particularly acute in some rural areas. For example, if an elderly person where I live has to be given chronic sick accommodation, he has to be sent thirty or forty miles away to a place where there are virtually no public transport service facilities for visitors, and his prospect of having visitors depends entirely on whether his relatives and friends have their own means of transport.

There is an additional complication, quite apart from the person having to be moved that distance from his own locality. This problem exists in my area; I appreciate that one can make heavy weather of this, but I should like to give a specific example. People from the Cardigan area are sent to Haverford-west. In the Cardigan area the first language of the overwhelming majority of those over 65 would be Welsh, and they are moved to an area which is entirely English. The staff in the home will be English, and the surroundings will be entirely strange to the persons concerned. I do not want to make too much of the point, but I think far greater care should be taken to ensure that the transference of elderly people is carried out in circumstances which are made as easy as possible.

There should be the maximum of flexibility in the type of home provided and the way in which the home is run. It is impossible to lay down national standards and overall conceptions which will fit into every area. However, it is certain—reference has already been made to the figures in the Phillips Report—that the problem will become greater and greater, and unless we face it we shall be failing in our social responsibility to a section of the community which particularly deserves our sympathy.

12.34 p.m.

Mr. John Wells (Maidstone)

I am particularly glad to be able to follow the hon. and learned Member for Cardigan (Mr. Bowen) as I also wish to deal with the rural aspects of this problem.

I have two rural districts in my constituency, and there even by the end of next year the number of old people's dwellings in council possession will be only approximately for one in 250 electors. By contrast, in the Borough of Maidstone the proportion of old people's residences in council ownership is about one in fifty electors. So the rural areas have a very real problem in this respect.

In saying this, I should not want the House to think that I am implying that our rural district councils are dragging their feet in any way. They have very good programmes, and they are doing their best. However. as the hon. and learned Member has said, they have certain problems. Also, by contrast, the effort of the Borough of Maidstone has been outstandingly good in recent years partly because of the great ability and drive of the chairman and vice- chairman of our housing committee, the chairman being a master builder and a very experienced man in this matter.

Out of some 4,700 council houses, very nearly 400 are already old people's dwellings of one sort and another, and there are many more projected for the coming year. In particular, in the boroughs we are going in for the conversion of Victorian properties into flat-let units. In regard to conversions there is a great problem. Leaving aside all matters of subsidy, the cost per unit of accommodation is extremely high. It would appear to be much higher where it is done to council standards and to the very best possible requirements and specifications than when it is done as a private building venture.

Last week I was talking to an hon. Member about the conversion of old houses for resale as flat units, and he estimated that £1,500 per unit complete for purchase and conversion was a reasonable figure. I understand that many local councils are spending considerably more than £1,500 per flat unit, and, of course, the flats which they are making for old people are very much smaller—they are, in fact, flatlets and not complete family units.

Another very important aspect of housing for the elderly is the almshouses which exist up and down the country, not only in the boroughs but scattered about the countryside. Many of these almshouses have been well modernised, and it is a fallacy to think they are all quaint, damp old places. Nevertheless, there are some bad ones which must be attended to. There are cases in which if some assistance could be given to enable a once-for-all modernisation to be carried out the trustees of some charities would be enabled to put their almshouses on a better footing.

The hon. and learned Member referred to public service transport, particularly in rural areas. In various parts of the country there are old people's workshops which provide pensioners with light employment to bring them in an extra income and keep them busy and happy. These very excellent workshops are often sited in conjunction with the factory of a committee member or other philanthropic person. It would be a great advantage if persons planning works of this sort would bear in mind that they should be convenient to a bus route which goes straight to where there is a collection of old people's houses so that those old people do not have to change buses or wait inconvenient hours for buses.

The voluntary effort in my own constituency has recently had a great impetus as a result of the arrival of Group Captain Cheshire's Home for Incurables, which has taken off the hands of my town council a large and nearly derelict property. I fully appreciate that all incurables are not necessarily old people, but if there can be specialist homes on a voluntary basis for incurables it will most certainly lighten the burden of providing old people's homes as such. Here is an excellent example of co-operation between a council, which has let this mansion for a nominal rent, and voluntary effort. There is great scope in this matter for co-operation.

I turn to a number of the rural difficulties. First and foremost is the one of people not wanting to move from the village where they have lived and worked and in which, maybe, they were born. There are many pre-war three-roomed council houses in the rural housing estates which are occupied by single, ageing couples. This problem is the same in the country as it is in the town, but it is aggravated in the countryside, because couples do not want to leave it. It is, therefore, essential that councils should do what they can to scatter their old people's houses around the parishes. Their bungalows ought to be near the other housing estates, as has been said in the case of the urban problem.

In the country, there is the additional matter of the bus, and, if I may draw the attention of the House to it, the problem of the church, which in a village community is nearly always the centre. There is a great scarcity of building land in the centre of our villages near the churches. Old people like to be within easy walking distance of the church. The rector or vicar is nearly always a part-time voluntary worker attending to their needs, and it would ease his burden if building land could be found near the centre of the village where, perhaps, the single shop, the church, bus stop and Post Office are all situated; and, an important point which we must not forget, the telephone kiosk. All these matters are of great importance to our old people.

In the matter of town and country planning, the country planners far too often take excessive note of the value of agricultural land. I know of no farmer who would not willingly sacrifice a small area of his land to provide dwelling places for the old people of his own village, and particularly for his own retired agricultural workers. I imagine that the hon. Member for Enfield, East (Mr. Mackie), who spoke so interestingly about a retired employee of his, was speaking of an agricultural worker.

We are all aware of this great problem in the country of the retired agricultural worker living in an isolated house. It may be that the house is on a farm and the farmer wants possession of it for a younger man; but the old man has, indeed, become a family friend. This is a great problem. I hope that the Minister will see his way to easing the planning restrictions in our villlage centres to help local councils to find more building land. This problem is particularly acute in counties near London, which, although not strictly green belt areas, are very green-belt-minded. It is particularly important that people should be able to live their old age in their own village and near its centre.

The economic rent of these old people's bungalows in the rural areas is about £2 a week. My two councils are at present charging 12s. 6d. and 13s. 6d. a week, respectively. Many of those resident in old people's bungalows are in receipt of National Assistance. There is also the problem for those who are just above the National Assistance level, who need council accommodation, yet this relatively moderate rent of about 13s. or 13s. 6d. a week is a little high for them. Unfortunately, these rents are, I understand, going up on 1st April, and the councils are having a very great job in providing houses for their old people. The loneliness problem in the country can undoubtedly be got over if we take the step of providing more houses in the village centres.

Turning back to previous matters, which we have discussed in the past, about rural housing for old people, there has been very little comment on it in the House for many years. The only matter of note that I can find was the Committee, presided over by a previous Bishop of Winchester, reporting to the Ministry of Health as long ago as 1937, which stressed this very point that aged people in rural areas do not want to move. As a Government and as a House of Commons we have been aware of this problem for 40 years. It has seldom been discussed, but we have been aware of it. I should like today to press the point home to the Minister that something must be done

Another point concerning country districts is not only housing but amenities, such as electricity, sewerage and piped water. Young people living in country districts can manage reasonably well. They may complain about this and that and hope that facilities will come: but for old people it is absolutely essential that these amenities should come before too long. I would particularly draw the attention of the Parliamentary Secretary to various letters I have written to him about drainage in places within 40 miles of this House.

Again, there is the peculiar problem of rural electricity in green belt areas. An electricity board is not always willing to bring electricity to an isolated cottage on land where there will be no further development. Development is prohibited. Therefore, the authority asks why should it spend a vast sum of money in bringing electricity to one or two isolated cottages. It is obviously impracticable for the farmer or other owner to bring electricity, possibly many miles across country, to individual dwellings. This matter of electricity is tied up with the safety in the home of old people. Calor gas and other bottled gas, which are, of course, very good where one has not the piped gas, do not have quite that safety as electricity. If we wish to see the countryside continue to attract a full population—and by a full population I mean old, young and middle-aged—we must have more and more rural electricity.

I have mentioned almshouses. In my constituency the local authority has acquired five almshouses in the parish of Marden and has rehoused the old people who were living there. The council is to demolish those almshouses and on the site build ten old people's units. That shows what can be done by a go-ahead council.

There has been another interesting voluntary housing scheme at Otterden Place in my constituency. It is a large mansion on the top of a hill and a considerable distance from anywhere. It was the residence of a former Member of this House and has recently been passed over to a body known as the Mutual Household Association, which is an association providing individual residences and semi-communal residences for people of certain reasonable financial means.

I make that point because the problem of old age is not a matter of any one financial section. Old age and housing for the elderly affects people of all income groups. As I am endeavouring to deal with the rural problem, let me say that many of us are aware of retired farmers who went to live in a small house or bungalow, having perfectly adequate capital and taking a few acres, but then finding as the years went on that the bungalow and the few acres became a problem to them. The problem of old age affects all financial groups and among the better-off sections of the community this mutual aid system has great advantages and also helps large houses in the countryside to be maintained in good repair, thus preserving for the nation buildings of architectural importance.

I therefore urge the Minister to do what he can for us in the countryside, bearing our particular problems in mind. With other hon. Members, I am glad to see my hon. Friend the Parliamentary Secretary to the Ministry of Health here, because she is aware of many of the problems which we have in our constituencies concerning joint hospitals—belonging partly to the county council for Part III patients and partly to the hospital boards. In many, bathing accommodation is not up to standard. The hon. Member for Enfield, East mentioned poor bathing accommodation in old people's homes, but it is often bad even in hospitals for old people, and I urge the hon. Lady to study the standard of bathing accommodation in all hospitals which specialise in old people's welfare.

12.52 p.m.

Mr. B. T. Parkin (Paddington, North)

Listening to the speech of the hon. Member for Meriden (Mr. Matthews), like other hon. Members, I had no difficulty in finding compliments which I could pay to him if, later, I were able to speak. Not the least of the merits of his speech was the self-discipline which he exercised in compressing into a very clear and cogent speech a full survey of the whole problem as he has seen it and studied it and as he knows it to be from personal examination.

There was one phrase at the end of his speech which was unfortunate. I am sure that it was because it was a closely reasoned speech and that he kept within the limits of time which he had allowed himself that he did not have much time for his personal views and that a phrase slipped in which he wild regret, when he reads it in HANSARD, as much as those of us who heard it regretted it. It was a phrase about gratitude. I am sure that he will agree that there is no gratitude due to us from old people for what has been done for them. If there is any gratitude, it is due from us to the old people.

Mr. Matthews

I have found, in my experience in voluntary work in recent years, that it is a great help, when taking younger people to see older people in their homes, to make the younger people appreciate what is being done and what will be done far them in their old age, if the old people support us, in turn, by expressing appreciation. That has an important bearing on the efforts of us all—the Government as well as the private agency. The public must be made to realise that there is an appreciation at the other end. That is vital when it is a matter of spending public money. The battle is to get public support and good will and anything we can do to build up good will is all to the good, is it not?

Mr. Parkin

I am sorry about that. I do not think that that helps. I was hoping to hear that the explanation was that the hon. Member meant that there would be an appreciation of experiments and of efforts made to find a solution to problems of management to which there is no easy answer. I join with others in paying tribute to the immense range of experiment and study which is going on all over the country by public authori- ties and voluntary workers and the full-time workers in the welfare services. It is only out of that experience and case work and carefully noted results that, in the end, we shall get some understanding of the solution.

