Lord Borwick
Main Page: Lord Borwick (Conservative - Excepted Hereditary)
Lord Borwick
That this House takes note of the issues facing people with disabilities and the potential for improved treatment and outcomes in the next 50 years.
Lord Borwick (Con)
My Lords, I declare my interests as noted in the register, particularly my interests in accessible transport, housing and charities.
The lives of disabled people are often challenging. We rightly work hard to try to meet those challenges, and many disabled people say that we do not work hard enough. But the main reason I called for this debate today was to focus on the positives. Over the past 50 years, there has been an enormous improvement in the public’s attitude to disabled people, public understanding of their disability, and provision for their needs.
Sir Bert Massie repeated a story of being told in a restaurant, “I’m sorry, we don’t serve wheelchairs”, only for him to reply, “That’s okay: I don’t eat them”. That would not happen today, and that is something to celebrate, but, as we have seen those improvements over the past 50 years, we should now be optimistic that for the next 50 years we will promise even more.
A charity’s main aim should be to shut itself down. It should strive to achieve its mission, fulfil its special purpose and find that there is no reason for it to exist any more—but this is rare, if not unknown. The perhaps mythical charity for the relief of the destitute of Beverly Hills might have been such an example.
In this House, and in politics generally, there are quite enough problems to keep us busy, and so often the important gives way to the urgent. Setting a date of 50 years hence for this debate, we can start to think about the important. It gives us the opportunity to talk about a tantalising time when many of the urgent problems have retreated, in the hope that that might reveal the important ones left exposed on the beach of debate.
One charity that considered the possibility of being redundant was RADAR, when it was run by the late Sir Bert Massie, whose enjoyable autobiography was recently published. I am told that RADAR produced an annual report for 2030 looking forward in that way. Sir Bert imagined a world in which disability discrimination no longer existed—indeed, when no discrimination on spurious grounds existed. But the original idea for this debate was sparked when I discussed housing matters with a fine social housing provider called Habinteg, known to many of us in this House. It should be congratulated on its 50th anniversary, but did it imagine what the world would be like now when it started? I am not sure that there were many disabled Members of this House 50 years ago, and public transport was wholly inaccessible. Life is better now—still bad for many people, no doubt, but also better for very many.
Many noble Lords present will—but I personally shall not—see the world in 50 years’ time, when I would be approaching 115, but what will be the nature of disability then? Average longevity has been growing for years, so perhaps a life expectancy of 120 will be ordinary. We can hope to see ways of looking after the elderly improve, but perhaps the frailty that so often comes with age will grow further. Will dementia be preventable by then? Research is certainly progressing well, and there may turn out to be an infectious agent of some sort that can be prevented, just as we have discovered that many cancers are started by viruses.
Will we have solved some of the other problems of extreme old age? In every generation, people have felt that technology has passed them by, whether that be transport or iPhones. The older generations can now handle—just—the mystery of computers, but it has always been the case, and probably always will be to some extent, that technology will leave some of the older generation behind. It means that there are so many people alive today who are isolated by technology—who, for instance, cannot handle a ticketing system that is online only or that restricts cheaper tickets to online only.
Isolation makes people miserable. It may be one of the big challenges of the future. We should always be grateful to be Members of this great House, because so many deserving people do not have our privilege of having friends to disagree with. Perhaps, when our successors are debating the installation not of 5G but of 50G, they will convince the teenage designers of that system to design it with older people in mind. Better communication should reduce loneliness, but does technology always achieve this? I can hope only that the sheer numbers of older people will mean that that demographic group is a commercial opportunity.
Many scientists believe that, were people to engage in a healthy lifestyle throughout their lives, they could live for well over 100 years in relatively good shape, with preservation of cognitive ability. In a book entitled The Blue Zones, Dan Buettner studies communities around the world where people frequently live past 100. They stay physically active, eat well and usually never smoke—not even on the terrace. Crucially, they also enjoy loving, purposeful relationships throughout their lifespan. Someone can be physically well but lonely; loneliness clearly increases the loss of cognitive function and accelerates costly, preventable decline.
Technology can isolate people, but it also has enormous potential to alleviate loneliness. For instance, we can be sure that autonomous cars will be routine in the next few years. That could mean much more independence for those who are currently dependent—but when will we see autonomous ambulances with perhaps only one nurse to look after the patient while the ambulance drives itself? Autonomous cars may enable those with learning difficulties to travel as easily as everyone else, but what will happen without the contact with other people that happens on a bus? Will buses find themselves priced out of existence? Perhaps the autonomous taxi will be just a haven from increased crime.
