HL Deb 01 May 1947 vol 147 cc336-68

5.54 P.m.


rose to call attention to the plight of the old people in this country; to inquire whether the Government intend to carry out any of the recommendations of the Nuffield Report; and to move for Papers. The noble Lord said: My Lords, when, in the year 1943, the Nuffield Foundation appointed a Survey Committee, under the Chairmanship of Mr. Seebohm Rowntree, to inquire into the aged, I think it was the first time that any serious attempt had been made to find out whether there were any particular problems which applied to old people in general; and if there were, what were those problems and what could be done to help them? The Committee should be encouraged in their work, because the number of old people has increased enormously in this country during the past forty years. I do not at the present time want to take up a lot of your Lordships' time, but I want to give you one or two figures to make my point clear.

In the year 1900 there were about 1,000,000 people whom we should call old people; that is, people who have reached pensionable age, 65 for men and 6o for women. By the year 1947, that figure had increased to about 5,000,000 —it may be a little more than 5,000,000 now—and people reckon that if the present trend continues, by about 1980 that figure will be in the neighbourhood of 9,000,000 people. I think that was the point which made the Foundation feel it worth while making this inquiry. The Report was published in January of this year, and it disclosed rather an unfortunate state of affairs. There was one really important point: the Committee discovered that with the various systems of pensions the problem of real poverty was not now a very bad one for old people. They could, if they took advantage of the various pensions, provide themselves with a competence, adequate but austere, and not fear real poverty.

The real problem which confronts the old people now is something rather more dreadful; it is the general difficulty of living and carrying on their normal way of life. It is the difficulty of shopping, housekeeping, cooking and cleaning, and taking care of themselves. Those are difficulties which are affecting people in all walks of life, the rich and the poor. It is now quite impossible to find nurses to take care of people in their homes, and it is not possible for many people to live with their familes as they did, since the bulk of the younger people have to go out for themselves. and therefore cannot give up a great deal of their time. That was the general view about it.

The number of people who are getting into the ranks of what one calls the medically destitute—not financially destitute—is increasing, largely because old people cannot take care of themselves and get along by themselves. One of the great difficulties is that a very large number of people are suffering to a greater or lesser degree from under-feeding. I do not think it is that they are not getting enough rations, because I think the rations are as adequate for old people as they are for the middle-aged or young. The old people find it very difficult to shop, because they cannot stand in queues and carry home large bundles. The Nuffield Report, in paragraphs 135 and 136, refers to the fact that when they surveyed a large part of Cambridgeshire they found a great many old people were living on their meat, bread, butter, tea and jam ration, and nothing else. It was not surprising, therefore, that a great deal of ill-health was found. When these people were admitted to a home for old people, and were given a normal adequate diet, their mental and physical health improved enormously.

That was brought home to me in rather a different way during the winter when I was presiding over a conference, organized by the London Council of Social Service and attended by representatives of hospitals, local authorities, and voluntary bodies, to inquire into diets for old people. They all said that many old people needed to be admitted to hospital because they had not enough food. Once they got into bed and were taken care of, and properly fed on an ordinary diet, they improved quickly and could be sent back to their homes again. It is extremely expensive to maintain a patient in hospital. There are not a great number of nurses and the cost of keeping a patient in hospital is rising rapidly, ranging from four to six guineas a week. There are various means which could be employed to see that they did get a certain amount of extra food—not rationed food but extra food. It should be possible to assist these people by extensions of such schemes as the service run by the Red Cross in many towns, such as the "Meals cm Wheels" service, or the Invalid Kitchens of London. If it were possible for local authorities, under the Civic Restaurants Act, to supply meals from their restaurants to clubs for old people, their value would be increased enormously. I think that would be extremely helpful.

Another thing which I think could help in certain areas is an extension of the clubs which have been founded already in some districts, where the old people can go for so many hours a day. These clubs were begun from a rather sentimental reason, but that does not matter. It is pleasant for the old people. But if some extension of the Civic Restaurants principle could be applied to clubs for old people, so that they can get more than they do now—at present they cannot get much more than a cup of tea—it would be extremely helpful. It is not a very costly thing. It is not very easy to find accommodation for clubs, but there are all sorts of things to be done, ranging from taking a small house to finding accommodation in some local hall for four or five hours a day—that is all that is really necessary. The provision of more homes for old people is another method which I think is worth encouragement. A certain number have been opened by voluntary bodies and local authorities and have had considerable success, but most of them have very long waiting lists; indeed the demand for admission is such that waiting lists have become meaningless.

Most of these places for old people are very well and adequately run, but some of the voluntary homes which are not nursing homes are purely homes for healthy people. The Nuffield Report refers to some, of the more scandalous of these. Quite recently I came across two homes myself, one in London and one in the suburbs, where the people were charged seven guineas a week, and for that they shared a room containing four beds in a private house. My informant went to visit a relative in one of these homes and wanted to talk to her privately, and it was necessary to take her down to his car and sit there; there was otherwise no accommodation at all. That seemed to me not a very satisfactory state of affairs. The Nuffield Report suggests that these places should be open for inspection. That is going to be difficult, because it is not very easy to decide when a home is a home and not a boarding house or hotel; but I do not think the problem is insoluble. It would be better if these homes were brought under some kind of clause for inspection, even though it might mean that a few hotels might be involved. If an old person makes a complaint he is told that there are plenty of people wanting to come in and he can go elsewhere; so these old people keep their mouths closed.

The only accommodation that most local authorities can offer now to old people is the public assistance institution. According to the Report, only about 5 per cent. of the aged are in these institutions and anyone who has visited these places will understand why; they are large, grim masses of buildings, with ill-decorated wards, and often built about the time of the Poor Law Commission—1834 to 1840. The people are stifled under a mass of regulations and rules. Doors are locked at certain times and visitors are allowed at only infrequent intervals. There is no encouragement for the people to work or to take any active part in things, and they just sit round the walls of the institutions with nothing at all to do. One or two local authorities have been extremely good. I should like to mention two, because I know them. Excellent homes have been opened by the Surrey County Council and by the Glasgow Corporation. These homes are modern and up to date. They have single and double rooms, and the people are treated as if they were normal human beings.

The Ministry of Health have just issued a circular, No. 4947, in which attention is drawn to the necessity of providing reasonable homes for old people. They suggest that the ideal would be small homes for thirty to thirty-five persons where they could enjoy complete freedom with frequent visiting hours. They would have some kind of place for locking things up—a locker or just a drawer—and if possible they should be able to bring some of their personal belongings. I think that is an extremely encouraging circular and I hope it will be widely taken up by as many local authorities as possible. It is not a very costly thing; it can be done very largely by acquiring existing premises and would therefore go some way towards helping in a solution of the housing problem. There is great need for housing of this sort for people who can afford to pay something. A series of homes in North London keeps quite solvent by making a charge of two guineas a week. It does not make any profit, and does not want to. So, the expense, I suggest, would not be very great and would indeed be far cheaper than any kind of hospital provision.