The problem which is chiefly our concern this morning is how to make more comfortable the extension of the expectation of life which has recently occurred because many of the important killer diseases have been conquered and most of us are nowadays destined to die of old age—which may be a long and painful process. That means that all this study of the right kind of housing and how far it ought to be self-contained and how far from medical services, and so on, is made more complicated by the fact that we are dealing with a group of people whose needs are changing almost from month to month, and certainly from year to year. We cannot make a static decision and say that an old couple will be all right for the next ten years. Their needs may change and their capacity to look after themselves may change.

I want to pay attention to the needs of what the hon. Member for Meriden described as his third category, those who are not yet moved into voluntary homes. In that connection, it is important, first, to consider the definition. IL is most unfortunate if we regard the elderly as a sort of homogeneous collection of people who are very much alike in their habits and needs. That is the first mistake. The elderly are just like us, only more so.

Each of us, at the beginning, will have minor ailments which will be exaggerated as the years go on and each of our difficult quirks of character will become more intolerable to the people closest to us when we have little else to do except to display those weaknesses. There is an immense variety. Those who are scholarly will become more scholarly, Those who are aggressive will become querulous and complaining, and those who are fearful will become more fearful, and so on. We are dealing with individuals.

One of the chores which distresses me, as a constituency Member, more than anything is having to go to old folk's Christmas parties. I am always asked to go and I sometimes go not as a compliment to the association of old folks, but to the people who have organised them. But it is positively indecent to be asked to watch a group of old people wearing paper hats and singing "Any Old Iron," or "Boiled Beef and Carrots," or something of that kind. Nobody is asked to go and visit a stockbroker's family's Christmas party and watch them put on their paper hats on the assumption that they are dear old things. A Christmas party is just something which takes place once a year. Like the rest of us, old people do not spend all their time at parties, but have their individual hobbies and interests to pursue.

However, there is one common factor applicable to ail elderly people, one thing which I would like to stress, because it will lead on to the particular difficulties of old people in overcrowded cities. It is the need for dignity. One of the most important things that we have to bear in mind is the need to preserve the dignity of old people and to be able to show them respect. The hon. Member for Maidstone (Mr. J. Wells) spoke about the problem of the rural areas. I know what those problems are. I have lived in rural areas and had grandparents who were agricultural workers. I had happy holidays at their cottage, for all its inconvenience.

The one thing about that way of life, in spite of its material inadequacies and the serious hardships imposed on elderly people in coping with those inadequacies, was that they could nevertheless keep a sense of value and dignity, which naturally attracted the respect of their grandchildren. It was a pleasure and an education to meet the grandparents in those circumstances. That is something which is missing in overcrowded city life.

The great undermining and rotting effect upon family life is the taking away of dignity from the life of old people in tenement houses—that and the question of security, which is something that the Parliamentary Secretary to the Ministry of Health will have to give a great deal more thought to as one of the consequencies of present trends in housing policy.

If a family lives in a country cottage, grand-dad goes to the "little house" at the bottom of the garden and stays there a long time. Nobody thinks that this is something to grumble about, or to be funny about. But it is a terrible thing when an elderly gentleman has to go down tenement stairs, in an embarrassed fashion, perhaps through the kitchen of a family living in the basement, to get to an outside toilet—knowing, as he goes, that the mother of the family, who has seen him pass, is annoyed because she must get her children to the toilet before they go to school. These are the terrible and undignified factors which make old folks lives a misery, making it difficult for their grandchildren to go and see them and appreciate the circumstances in which they live.

I hope, therefore, that when the Parliamentary Secretary to the Ministry of Housing and Local Government replies, he will say something about incentives which will be offered to planning authorities now that we understand the need for mixed accommodation, single flatlets and other devices. By subsidy or some other means, a certain proportion of small flatlets should be allocated to old people. It is not difficult to find a device by which to do this. The local authorities have found a way of insisting that there must be room for a certain proportion of garages, and who am I to quibble about that scale of priorities? But now that cars are all right, some device may be found for insisting that a certain proportion of flatlets should be available for old folk.

In addition, there is the problem of statutory tenancies—the dwellings left under control after the Rent Act, 1957. The Minister seems to think that progressive decontrol is something he need not worry about, that it will eventually work itself out, and that, in the free play of incentives, the right kind of reconstruction will take place. In my constituency there is a very nice small block of flatlets, produced after years of effort and detailed study. It is a gem. But it has only 18 flatlets, and what is that in relation to the population of a crowded area?

It is a valuable experiment and example, but in the meantime we shall have a missing generation of old folks who will get no attention. These statutory tenancies are increasingly occupied by older people, because of the date of the beginning of the tenancy. Their grown-up families have been rehoused, and once a couple's family has gone, and they are not going to have any more children, they cannot hope to improve their position on the housing list. They will not be rehoused, and they are at an age when they cannot be expected to have the initiative necessary to undertake ownership of these large houses.

Sir K. Joseph

Is the hon. Gentleman talking about people whose families move out, leaving empty bedrooms?

Mr. Parkin

I was coming to that point. It is a separate issue, but for the most part in my constituency it hardly arises, because the standard one floor unit is two rooms plus a back addition, which may be on the upper floors of the house, and, perhaps, is nothing more than the tiniest kitchenette. That could not be said to provide much room. Indeed, such a place should not be used for family accommodation in any case. That is a point to which I hope the hon. Gentleman will now give his attention, for I know that he has studied many aspects of the problem.

Let me put my points, however, before I deal with the problem which he raised. Old folks left behind in accommodation which is not overcrowded by present standards—one bedroom, one sitting room and a kitchenette—cannot get rehoused. But if there are vacancies in the rest of the house their lives are likely to be made more difficult, unless there is an improvement in the accommodation by the installation of sanitary facilities and self-contained units, because overcrowding in the rest of the house is of a disagreeable kind.

If a unit of that kind is left vacant, it cannot be made into a satisfactory self-contained family unit without considerable expense, so it tends to get let off in single rooms, which leads to more trouble over the sharing of facilities—the staircase, the toilet, the bathroom and the kitchen. Such a situation was all right when these old folk were young, when they got on with their neighbours downstairs and did not worry about who cleaned the staircase, or the doorstep, or the toilet. But the situation gets more difficult when strangers come in and the old people are not used to them. That is to put it at its mildest. Great social tensions stem from such a situation.

If we rehouse these people, moving them to a subsidised flatlet, we are mak- ing an undeserved present to the owner of the house—though I know that the Parliamentary Secretary to the Ministry of Housing and Local Government does not agree with me about this—of an increase in value, got at the expense of the community which built the flatlet to which the old folks have been moved.

The Ministry is in some way doctrinally inhibited from taking any steps to control such dwellings after moving the old folks out. Some way should be found of collecting from the owners a contribution towards the expenditure of building new council flatlets, or of guaranteeing that the vacant dwelling is reconditioned and properly equipped and made available for another old couple. Or there should be some tie-up by control of letting or by control of rent. There might be a forced grant to the landlord to make what can be made out of the dwelling.

I hope that the Ministry will look again at this matter—it has shown some flexibility recently over the subject of grants—to see whether it cannot take the same attitude as it takes towards discretionary grants and statutory grants, which are provided to owner-occupiers for certain periods on condition that they are used for certain purposes. With the existing rents payable in statutory tenancies there is very little a landlord can do. He cannot undertake the installation of a separate toilet, bathroom and hot water facilities. Strangely enough, it is only in the case of the old couples that there would be room for these improvements. On the other floors where there is a large family, one could not take part of the accommodation to instal these things, but one could do it in these thinly occupied old folk's dwellings.

Many hon. Members wish to speak. I do net want to make a major speech, but perhaps I might make this one point, that there is a missing generation here Which will escape all the benefits which have been hinted at by hon. Members today. They have no opportunity of getting accommodation far themselves in the kind of flatlets which are being experimented with and built. I ask the Parliamentary Secretary to pay attention to this missing generation because these people seem destined to live out their lives in these entirely unsuitable old statutory tenancies.

I ask the Government to think of a way to tie up grants for the reconditioning and control of them, or to make offers to landlords to acquire them, or to take leases over them. Grants for reconditioning would very much even out the cost, because if one considers the cost of a new flatlet, and considers, on the other hand, the cost of reconditioning one floor in the sort of dwelling house that I have described, it would average out at a considerably lower figure. Besides, with all the money in the world we could not construct the highly desirable new flatlets in time.

This is a case for vigorous interim action to make life tolerable during the next ten to fifteen years for the people who have the right to choose to live out their lives in the area in which they have been happiest if they wish to do so, and to continue to enjoy respect, affection, and visits from their children and grandchildren.

1.12 p.m.

Mr. William Clark (Nottingham, South)

I am delighted at the opportunity to take part in this debate so ably opened by my hon. Friend the Member for Meriden (Mr. Matthews). Most hon. Members have so far dealt with what the Government can do directly or indirectly through local authorities. I should like to consider this problem from the voluntary angle.

There are many voluntary associations which are doing an extremely good job of work for old people. Hon. Members know that there are many organisations for helping youth, but I should like to see a tremendous increase in the number of voluntary organisations for helping old people. The proportion of old people is increasing, and will continue to increase. What elderly people want above all else is independence. The older one becomes, the more one realises that eventually one will be entirely dependent on someone else. That seems to have a psychological effect as a person gets older, in that in the interim period while he is waiting to become dependent on someone he becomes a little more independent. People in that independent frame of mind seem to have a kind of antagonism towards anything connected with the State or with a local authority, and voluntary organisations could do a tremendous job, particularly in towns. We know that there are many Victorian houses which could economically and easily be converted into flatlets for old people. When I say "flatlets" I do not mean the kind of home where they all must eat and live together, but where they can have their own cooking facilities and take part in communal activities if they wish to do so.

I hope that the House will not think me parochial if I quote an example of such a house in my constituency. The Round Table of West Bridgford in South Nottingham has started one of these houses for old people. There are only 45 members in this Round Table, and they have nearly all the money necessary to purchase this house which will house about 12 old people. I know that it is a mere drop in the ocean, but what has been done in one place can be done elsewhere.

In its brochure in which it appeals for funds from the public and members, the Round Table puts the problem concisely and aptly. It refers to old and retired people who though they may have given a lifetime of service to the Community were ineligible for Council accommodation, or were finding maintaining and running a house beyond their capacity, but still wished to be independent. The Round Table in West Bridgford is doing an excellent job of work. I ask my hon. Friend to consider giving more and more assistance to this type of association. The people who are running them do not want direct State or local authority control. They want to be independent. These are economical schemes, and they will satisfy a need in that the houses can be converted in the areas from which the old people are drawn and their will be no question of sending the old people away in isolation. One of the greatest tragedies of old age is loneliness, and loneliness is only accentuated if old people are isolated iv some new environment. One hon. Member referred to old people moving to an area where a different language is spoken, but I presume that that was an exaggerated case.

It is essential to let elderly people live where they want to live and not where somebody else thinks they ought to live. Some people think that old people should live where they can enjoy the fresh air and see green fields, but if they do not want to live in such surroundings nobody should say that it is better for their health. Old people have reached the stage in life when they are not necessarily worried about their state of health. What they suffer from is nostalgia for the environment in which they grew. They prefer to live in familiar surroundings and keep up old friendships, and I repeat my request to my hon. Friend to give more assistance to voluntary associations.

1.17 p.m.

Sir Barnett Janner (Leicester, North-West)

I add my thanks to those already given to the hon. Member for Meriden (Mr. Matthews) for the excellent way in which he delivered a practical and important speech.

It is sometimes asked why we do not speak about the useful provisions which exist and why we constantly press for remedying those matters which require remedy. I had the question put to me in debate not long ago and I said that sometimes one has not the time in a short debate to deal with anything other than to make an attempt to remedy difficulties which exist. The Ministers see to it that the good side is presented in its best form, and I am sure that the Parliamentary Secretary will do that today in his customary way and with genuine concern about the issues raised.

