§ Motion made, and Question proposed, That this House do now adjourn.— [Mr. Hughes-Young.]
§ 10.0 p.m.
§ Mr. George Thomas (Cardiff, West)
I wish to raise a subject of major concern in every community throughout these islands: that is, how to care adequately for the ever-increasing number of elderly people who are living amongst us. Obviously, our greatest anxiety in this matter concerns the old folk who live entirely on their own. I have been appalled at instances of old folk who have been found ill after days of lying unattended in their own homes.
A serious defect in our Welfare State is the utter lack of reliable information concerning the scope of this problem. No machinery exists whereby actual 542 statistics are made available giving the numbers of old people living alone in city, town or village. No one has a statutory obligation to undertake a survey to obtain these figures. Welfare committees of local authorities give a first-class service in their own field in most areas, but they have neither the financial resources nor the manpower to undertake a door-to-door survey to find out and to register the names of old folk living alone who have special needs.
I understand that in Liverpool and Bristol, and one or two other progressive areas, a special survey of the needs of old folk in general has been undertaken, but I am not sure of the extent to which this has been done by local authorities or by the voluntary agencies. In the City of Cardiff, we have undertaken a pilot survey of our own. It is because I believe that that survey has a lesson for the whole country that I raise the matter here tonight.
We have sought to bring the voluntary agencies and the statutory bodies in Cardiff into co-operation. So that we may have a reliable guide to the magnitude of our problem in a city of roughly 300,000 inhabitants, we undertook a pilot survey in two fair-sized areas, including two large new housing estates, in Ely Racecourse and in Fairwater, Cardiff. Both of these happen to be in my constituency.
The survey was undertaken by the members of two youth clubs, the Trelai Youth Club, and the Waterhall Youth Club. I cannot pay too high a tribute to these young people, who readily gave up their leisure time to plod from door to door seeking the basic information which we needed.
These two youth clubs have proved once again the high quality of our youth today. They have made news, not by getting into trouble but by dedicating themselves to serve other people. We hear a great deal when youngsters get into conflict with the law, but it is encouraging to know that when an appeal on the basis of idealism and service is made to youth we never fail to get a response.
Two young schoolmasters in the City of Cardiff, Mr. Derek Rees and Mr. Trigg, provided the leadership for these youngsters. In so doing I believe that they have pioneered what may well be a 543 new cause for our welfare services. The city welfare youth organiser is Mrs. Margaret Craddock, the wife of my horn. Friend the Member for Brad-for, South (Mr. George Craddock), and I am glad of the opportunity to pay her a tribute in this House for the splendid part she has played in the youth work of the City of Cardiff, and, in particular, for the inspiration which she has given to the young people concerned in this survey.
Three key questions were asked by the young people at each house visited. First, "Are you a pensioner?" Secondly, "Are you living on your own?" Thirdly, "Do you need help or visitors?" Our survey was in no way directed to finding out the financial circumstances of the old folk. This, we believe, is a matter for the Ministry of Pensions and National Insurance, the National Assistance Board and others. We were concerned with solving the cruel problem of loneliness amongst old people in crowded cities, and to meeting other needs which they may have.
The survey soon proved to us that the needs were far more extensive than we had anticipated. Here are some typical cases. Mrs. H., 81 years old, help needed with shopping; Mr. and Mrs. N., aged 80 and 86, two very lonely people needing help badly; Mr. H. very lonely, unable to go out, needs help with shopping; Mr. S. needs help with garden. There were 12 cases of people just wanting someone to talk to them.
I understand that in some areas local authorities employ a warden whose sole job it is to call on old people and to care for them. I had this morning a letter from an old-age pensioner in Ely, in Cardiff, saying this is so in Weston-super-Mare.
The first question I wish to address to the Parliamentary Secretary, whom I congratulate on his appointment, and whom I am so glad to find in his first Adjournment debate in his present office—
§ Mr. Thomas
Second? Well, I still congratulate the hon. Gentleman, and I hope that he will do a good job, particularly for the people whom I am mentioning.
544 Will the Minister circularise local authorities to encourage the appointment of wardens on a full-time basis for following up the work undertaken by such organisations as these youth clubs? I believe that people who are aware of the need of the old folk in their community would gladly go to their aid, but they must have the need proved for them. I hope that we shall be able to take the measure of the need in every area of the country.