I think local authorities might be encouraged—as indeed I understand in certain instances they have been—to build special accommodation for old people in their new housing estates or blocks of flats. But it is a great mistake to think that old people like to be segregated. They want to have accommodation near shops, churches, cinemas and other places of amusements, and, in a certain sense, they like to be mixed up with their younger contemporaries. And, be it remembered, provided they are not too much mixed up with them, they can contribute a lot to the lives of their younger contemporaries. Old people, for instance, can take care of children while their parents go out. One knows that when the father and the mother go out, children are liable to get into all sorts of trouble if there is no older person to look after them. Therefore some provision of this sort would be a good move from that point of view.

With regard to the liking old people have for company, I must say that two things struck me forcibly during the war. The Infirmary of the Royal Hospital at Chelsea was evacuated to a large house in Buckinghamshire. Here there was complete peace, beautiful gardens and a large park about two miles from the nearest small town. But the old men were absolutely miserable; they felt lost and cut off from their friends, and it seemed to them that they had already started upon their last road to the tomb. The matron told me that in London the most popular ward in the Infirmary had been one that faced, I think, Royal Hospital Road, and from those windows the tops of buses could just be seen. Even that meant a lot to these old people, and they were just longing to get back from the country to London again.

I remember, too, being told by a friend of mine who is interested in housing that during the war she visited a housing estate on the outskirts of a Midland town. While waiting for a bus to take her back to the town one day, she got into conversation with an old woman who lived on the estate and asked her how she liked her house. "Oh, it's fine," the old lady replied, "I have never had such a nice house, warm, comfortable and easy to manage." "Good," said my friend, "then I suppose you will be staying here for the rest of your life?" "Oh, no," said the old lady, "as soon as the war is over I'm going right back to the middle of the town. I know the little house I am going to get; it has been condemned, it is true, but I don't suppose they will pull it down in my time. "Now, that is the attitude of a lot of old people. They do not want to be parked out in the country—even though on beautiful estates—and cut off from the town.

It has been objected that it is not economic to build small houses for old people at the present time, but I have read that in Hornsey a close of thirty-four one-bedroomed houses for old people has recently been built by the borough council at a fairly cheap cost—I think it was £27,000. These houses are let to old people at an economic rent of 12s. 6d. a week, and old people have been pleased to move into them, thereby freeing much larger houses with many more rooms. Many old persons would be delighted to move into smaller houses. Their families have grown up and left them, and often they find the houses in which they are living much too large for their needs. But the new houses must be modern in design, well found and fitted.

Now a word about almshouses. There are many almshouses in the country, but more than 50 per cent. of them are old fashioned, having been built in the middle of the 19th Century. They are in many cases quite unsuitable for the aged, as they have steep, narrow, dark stairs, outside sanitation and perhaps no running water, and no coal cellars. Now many of the charities which founded these alms-houses provided money to supply a small pension to the occupants, but left no adequate funds for repairs and modernizing. This is a matter perhaps for the Charity Commissioners, but it does seem to me that this would be an appropriate course to follow. With the scheme for national pensions about to take effect, it would be sensible to attempt to divert this money from paving pensions—which will not only not be necessary but, if they exceed 7s. 6d. a week, lead to a corresponding reduction in the national pension—to work on these houses which is very necessary. As I say, this is probably a matter for the Charity Commissioners, but I hope that whoever is responsible will take the view that the desires of the pious founders will be better met in care of the buildings than in subsidizing the State, which was surely not their intention.

I have one more point. When people grow older, the distinction between health and disease becomes narrow and very difficult to define, and there must be great care taken to ensure that all old people, particularly those who live communally, can receive adequate expert medical attention when they are ill. In the past, there has been a tendency to consider chronic sickness as an almost inseparable feature of old age, and that all that was needed was careful nursing and attention. Any attempt to remedy a chronic condition in an old person was not attempted because it was thought to be impossible. The attitude to which I have just referred has caused a tremendous dislocation of the hospital services. It has led to a great slowing up of the stream of patients through the chronic wards of any hospital and to long waiting lists. Also, as a consequence, great discomfort has been occasioned to many. But there are hopes of a change. During the last few years a certain number of doctors have shown that old persons with their chronic diseases respond well to treatment, and that a large number of them—40 per cent, or more—who are admitted to chronic sick wards can be discharged either to their own homes or to a Home. The knowledge that this can be done will bring about an enormous revolution in the treatment of the elderly.

I should like to see all old persons who need hospital treatment, no matter what their disability, admitted for investigation and diagnosis into an acute general hospital. Her suitable treatment can be planned, and even if this has to be carried out in some separate building, it should be undertaken under the general supervision of the expert staff of the acute hospital. Any home for old people may well need some kind of a small sick bay where the occupants can be put for a day or two with minor ailments, but it is necessary that great care should be taken in this matter, otherwise these places may well develop into a new version of the old poor law infirmary, and you will get long lists of people waiting for beds. These sick wards or bays should be looked after by at least a general practitioner, and there should be a very firm link indeed between them and the local hospital. It is important that there should be no obstacle to patients' prompt admission when necessary, and to their equally prompt discharge when they are ready to go out. It would be necessary to have a certain number of homes available for, those who cannot quite get back to their normal condition, but who are not so bad that they need to be kept in hospital.

The last point I wish to make is this. We have a population that is rapidly growing older, and it is reckoned that in a comparatively short time—by 1971 I believe—what I may call the middle or productive group of the population will be smaller than the young and old groups together. That will mean that a small group will have to support two large groups. This will remain true of the older group if you continue to enforce a retiring age of sixty-five. But, I submit, it is important that old people, within the limits of my definition, should be encouraged to work for as long as they are capable to contribute to the nation's wealth. Persons should not be compelled to retire when they are still sound and fit for work and desire to continue. The Nuffield surveyors found that many employers said that a large number of their elderly workmen gave satisfactory work when well over the normal age for retirement. This is important. Clearly, every incentive should be given to those who are fit to work, to do so.

Some financial adjustment must be made. The surveyors recommend that certain financial rewards should be given to those who remain at work after pensionable age. It is, of course, imperative that no one should be compelled to work who wishes to retire, and that no employer should be forced to employ a man who has reached pensionable age, with whose work he is not satisfied. Many an elderly person would respond to an offer to remain at work, with advantage to himself and the country, and I think all reasonable inducement should be offered to him to do so. I submit that the suggestions that I have put forward would, if carried out, contribute to providing a reasonable service for old people. They do not require much labour or material, and they are not costly.