It has been said today that we are debating an extremely important subject of human interest. I always look at the problems with which we are dealing from that angle because we are here for the purpose of satisfying the human needs of men and women and seeing to it that the machinery is available to meet those needs. Whether our discussions relate to a question of individuals, or of States or nations, they should boil down to the endeavour to enable men and women to lead a happy and healthy life wherever they may be.

Of course, there is this tremendous problem of the aged who, as individuals, are entitled to as much consideration as anyone in the community and perhaps to a little more than most. A considerate family definitely has a very great concern for its older members and sees to it that they are as comfortable as possible in what, we hope to make the mellowed years of their lives.

Very considerable difficulties face us. A day or two ago I had brought to my notice in an emphasised form something of which I knew before but which in my own locality is perhaps one example of what exists throughout the country. It is a startling thing that the housing committee in Leicester has been unable to cope with applications for bungalows or flats for pensioners unless such applications were made before December, 1947—a shocking position. Furthermore even those concerned have had to keep renewing their applications to be considered at all. Anybody who first applied after that date cannot be considered at the present time.

It is true, of course, that exceptions are made—for instance, where on grounds of serious health difficulties the medical officer of health has made an application or assisted an application and in some cases where landlords have exchanged tenancies. Nevertheless, the matter has been and still is a very serious one indeed.

I think that next to financial security the most important provision for the aged is that of suitable living accommodation. By that, I mean not only suitable living accommodation in the one restricted sense but in the sense of taking into consideration the needs of and the provisions that should be made for such people in a general sense.

The hon. Member for Nottingham, South (Mr. W. Clark) gave an illustration of one way in which this can be done. But we on this side of the House have a somewhat different approach to these matters. Our approach is that voluntary help is ancillary to the big and important provision by the State.

Mr. W. Clark

I am sure the hon. Gentleman appreciates from what I said that this voluntary organisation would not supersede what the State was doing —it is purely ancillary.

Sir B. Janner

I appreciate that, but we feel that every individual has the right to expect the State to make proper provision for his essential needs. Voluntary organisations should and do exist for the purpose of giving additional opportunities to those who have a particular need in their mode of life which is applicable to them above the normal one which the State should provide.

The most important thing in my view is that only by suitable housing in proper numbers can many old people retain their independence and thus their sense of dignity and self-respect. The problem at the moment regarding houses being used by old people as distinct from special provision for them is one of over-occupation rather than of under-occupation.

A survey conducted by the National Assistance Board into the circumstances of 139,279 persons over 80 years of age in receipt of National Assistance suggests that less than one in ten are living and cooking in one room and two-thirds in three or more rooms. Thus, purpose-built or purpose-converted housing units not only help the elderly to retain their independence with the accommodation but are more economic in so far as fuel costs are concerned. These provisions should include shallow stairs, supports for the bath, water closets and a more reasonable rent, and it should be seen to that they are in a condition satisfactory for young married couples who might also be living in the same house as the elderly so as to give the facilities referred to earlier by other hon. Members.

The suggestion of the Rowntree Committee and the National Corporation for the Sick and Old People is now generally accepted, as a bare minimum. It provides that at least 5 per cent. to 7 per cent. of housing in a given area should be specifically built for old people. Even on the basis of 5 per cent., which many now feel to be a ludicrously low figure, 750,000 such dwellings are required. At the present time, approximately only 195,000 single-bedroom houses have been built for old people since 1945.

To put it another way, to reach this calculation of 5 per cent. and to make up within a reasonable space of time for the lack of numbers of such dwellings built in the past, it is necessary to provide for the elderly over a considerable period something like 25 per cent. to 30 per cent. of all housing units built during that time. We are told that the proportion of dwellings suitable for the aged reached 18½8 per cent. of all houses built by local authorities during the quarter ended 30th September, 1958. But over the period since the last war it is only 8½3 per cent., which is nowhere near within striking distance of the total estimate required.

The Minister of Housing recently made a statement that in 1959 dwellings built for the aged represented 22 per cent. of the total houses built by the local authorities. At first sight this seems an impressive improvement. Unfortunately, however, this percentage increase was almost entirely account for by the drastic reduction in the total number of houses built owing to the Government's removal of subsidies for general rehousing. The increase in absolute numbers is negligible.

Sir K. Joseph

I would not dream of trying to show that the numbers are yet adequate, but I cannot accept that the increase has been absolutely negligible. The increase, in terms of local authority housing, has been from 10,000 in 1950 to something over 27,000 in the last year.

Sir B. Janner

I appreciate that the hon. Gentleman is on the alert in these matters, and I concede the figures which he gives, but there is certainly no room for complacency regarding the inadequate number of housing units being built. We can hardly regard with pride the lack of imagination and vision shown by many local authorities. I do not say all local authorities, and I am not talking about my own local authority because in a debate of this nature we should range over a wider field to see what the situation is.

As far as Leicester is concerned, we have a very good local authority which has done its utmost within the possibilities afforded to it by the Government to meet the requirements, but the result of its efforts have been inadequate in the full sense of the term. Leicester Corporation is desperately anxious to provide the houses which are necessary. A recent report by the National Corporation for Sick and Old People pointed out that in the past, referring to some other areas, schemes have often been unimaginative and they fail to take into consideration the physical disabilities from which old people may suffer. Too often, even when bungalows for old people are built on new housing estates, they are segregated ghetto-like into one corner away from the life and movement of the place instead of being interspersed so that the people there may still feel independent and, at the same time, part of the community. Too often, the attitude of the local housing authority is, "If they need special houses, that is Welfare's job". This leads to reluctance to build group schemes with a cluster of bungalows or self-contained flatlets with a warden to keep a watchful eye on the tenants. Also, it frequently leads to little more than lip-service being paid to the statutory duty on local welfare authorities and local housing authorities to co-operate in the provision of proper places for old people who do not normally require care and attention.

Too often, houses occupied by the aged have been neither designed nor planned specifically for their needs, and housing authorities generally have done too little to incorporate special provisions in accordance with recommendations which have been issued by the Government for guidance. Obviously, the main way in which the central Government can exert influence on local authorities is through the use of subsidies. When housing subsidies to local authorities for general housing needs were abolished, a subsidy of £10 per annum for sixty years on one-bedroom dwellings was retained in order, it was said, to stimulate more and better housing provision for the aged. Unfortunately, however, this is an ineffective way of working for the vital objective. The level of subsidy is very far from generous by any stretch of the imagination and, in my view, it is having very little effect accordingly. The more progressive authorities like Leicester do their best anyhow. The less progressive authorities continue to ignore the need, and the miserable subsidy of £10 per annum does not tend to make a great deal of difference. Not only is the incentive effect of this level of subsidy negligible but, by tying the subsidy to one-bedroom dwellings rather than specifically to purpose-built housing for the elderly, the Government are reducing the efficiency of the subsidy still further.

Sir K. Joseph

While one may not trench upon matters not before the House, I must say that the hon. Member does not seem to have read my right hon. Friend's White Paper, which alters or proposes to alter all this.

Sir B. Janner

I am underlining what is an important matter, and I hope that there will be help in providing the necessary remedies. There is no guarantee that even all the one-bedroom dwellings will be occupied by elderly people. I think it likely that about 60 per cent. are allocated in this way.

I am sorry that the Parliamentary Secretary to the Ministry of Health is not here, because I feel that this whole matter is closely linked with services which are or should be rendered by other Departments of the Government. I wish to digress for a minute or two to give an example of the kind of way in which the housing problem could be alleviated. I have, perhaps, a little more close knowledge than most hon. Members have of the problem of providing suitable accommodation in certain circumstances for people who are incurable, and I know well a case where an application has been made for 20 additional beds to be provided in a home for those who, unhappily, have very little longer to live.

This home was taken over by the Government, by the National Health Service, after it had been built up by voluntary contributions. I refer to the Jewish Home of Rest in the Wands-worth Hospital Group, and I give it as an example of what I believe must be many cases where action could be taken to relieve the pressure on housing for those who need to have special attention. The home was opened in 1926 with a complement of 30 beds, for the care and comfort in Jewish surroundings so essential to those people of the Jewish faith who were chronically sick, and whose expectation of life was very limited. In 1934 a further 20 beds were added in an endeavour to meet the demand. The place was then entirely maintained by voluntary contributions. It was eventually taken into the Health Service.

Today, there is a crying need for a further 20 beds in that home. In my view, there is almost sufficient money in hand for the purpose in the form of contributions still available, to be utilised. If those moneys were used and another 20 beds were provided, the cost would be very small indeed for the Government. I believe that only about £15,000 would be involved over and above the sum of money which is in hand and which could be put to that purpose.

I believe that the Minister of Housing and Local Government, in consultation with other Ministers, notably the Minister of Heath, could find ways to assist in relieving the problem which we have been discussing this morning and giving an opportunity 'to provide accommodation for those who otherwise have to be accommodated in other circumstances where they are not, perhaps, so happy.

1.38 p.m.

Dr. Alan Glyn (Clapham)

I am particularly glad to follow the hon. Member for Leicester, North-West (Sir B. Janner), because the Jewish Home of Rest, to which he very kindly referred, is in my constituency. Every time I have visited it I have found that the people there are extraordinarily happy and well looked after, and I join with the hon. Gentleman in paying tribute to that home. I was very interested also in what he said about recognising the good things. His references to the Jewish Home of Rest were one example of that. I shall later pay tribute to some of the very excellent services provided by the voluntary organisations.

The voluntary services now fulfil two functions. They provide certain homes which are entirely independent, but another of their great functions is that they fill in the small personal gaps which an impersonal service run, however efficiently, by the State must leave. We are all eternally grateful to the voluntary organisations for the efforts they have made in making the lives of our old people comfortable.

Sir B. Janner

I thoroughly agree with the hon. Member about the service rendered by voluntary organisations. I know it very well myself.

Dr. Glyn

I am grateful to the hon. Member. Perhaps I did not express myself very clearly. I was trying to emphasise the point the hon. Gentleman himself had brought out.

This debate has been one of the most friendly in which I have been privileged to take part. It has revealed that hon. Members on both sides of the House regard this as a fundamental problem of the nation, almost entirely removed from party or politics. It is something we all have to attend to with great diligence in the future.

My hon. Friend the Member for Meriden (Mr. Matthews) said that we were an elderly nation, and I do not think one needs to enlarge on that. Before the war, for example, a man who had a broken leg and contracted pneumonia might die, but today that sort of thing does not happen. Such a man would be given a wonder drug and his life would be prolonged for a number of years with consequent benefit to himself and to the community. One important point was brought out in the Phillips Report. By 1979 we shall have approximately three times the number of old people that there were in 1911.

Before the war we did not realise the longevity which people were to enjoy because we had no experience of new medical methods. I suggest that now we have a national picture of the figures for old age for the next 25 years. It is up to the Government to provide for the situation as indicated by these figures which are now known to be accurate. I estimate, roughly, that one in five will be what is now termed an elderly person by 1979. I have the honour to represent a constituency where there are a large number of retired people, and the problems connected with old age particularly affect my constituents.

One element, which has not yet been referred to is sometimes called family responsibility. In Victorian times there was a great sense of family responsibility among the children of a family, but for various reasons, which I wilt not discuss in detail, that responsibility has declined. In many cases it is because with mobility of labour, the children of a family have moved to other areas of employment, leaving behind the elderly folk to be looked after by the State. The responsibility has shifted from the members of the family to the State, and the important thing is that these old people should enjoy the eventide of their lives, as I like to put it.

