As many as 800,000 old people in England are chronically lonely, says the Health Secretary Jeremy Hunt. He is surely right that our neglect of the elderly ought to be a source of shame. Neglect contributed to the deaths of five pensioners in the Orchid View care home, a coroner ruled last week. And there is something just as shocking about the statistic that as many as 5 million old people count the television as their "main form of company".
Yet the Tory minister is wrong to suggest the answer is for Britain to learn from other cultures where "the social contract" between young and old is far stronger. Hunt, whose wife is Chinese, and who lived in Japan 20 years ago, says he is "struck by the reverence and respect for older people in Asian culture". There, a care home is "a last rather than a first option".
But, in saying that, Jeremy Hunt is avoiding confronting some awkward home truths about the policies and world view of the government to which he belongs.
There are, of course, some long-term background factors at work. The problem is, perversely, a product of success. Modern medicine means people are living longer – up from age 67 in 1950 to 79 today. The British National Health Service, for all its woes, is the crowning political achievement of the last century. But the boom of babies born after the Second World War is reaching retirement age. It is not just here; the percentage of over-sixties is set to double everywhere by 2050, with imaginable impacts on global pension systems.
Small wonder that the Pope says "the most serious of the evils that afflict the world these days are youth unemployment and the loneliness of the old." The way we push "our elders into nursing homes with a couple of mothballs in their pockets as if they were an old overcoat", he has said, constitutes a form of "covert euthanasia".
But that does not mean Jeremy Hunt is right. Consider these facts. Two-thirds of old people live with their families in Japan (as do 40 per cent in Italy) compared with just 15 per cent in the UK. And yet surveys also show the loneliest old people are in eastern Europe (30 per cent), followed by southern countries like Italy (15-20 per cent) with the UK coming in at between 3 and 10 per cent. In Japan, which has the highest proportion of old people in the world, gerontologists are charting the growth of kodokushi, (lonely deaths) which gives the lie to the myth that all old Japanese live in three-generational families. Malnutrition is rising among Japan's elderly.
For Hunt, the representative of a party which has for decades told the unemployed to "get on their bikes", there is a bitter irony about his discovery that the socially and geographically mobile generation he desired have left their old folk behind back home with no one to look after them except the state.
Government policies do matter. Sweden is the best country in the world in which to grow old according to the United Nation's AgeWatch Index; it has high pensions, top healthcare and public transport, and a good sense of social solidarity. Norway, which is second, has good pensions and job opportunities for the old, but less good healthcare. The Netherlands, third, emphasises social networks and pensions over health and job opportunities. The United States, eighth, puts jobs before pensions and health. The UK, 13th, puts pensions above health and countering ageism in the workplace. Mexico is where the old have the best social life. Japan is where they most easily find a job. Even with Afghanistan, bottom at 91st, some factors were a lot worse than others.
And yet there are common underlying factors. The growth of women in the workforce over the last half-century has meant there is no one at home to look after the infirm. The rise of individualism and the contraction of community are global phenomena. Families are becoming smaller; in China the one-child policy means a single child has responsibility for two parents and four grandparents. Contrary to the Jeremy Hunt idyll in China, home to a fifth of the world's elderly, a quarter of senior citizens live alone – something unforgivable under the old Confucian philosophy. Korean newspapers are reporting stench-filled care-home scandal stories worse than here. A vast care home for 5,000 people is about to open in China.
Industrial economics are being applied to elderly care everywhere, which is why in Britain 15-minute care-visits are routine in two-thirds of local authorities. How long does it take to get an old person dressed, fed, taken to the toilet and given their medicine? At least an hour in my experience.
Things will not get easier. Our fastest-growing age group is those over 85. Fewer people are dying suddenly; instead they decline into chronic conditions that require long-term treatments. Expect the conundrums to grow. The coalition government has tied itself in unrealistic knots over its pledge to prevent old people having to sell their homes to go into care. Cash-strapped councils are cutting, not expanding, care for the elderly.
Jeremy Hunt is right that responsibility for the elderly must be returned to the wider community. Compassion, once incarnated through family, neighbours and the local church, cannot be relegated to the state alone. But harking back to a golden age is not enough. New vehicles for volunteering are required. Within three decades the world's old will out-number the under 15s for the first time. As the elderly population grows the working population will shrink. The European Union, for example, will need 170 million new immigrants over the next 25 years to maintain levels of tax revenue. Joined-up policies, and different political priorities, are what we need from ministers. Not wistful laments for a rose-tinted past.
Paul Vallely is Visiting Professor in Public Ethics at the University of Chester