6.20 p.m.


My Lords, I am glad that my noble friend, Lord Amulree, has brought this subject before your Lordships' House, and he has done so, if I may say so, out of a large store of knowledge, and with great sympathy and understanding. The number of urgent problems before the country at the present time is so great that they are in danger of crowding one another out. The problem of the accommodation and the care of old people, which is growing steadily more urgent, is certainly in danger of being crowded out, or at least of being pushed into the background. At the present time only a small proportion of the local authorities in England and Wales realize the need for small dwellings for old persons. But surely it is obvious that to build small houses for the old will release larger houses for the young, and it should be made compulsory for all local authorities to include a suitable proportion of small-sized dwellings in every scheme. In addition to cottages and bungalows, a few "plus granny" flats should be provided—annexe flats adjoining dwellings for families, so that an elderly relative can lead an independent life as a householder and yet be within reach of help should need arise. It is greatly to be hoped that the Government will bring pressure to bear on local authorities to provide more of these types of accommodation for the elderly.

Of course, accommodation is not the only problem. If old people are to be able to live in their own homes, various auxiliary services are needed. The Red Cross are now expanding their most valuable work of visiting elderly people in their homes, and they find urgent need of such services as home help can give. Schemes of home help have been organized in some districts, though as yet they are but few. They should be made general throughout the country. Further, a number of elderly people become unfit to live on their own. As a rule they are reluctant to enter an institution; often they choose to remain at home until their condition becomes truly pitiable. For these people homely hostels are the right solution. A beginning at supplying such hostels has been made in a few places, but only a beginning.

In the county of Cornwall we have two hostels run by the local authority, and one by a voluntary body. Another "eventide home" is being opened at Bude this month by the local Old People's Welfare Committee. The county authority have also acquired another house in Penzance which should accommodate about twenty elderly persons, and that authority has been trying for eighteen months to get permits for making the necessary adaptations to the building. Why is it that permits are so notoriously difficult to obtain? is it always because there is a great shortage of so many materials, or are these most trying delays sometimes due to some inefficiency in administration? The result, at all events, is very unsatisfactory. Cannot the Government do something to expedite the grant of permits in cases of this kind? As will be evident from what I have said, the provision for elderly people in Cornwall is entirely inadequate. And if I am rightly informed, the position in neighbouring counties is hardly better. Could not the Government take the initiative and give some stimulus and practical encouragement? Wise programmes of extension should be drawn up all over the country and they should have their due share of public attention and effort.

The Report of the Nuffield Survey Committee contains several practical suggestions which might be put into operation without delay. One of them is concerned with almshouses. There are a large number of almshouses in the country which could make a valuable contribution to the housing problem if they were put into better condition. Surely it would often be more economical to give grants to charities for the improvement of their almshouses (as regards water supply and sanitation, for example) than to build entirely new dwellings. Reputable charities in areas where there is an urgent demand for houses might well receive help from the Government. And, as my noble friend has already suggested, in many instances actual grants would not be necessary—simply some power of modifying their trust deeds.

I should like to underline two other paragraphs in the Nuffield Report. The first, paragraph 269, refers to a class of the community which is scarcely catered for at all—namely, old persons who have some private means and are able to pay somewhat more than the sums usually charged in existing voluntary homes, but less than the fees of a nursing home. Many of these elderly people are amongst the most thrifty and deserving of His Majesty's subjects. It seems to me that the present tendency is to do far too little to encourage thrift and to reward merit. The Council of Social Service for Cornwall have been receiving numerous applications from the old people of the county, and the large majority of these applications are from persons of this kind, with small savings of their own. In some instances, voluntary bodies or private benefactors are giving welcome and valuable help. Mr. C. C. Morley, for example, has recently most generously handed over his house, the ancestral home of the Trelawny family, with a benefaction, to be a hostel for aged retired clergy and their wives. The possibility of a somewhat similar scheme is being explored in connexion with Cotehele House, one of the best preserved of the ancient historic houses of England, through the kindness of the Earl of Mount-Edgecumbe and the National Trust. If I may say so, the clergy are a good example of aged people relinquishing official residences, often with nowhere to go. Any effort on the part of individual benefactors or voluntary bodies to make provision for such homeless elderly persons should receive every possible encouragement.

The other paragraph of the Nuffield Report to which I should like to call special attention is paragraph 272. This suggests the setting up of an experimental centre for demonstration and training in methods of caring for the infirm and the aged. The establishment of such a centre would kill two birds with one stone. The centre would take charge of a certain number of elderly people, and at the same time would give a much-needed training to persons wishing to specialize in the care of the aged. One of the last recommendations of the Report emphasizes the need for continued and systematic inquiry into all matters affecting the aged. Very good. "Let knowledge grow from more to more." But let there be no waiting for the result of further inquiry before doing something practical. One of the major industries of this nation at the present time seems to be the making of inquiries—inquiries here, there, and everywhere; masses of inquiries, with but meagre results. As to the aged, we have plenty of knowledge to be going on with. And now, as the Nuffield Report itself concludes: Above all there is need for energetic action to secure enough suitable dwellings for the aged, and much more and better communal accommodation for those unable to continue independent lives.

6.30 p.m.


My Lords, I usually trespass on your Lordships' time with a few observations about the very young, sometimes when they are very good and sometimes when they are very bad. I want to make a few observations (I promise your Lordships that they will not be very long) on the Motion moved by the noble Lord opposite, and I want to make them for two reasons. First, I think that the young and the very old have this in common, that they are quite powerless to look after themselves, particularly if they are impoverished and deprived of a home. Secondly—and this is more a personal reason—like many of your Lordships now in the middle years of life I still have a recollection of the frivolities of my youth but I am sufficiently advanced in years to have to face up to the prospect of old age in the not distant future.

I should like, if I may, to mention three types of institutions, some of which have been mentioned by my noble friend opposite: first, Public Assistance institutions; secondly, homes run by bodies of a religious character; and, thirdly, homes run purely for private profit. Many of your Lordships will know what a Public Assistance institution looks like. From the outside it can look very pleasant. Architecturally it is sometimes attractive. In many cases it was built in the early years of the 19th Century. As you approach the spacious door you might rather envy the lot of those inside but, as was indicated by the noble Lord, Lord Amulree, your feelings are very different when you get inside. You will find a ward, or a series of wards, sometimes with as many as too beds, separated from each other by only two feet. You will also find that the only furniture a resident has is one chair, although I am aware that lockers are now being more freely installed in those institutions. You then pass into the day room, which is equally dreary. There is no carpet covering the floor boards. You will find those—to me —unattractive Windsor chairs all round the walls. Naturally, in such a place, apathy must exist. There is no doubt that the people in those institutions have nothing whatever to do except to wait for the next meal or for bedtime. The Nuffield Report contains a recommendation, which is rather vague—though in the circumstances it could not be more positive—to urge local authorities to try to build homes for thirty or thirty-five people to take the place of these institutions. I think it can be said that it is homes rather than institutions in which we should like our old people to live.

