Friday 20 October 2006
Joan Bakewell: These cuts will only add to the misery of the elderly
Two million old people in Britain still live at the margins. Closing post offices will hit them hardest
Whenever a cluster of apparently random events converge round a particular social group they, not surprisingly, feel they're in some kind of frame. Witness the effect that the row over the veil, an individual exemption from guarding the Israeli embassy and the proposed quotas in faith schools has had on the Muslim community. First the regular headlines make them feel targeted; then the groundswell of media comment makes them feel demonised, right-wing opinions and parties take comfort, and the whole debate about assimilation versus integration is ratcheted up into one of the leading issues of our time.
But there's one group of people around whom a number of current policies are clustering without a national tide of either sympathy or outrage. Members of this group find themselves sufferers at the hands of policy after policy, and yet no one is making headlines of their stories, or their helplessness. Yet they are growing in numbers every year, a relentless trend that has nothing to do with recruitment, with religious allegiance or political affiliation. I refer, of course, to the old.
The steady accumulation of news that directly and adversely affects their lives lacks the political edge to shock the nation. Instead they make their modest protests and resign themselves to what has traditionally been their lot: to get older without being any trouble then quietly drop off the twig.
First was the decision by Nice to reject an appeal to keep available free on the NHS to those in the early stages of Alzheimer's, drugs that slow down the progress of their condition. Nice's chief executive declared that "these drugs do not make enough of a difference for us to recommend their use." That such a subjective judgement carries the day is a disgrace. It fails completely to understand the psychology of being old, when each day snatched from the jaws of impending blankness is precious, when every moment of lucidity among family and friends is a blessed reprieve. The cost of these drugs is said to be no more that £2.50 a day. Clinical trials show that they can be effective. Nice recommended their use in 2001. Old people's welfare is being bounced hither and yon, confusing them and their families. As if they were not confused enough already.
Next up, care for the old in hospitals. A recent report highlighted that the very old are suffering malnutrition because of the way meals are offered to them in the wards. I know from personal experience how the food is often plonked unthinkingly down in front of patients too old to feed themselves. I know of one case where a woman who was blind simply didn't know where her food was or how to handle it. Minutes pass and the trays are collected again, with scarcely a thought as to who has eaten or not. It's a fair bet the feeding round has been the subject of cost-benefit analysis that allows for no hanging around doing anything as generous as relate to the patients.
Now we learn that care for the elderly in their homes is also seriously inadequate. Again, those management gurus must have been at the time sheets, designating visits of no longer than 15 minutes at a time, to feed, wash, dress and offer help with the toilet of seriously afflicted old people living in lonely isolation. Plenty of things can be found wrong with institutional old people's homes, and the latest pitch is to keep people in their own setting for as long as possible. But, just as "care in the community" dumped the mentally inadequate to fend for themselves, this latest care for the old is woefully short of what is needed.
Earlier this week, the Government published figures that show a 2 per cent fall in the numbers of pensioners living in persistent poverty. Don't get too excited. The fact remains that 2 million older people in this country are still surviving at the margins, with Britain ranking 20th out of 25 in the European league table of pensioner poverty. Even more of a scandal is the fact that £4m of pensioner benefits go unclaimed every year. Money that is meant to relieve the wretchedness of a poor old age is simply not reaching them. Again, there's a complete failure to understand the state of mind of the elderly, who find officialdom beyond them, and have sadly learned to expect little from society.
Now comes even worse news - the threatened closure of post offices, which will certainly hit the old hardest. Of the 14,000 that survived recent closures, the government might well close down a further 5,000.The rural post offices will be the first to go. But it is in rural communities that the post offices matter most. They represent a particular lifeline for the old: it's where they are meant to claim their meagre benefits; it's where they exchange gossip and local news; it may be the only place they have human contact within their long and lonely days. Again the old will suffer to a disproportionate degree. No wonder 4 million people signed a petition to Downing Street.
People in early old age can enjoy a good life, with fewer worries, a comfy enough pension, mortgage paid off, time on your hands. I'm happy to be of that number. But it shouldn't blind us to the fact that later old age can be wretched and neglected, a neglect compounded by deliberate government choices. And right now it looks as though events are conspiring to make it even worse.
Joan Bakewell's book 'The View from Here' is published by Atlantic Books
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