The question of housing which we are discussing today is an important matter, but there are many other things which bear on this problem. It is not only a question of the amount of money possessed by an old person. It is also important that there should he facilities available to him, such as clubs and other things, to make his life happy and comfortable. I divide the elderly into three classes. There are the chronic sick, the elderly infirm, and the able bodied. As was said by the hon. and learned Member for Cardigan (Mr. Bowen), there should be great flexibility between these three classes so that transfers might be effected more easily. I am glad to see that the Parliamentary Secretary to the Ministry of Health is present to hear what I have to say about the chronic sick. The problem is to get them out of the hospitals. Hon. Members have referred to the fact that very often there is great delay in getting such a person from a hospital ward into a suitable home. If they are left in the hospital they occupy accommodation which is required for others who are actually ill, and I hope that matter will receive attention.

The elderly and infirm include a large group of people who have got to the stage when they can no longer look after themselves. They cannot cope with the cooking and everyday chores with which they are faced if they are living alone. For these people the meals on wheels service and other voluntary services are of extraordinary value. There are large numbers of voluntary homes. The Salvation Army, at Alvar Bank, in particular, runs a very good service in my division. There is also the work of the church workers, and there are the London County Council homes. Those in my division are very well run. I think there is a new spirit abroad and that the old spirit, what has been referred to by hon. Members as the workhouse attitude, is disappearing.

The hon. Member for Paddington, North (Mr. Parkin) said that the old people should not have to thank us. We all agree that they are getting what is their due, but if old people express their gratitude to those responsible for running these homes there is so much more response from the staff. Many times I have been told by members of the staff how encouraging it is for them to know that the old people appreciate the little extra things that are done for them. It is a reward to the staff to know that their efforts are appreciated by the old people. The starched, white-coated, hard-faced matron of the old days is disappearing and one finds that the people in charge of old people's accommodation act with kindness and consideration. One is also impressed by the quality of these people who seem to possess a spirit of service and a desire to please those who are in their care.

The Linen and Woollen Drapers Institution and Cottage Homes have one great advantage which it is perhaps not easy to operate in London. It is that the people there know when they come that they will not have to move. Every sick person does not adopt the same attitude. One person may not perhaps wish to stay in one place and another may not want to move. Careful consideration should be given to the possibility of making arrangements flexible.

To suit the individual requirements of Wandsworth we are making a tremendous effort to fit in a third category, the people who wish to remain independent. I am sure we all desire to remain independent far as long as possible. The problem is to find accommodation where elderly people may have their own furniture and belongings and remain until they are no longer able to cope with the various difficulties which eventually arise.

In Wandsworth, where we are converting older houses and building new units, there are 600 people on the waiting list for this accommodation and, as hon. Members will know, Wandsworth is one of the largest boroughs in London. I believe that it will take something like three to five years to clear that list. But that figure does not give the whole picture. There are many other people who are housed in what was described by the hon. Member for Leicester, North-West as unsuitable accommodation, and it is necessary to ensure that they are provided with suitable accommodation. There is great difficulty connected with the transfer of these people to other accommodation. For example, should a person leave an upstairs flat for a downstairs flat, he may find that his tenancy has become a decontrolled tenancy.

I want particularly to put forward some points about transfers. Most elderly people wish to live in their retirement in the area where they have been brought up because their friends are there, and often because, as my hon. Friend the Member for Maidstone (Mr. J. Welds) pointed out, the church to which they are attached is adjacent. I see no reason why that should not be so. Many old people come to me, however, and say that they have not many friends in the district and would be quite willing to go elsewhere. In those cases the Government could help.

At the moment, the transfer system from London to outside is based on the "old boy" voluntary sort of basis. If we could get some means whereby people could be transferred to other boroughs that would be a tremendous step forward. It could help in two ways. The old people would get the type of accommodation they want and the accommodation they left in London would be freed for those who really need it. I hope that possibility will be gone into very seriously. There could be a great movement of people both in and out of London.

There should be a very close tie-up between the two Ministries. There is a border-line between the two, almost a fringe, in which it is difficult to say whether problems should come under the care of the Housing Ministry or the Health Ministry. The tie-up between the two must be extraordinarily close. The point I have made in this House on many occasions is the difficulty of finding where to build accommodation. The problem in London is that of finding land. There are few sites and the cost of land is very great. For that reason I plead for higher densities.

One of the objections put forward against density increase is the difficulty about finding parking space. When an enormous block of flats is built transport facilities are overloaded and car traffic becomes congested in the streets, but that problem does not apply in the case of old people. When people are over 60 or 70 they do not usually have cars and they would not add to the congestion of traffic if there were greater density allowed in this accommodation.

The question of providing lifts for these flats presents a problem because some old people find that they cannot use lifts without difficulty, but lift facilities could be provided which could take wheeled chairs. I have known instances, as other hon. Members have known, where an elderly gentleman has not been out of his home for two years simply because he could not get down the stairs. If accommodation such as this could be provided with lifts, some of the difficulties about finding sites in London might be removed. The Minister of Housing and Local Government has a responsibility over planning. If he gives a grant a certain measure of supervision is involved with reference to the type of baths or showers which are provided in the accommodation.

In closing, I draw attention to paragraph 17 of the White Paper, which says: The main tasks facing local housing authorities are now…building for slum clearance, for old people… and so on. I believe that Parliament is paramount and that it is no use our trying to shift burdens on to local authorities. It is up to us in this House to make sure that every possible facility is given to local authorities. If they do not carry out their duties, it is up to us to put pressure on them to make sure that every local authority provides the accommodation which is required and that there enough of it to satisfy the needs of elderly people in the community. I hope that when my hon. Friend the Parliamentary Secretary sums up he will say that there are ways in which pressure can be brought by the central Government on local authorities to see that this very great task is fulfilled.

1.56 p.m.

Mr. Michael Stewart (Fulham)

I think that we all congratulate the hon. Member for Meriden (Mr. Matthews) on raising this subject today. He did well to interpret it widely, so that we have been talking a great deal about housing and yet have been concerned with the health, welfare and the social side of the life of old people.

I am particularly happy to get this opportunity to speak, not only because this is in the field of subjects on which I address the House, but because of special constituency interests. All of us who live in the County of London find that in our constituencies the proportion of the elderly is growing rather more than it is in the nation as a whole. The White Paper comments on the exceptional success which the London County Council has had in making arrangements for the rehousing of its people well outside the county. That is a good thing at present, but, quite naturally, the people who go that distance away tend to be predominantly younger people, younger married couples with families, and in London we are left with a growing population of older people. In time, I think that balance will right itself, but for some time that will be the position in London.

My borough of Fulham, like others, has had to apply itself particularly to the study of the needs of old people, so I have followed this debate with a great deal of interest. The hon. Member for Clapham (Dr. Glyn) classified elderly people into three categories, the chronic sick, the aged infirm, and those who are hale and hearty. Certainly, as a beginning, we may accept that classification, although we should not define it too rigidly, but there is one group which we can quite easily define. That is those whose health is such that they must be in hospital, and may perhaps have to be in hospital for the rest of their lives. Sometimes they are those suffering from a specific ailment and sometimes their health has reached the point at which they need the constant care which at present only a hospital can supply.

I should like to address a few comments on that side of the problem to the Parliamentary Secretary to the Ministry of Health, whom we are very glad to see has been able to be here throughout nearly the whole of this debate. It seems to me that in the future development of the Health Service one of the things to which we must pay particular attention is the increased supply of accommodation for old people who have no specific complaint, but who need constant attention such as at present is obtainable only in a hospital.

We know that it is intended to provide the kind of accommodation specifically to meet their needs, but there is not a great deal of that accommodation at present. Hospitals have to face very serious demands of those who are seriously ill and sometimes, not unnaturally, they are reluctant to accept people of whom we have to say, "The trouble here is old age, which has brought them to a point at which they simply cannot look after themselves." We need more accommodation for that group—which, mercifully, is a small group—in the proportion to the whole number of old people.

I take the opportunity, since the Parliamentary Secretary to the Ministry of Health is here, to remind her of the special concern in my constituency where there is a growing proportion of old people needing hospital accommodation for that reason. The hon. Lady knows that I have addressed repeated questions to her Minister and his predecessor about the need to speed up the rebuilding of Fulham Hospital. How earnestly that project is watched by people in the neighbourhood! Will the hon. Lady also make sure that nothing is done to disturb the arrangements being made for the accommodation of old people at Western Hospital during part of the rebuilding of Fulham Hospital? We have been worried about the inadequacy of accommodation for old people all through this hospital development at Fulham. I hope that that matter will continue to receive the attention of the Minister.

I now turn to old people who are infirm, or feel infirmity creeping on them. One of the most difficult phases in the life of an elderly person is when he begins to feel, "I do not want to go and live in a home. I like my own little home or flat. I am within easy reach of the neighbours. However, I am beginning to feel that I cannot go on living by myself with safety." Some of them get accommodation in old people's homes. If they are fortunate, some live very happily there. But from the first moment when an old person begins to feel like that, to the point where infirmity becomes almost complete, there is a wide range of infirmity or activity. For some of these people there is provision in old people's homes, frequently provided by voluntary associations with the material help and encouragement of the local authority.

I trust that the representatives of the Government have listened carefully to some of the serious criticisms made by the hon. Member for Meriden about some of these homes. I could not help but feel how fortunate the old people are at the home which I know best, Royston, on Putney Hill, a product of the Fulham Housing Improvement Society, with the encouragement and help of the Fulham Borough Council, compared with some of those mentioned by the hon. Gentleman.

One of the things which the Government ought to consider is proper training and advice for people who are to staff these institutions. I agree with my hon. Friend the Member for Enfield, East (Mr. Mackie), who said that it is most desirable not to assume from the start that elderly people who are in homes are helpless, and need and want everything done for them. One of the things which elderly people dread is the feeling that they are of no more use in the world. If they can be encouraged to feel that they can help themselves and each other, life in a home will be very much more cheerful for them.

The decision on exactly how much activity it is reasonable to ask from elderly people needs skill and tact. There is a great deal of difference between being 65 and being 85. If someone lives in a home for a number of years, what one expects of them and what they can do in helping themselves and in the home will gradually alter. As I say, this is a matter for tact and skill on the part of the staff in the home. I am sure that people who are doing this work successfully could become a useful source of advice to those who have had less experience and, perhaps, are not managing quite so well.

There is always the danger in any kind of social work of the people engaged in it underestimating the amount of skilled knowledge required to do it well. One cannot be a member of the staff of an old people's home simply on the strength of a kind heart —although it is necessary—any more than one can be a school teacher on the strength of a kind heart. We must spread among those who have kind hearts the knowledge and experience necessary to do the job well.

Some elderly people are infirm, but are still living in their own homes. For them, we need an organisation which will keep in touch with them so that we do not read of tragic cases of elderly people being found dead in their homes, having been dead for a day or more before anyone discovers them. We want to feel that elderly people with partial infirmity and living at home are constantly in touch with the outside world, not only for health and safety reasons but also to conquer the loneliness, about which hon. Members have spoken and which is one of the chief enemies of old age.

I cannot resist one other constituency reference. I refer with pride and gratitude to the activities of Bishop Creighton House, in my constituency, which is another valuable focal point at which private good will and the public authorities come together. Bishop Creighton House does a great deal to see that the infirm living at home are not left alone. One instrument to this end is the development of the home-help service, which is a local responsibility. I hope that in the forthcoming council elections one of the questions which electors of all ages will ask of those standing for election, irrespective of party, will be, "What will you do about the home-help service?"