When the Minister replies I hope that he will reveal the plans of his Department for blending the voluntary services with the statutory organisations. I have in mind the way we have acted in Cardiff, for every case of need we have unearthed has been sent to the Medical Officer of Health for Cardiff, who has a register, which is growing all the time, a register of old folk on whom the welfare workers should call, and this register is at the disposal of the churches and welfare authorities in the city. None of us can measure the extent of voluntary work already being done, particularly by the churches and chapels, for those who are able to give nothing in return, except their gratitude.
I believe that if the Minister will support the idea of a national survey, to find out how many of our old guard now stand in need of loving care and attention, he will be doing something that will remove a blot from our current Welfare State. I want to pay tribute to our South Wales Press—the South Wales Echo and the Western Mail—for the way in which it has supported this survey and encouraged people to cooperate.
I realise that we cannot legislate for every need of human kind, for there are needs for fellowship and friendship, for company and for acts of kindness in which we have to leave to the good spirit of our people. But, even while I recognise that, I believe that there is far more suffering amongst old people than we realise, and that, in view of the increasing number of old and ageing folk in our community, this is a subject to which the House is right to give its attention.
I hope that I shall hear from the Parliamentary Secretary tonight that he is aware of the problem and is anxious to match his cognisance of it with deeds.
§ 10.12 p.m.
§ The Parliamentary Secretary to the Ministry of Health (Mr. Bernard Braine)
I am sure that the whole House will be grateful to the hon. Member for Cardiff, West (Mr. G. Thomas) for providing the opportunity to discuss this important subject, and for introducing it with such an interesting and sensitive speech. May I too say how much we appreciate his efforts in helping to focus attention on the needs of old folk, especially those living alone, who may need special help?
I think that we are all agreed that one of the tests of the worth of a society is the extent to which its stronger members are aware of the need to care for the less fortunate, the weak, the infirm and the aged. The existence of what we call the Welfare State does not absolve any of us from our duty in this regard. It was Lord Beveridge who reminded us, some years ago, that the problem of helping the elderly in our society—is not one for uniform treatment. It is as variable as it is large and growing. It calls for services of many kinds … it has not been solved by the National Insurance Act.At the outset, I should like to put the question raised by the hon. Gentleman into perspective. All our information indicates that the majority of old people are able to support themselves with the ordinary range of help available to the community at large. The majority are not a problem group, and most of them, as I think we all know, would resent any suggestion that they are. We also know from a large number of surveys which have been carried out in recent years that the majority, whether living with relatives or on their own, are helped to do their shopping, household chores and the like, by their relatives. This is as it should be, but we know, too, as the hon. Gentleman reminded us, that there are some who are not helped in this way, and who are not reached by the various services which exist, that there are gaps in our social provisions and that these vary from locality to locality.
Here, perhaps, I should remind the House that while living alone increases the vulnerability of old people to misfortunes of one kind or another, it is not necessarily an indication of need, for 546 elderly people need not be lonely living alone if they have a circle of friends. On the other hand, a person can be desperately lonely living in a crowded household if his special needs are neither understood nor met by those around him.
Moreover, we are faced with the fact that the numbers of old people are going to grow, particularly the numbers of the very old and frail, who, of course, make the heaviest demands on our welfare and health services. It is a sobering thought that during the next twenty years the numbers of those aged 65 and over will increase from 5.6 million to 7.6 million, while those aged 75 and over will increase from just over 2 million to nearly 2.9 million. This means that during the next twenty years the rate of increase for those aged 75 and over will substantially exceed that for the group aged 65 and over. The House will appreciate that these figures have very wide implications indeed for our social services.
If there are gaps in our present social provision for the aged, how can they be bridged? That was the question the hon. Gentleman has raised tonight. It cannot be done by pushing leaflets through letterboxes. It is the crux of the problem that some frail old people may not know what they need, or how to get it. What is required then is personal contact with someone who really knows what the old person needs and how that need can be adequately provided.
How best can we organise contacts of this kind? The hon. Member has referred to the work of the Cardiff Youth Service. Before I say anything about this, perhaps I should warn against generalising from the particular, or arguing that what is necessarily suitable for conditions in Cardiff is right for the rest of England and Wales.