May I now say something about homes run by religious bodies, or rather bodies of a religious nature? There are about 100 of those homes. (I am talking only of those for poor people.) Eighty per cent. are run by the Little Sisters of the Poor, the Sisters of Nazareth or the Salvation Army. I should like to pay a tribute to all those organizations—certainly to the first two of which, as a Roman Catholic, I have some knowledge—for the devoted service they have given. And indeed that also applies to the Salvation Army. I have, however, two criticisms which I must make, although not of the people who run the homes. It is perhaps the organization that is responsible. All are run by a headquarters organization. In consequence, up to a point their rules are bound to be stereotyped. Too little regard is paid in the individual home for individual tastes and requirements. The second criticism which I wish to make (indeed it is hardly a criticism because I know how difficult the position is) is that they are very understaffed. They have on an average, one member of the staff for ten residents. That is not enough. It is, of course, easy to criticize but it is difficult to get the people. We have to be thankful for the valuable services which the people in those institutions of a religious character give for no payment whatever.

Before referring to the recommendation made in the Report, I should like to say a few words about homes run purely for private profit, because the recommendation in the Report is the same for both types of home. Here, as regards staff and residents, we have a ratio of roughly one to fifteen. I think that it is obvious, in such circumstances, that poor people are bound to be neglected, particularly when they have no relative or friend to look after them. The noble Lord opposite referred to what the Nuffield Report said, (and, the, examples it gave, of the disgraceful conditions of neglect and exploitation in such homes. As he did not read them out, perhaps your Lordships would allow me to read two short extracts. They are extremely shocking, but I am not suggesting that in every case this applies. These extracts which I am about to give relate to homes run for private profit: Miss X runs a home for thirty old people. … The registration of the home as a nursing home was cancelled some years ago after a patient had been reported to the Medical Officer of Health as verminous and uncared for. Miss X was recently fined for drawing an old age pension after a pensioner's death. … The patients seen by the Committee's investigator were frightened of Miss X and unhappy. Here is another short extract: Miss Y ran a small Home for six or eight old women. Miss Y's manner to visitors was always strange, and her reply to an inquiry about residents' health was invariably the formula She is very well; she had a lovely dinner yesterday of duck and green peas.' Residents visited were not infrequently found naked in bed and often crying. Miss Y eventually had a breakdown and was diagnosed as a dipsomaniac. To read of those things hurt us deeply. I am sure it is, or should be, a shock to the conscience of anybody who is aware of them.

In conclusion, I should like to make a reference to the recommendation, to which my noble friend opposite has referred, with regard to the voluntary homes; that they should have periodical statutory inspection. I certainly think that is essential. I know the difficulties. My noble friend opposite referred to them. One obvious instance was the possibility of a home being able to call itself a boarding house, and therefore being able to escape very necessary inspection. I believe that such difficulties can be overcome. I also feel that all good homes, properly run, should welcome inspection, and should not object to it in any way. The second recommendation made in the Nuffield Report—which is a general one (it is only tentative; and I would like to think that one day it might be possible of achievement) was that there should be created a co-ordinating committee charged with looking after the welfare of the aged people of this country, and that it should also attempt to improve and co-ordinate all the different organizations which look after them. That is perhaps a more remote objective, but I feel that inspection of voluntary homes is important; it is urgent and is practicable. If we can do this, I feel sure that the last years of many of our ageing fellow citizens will be spent in conditions of greater happiness and security.

6.40 p.m.


My Lords, I am sure that all members of your Lordships' House will feel they owe a debt of gratitude to the Nuffield Foundation for instituting, and to Mr. Rowntree and his colleagues for making, the inquiry which has resulted in the issue of the Report which is the subject of to-day's discussion. I think your Lordships will also feel a debt of gratitude to the noble Lord, Lord Amulree, for bringing this matter before us to-day, because this problem of the old people (and I would take old people as meaning old people of pensionable age, men over sixty-five and women over sixty) is one of the major problems facing all of us. It is major in numbers. We all know that, roughly speaking, one in five or six of the people of the country will be of that age. In the presence of the right reverend Prelate who has just spoken, I hesitate to refer to an inquiry which I made into social insurance a few years ago, but in the course of that inquiry it was vividly brought home to me how enormous was the problem of the old, and how big a difference every shilling that was added to the pension made to them. That particular-difficulty has been overcome, and we have faced the problem of finding adequate pensions, or subsistence pensions, for these old people.

Perhaps on that question I may just refer to one thing which was said by the noble Lord, Lord Amulree, which might have given the idea that there was a possibility that the middle section of the population—those between the age of childhood, under fifteen, and those of pensionable age—might be less than the other two together. I do not think that is a possibility. There are various estimates made by different people, but they all come down to this: that of every 100 people about twenty, twenty or a little under will be children under fifteen; about twenty or a little under will be people over pensionable age; and the other sixty will be people in the middle group. But it must be remembered that half of that sixty will not be engaged as workers; they are the housewives bringing up families. So it is true that a minority will have to do the paid work. Those are, roughly, the figures. The problem of old age is a major problem, not because of its numerical size, but because of its quality. Although we have now in this country provided pensions which are within sight of being adequate for subsistence for everybody, that does not solve the problem of old age, but only raises the question of how we are to deal with the additional human needs which cannot be met merely by guaranteeing a minimum income. That is really the subject of this debate.

Most of the points have already been dealt with, so I can speak very shortly about them. I want to say only a word or two upon the most important points. There is, of course, the question of housing. I believe that one of the most valuable points made in this Report of the Nuffield Foundation is in paragraph 268, in their condemnation of the accommodation provided in most homes and institutions for the old. I would like to read the following: The visits by members of the Committee to a number of institutions have confirmed the widely held view that, in the majority of them, the structure, equipment and regulations are unsuited to the needs of most old people. From that the Committee draw the conclusion—and I do not think it can be escaped—that it is necessary to contemplate building a very large number of additional homes—they put it at some- thing like 1,000—for the old people who cannot live ordinary, completely independent lives in private houses, either alone or with their families. The Committee point out that the great majority of old people will go on living independent lives; that is to say, they will go on living in ordinary houses. Perhaps 95 per cent. of them now do. I think we ought also to realize that probably a certain number of them ought not to, and if there were reasonable homes they would go to those homes. Let us bear in mind the judgment of the Committee on that point.