One thing which I have never liked, but which is dangerously liable to become fashionable, is to assume that the way to interest young people in public affairs is to talk exclusively about what the public authorities can do to meet the needs of young people. I do not believe that young people want that. They can be made very interested, through their natural generosity, in the needs of old people. This is something in which electors of all ages should be interested.

I turn to the position of the elderly people whose problem is not infirmity, but who often face housing problems, problems of social life and the combating of loneliness. I hope that the Parliamentary Secretary to the Ministry of Housing and Local Government will pay considerable attention to what was said by my hon. Friend the Member for Paddington, North (Mr. Parkin). He made an important point, and I wish to make one or two other points which are allied to it. They can be best illustrated by two cases which have come to my attention in recent months. They both concern elderly ladies. As they are widows, the accommodation which they are occupying is too large for them.

One was in comparatively comfortable circumstances, but by no means wealthy. Her accommodation was reasonably attractive, but too large for her, and. therefore, she wanted to move. She consulted her landlord, who owned a good deal of other property. She found that if she moved it would be from her present controlled accommodation into smaller accommodation, but at the same rent. She would have security there for three years, but after that there was no saying what might happen to the rent. Therefore, she has decided to stay where she is—and who can blame her? I do not want to introduce too partisan a note in this debate, but that is what creeping decontrol, as it is popularly called, Means.

The other case concerns an elderly widow of restricted means living in much less attractive accommodation. Her accommodation is too big for her. It would not be particularly attractive accommodation for anyone, but in the present housing shortage a number of families would be reasonably pleased to have it. In fairness to others on its housing list, the council cannot rehouse her unless it can put into the accommodation in which she is living a family which is on the list. It would be willing to do that. The council tried to get in touch with the owner, hut, as so often happens, he seems to be a notional figure rather than a person of flesh and blood.

The council tries to get in touch with the agent, and the agent says that he is quite willing to accept somebody off the council's list, but that whoever comes in will have to understand that he is coming in at an uncontrolled rent and into an uncontrolled tenancy. The council, not unnaturally, will start looking for a family on its list which will accept this not very attractive accommodation on those terms; but it will not be easy to find such a family.

It is fair to point out, without being too partisan, that the Government have created that kind of problem, and these are only two examples of a fairly widespread problem. The Government created that problem by their 1957 Rent Act. What are they going to do about solving it? We are entitled, even in a debate in which there are many nonparty aspects, to ask that question.

I wish, also, to say how very much I agree with my hon. Friend the Member for Feltham (Mr. Hunter), whose speech we all very much admired, about the undesirability of having considerable estates peopled entirely by elderly people. Not only is it necessary to arrange the housing so that ages are mixed, but also to pay attention actually to individual cases. When, for example, we are able to move out of a crowded area a family in which father, mother, grandma and the children have all been living together, wherever possible—and I am glad to say that has been done by my own local authority—it is advisable to put father, mother and the children in a fiat in the new estate and put grandma quite close by, which is very often the ideal position for her to be—neither in the same home, nor too far away from it. That brings down to a personal family level the general point made by my hon. Friend about the importance of not segregating the old.

On certain general points of housing policy, the hon. Gentleman's Motion welcomes the recognition by the White Paper of the needs of the elderly. I, too, welcome the fact that the White Paper recognises the need, and it says, in paragraph 15, that there is still an urgent need, but, since the White Paper is mentioned, perhaps I might say a little more about it. I wish that, in addition to recognising the need, it contained a little more about meeting that need. I want to express one or two doubts to the Parliamentary Secretary.

It is true that in paragraph 45 there is mention of the arrangement whereby housing associations that build accommodation deliberately meant for old people will get the £24 subsidy, and, so far as that goes, we welcome it. The total amount of housing built under this section of the White Paper will not be great compared with the volume built by councils as a whole. Later, we are obliged to notice that it is apparently the Government's intention in the White Paper that the total amount paid by the central Government in subsidy will not be affected by the White Paper proposals. It will go on growing at about the rate it is growing at present.

We must, therefore, ask: if the White Paper does not make any difference in the total amount of financial help given to housing by the Government—and that is admitted—and if, further, some of that help is now to be given to building for general need, where it does not go at present, must there not proportionately be rather less help for the elderly under the new arrangements than under the old?

I am unhappy to come to that conclusion, but, as a matter of arithmetic, it is rather difficult to see to what other conclusion I can come. We on this side of the House have often pleaded that the general need subsidy ought to be restored, but it was always our view that restoring the general need subsidy would be part of increasing the total amount of the subsidy paid by the central Government, whereas the White Paper proposal is a very back-handed way of restoring the general need subsidy. The White Paper says, in paragraph 15, how urgent is the need of the old people, but the financial arrangements seem to add up to the fact that they are going to occupy a rather less favourable place in the queue in future than in the past. I do not think that that was what the hon. Member for Meriden wanted, or that it is what anybody who has spoken in the debate has wanted.

May I say a word or two about the special needs of rural areas, which were referred to by the hon. and learned Member for Cardigan (Mr. Bowen). I hope that if anyone feels that one major problem of housing today is the undercharging of rent by councils, he will study what was said by the hon. and learned Member. We have in the rural areas, and, indeed, in some other places as well, a situation in which the rents of council houses are too high for some of the people who ought to be living in them. I wonder whether it can really be established that the new subsidy arrangements in the White Paper will specifically give help to areas of that kind. It is not at all easy to see how they are to work out.

One other point which I want to make about rural areas, and, indeed, about outside London in general, is that in dealing with old people in London we have one definite advantage in that the housing and welfare authority is the same. On the county level outside London, that tends often not to be so, which creates a problem in the care of old people.

Finally, speaking of housing, one has to mention social activity for the older people. I did not think that I quite agreed with my hon. Friend the Member for Paddington, North about not wanting to go to an old people's Christmas party. I have gone to such parties and have genuinely enjoyed them, and I think that I can say that they were glad to see me. I have never been invited to a stockbrokers' Christmas party. If I am, I will consider the invitation on its merits.

Mr. Parkin

I am sorry if I did not make my point clear. The only point that I was trying to make was that it is a mistake to regard old folks as a sort of homogeneous group, and to think that one knows all about them by a visit on an occasion like that. They are different individuals, living different kinds of lives, with different interests, during the rest of the year. That is the aspect that we should study.

Mr. Stewart

I agree with my hon. Friend. If that is what he said. I do not think that anybody disputes it.

The Darby and Joan clubs perform a very useful task. Just as we do not want, in housing, to segregate old people, so we do not want their social activities to be solely confined to clubs for old people. This is where the local authorities can help if they see that, in the development of their parks and open spaces, they provide more space where old people can go for a walk, and, at the same time, see young people playing the more strenuous games, and perhaps those of intermediate age playing bowls.

Similarly, the use by the local authority of its powers to provide civic recreation can provide opportunities for elderly people, who are those who are accustomed to have rather more leisure. If some provision in civic recreation could be specially made through these channels, the authority could use some of these facilities not entirely for old people, but so that old people can enjoy them in the company of people of all ages.

All these things will add up to spending money on the rates, and I hope that the public will realise that. As we become more civilised, we shall want to make even more provision for the old. Actually, whether the old people will be rather well off or not so well off, a goad deal of proper provision for them, socially, in housing and recreation, and so on, will have to he made through public channels. That means a greater acceptance by local authorities of that idea, and the need for a revision by the Government of the whole way in which local authority finance is raised. Thus, rather unkindly, I place that thorny point before the Parliamentary Secretary. I am sure that the House will want to hear his comments, and those of other hon. Members who have not yet caught Mr. Speaker's eye.

2.20 p.m.

The Parliamentary Secretary to the Ministry of Housing and Local Government (Sir Keith Joseph)

I join with all other hon. Members in congratulating my hon. Friend the Member for Meriden (Mr. Matthews) on the excellent choice he made after so luckily winning the Ballot and also on the sensitive, thoughtful, comprehensive and constructive speech with which he opened this debate. He set a tone which all hon. Members have followed, and I think we can all agree that not a single speech has failed to make a really useful contribution to this subject.

I hope to refer briefly to most of the points raised by each speaker, but I hope that the House will not think me invidious if I particularly congratulate the hon. Gentleman the Member for Feltham (Mr. Hunter) and my hon. Friend the Member for Barons Court (Mr. Compton Carr) on extracting the very gist of this problem in two speeches of exemplary brevity, cogency and feeling. That is not to say that the other speeches, which necessarily concentrated rather more on constructive details, were not equally useful.

I do hope that this debate will be widely read by local authorities and by people concerned both in rural and urban areas with these problems, because it will certainly be seriously studied by all those of my right hon. and hon. Friends concerned with these subjects. The range has been extremely wide. I had thought that we were going only to traverse the huge subjects of health, housing, the voluntary services, and the National Assistance Board, but I congratulate the hon. Gentleman the Member for Fulham (Mr. M. Stewart) on at the very last moment introducing parks and open spaces as well.

There have been, I fear, far too many points for me to guarantee that I shall take each one up in my answer today, but I do most seriously say that my right hon. Friends the Minister of Housing and Local Government and the Minister of Health will study everything that has been said. The House has already commented on the presence throughout this day's debate, except for one brief interval, of my hon. Friend the Parliamentary Secretary to the Ministry of Health, and I know by her interest here today that she will study carefully the detailed health points which have been raised. I shall not, therefore, try to deal in particular with the points about hospitals nor the very cogent comments made by my hon. Friends the Members for Meriden and Barons Court on private nursing homes. A number of hon. Members have referred to the care of the chronic sick, particularly the hon. Gentleman the Member for Fulham, and the hon. Gentleman the Member for Leicester, North-West (Sir B. Janner) referred to incurables. I know that all these comments will be studied by my hon. Friend.

But I take most seriously, and I hope to show the House that the Government take most seriously, the largest point of all that seems to me to emerge from today's debate. It was emphasised strongly by my hon. Friend the Member for Clapham (Dr. Alan Glyn) and emerged from all the speeches today. It is the need for co-operation between all those in local and central government dealing with the problems in housing, health, and welfare of the elderly.

Before I turn to my main speech, may I apologise to the House if I do have to leave to keep an engagement in the north-west before this debate comes to an end? I have listened to all of it so far, and I shall certainly read the speech of anyone who after I have left manages to catch your eye, Mr. Deputy-Speaker.

I will deal with this vast subject in three separate sections, first the need, on which we can spend very little time because it is agreed to exist, secondly how the need should be met, and thirdly who should meet it.

First of all, the need. There is no question about the need. We have a growing population. People are living longer, and people are prosperous enough now to form an ever-growing number of independent households. Within this growing population, within this increasing number of households, there is a rising number of elderly people, and each elderly person has a longer expectation of life with every year which goes by. At the moment one in seven of the population is of pensionable age. It is expected that within about nine years that proportion will rise to one in six. There are about 6.8 million of pensionable age in England and Wales and that number will be by 1969, according to the Registrar-General, about 7.7 million.

The need is to house them properly and enable them to enjoy their old age. This aim is, as several hon. Members have explained, doubly blessed. It makes the elderly happier, or rather, gives them more chance of being happier, but it also releases singly occupied premises for family accommodation. This was the point which the hon. Member for Feltham put so plainly, as also did my hon. Friend the Member for Hornsey (Lady Gammans) and my hon. Friend the Member for Barons Court. I have an interesting example which I quote only because it is typical; not in any way a dramatic example. I was privileged last year to open a voluntary home which had been provided with local authority help in Weston-super-Mare. This home for elderly people in tolerably good health had 29 bedrooms. I made inquiries while I was in Weston-super-Mare and I was told that those 29 bedrooms were releasing 54 bedrooms for general use. That just shows in a typical fashion how doubly blessed the provision of building for the elderly is.