Again, looking 50 years ahead means that we can start to identify the important things that we hope will not become urgent, because we know that a lot of costs are associated with disability. Lifts, special bathrooms and automatic door-openers are all expensive and all need electricity and maintenance. Whether they will get proportionately cheaper in 50 years’ time is an open question, but what is certain is that extra costs will exist, and I hope that all parties will accept paying towards them.
The subject of human helpers employed by many disabled people is more complex. With the growth of free trade—and, I hope, free immigration—around the world, I would expect the average wage of unskilled people to converge, so it will not necessarily be advantageous for British disabled people to employ foreign helpers. Will we see robots help instead? We see this already in places such as Japan, which has low levels of immigration.
One thing is predictable: in 50 years’ time, the promised Green Paper will actually have been published, and at least 50% of houses will have already been built to the lifetime homes standard. That is because the Government will have accepted the recommendation from all sides of the House to make it mandatory. That the majority of all houses should be accessible seems easy to me. We are winning the argument; I believe that building accessible housing will be seen as helpful not only in a practical sense but in an economic sense too. Given the number of times a house will change hands over the course of its existence, there is a good chance that a resident over that timeframe will need wider doors or accessible plug sockets. Building those things in at the start will be more economical than making alterations over a number of years.
Technology in healthcare can help, too. A few years ago, the American company Theranos popularised the idea—albeit perhaps fraudulently—that it should be possible for every patient to take a small drop of blood by themselves, which should reveal all the health markers that are so hard to find now. It is likely that another company might produce this in the future, meaning that every person could monitor their health daily with complete accuracy at trivial cost. All infections and diseases will be caught early, probably leading to much less suffering. Such technology might also, almost unbelievably, reduce the cost of our National Health Service. For those with disabilities, being able to track other health issues easily and cheaply will be of enormous benefit.
State borders will not be limitations on these benefits. For medicine in resource-limited countries, telecom-munication and telemedicine will be very helpful. It is happening today. Pathology reports and X-ray images can be sent to experts, and we can get second opinions through a group of physicians who volunteer to help in this effort. Surgeons can now operate remotely, thousands of miles away. So, looking forward, will it be easy for UK doctors to routinely treat patients in third-world countries, and will it be easy for doctors trained in South America to take on patients in the UK? How will we sort out prescriptions written in India and delivered in Westminster? Perhaps with prescriptions dispensed by Amazon—who knows? Treating conditions that might exist alongside a disability should be easier for those in the UK and overseas, which is a welcome prospect. Again, having a 50-year perspective is a useful framework for working out what issues might be important, so that we can start to use technology to tackle them.
I have addressed how technology can be used for good, but I have also acknowledged that it can isolate people. I think that loneliness might be the biggest long-term challenge for improving the lives of disabled people. The Government have, to their immense credit, recognised the problems that loneliness can cause. They have even given a ministerial role to the task, which my honourable friend Mims Davies MP currently occupies. The Government’s loneliness strategy was launched in October last year, and there is much to recommend in it. The strategy recognises the potential that technology has to reduce loneliness as opposed to exacerbating it, and it also seeks to discuss loneliness in classes at school so that children can learn about its impact.
While I welcome the Government’s willingness to tackle loneliness, it is also true that the best solution is the long-term care and support provided by families and loved ones. The Government can and should help when someone is truly alone, but they cannot and should not replace a family. There are thousands of family carers across the country, many of whom are balancing jobs and young families at the same time. This is a tremendous resource not just for the lonely person but for the country, and we should be immensely proud of these people. I have noticed an increase in award ceremonies and the like celebrating the role of family carers, and that is absolutely right. They are national heroes and may be the secret to making the next 50 years even better than the last.
Lord Borwick
My Lords, I will quickly thank all noble Lords for taking part and for taking a few seconds to pay undeserved compliments, for which I am very grateful. I think that, when the noble Baroness, Lady Thomas, called for more influential disabled people, she underestimated her own influence.
I thank everybody for putting aside other problems to talk about the future. I will have to look out for my mischievous and noble friend Lord Holmes laying plans for my 115th birthday party. I do hope that he will attend it, even if I am not able to do so myself and have to send my apologies—but I thank him very much for the idea.