The Committee also emphasize that the provision of houses suitable for the old should be regarded as an essential part of our building programme. I hope that what they have said will help to do what they say needs doing, in the way of correcting the widespread view which they found among individuals and local authorities, that in the present acute shortage of houses of all types precedence in the use of labour and building should be given to the family house, and should exclude any provision for the old. I suggest that that is a wrong. and wicked thing to do, and that the judgment of the Committee, that some percentage of all houses should be designed specially for these older people, and as part of the general housing scheme, should be accepted. I need not go over again what has been said by the noble Lord, Lord Amulree, and others, as to not segregating the old. Apart from housing, what the old need, of course, is home help. I think the only point on which I feel some disagreement with the Committee's report is where they rather suggest that the home help for the old is needed only if they are sick, and while they are sick. Actually a number of old people are not sick, but they are unable to do for themselves the ordinary domestic work; they are not able to do for themselves the shopping, as it now has to be conducted, in queues. The provision of younger people who will come in and do these things for the old people, where they have not got families of their own to do them, is an essential that should be provided, not only for the sick but for the old as such. Then, of course, what many old people need is companionship—not to be lonely. That is a question of organizing visits to them, and of organizing recreations and clubs for them. Finally, I am perhaps in an ever better position than the noble Lord who spoke first to say that what is really needed for the old people of pensionable age, like myself, is employment, if they are still able to be employed—but not compulsory employment. I hope the Government will act on the recommendation of the Nuffield Report, and look very carefully into the working of the present provisions, which are designed to encourage the continuance of the older people at work. If the incentives now given are not adequate, those incentives should be increased. Those things—housing, home help, employment and companionship—are additional needs which, from the point of view of the old, are not met by money. The thing one has to consider is: What is the best kind of agency to meet these needs? I hope that in considering agencies the Government will not think at once that I mean a Government Department, or a local authority. After all, this whole Report has come to us from a voluntary agency, an agency not stimulated by any Government Department but by voluntary charity, and undertaken by voluntary people. The question is, what kind of agencies can best meet these various needs?

I want to refer shortly to one more point, which has already been made, about the existing endowed charities. I hope the Government will adopt the proposal of the Report that there should be an inquiry. I hope the right reverend Prelate will not object to an inquiry into the existing endowed charities. I do not suggest that with a view to recasting, but to see how they can be made more useful in the quite changed circumstances. I believe there is something like £5,000,000 a year in endowed charities that are now available for the old. That does not go very far in pensions, but it might go an enormous distance in recreation clubs, specialized buildings, and things of that sort. Then there is another type of agency which I hope the Government will not forget in this matter, and that is what I may call the mutual aid agency—the agency represented by the friendly society, or the trade unions on their friendly side —by which, in the past, before the State came into this, people attempted to provide for old people.

I do not believe the day of that has passed. First of all, a great many people will feel that they desire more money than they are getting from the compulsory State pensions, and I hope the societies will continue to insure them, and that it will be easy for them to do so. But I am not sure that some of these agencies might not consider whether they could not organize themselves to provide, in return for contributions, a guarantee of home help in old age, or even suitable houses. I admit that it might be rather difficult to calculate the right premium for this insurance, but I am sure we should be very much happier—at least I should—if we felt that when we got to be old, instead of being only of a pensionable age, we could be sure of home help coming into our houses. At the moment we are not at all sure. I hope these voluntary agencies will examine carefully what they can do to meet the needs which still remain, and that they will be helped by the Government to do so.

Then, of course, there are many voluntary organizations, not actuated by any idea of pecuniary gain, which give scope to the social conscience motive—people who desire to devote their leisure time to helping the lives of their fellows. In that way, I believe, you really have great scope for providing for the unsatisfied needs of the old people.

I want to refer to one last point, and that is paragraph 279 of the Nuffield Report, where the Committee discuss whether there should be any single central agency for examining this matter. The Committee (it says) examined very seriously the desirability of recommending that a new and central body be set up, to study the changing conditions and needs of the aged; to undertake or stimulate research … I am sure we do not need a new Government Department for this purpose. I am not one of those who think there ought never to be new Government Departments, but I do not think we need one for this purpose. I believe there is perhaps need for something which would make itself the adviser of the Government on what could be clone in this major problem of the old. Possibly some kind of advisory council could be, set up, attached to the National Insurance Ministry, which would, I think, be the right agency for that. That advisory council could help the Government to see that all the additional needs which are not met out of the pensions of the old are met. And in a way they are more important for human happiness than a mere provision of a guaranteed minimum income.

6.54 p.m.


My Lords, I am sure we are all extremely grateful to the noble Lord, Lord Amulree, for having introduced this Motion, and I propose at this hour to touch, as briefly as I can on only two or three aspects of it. I believe that a Christian national life, such as is our aim at the present time, is best founded on happy homes and providing a separate dwelling house for each family as a unit. That is a most necessary step in that direction. The provision of a small house or flat, with modern, convenient fittings, and of a size and at a rental that the aged can quite conveniently manage, would enable them to continue for longer, if not for the whole of their lives, as independent members of the community, instead of adding to the number of inmates of institutions which are already overcrowded and which are certainly terribly understaffed, or of adding to the waiting list of those hospitals to which allusion has already been made. I think, also, that this would help greatly in the housing and happiness of others.

During the war, many cases occurred when at least three generations were sharing one home, especially when the young folk married during the war and the husband was serving. As has already been realized this creates many domestic problems. Every woman wants a home to manage by herself and to do her own housekeeping. The mother and the grandmother are so apt to have very widely divergent views upon the bringing up of the children, while the old may find that the natural noisiness of the children in the house is extremely trying and very irritating to them. It is therefore most necessary that these young couples, now re-united, should be able to start and create a family and bring it up in a home and family life of their own. This is done most easily by the older generation moving into small houses, which it has been found they are usually ready to do.

The noble Lord, Lord Amulree, has already quoted the example of the Hornsey Borough Council. In the Nuffield Report at the end of paragraph 94 the Committee say: Where this willingness to move exists, the building of small houses for old people becomes a cheap, speedy and effective contribution to the whole problem of rehousing the population by releasing houses for larger families. It would seem to me that by the expenditure of about two-thirds of the amount of labour and material required for a three-bedroomed house, and about two-thirds of the site, we could provide two convenient and happy homes, instead of overcrowding three generations into one inadequate house with all the consequent inconvenience and friction.