I do claim that hon. Members who have referred to the White Paper as recognising both the problem and the urgency of it are right. I quote from paragraph 2 of my right hon. Friend's White Paper in which he in the first part gives his description of the housing situation: There is as yet nothing like enough accommodation suited to the needs of the elderly. My right hon. Friend, as, I think, all hon. Members of the House have acknowledged, particularly the hon. Gentleman the Member for Fulham, has been himself a crusader in the cause of housing for the elderly. The results certainly do not yet satisfy him and do not satisfy anyone who is interested in this problem, but we can recognise, of all the housing ereoted by local authorities, that whereas in 1950 there were 10,000 one-bedroom dwellings, in 1960 there were 27,000 one-bedroom dwellings. In answer to the hon. Member for Leicester, North-West, who said that not all one-bedroom accommodation was occupied by the elderly, we must remember that the corollary is that many of the two and indeed three-bedroom dwellings are occupied by the elderly.

In answer to the hon. and learned Gentleman the Member for Cardigan (Mr. Bowen) I would accept that the position of housing of one-bedroom nature in Wales has been disappointingly low, but it is rising, and I know that my right hon. Friend, who is both Minister of Housing and Local Government and Minister for Welsh Affairs, is carefully watching this.

There has also been in parallel with the growth of housing for the elderly an increase in Part III accommodation, for which my right hon. Friend the Minister of Health is responsible, in the geriatric service's in hospitals and in the development of domiciliary services. There has also been a splendidly vigorous growth of contributions made by the voluntary bodies.

This is the need which we all acknowledge. How should it be met? First and foremost, as hon. Members have recognised today, the elderly should be enabled wherever possible to go on living independently in their own homes. That is what the very large majority want to do, and do now. It must be the normal aim of housing policy wherever it is possible to provide suitable accommodation for old people. But there are many old people who can go on independently by being supported in their own homes by domiciliary services and by voluntary services. I was glad that so many hon. Members, particularly my hon. Friend the Member for Hornsey, referred to the position of the voluntary services which are so often linked with and rather overlap the services provided by local authorities. I only mention in passing the clubs, the chiropody services, the boarding out arrangements which some voluntary services are providing and all the others which come within the purview of old people's welfare committees.

But despite all this there will always be a need to help those who cannot continue living independently. That is why Part III of the National Assistance Act, which provides for residential homes, is so necessary to look after those in need of care and attention. These homes are provided by welfare authorities as authorised by my right hon. Friend the Minister of Health. Of course, a large number of homes are provided and looked after by voluntary bodies. It is a fact, as hon. Members have so frequently recognised, that the more plentiful the proper housing provision for the elderly, the better can the hospitals play their own proper part of curing rather than of custody.

This leads me to what I think is the principal lesson of this debate, a lesson the Government has always recognised and I hope to show is effectively supporting: that housing, health and welfare for the elderly are linked services. No one of them should be planned in isolation, whether housing, hospitals, local health services, or domiciliary welfare services, they should, wherever they can be co-ordinated.

There must be joint planning of these services with the voluntary services. The initiative often lies within local government framework, and so my right hon. Friends the Minister of Housing and Local Government and the Minister of Health are preparing a joint circular on services for old people. This circular, following consultation with the local authorities associations and the voluntary associations working in this field, will be published shortly. It will deal with ways that the housing and local health and welfare authorities can usefully work together with voluntary organisations to promote the health and welfare of old people. It recognises the big demand for housing which will enable as many old people as possible to go on living independent lives in their own homes and the need for domiciliary help to be available to give help where required.

Having, I hope, convinced the House that nobody in the Government underestimates the need for this co-operation, I turn to housing. There has been a refreshing, though minor, controversy today between hon. Members who support various different ways of solving the housing need and so I will start by suggesting certain solutions to the housing problem for the elderly.

Some things are not very sensible. Firstly, it is not very sensible to build for the elderly without taking great care in every detail that the accommodation is suitable for the elderly. Secondly, it is not very sensible to build on an unsuitable site too far from access to the shops and to other people. Thirdly, it is not sensible—and I hope I will retain the friendship of my hon. Friend the Member for Meriden—to build large colonies for the elderly where they are isolated. My only criticisim of my hon. Friend's speech is that he did praise, without mentioning this, the otherwise absolutely admirable work of the voluntary organisation with which he is connected.

Mr. Matthews

I think I did suggest that colonies of this kind should be in built-up areas and amongst other houses.

Sir K. Joseph

I am glad that my hon. Friend and I are in agreement upon that.

If those are some things which are not very sensible, what is needed? It is that there should be built flats, bungalows, or flatlets—or that the same result should be achieved by conversion—carefully sited in the midst, wherever possible, of other human activities, of easy access and in such numbers that they can easily be integrated into the local community.

I fully agreed with my hon. Friend the Member for Fulham in stressing the importance of careful attention to detail in design, whether of new buildings or conversions. The bungalows, flats or flatlets, or conversions, of which my hon. Friend the Member for Maidstone strongly spoke, should be labour saving and have as many amenities as possible to add pleasure to the life of the elderly. Great attention should be paid to the height at which shelves are placed, where windows are inserted and the height at which switches are placed. Careful attention should be given to the safety angle of all installations.

I was glad that the hon. Member for Enfield, East (Mr. Mackie) has added himself to the large class of people who are so helpfully designing suitable baths for the elderly. There is room for honest doubt as to what is best in this problem.

I hope that the House will welcome the information that my right hon. Friend the Minister for Housing later this year will issue a comprehensive bulletin to draw attention to points of this sort which those who are building and planning for old people should bear in mind. My right hon. Friend, through his Department, has considerable experience of what has been done and he is able to draw some lessons of general use.

My right hon. Friend has, as the House may realise, particular sympathy with those who seek to solve at least part of the problem by building flatlets. The flatlets scheme provides for elderly couples or single people a combination of privacy and independence which seems particularly suitable.

As the House knows, the idea of flatlets is that within one building, or set of buildings, there are a number—not too large and not too few—of small flatlets, each completely private and behind its own front door, but sharing in some cases lavatory or bath facilities. They have, of course, running hot water and kitchen facilities within each flatlet. There is usually a bell for each flatlet to a resident warden and there is also the boon of central heating which is so welcomed by the elderly. This combination of privacy and independence, with security and the possibility of company, is proving enormously popular wherever it is tried. The best schemes often include a common room and a guest room in order to ensure that the great evil of loneliness need not remain in old age for those who are in such buildings. My right hon. Friend has issued two handbooks on the subject, and I am glad to say that there are now 42 schemes which are complete. An additional 46 schemes are at some stage between approval and completion.

I must, sadly, agree with the hon. Member for Paddington, North (Mr. Parkin) that admirable though each one of these schemes is they are relatively small. Let us hope that the new arrangements and existing enthusiasm will combine together to increase the number of these schemes.

I turn now to the question of who is to do all this. I have spoken of the need; I have given some comments on what is needed to be done, but who is io do it? I start on the common ground that there is a great deal more to be done. I think the hon. Member for Fulham was absolutely right when he said the larger share of the cost must remain with local authorities. I take the point very strongly made by my hon. Friend the Member for Clapham that conditions may vary from place to place and, indeed, the chance of providing accommodation may vary from place to place and that is why there is need for as good a transfer scheme as possible from area to area.

I know that my right hon. Friend is carefully studying this particular question. He has recently asked new towns whether they can increase their provision for elderly people. Local authorities have, of course, already a very large programme of one-bedroom dwellings and the new subsidy arrangement will enable those who wish to look after the elderly by two-bedroom dwellings, as some do, to use their discretion within the proposals in the White Paper and the Bill at present before the House.

I was asked several questions and it might be suitable to answer them at this point. The hon. Member for Enfield, East commented that if only there were no office building in his constituency there would be plenty of room, and more, to solve the problem of housing for the elderly.

It would be very easy to solve one problem if we could ignore another problem. The whole dilemma of government is that we have to move forward on every front simultaneously, and I am sure that the hon. Member would be the first to recognise that there is need for work in his constituency and a need to reduce the problem of travel to work. There is relatively a small amount of labour in the whole scene going into office building throughout the country, but of course it makes a bigger visual impact because it is generally in the centre of towns. There are those, of course, who say that our offices need regeneration even more quickly than happens now.

The hon. Member for Paddington, North in, as usual, an extremely constructive speech, appealed particularly for dignity for the elderly. I think that we would all agree with that. I hope that he will be encouraged by the attention given in the White Paper to the conditions of squalor that now have invaded so many of the new tenements of our age and that he will be encouraged by the vigorous proposals that my right hon. Friend is making to give the local authorities the weapons with which to deal with them.

But both the hon. Member and his hon. Friend the Member for Fulham spoke about the problem of people who can only move to more suitable accommodation at the cost of losing their controlled status. This is a problem certainly, but hon. Members should remember that someone who is in a controlled tenancy and who is approaching his landlord to seek a transfer of a controlled tenancy to another tenancy more suitable in other ways is in a very good position to bargain with the landlord, since the landlord by hypothesis will get vacant possession of a controlled tenancy which otherwise he would not obtain.

I now come to the larger question raised by the hon. Member for Fulham. He asked whether, if the Government's intention is neither to increase nor reduce the amount that the taxpayer at the moment pays in subsidy, this does not mean that the introduction of a subsidy for general needs, with the approval of my right hon. Friend in each case, will reduce the subsidy available for housing the elderly. The hon. Member forgets, of course, that except in cases of slum clearance a subsidy for new houses, whether for the elderly or for the decanting of an individual at present in an overcrowded house, tends to increase the accommodation that would not otherwise have been available. Therefore the total result is an increase in accommodation.

The hon. Member might answer and say, "Yes, but the accommodation released may itself be squalid". It is not, by this hypothesis, a slum, but if it is squalid it is open to the individual owner to seek an improvement or conversion grant with the taxpayers' help.

Mr. M. Stewart

It has been much stressed that under existing subsidy arrangements the proportion of the total amount of housing that went to the elderly was increasing. Is it expected that under the new arrangements that that proportion will go on increasing? I should have thought that the proportion of housing provided by public authorities for the elderly would decrease under the new arrangements. Is that not so?

Sir K. Joseph

The essence of the new proposals, now that the slum clearance drive has been started with such momentum and is going relatively so well, is to give local authorities discretion in dealing with their own most urgent problems. It will be left to them, again with the approval in each case of my right hon. Friend, to decide the exact speed with which they deal with each problem. But every time they build new houses with general-need subsidy, because by hypothesis they will not be simultaneously pulling down houses as slums, they will be releasing extra accommodation. The elderly therefore will benefit in two ways —not only from the specially built new or converted accommodation but from the release of overcrowded accommodation which may be available more suitably to them.

My right hon. Friend has been seeking over the years in every way to increase accommodation for the elderly, and I know that he will be continuing to do so. I will not weary the House with quotations from his circulars or extracts from his speeches on the subject, but one of the most effective ways of increasing housing for the elderly by various bodies, including voluntary bodies, is by the effect of official openings and demonstrations arising from various flatlet and other housing schemes. Conferences of voluntary and other bodies on this subject also inform wide circles of people and these lead to enthusiasm which results in the further building of accommodation for the elderly.

The House will realise what a great scope for housing associations this whole problem of building for the elderly affords. The White Paper shows that the proposals now before Parliament give special attention to encouraging housing associations with a subsidy when they build for the elderly. Some of these associations, like the admirable voluntary organisation to which my hon. Friend the Member for Meriden referred, are tied to a particular group of tenants.