It might be helpful at this stage if I described the existing machinery for bringing help of various kinds to elderly people who for one reason or another have need of it. First, we have a very wide range of statutory services centred round the general practitioner. Working with him are the home nurses, health visitors, home helps and social workers. Between them, these trained and experienced workers should be able to identify those old people who need special help.
547 Supplementing them we have a wide range of voluntary services, to which the hon. Gentleman rightly paid tribute, which have been developed steadily year by year. Regular visiting, meals on wheels, the keeping of a kindly but, I hope, always unobtrusive eye on these elderly people helps them to maintain independence in their own homes and to combat loneliness. Here I pay tribute to the National Old People's Welfare Council, which has been most successful in promoting these visiting services. There are now nearly 1,700 local old people's welfare committees in England and Wales which co-ordinate the work of organisations and individuals in this field. Tremendous effort is devoted by the Council to the training of voluntary workers so that when they are visiting they are able to recognise the needs of elderly people, who should be more readily aware of the statutory services which they can call on in case of need. The information which the hon. Gentleman has given us tonight points to the need for a really effective visiting service in his own City of Cardiff, and I hope that the efforts that he has been making will help to promote that.
It is self-evident that in the task of identifying need we must secure the closest possible co-operation between local authorities and voluntary organisations. The hon. Gentleman asked me what we are doing about this. My night hon. Friend called a conference of statutory bodies and voluntary organisations last April. His purpose was to try to thrash out what needs to be done in this field and encourage a much greater degree of co-operation than has existed up to now, and to do this in the context of the ten-year plans for local health and welfare services which they had previously been asked to prepare.
That was followed by the issue of Circular No. 7/62, which drew the attention of local authorities to the very welcome assurances by voluntary organisations that their work could be expanded. It asked them to give fresh thought to the part which voluntary organisations could play in the development of domiciliary health and welfare services. Last month, my right hon. Friend called a further conference to spread the gospel over a much wider field; representatives 548 from no fewer than seventy organisations were present.
§ Mr. Douglas Houghton (Sowerby)
Can the hon. Gentleman say whether the National Assistance Board was represented at these conferences? I ask because my hon. Friend, in his most admirable speech and survey of this problem, did not mention the Board. There are 1,800,000 homes to which the Board's officers are going in order to give supplementation. We have heard a great deal about the additional services they render in cases like that. Can the hon. Gentleman say where the Board comes into this?
§ Mr. Braine
I stand to be corrected, but I do not think that the Assistance Board was represented at these conferences. I will look into that point, however, and communicate with the hon. Gentleman.
What my right hon. Friend had in mind was that in drawing up their ten-year plans the local authorities should tell the voluntary organisations precisely what help they would like to receive from them, and that the voluntary organisations, in their turn, should say not only what help they could give but what they were ready to undertake. Obviously, there will have to be machinery for the joint inter-change of information and ideas and the joint preparation of plans.
The hon. Member for Cardiff, West is really pushing at an open door in this, for what my right hon. Friend envisages is a partnership between the statutory and voluntary services, both to fill the gaps in the services for the elderly that now exist and also to meet the challenge of the rapidly rising numbers of old people in the next two decades. That partnership will be an integral feature of the ton-year plans for health and welfare which, in turn, are intended to supplement the Hospital Plan.
The hon. Member suggested that youth clubs should be asked to undertake a survey similar to that conducted in Cardiff. That is an interesting suggestion and could be useful, but I think that we would have to examine very carefully what the Cardiff survey has achieved before one could go any further. It is important to be quite clear what the purpose of such a survey is and what results it can achieve.
549 We share the hon. Member's opinion that surveys are very important. In fact, they are one of the main means of identifying and assessing needs. They are bound to vary considerably in type and aim, ranging from sociological studies carried out by experienced social workers to the more modest survey of the kind which has referred to, which might properly be called an inquiry to find out which elderly people in a particular locality need special assistance, such as help with housework.
Without casting reflection on the Cardiff youth clubs, whose enterprise and public spirit I wish to commend, I am sure that the hon. Gentleman will agree that it is important to ensure that those who carry out these surveys have the necessary skills and experience to ask the right questions and to interpret the answers correctly. Broadly speaking, I would not think that youth clubs could be expected to undertake a survey of sociological significance, but they might be able to help in the more limited kind of inquiry I have mentioned.