May I say a word about the proportion of houses for the aged? The Nuffield Report says, in paragraph 102: We are inclined to suggest, with great reserve, that on the average 5 per cent. of the houses in any community should be such as are suited to the needs of old people. They add that this is a national estimate, and that precise housing needs must vary according to many local factors, The Amersham Rural District Council in my own county of Buckinghamshire, who have been building houses for old people on their housing estates for over fifteen years, are now having 15 per cent, of the total of those houses suited to the aged people, and they have found that in a rural area that is the correct proportion. Of the four great London trusts, the Peabody Trust has no less than 51 per cent. of its buildings of small size. The Guinness Trust has 60 per cent., the Sutton Trust about 48 per cent., and the Lewis Trust about 33 per cent., so that when you get to cities it seems that they should build up to 30 per cent. of small-sized dwellings.

With regard to the size, taking Amersham again, they have built some under the 1924 Act with one bedroom, one living room, a kitchen and a bathroom, at a standard rent of about 2S., with rates at Is. 2d. Under the 1936 and 1938 Acts they have built them with two bedrooms, a living room, a kitchen, bathroom and hot water, at a rental of 5s. 8d. plus rates. They are now planning to build flats on two floors, which seems to be a very convenient way of providing for these old people houses with two bedrooms, a sitting room, a large kitchen and bathroom and hot water, and they plan to be able to let them at 9s. 6d. plus rates. Some of these houses might be convenient for homes for newly married couples, for small families or for families with children of one sex only. It is entirely optional at present whether local authorities include any proportion at all of houses for their old people in their schemes. It has been shown that the very large majority are building three-bedroomed houses only. I therefore support the plea made by the noble Lord, Lord Amulree, and the noble Lord, Lord Beveridge, that all local authorities should build an adequate number of small houses for these aged people, scattered over their various housing estates.

As to the question of siting, they should be scattered, and conveniently situated near the houses of other people and of their relatives, and not too far from the main road, so that the occupants can see the tops of the buses and so that they can get easily to the shops and other places. I would ask the, noble Lord who is to reply whether he can see that the Ministry procure this, either by persuasion, by regulation, or even, if necessary, by a short Bill. All the housing plans of local authorities are submitted to the Ministry, and I should have thought it would have been quite practicable for the Ministry to acquire a proportion of these small dwellings in substitution for some of those that they may have acquired—sometimes by drastic alterations to the housing schemes put up to them. The noble Lord, Lord Amulree, referred to circular No. 4947, and I would like to congratulate the Ministry on its reception. It outlines what your Lordships have heard as to the aged in public institutions. We were quite ready to accept suggestions as to modifications of the rules regarding visits, going out, times of closing, and so on, and I do not think they will provide any great difficulty; but I would like to ask whether the Ministry would readily issue the permits for lockers—such lockers as are either of well-seasoned wood or mild steel. I am advised that some of these three-ply lockers buckle up in the dry atmosphere which prevails in these places.

These needs of the aged do provide, as the noble Lord, Lord Beveridge, has pointed out, scope and opportunity for those social services which were so splendidly run throughout the country through a variety of bodies during the war. This again has already been very well started in some cases. Buckinghamshire has a very efficient Old Folks Welfare Committee. They have already started at least two very satisfactory hostels for old people, and the Public Assistance Com- mittee are just now acquiring one. The small town near which I live has an old folks club. So, generally, welfare for the aged will depend very largely on the way in which all these rules are administered, and on the spirit with which those who look after them carry out their duties. I believe that spirit must depend on our Christian faith and on our love of our fellow men which, in its turn, depends upon our belief in the Fatherhood of God.


My Lords, there has been a very pleasant unanimity among noble Lords who have spoken, and I am well pleased, because almost everybody I meet who is really interested in the care. of the aged has a different solution. I believe there is one African tribe which solves the problem of the aged by keeping a convenient pool in a nearby river, with sacred crocodiles. I have met some intellectual supporters of noble Lords opposite who hold very much the same views, but I do not believe they hold those views themselves save possibly only in the case of company directors. But other views are held: some people prefer institutional treatment, some prefer homes for the old; and there are other ideas. There are problems in this connexion; one knows of the senile and impotent hate that sometimes arises when eighty-three and seven weeks takes a chair which eighty-three and eight weeks thinks properly belongs to him. They are not always as happy as one thinks. Then there is the almshouse system, which I think is very good, with one exception—namely, that it keeps the old people together. We must not run away with the idea that all almshouses are bad; some of them are very good indeed.

Then there are special houses or flats for the old; and finally there are those who maintain the old in their own homes. It is with this type of old person that my own experience has chiefly lain. In some cases it would be cruelty to take them from their own houses. But where so many earnest people have different views, it is likely, I think, that they are all right and that each system has a place in the care of the old.

I am quite satisfied, from reports that I get from all over the country, from the general population and from doctors, that old people in this country are not being properly looked after. That is a very serious statement to make, but I make it conscientiously and soberly, and I want to say, quite definitely, that I do not attribute any blame in the matter to the Assistance Board. As your Lordships know, there has been a very great extension of the duties of the Assistance Boards and they are extremely understaffed. They have had to reduce their staffs and it is difficult to get over the ground. This is an important matter because, with the old, visiting—frequent visiting—is absolutely essential. The Assistance Board is frequently five miles and sometimes forty miles from places where they have to undertake the care of old people.

One of the most moving passages in this Report is, I think, contained in pages 52 and 53. The passage speaks of the loneliness of old people and of the extreme value, which they put on visits that are paid to them. The need is for people who will make periodic visits to the aged perhaps once a week, at least once a fortnight. A person who performs that sort of service hears about their family affairs, and gets to know the people intimately. He notes indications of failing health—and changes of health occur very suddenly in old people, quite apart from any question of incidental disease—he knows their family circumstances and he understands exactly how best they can be helped. In fact, one of the very few points in this Report that I would criticize—and perhaps my criticism is unfair—is the matter which is dealt with, I think, on page 171 —the questionnaire. While the questionnaire contains almost all the questions one would wish to have answered, it does omit one extremely important question. That question I suggest is: "What family have you living away from home, and where are they? "That is a most necessary question, because the information which it is designed to elicit is of such importance. Not only is it the fact that members of the family are probably the best advisers, but, very often, in the case of those who can manage to do something for their aged relatives there is a duty upon them.

His Majesty's Government recently, in matters of education, have, I think, been stressing what I have always felt to be one of the most important matters in connexion with education— that is, the influence of the home. If the influence of the home is called into play to assist in the educa- tion of the young, it imposes on the young a special duty towards the persons who have made the home; and whatever theory of social life an individual may hold, I maintain that that duty must always exist. The duty lies on children to look after their elders, or at any rate to assist in their care. The information to which I have just referred ought to be known to the person whose task it is to visit the old people.