Some are sectarian, some are general, some deal with conversions, and some with new building. I would hope that housing associations will not limit themselves in looking at this problem to the needs of those with the very least income. There is a whole section of the elderly community that tends to be served neither by private enterprise nor by public enterprise, and this is the ideal hunting ground for a housing association.

I would say to the House and to all outside who are interested in the subject that perhaps the modern way of achieving immortality—the equivalent of the endowment of chapels in the Middle Ages —is to launch and run a housing association for the elderly. Great financial help is available, and that is my answer to my hon. Friend the Member for Nottingham, South (Mr. W. Clark). This help is available to all those who will take the initiative and show enterprise in starting a housing association. I only hope that all hon. Members who have spoken so eloquently on this theme today will do what they can to launch in their own areas just such a housing association.

I hope also—and this can only be a hope at this stage—that private enterprise will one day recognise the market that there will be for the housing of the elderly. More and more of those who reach pensionable age will have substantial savings and will have not one pension but two pensions, and there will certainly be a market for the elderly just as private enterprise has recognised a market for the teenagers.

On the, health and welfare side, I can only answer indirectly for my hon. Friend the Parliamentary Secretary to the Ministry of Health. My right hon. Friend the Minister of Health is fully aware of the need to increase the provision of Part III accommodation for the elderly.

There is a vastly increased capital programme for this purpose. The money available to local authorities has quadrupled and is now running—and I am only taking money available for welfare accommodation of this sort—at a rate of £10 million per annum. I am glad to say that local authorities are coming forward with schemes to take up this increased capital.

As the hon. Member for Paddington, North said, we live in an age of wide-ranging experiments in all this field. I can assure the House that all the experiments that are going on are studied with great interest by my right hon. Friends the Minister of Health and the Minister of Housing and Local Government. This debate has been an extremely valuable one. It has shown the need for co-operation between central and local departments dealing with this problem and it has shown the huge part that voluntary bodies can play.

The elderly deserve better housing and better health and welfare care. The scale of human loneliness, particularly of those who no longer have a function or Who feel that they are no longer needed, is daunting. In the vast majority of cases where there is a family the relatives are doing noble work, and so are the voluntary and statutory bodies, but, as the White Paper says, there is still very much to do. A great contribution towards the Whole range of needs of the elderly can be made by the linked growth of housing, health and welfare services.

I hope I have shown that the Government recognise this by authorising more expenditure, by constant pressure and leadership and by legislative proposals. By all these means they propose to continue at an increasing pace their present progress. I hope the House will accept the Motion.

2.50 p.m.

Mrs. Joyce Butler (Wood Green)

My usual situation in debates in this House has been to have five minutes just before the occupants of the Front Benches have wound up the proceedings, but today I find myself in a very different situation in speaking after the Minister has, in a sense, wound up the debate. I hope that the House will bear with me for a few minutes, because I have sat through this debate and there are one or two points that I want to make which have not been raised by other hon. Members. Also, I cannot, of course, resist the temptation to say something in reply to what the Minister has said.

I was very glad indeed that the Minister and all other hon. Members who have spoken in the debate recognised the need for housing for the elderly and congratulated the hon. Member for Meriden (Mr. Matthews), who initiated the discussion, which has been remarkable for the unanimity of the opinions expressed. There have been divergent views here and there, but on the whole there has been a marked consensus about the real debt that we owe to the elderly people and the need for us to repay that debt as quickly as we possibly can.

The point made by my hon. Friend the Member for Paddington, North (Mr. Parkin) about the urgency of this matter is very much in all our minds. To say to a family on the housing waiting list that it must wait a year or two for fresh accommodation is harsh enough, but to say that to elderly people, when they see their years so limited by time, is very much harsher. Therefore, we have to do what we are going to do as quickly as we can to meet this need.

I shall speak, as other hon. Members have done, about the particular problems in the conurbations. I hope that, in spite of what the Minister has said in replying to the debate, he has really appreciated that there has been this consensus from the rural areas, the urban areas and particularly the conurbations that not nearly enough is being done, and that there are doubts in the minds of many hon. Members who have spoken whether what the Government intend to do will really meet the need.

I was rather sorry that the Minister mentioned a number of things, such as circulars, which are going out to local authorities—excellent though the circulars will no doubt be—but was rather less vocal about practical financial help. He referred, towards the end of his speech, to financial inducements or some such phrase, but I did not gather from what he said that there would be the financial assistance without which local authorities, in particular, will not be able to carry out their duties.

Sir K. Joseph

I thought, perhaps wrongly, that since there was a Bill before the House at present it was not open to me to dilate on that theme of how the Government propose to make more money available to local authorities which need it.

Mrs. Butler

I appreciate the limitations under which we are speaking on this subject today, but I thought that, since the Minister made quite liberal references to the White Paper, if there has been substantial financial intentions on the part of the Government with regard to housing for old people he might somehow have worked that into what he had to say.

As has been generally agreed today, the position can be met in several different ways, but I think that most hon. Members feel that the local authority has a prime function in respect of housing for old people who can still live independent lives but need labour-saving, warm, comfortable flats or rooms in hostels. This involves local authorities at both levels who are providing housing accommodation and welfare accommodation.

I do not think that the nature of some of the difficulties in an area like the London conurbation have been sufficiently appreciated, although the hon. Member for Clapham (Dr. Alan Glyn) referred to some of them. We are agreed that, if they wish, old people are entitled to stay in the place which they have known all their lives. Particularly in the case of some of the older women, the people in the shops are familiar to them and they can talk to them, and they are, indeed, part of the background to their lives and almost part of their families. There is something very real and valuable to an old person in being able to remain in known surroundings. Thus, we are agreed that when old people are in need of housing they should, where possible, be enabled to stay in the area where they have spent their lives.

Yet, when dealing with the problem of the Rent Act, the Minister has very often said that people who do not need to live in the London area should move out of it. There is a difference here between what the Minister says in one capacity and what the House has been saying today. We are agreed, looking at it from the point of view of elderly people, that if they have grown up in the London area and are desirous of staying there, they should be enabled to do so. The local authorities should help them to stay there when they are threatened with eviction under the Rent Act, as many of them have been, or when they are living in very unsatisfactory housing conditions and need better accommodation, or, as happens so often in my constituency, where they are perhaps living in one or two rooms in a house the rest of which becomes empty and is subsequently bought by a new owner who moves in with his family.

Even with the best will in the world, the elderly person and the new young family may not be a very harmonious living unit and may not be able to get on well together. Sometimes there is ill will on the part of the new landlord and a desire to force the elderly person out. That happens very frequently.

I should like to mention a certain category of elderly person which is affected in that way. I have had many cases of widows and elderly single women living in one or two rooms in a house which has been bought by a new owner, and these women have gone desperately to the local authority saying, "Please get me out. If only I could have my own front door and go in and shut myself in my own little place and my own little kitchen to do just as I liked!" The strain on such women is intolerable, and there is a need for local authorities to provide housing accommodation for them.

In the Borough of Wood Green, where we have a population of fewer than 50,000, we have 254 elderly people on the housing waiting list for elderly persons' accommodation. Very often these are people who are living on upper floors of buildings where stairs present an insoluble problem if they are crippled or suffering from heart trouble or various other complaints.

I and other hon. Members have many times said that if local authorities are to build what is necessary something more is needed by way of financial encouragement to them. The Minister said that it was not sensible to build accommodation for old people without all the necessary fitments and special provisions which old people need; but such accommodation very often costs more in proportion than ordinary accommodation, and if one is to add many of the things which make all the difference between just a shell and a comfortable home for old people, it may cost even more.

The Minister referred to how much local authorities have been doing about providing accommodation for elderly persons. I rather wondered, from his subsequent remarks, how much of that accommodation has been built for elderly people who are on housing waiting lists and in real housing need and how much of it has been built as a side product of slum clearance schemes. When a slum clearance scheme takes place, there are always a large number of elderly people displaced who have to be found alternative accommodation.

I wonder whether the Minister, when giving figures, was referring in part to regular slum clearance, which, important though that is, does not touch the real housing need of these other categories of people of whom I have been speaking, which the Minister says he hopes will now be tackled under the new provisions mentioned in the White Paper. I cannot see, however, that they will be adequate from what he has said so far.

The hon. Member for Clapham mentioned the difficulty of transfer arrangements for people who do want to move out of the London area. The Minister said, in reply, that he had sent a circular to the local authorities and the new towns.

Sir K. Joseph

The hon. Lady is right about the circular to the new towns. That has recently been sent, but I said that my right hon. Friend was studying the transfer problem in general.

Mrs. Butler

I had not quite finished my sentence.

The Minister said that he had sent a circular to the new towns and local authorities about the housing of elderly persons in the new towns. It is that point that I want to take up. My own authority in Wood Green received such a circular from the Minister, but because we have a waiting list of old people we were very reluctant to raise their hopes without being able to fulfil them, by writing to the old people and asking, "Would you like to go to a new town?" So we wrote to the Minister asking what vacancies there were for them in new towns.

The Minister's reply was that he could not say We wrote, therefore, to the new towns with which we are associated in Wood Green, to ask what was the position and whether they could take old people if they wished to move out. Seven of the new towns have schemes for housing retired persons from the London areas, but they said that these schemes were to house parents of their tenants and they had long waiting lists. I emphasise that where these schemes are available, it is quite clear from the letters received from the new towns that they are extremely small. I should like, if I had greater time, to quote from the letters, but I think that when the Minister receives the replies, if he has not already done so, from the new towns, he will agree that they have done very little to provide houses for older Persons and that where they have, they are almost exclusively available for parents of families moving out to the new towns.

That is very desirable, but it does not touch the problem of elderly people who have no children and unmarried elderly people who may also want to move out. In any case, the parents have to wait for years before they can get accommodation, and for an elderly person this is a very long wait indeed. The new towns are unable to help.

I stress that because it is one thing to send out circulars about these matters and quite another for results to accrue. I was especially interested in one of the replies in which one new town authority made it clear that it would need to discuss with the Minister the question of subsidies for providing housing for elderly people. It went on to say: Obviously, special and additional schemes of building a suitable type of accommodation will have to be undertaken, as the existing demand on the Council for types suitable for housing older people is very heavy. I hope that what I have said about the circular is sufficient to show that it is not enough to send out circulars and exhort exporting authorities to co-operate with importing authorities. More needs to be done practically with financial arrangements to encourage this kind of transfer.

I want to refer to the practical difficulties of local authorities in the London area, for example, in acquiring land for old people's housing, a matter to which the hon. Member for Clapham referred. I do not know whether the problem is thoroughly appreciated. There was a manse in Wood Green which belonged to a church and which came into the market. The council wanted to acquire it so that it could demolish it and build flatlets for elderly persons. The council's original offer was £1,000, which was merely the site value, because the house itself would not have been habitable.

Eventually, the council had to drop out of the bidding and the house was bought by a private developer who paid £5,000 for the site and proceeded to put up maisonettes. I have no doubt that the Minister will say that that will help to solve the general housing problem, but the point is that it prevented the council from putting up flatlets for elderly people as it wanted to do. It was a small site and it had to go to the highest bidder because the seller was a religious organisation.

There are many other places in the Greater London area which would be suitable for building elderly persons' flatlets, hostels, welfare homes, and so on, but where the same problem arises and where the private developer is often the only person who can provide the money to buy the site, either to convert the house or to pull it down. The property does not then go to people on the housing waiting lists or to elderly persons.