I believe that young people could help in another way. As we all know, a little help given at the right time may save a great deal of trouble. For example, there are moments when to keep the garden tidy, to wash the curtains and to hang them up again, or to run an errand, can relieve an old person of an enormous load of worry. In many areas, young people are helping in this way and I would like to see more of it.
Even so, I must emphasise that whatever help is undertaken by youth clubs or organisations or individuals there should be the closest co-operation between them and the local authorities in order to ensure that appropriate work is undertaken by the right people, that there is no duplication, and that any help found to be necessary is properly co-ordinated. It must be for each local authority to decide what sort of inquiry is needed in its own locality, or indeed whether any inquiry is needed at all. It does not follow that an inquiry of the Cardiff type would be suitable or needed in all areas.
As long as these principles are followed we would welcome any survey or inquiry which would contribute to the knowledge about the needs of old folk in a particular area. Such surveys are 550 continually being carried out by people inside and outside both the statutory and voluntary services. Good planning depends upon reliable information, and these surveys are an indispensable source of the information we need.
What is important is that they should be carefully co-ordinated and properly carried out, otherwise they may antagonise those whom they seek to serve and make it difficult for those who can bring help. Indeed, the report to which the hon. Gentleman referred brings out the fact that there are some old people who are extremely difficult to approach in these matters and who have to be approached in a very understanding and knowledgeable way if the right result is to be achieved.
I turn now to the hon. Gentleman's suggestion that local authorities should be asked to appoint special officers whose jobs should be the organisation of the care of old people. The hon. Gentleman will be aware that we already have chief welfare officers, or medical officers of health in charge of welfare departments in local authorities, who are responsible for organising the care of the elderly. On the other hand, if the hon. Gentleman is suggesting a voluntary person who would act as a warden for the elderly in a particular locality, I would warmly welcome this. It would depend on local conditions, but there is scope far a great deal of experimentation on these lines.
§ Mr. G. Thomas
I hope that the hon. Gentleman is not forgetting that medical officers of health can only deal with cases which are brought to their notice. I am anxious about the old people who live alone and who would never be discovered unless we looked out for them.
§ Mr. Braine
This is the kind of thing to which the new emphasis which is now being given should be directed. I take the point made by the hon. Gentleman. I do not think that there is any room for complacency on this score. I am delighted that the hon. Gentleman has raised this matter tonight. We in the Ministry of Health appreciate that a great deal needs to be done. As I have said, we have laid the foundations for a considerable expansion of services. What is now needed is development and expansion to fill the gaps.
551 Perhaps I might summarise the steps that we are taking to provide for this expansion. First, health and welfare authorities have been asked to prepare ten-year plans for submission to my right hon. Friend by the end of October. Secondly, local authorities and voluntary organisations are embarking on joint studies of needs in the health and welfare field and on the preparation of schemes to meet them. Thirdly, surveys of one type and another, some by statutory authorities, some by voluntary organisations and some by outside agencies, are under way.
Thus. I hope that by improving the machinery by which we can ascertain need, and by expanding the services to meet that need, we shall improve the provision for the support of the elderly in the community. Nevertheless, I think that I should emphasise that if the task is to be tackled effectively we shall need the voluntary organisations and all the help that we can get from people of all ages in every walk of life. This is why I welcome the initiative which the hon. Gentleman took, together with the Cardiff City Council and the churches in Cardiff. We have heard tonight how their joint effort in developing. I understand that they are to meet again in conference to decide future action, and I am 552 sure that the whole House joins me tonight in wishing them well.
§ 10.29 p.m.
§ Mr. A. V. Hilton (Norfolk, South-West)
I am sure that we all echo the sentiments by the Parliamentary Secretary. We are indeed grateful to my hon. Friend the Member for Cardiff, West (Mr. G. Thomas) for raising this matter. I confirm what was said by my hon. Friend about the good work done by this group of young people. I wish that as a result they had got their names into the headlines of the newspapers, just as people do when they kick over the traces.
These young people have done a first-class job of work in carrying out this survey, but we did not really need a survey to remind us of a problem with which those hon. Members who live amongst their constituents are familiar. It is a problem which exists not only in Cardiff but in all the big towns and cities.
§ The Question having been proposed at Ten o'clock and the debate having continued for half an hour, Mr. DEPUTY-SPEAKER adjourned the House without Question put, pursuant to the Standing Order.
§ Adjourned at half-past Ten o'clock.