I have one other point. You cannot possibly know who is in need unless you have local people steadily paying visits. This question of visiting has remained uppermost in my mind since reading the Report, and I emphasize it because hitherto in this debate only one noble Lord, Lord Beveridge, has stressed it. And in this connexion I make a practical suggestion, and it is one which does not call for any inquiry or even for a Bill. It is that the staff of the Assistance Board should be so far extended and increased as to permit of an experienced man being appointed in every parish—or, if not in the parish in every case, at any rate, in such areas as may be deemed reasonable to cover—whose duty it will be to visit the old people regularly, and look after them. That, to my mind, is one of the most essential needs in respect of the care of the old. Many people who are interested in this matter differ in the various schemes which they would like to see applied—I believe I am right in thinking that there is merit in all of them—and it is only people who know the conditions under which the old people are living, their family circumstances and all about them generally, who can really say whether they are best left in their own dwellings, or established in a home or institution, or fitted into some other scheme of life which may be most suitable for them. Having expressed my view in those few words, I should like to pay a tribute to the noble Lord, Lord Amulree, for the extremely able and interesting way in which he opened this debate, and to express the hope that what he said has won favour with the noble Lord opposite, and that we shall have a happy reply on behalf of the Government.

7.15 P.M.


My Lords, we all welcome this Motion as drawing attention to an aspect of social service which is of the greatest importance, and I wish to join in the expression of gratitude to the noble Lord, Lord Amulree, for the sympathetic and very clear way in which he has discussed the problem. The importance of the subject will have been realized from the figures which both the noble Lord, Lord Amulree, and the noble Lord, Lord Beveridge, quoted to illustrate the general population trend. The inference is startling. The figures show that the numbers of persons of pensionable age have doubled since the beginning of this century, and in another twenty-five years they will represent approximately one in five of the population. Clearly, the needs of so large a section of the community must be kept in the forefront in the moulding of our social attitudes and the development of our plans of social security and welfare.

Much is already being done in this direction. As your Lordships are aware, the financial needs of the aged have been dealt with by the National Insurance Act, and noble Lords have rightly drawn attention to the conclusion of the Nuffield Report that real poverty need no longer be one of the fears of old age. This is an important social change of which we can justly be proud. The increased old age pensions which are now being paid have at last brought real security to the great majority of our old people. Whilst on the question of money, I would add that the Government have made people of pensionable age the first to be given facilities for cashing their post-war credits. The health needs of old people will be met by arrangements under the National Health Service Act. We agree, as has been urged, that the present provisions for the chronic or, rather, long-term sick are inadequate—indeed, it is not unfair to say that in some cases they are lamentable, both in quantity and quality. As has also been said, there is much that can be done by way of treatment to restore at least an appreciable proportion of these patients to better health, to prevent their becoming bedridden, and to enable them to be discharged from hospital to live in their own homes or in an old people's home or hostel.

We welcome, therefore, the noble Lord's suggestion that more treatment should be afforded to the aged long-term sick, and I am, glad to be able to say that, only a week or two ago, the Chief Medical Officer of the Ministry of Health wrote to this effect to the medical officers of health of counties and county boroughs. More particularly we welcome the suggestion that hospitals for the long term sick should be much more closely linked up than they are at present with acute general hospitals. Such a link will undoubtedly make easier and more fruitful the continuous treatment from which many of them could benefit. We may well come in time to an arrangement by which many of the chronic sick hospitals cease to exist as such, and long-term patients are admitted to special wards of general hospitals. All this will become a possibility when the new national health service comes into being. As your Lordships know, the Regional Hospitals Boards, which are very shortly now to be appointed, will have among their early duties the re-planning of the hospital services; and the problem of the long-term sick, so many of whom are old people, will be among those to which my right honourable friend, the Minister of Health, will be asking them to direct their attention.

Apart from the hospital and specialist services, the national health service will, we hope, bring many advantages to old people. Such things as spectacles, artificial teeth and hearing aids, which many old people are now without because they cannot afford them, will be available to them without charge. And the general practitioner family doctor services will be available to the old as to everybody else—specially important, perhaps, to old people, because of the economic factor. Again, there will be services provided by the local health authorities — domestic or home help when the labour position becomes easier, and a service of care and after care, which will be of special value to old people. Preparations are going ahead, and all these parts of the new service will, we hope, be available to a greater or lesser extent from the outset. The question raised by the right reverend Prelate of providing more adequate nursing service will certainly fall to be dealt with as part of the new health service. I can assure the right reverend Prelate that the recommendation of the Nuffield Report regarding the experimental centre for the training of nurses will be borne carefully in mind.

Noble Lords have rightly given prominence to the provision of special housing accommodation for the aged. This service must have a high place in our housing programme. Too many old people are living in accommodation which is unsuitable for them. Theirs is a very special housing need which requires a sympathetic and understanding approach. There is, I think, general agreement about the principle on which these dwellings should be planned and sited. The most important of them is this—that the old people should be enabled to lead normal lives in normal surroundings. They want to remain in contact with their friends and with the life of the community. Their dwellings should be close to churches and shops and centres of entertainments and community life, and should be sited amongst the homes in which younger generations are living and growing up. The exact type of accommodation required must, of course, vary according to the age and the vigour of the old people for whom it is intended. But whatever the type, it should have three qualities before all others: it should be small, warm, and convenient. The able-bodied aged are well suited in one or two storey cottages or cottage flats or on the lower floors of blocks of flats. For those who are not wholly able to look after themselves, accommodation can be provided in self-contained dwellings with certain communal quarters, and quarters for a nurse or warden. There is clearly scope for much variation in schemes of the latter kind—that is, in the combination of communal and private living—and scope, too, for experiment of considerable social interest and value.

I am glad to be able to assure your Lordships that housing authorities are very much alive to the importance of this work and are giving much careful thought to the planning of the right sort of accommodation. More than 10,000 one-bedroom dwellings, a large proportion of which are designed for old people, are now in tenders approved by the Minister of Health. That represents about 4 per cent. of the total houses which local authorities now have in contract. We would not claim that this number was adequate to meet the need. The task must be viewed in relation to the general housing programme on which we are now engaged. But we can claim to have made a beginning. It must not be forgotten that over 90,000 two-bedroom temporary houses have been erected, apart from the one-bedroom permanent dwell- ings to which I have referred. Although I have no figures, I am quite sure that a proportion of that total has gone to the aged people about whom we are speaking.