An example of the astronomical figures is given by the case of a site in Tottenham which, on the development plan, is allocated to residential accommodation. Admittedly, it has a commercial use at the moment, but it is desirable residential land and is close to shops and the centre of population—and hon. Members have agreed that that is where elderly persons' accommodation should be. However, it is the land which is close to shops and the centre of population which is the most expensive in every town. This site of .74 acres has a valuation of £105,000. Not unnaturally, the local authority is not proceeding to develop it for residential accommodation and certainly not for old people's accommodation.

With land at these high figures, the tendency is for the developer to build to the maximum possible density. I do not agree with the hon. Member for Clapham that we should build old people's accommodation to the maximum possible density. I agree with the Minister that we should build bungalows, small buildings, and flatlets—nothing very high—because, even where lifts are provided most old people do not like living in very high buildings, and we are supposed to be doing what the old people want and not what is convenient or what we think that they ought to want.

Dr. Alan Glyn

As the hon. Lady has said, there is a shortage of sites and one has to make the maximum possible use of the remaining sites. The only way to do that is to build up and to provide proper lift facilities for chairs, as I have said.

Mrs. Butler

There is a shortage of sites, but the sites which are available are not available to local authorities, either because they do not have the power to acquire them, or because they do not have the money necessary to do so. Another reason, of course, is that there is no control of rising land values and no means by which the community can benefit from that rise.

Elderly people do not like living in very high buildings and do not like having windows at high levels. We all agree that one of the things which elderly people like to do is to be able to sit and look out of their windows at the world as it passes by, and we are asked to keep the windows low so that they can do that.

These are great difficulties to which the Minister has not given sufficient attention. I hope, in spite of what the Parliamentary Secretary said about his right hon. Friend's concern about this, that much closer attention to the problem will be given. We were all pleased to note that there is to be encouragement of greater co-operation between the health and housing authorities on this matter, but without more financial assistance and more attention to the problem of land, particularly in the built-up areas, I do not think that we shall see the improvement in housing for the elderly which many of us want.

We are all agreed that the welfare work being done by old people's welfare committees and voluntary organisations is first-class, and that we cannot have too much of it. But the bad housing conditions of many old people are putting an unnecessary burden on voluntary welfare workers. If we could improve those conditions, that burden would be eased because it would solve so many of the problems with which they now have to deal.

I want to refer to the "good neighbour" scheme, being introduced by Middlesex County Council, which has not been mentioned today. It is planned to use it to supplement the home-help scheme, and to give a payment to people who will go in to old folk living alone and light their fires, do their shopping and other jobs like that. Some of this is being done in a voluntary way, but the county council, in introducing this scheme, is enabling payment to be made to people who are willing to do these services but find that other commitments make it difficult, unless they receive some financial reward, to cover their expenses and to keep them going.

I am very grateful for the opportunity to join in this debate, and I hope that, as a result of it, there will be a renewed interest on the part of the two Ministries in this problem, and that they will also consider the financial aspect, so that housing authorities, housing associations and all those associated with the welfare of old people may feel that there is a genuine drive at last to put the elderly in their rightful position.

We in this House, if we survive all-night sittings and the other vicissitudes of Parliamentary life, all want to feel, when we become old like those outside, that here is a country in which it has been worth while to live, and that we can have an old age which we can enjoy because the services, facilities and housing are there for us to make the most of in our declining days. The rest of the community looks to us to do what we can to put this problem into proper perspective in a way that has not been done before.

3.14 p.m.

Mr. Geoffrey Johnson Smith (Holborn and St. Pancras, South)

All of us will echo the sentiment expressed by the hon. Lady the Member for Wood Green (Mrs. Butler) in the closing words of her speech. I hope that she will not mind if I do not follow her into the ramifications of her argument about the shortage of sites in London. It is a wide subject. I agree with my hon. Friend the Member for Clapham (Dr. Alan Glyn) that there is a genuine shortage of sites. This is not a question which can be solved purely by action alone. The hon. Lady was roaming far into the whole problem of urban renewal.

I should also like to express my apology to some of my hon. Friends who are bursting to plunge into the more turbulent waters of the United Nations. That is a very heady brew. I apologise for detaining them and keeping them away from tasting this heady brew by my efforts to prolong this debate, but I am sure that they would be the first to agree that there are many who are passionately concerned with the kind of social weapons which they think ought to be brought to bear on this enemy of old age.

"Old age is bad. It is not an achievement, but a defeat." As that eminent Jewish leader, Ben Gurion, once said, "it should be fought like any other enemy", and in the next few moments I should like to emphasise some of the ways in which we might sharpen some of these social weapons and so help to defeat this enemy.

I represent a constituency which has a high proportion of old people. Part of the Borough of St. Pancras comes within my constituency. Taking the borough as a whole, about 14 per cent. of the people are of retirement age. To translate that into figures, it means that there are about 17,000 out of 128,000 who are of retirement age, and, as we have heard today, we can expect this proportion, which is already high, to rise still further.

Compared with many other parts of the country, we are fortunate in having a special association which helps to take care of the elderly people in this part of the country. It is the St. Pancras Association for the Care of the Aged, which was started in 1951. The House will be interested to know what progress has been made, because by looking at one organisation like that one can begin to understand the size and scope of the problem and also to understand how quickly it has grown.

In 1951, the first year for which I have figures, the number of visits paid by health officers to elderly people was 1,461. In 1960, health officers made over 10,000 such visits. In 1951, about 9,000 meals were provided to elderly people in their own homes. In 1960, that figure had risen to 38,000. I choose those two examples to give some idea of how much the association's work has expanded.

There has also been a considerable expansion in terms of cash. The borough council makes a grant in aid to this voluntary association. In 1951, it was about £1,500. Last year, it had increased to £7,000. Voluntary support too increased from £148 in 1951 to over £1,000 last year. Fortunately, this year it has received an extra grant, this time from the London County Council, to support chiropodist services, because these services have been decentralised through London, which is a step in the right direction.

Despite the tremendous increase in financial support, and the burdens it has undertaken, it is obvious to those who have something to do with the work that the number of people required, especially health officers, to visit people in their homes is unlikely to be sufficient to meet the growing needs of the area.

Here we come to the first big problem which I should like to underline. We have here a voluntary association which has expanded and which will continue to expand, but is still insufficient. We have a local authority which, apart from giving assistance financially, tries to help to remedy the situation by building homes for the elderly. If there are not sufficient people to visit the elderly in their new homes once the accommodation has been converted, then, despite the better amenities which we will provide for the elderly, we will, in effect, because of the shortage of health visitors, be consigning them to nothing more or less than a rather brighter but living tomb, isolated from contact with the outside world.

I feel that part of the trouble still lies in the fact that many housing authorities have so few statutory welfare duties—my right hon. Friend the Minister of Housing and Local Government gives considerable financial incentive to build for the elderly—but many have to rely. so far as welfare is concerned, on the efforts of voluntary societies, whose activities I certainly do not denigrate--and, apart from the efforts of such voluntary societies, on the activities, also, of another authority. In my constituency, it would be the London County Council, for whose efforts in this direction I have a great deal of admiration.

I would have thought that in helping the elderly there was a very special case for transferring some of these welfare funds from the higher local authority to the more local level of the borough council. A start could, for instance, be made with the home-help service, which particularly applies to elderly people. In this way the service would be swifter. It would certainly be more personal for elderly people and would be better and more closely integrated.

This is one of the reasons why, speaking as an hon. Member representing a London constituency, I welcome the proposals of the Royal Commission on London Government. As I see it, the effect of its proposals, if implemented, will be to see that the welfare and housing services will be joined together and be much more local through the creation of new and bigger local authorities which will be able to combine these big welfare and housing powers. I welcome that, because it seems to me that these are particularly the services which essentially should be confined to a local level because they are of such a personal nature.

The hon. Member for Fulham (Mr. M. Stewart) put a question to my hon. Friend the Parliamentary Secretary to the Ministry of Housing and Local Government which I do not think he answered. Th hon. Member asked whether or not the new proposals in the Housing Bill were likely to have the effect of making more money available with which to help the elderly as far as housing is concerned. He wondered whether there might not be less available. I, too, should like to put that question to my hon. Friend the Parliamentary Secretary. I know that he is not in his place at the moment, but I am sure that his hon. Friend the Parliamentary Secretary to the Ministry of Health will put it to him later.

I should like to know—this is a rather hypothetical question—if the proposals of the Royal Commision are implemented so that bigger boroughs are created in London which would be responsible for both welfare services and housing services, what will happen to the London County Council grant which, at present, goes to the borough councils which build for the elderly? Will this grant in aid from the London County Council disappear when that body in its present form disappears and when we have a larger borough group? If so, there will be less financial inducement for these new and bigger boroughs to build for the elderly.

My next point refers to the services of local authorities in connection with the health of the elderly. As we know, the residential hostels are the responsibility of the local authorities, where as hospitals are the responsibility of the regional hospital board. I wish to emphasise what I believe to be a problem affecting many areas. Both hostels and hospitals have increasingly large waiting lists, and it seems to me that each is chary of taking cases from the other. As was said or implied earlier today, there are people in hospitals who might be better off in hostels, and there are some in hostels who might well prosper and profit from being in hospital.

I understand that there are occasions when doctors, misguidedly, perhaps, suggest that elderly people should go into a hostel because they think that that is a quick, back-door way into hospital. Unfortunately, it does not work out that way. Apart from the confusion which arises in this situation, many elderly people who are in hostels are deprived of the latest advances in geriatric practice.

Finally, I wish to lay further stress upon a point which has been made by some hon. Members today, though not, perhaps, with what I regard as sufficient emphasis. Are there not too many different social services to which the elderly may turn? I strongly urge that there should be some sort of integration of such social services as do exist. In the old days of the Poor Law, an elderly person applied for assistance at the office. He obtained medical attention through the same office. He drew his relief from the same office, and he was paid in his own home once a week by a relieving officer from the same office.

Today, such an elderly person seeking financial assistance goes to the office of the National Assistance Board. If he wants medical aid, he goes to his general practitioner. Such a person wishing to draw an allowance goes to the local post office.

Mr. Hunter

I am quite sure that old people would rather go to their post office to draw their National Assistance or allowances with their pension rather than go about it as it was done under the old Poor Law.

Mr. Johnson Smith

I am quite sure that the hon. Member is right, but that is not really the point I was making. I ask him to bear with me for a moment while I complete the argument.

As I was saying, the elderly person today goes to the post office to draw his allowance. If he wants extra help in the home or special care, or if he is unable to look after himself, he has to apply to the welfare department. If his needs are housing needs as opposed to being rehoused in a residential hostel, he has to go to the housing department.

I recollect very well, from my experience in my own "surgeries", that many elderly people are increasingly confused. They do not know which person to go to. There are so many. If, in addition, there is a voluntary association to which they can go, such as there is in St. Pancras, one can also add the W.V.S. and other voluntary groups, so elderly people can go through the hands of three Ministries and two or three private organisations as well.

I am not at all convinced that this multiplicity of welfare services is, in the long run, the best solution to the problem. I hope that I have shown that it is certainly not of great help to old people in the matter of housing. In many areas, when housing is provided without co-operation with the welfare services under the same authority's umbrella, we may be doing no more than put people into what I advisedly call a living tomb.

Question put and agreed to.

Resolved, That this House welcomes the recognition given in the White Paper on Housing in England and Wales to the urgent and increasing need for more housing and other accommodation for old people; and, while recognising the progress being made in providing it, calls on the Government to see that this progress is maintained, and to take further steps to ensure that the accommodation provided for old people is really suited to their special needs.