There remains the problem of the care of those old persons who are not ill or infirm in the sense that they need treatment in hospital, but who, nevertheless, require accommodation of a special kind. It is clear from the Nuffield Survey that probably more than 95 per cent. of old people live more or less normal lives in private dwellings, some in homes of their own, some with relatives or friends. Many, however, for one reason or another, are really unfit to live in this way. They need accommodation in homes and hostels that are small enough to avoid the atmosphere of an institution, and equipped and staffed to provide the care and attention which the infirmity of old age requires. This is a need which is fully appreciated by the Minister of Health, and he has advised local authorities to use their Poor Law powers, whenever possible, to acquire and adapt premises which would be suitable for the purpose. A number of authorities have in fact already done so. The right reverend Prelate raised a particular case where he said there had been a difficulty about the licence. I have not the details of the case, and, naturally, am not able to deal with it. But now it has been raised by the right reverend Prelate it will be on the records of the House and I will see that it is brought to the attention of the proper authorities.

It is the Government's intention to introduce legislation in due course to break up the Poor Law and to institute a comprehensive system of national assistance in its place. Under this plan, the responsibility for providing residential care for those of the old who are unable fully to look after themselves is likely to continue to rest with the larger local authorities, the county and county borough councils; but while new legislation is being prepared we are not neglecting possibilities of improving the local authorities' existing services for old people. Much can be done also to brighten conditions in the institutions in which, unsuitable though many of these buildings are for the purpose, many old people still have to be cared for. The noble Lord, Lord Amulree, and the noble Lord, Lord Addington, referred to the recent circular of the Minister of Health which offers many practical suggestions to local authorities for improving the accommodation and atmosphere of their homes and institutions.

It is, as has been said, most unfortunate that many of the old workhouse buildings have still to be used for the old people, and it is not surprising that the Nuffield surveyors, in suggesting plans for the future, have declared that most of these old buildings are probably unsuitable, even for the classified institutions which the surveyors recommend for specially difficult classes. But I do not need to remind your Lordships that there is a great shortage of accommodation of all kinds and a great shortage also of the labour and materials to build more. We have no alternative but to make the best use we can of such accommodation as we have until new and more suitable accommodation can be provided.

The noble Lord, Lord Addington, rightly stressed the need in these institutes for furniture such as well constructed seat lockers. I am glad to tell him that the Minister regards the provision of lockers as the least that can be made. In the recent circular to which I have referred, the need for comfortable chairs of a type suitable for old people is pointed out. It is also recommended that each resident should have a wardrobe, chest of drawers, or at least a locker with keys where personal clothes and private possessions may be kept in safety. The circular went on to state that in providing improved accommodation, where the local authorities can supply or find the necessary labour to carry out this kind of work, a scheme should be submitted to the Minister who will give it sympathetic consideration even though priorities may be involved.

The Minister of Health's recent circular also encourages local authorities to support the development of old folks' clubs to which the noble Lord referred. He rightly emphasized the importance of clubs as a means of alleviating the loneliness of old age. He stressed the value of having facilities for serving meals in the clubs, and I understand that an old age pensioners' club may be licensed for catering purposes if it is sponsored by the local authority or by a pensioners' committee working through a local authority. The noble Lord was a little doubtful about the facilities provided by Civic Restaurants being available, or advantage being taken of them, and he suggested that perhaps many local authorities were not aware of the fact that through these Civic Restaurants there was power to provide meals "off the premises," to use a well-understood phrase. I will have that point looked into at the Ministry of Health, and if it is necessary I am sure that the Minister will not hesitate to bring this matter to the attention of the local authorities.

The noble Lord, Lord Addington, asked about the payment of subscriptions to these clubs. I understand that the organizations running such clubs may apply to the county or county borough council who, if they wish to make a subscription, will apply to the Minister of Health for his consent under Section 67 Of the Poor Law Act. I am quite sure that the Minister will give favourable consideration to any such applications. Reference was also made by noble Lords to the almshouses and pension schemes which were founded by the ancient charities, and to the desirability of revising the terms of the trusts. This issue was raised recently in another place, and the Minister of Health stated in reply that the matter was under discussion with the Charity Commissioners. The problem is extremely complex, and bristles with legal difficulties which will require close examination. That examination is in progress. and I do not think I can add anything more at this moment.

As regards the question of continued employment—which was raised by the noble Lord, Lord. Amulree, and other noble Lords—the case has been stated for the continued employment of the aged worker after he has reached a pensionable age. With our population trend, and particularly in these days of labour shortages and production needs, we are all bound to agree with the general principle that all who can— and who wish to— should be allowed to carry on with their work. This would be both in the national interest and in the interest of the able-bodied elderly persons themselves—as has been suggested. But I should like to add one comment. One man may find the continuation of his lifetime's employment as the most effective means of maintaining his interest and challenging advancing years. Another will be eager to make a change, or will feel in need of at least a temporary rest. Retirement may, in fact, be desirable rather as a change of occupation than as the end of working life. Many, I feel sure, could take a new lease of life by making a change and following some interest which they have longed to take up during their lifetime and have never had the time or opportunity to pursue. The important thing, I suggest, is for the pensioner to find an occupation within his capacity. I think I have now covered practically every point that has been raised.


Before the noble Lord sits down, while I do not press him for a reply, I would ask him if, with regard to the question of some means of procuring constant visiting, that matter will have attention?


It will certainly be brought to the attention of the proper quarter. I hope that I have been able to satisfy your Lordships that the Government are not only keenly aware of, but also deeply interested in, the needs of old people and that, in the face of shortages of every kind, we are doing what we can to meet those needs. Information is being gathered together; experiments are being made by local authorities and voluntary organizations in all parts of the country. An increasing amount of interest is being taken in the valuable work of the old people's welfare committees of the National Council of Social Service; and, in short, the ground is being well prepared for the day when—building, labour and staffing difficulties having been overcome —we may go ahead confidently with the plans which have been outlined to-day.

In this preparatory stage, the Nuffield Survey will serve a great purpose. It combines a sober survey of existing facts with comprehensive recommendations for a long-term programme, and both will be of considerable service. We are grateful, as I have said, to the noble Lord who moved this Motion and to other noble Lords who have taken part in the debate, for their sympathetic comments and the several helpful suggestions which have been made and which I shall bring to the personal attention of my right honourable friend the Minister of Health.


My Lords, I should like to thank the noble Lord who replied for the Government for his very encouraging and helpful observations. He has gone a very long way to meet most of the points which I raised and most of the points which were raised by other noble Lords. In those circumstances, I would ask leave to withdraw my Motion.

Motion for Papers, by leave, withdrawn.