Elderly and Vulnerable People: Loneliness and Isolation

Debate between Derek Thomas and Jamie Stone

Wednesday 6th December 2023 Westminster Hall

[Derek Thomas]

I support that, and my hon. Friend is right to refer to our report from the EFRA Committee. In my constituency, we have a number of community-led bus schemes. Douglas Woolcock, for example, runs two buses that allow people to get to appointments and other things that they need to lead normal lives and fulfil normal functions. It is right to welcome broadband and all the things that connect homes and communities, but so often we rely on community organisations and volunteers to provide some of these services—things that it is important that only communities can do—but they should not be welcomed at the expense of things that maybe the state should continue to support and foster.

To support that point, the Minister’s own Department has reported that loneliness can contribute to early death. The effect of loneliness on mortality is thought to be on a par with that of other public health priorities, such as obesity and smoking, and it also increases the risk of depression, low self-esteem, reported sleep problems and an increased stress response. Loneliness also creates a greater risk of cognitive decline and the onset of dementia, all of which are good reasons to be discussing the issue today and trying to find solutions to address loneliness and isolation as much as we can.

We referred to fibre and broadband connectivity, and some older people are able to break the cycle through technology. That is a fantastic thing. Like many of us, one 70-year-old in my constituency discovered Zoom over lockdown. Now her family has to work around her busy schedule of Zoom calls to friends old and new all over the world. Evenings are out because she talks to America, and early mornings are for new friends in New Zealand. But—and this is a big “but”—she was only able to do that because she had a grandson who could talk her through setting up Zoom on her computer. I would like to meet him so he can help me. She also had a daughter who could talk her through buying a computer. I could not say how often I go to my 16-year-old just to try to set up wi-fi calling on my phone.

For many elderly people, that is not the case. Social isolation leads to digital exclusion, and digital exclusion leads to further social isolation. Life becomes more difficult for the 2.4 million people aged 65 or over who do not use the internet. The more they are cut off from everyday activity, the lonelier they become. The same is true of people with disabilities, who make up 60% of internet non-users.

The Government have not published a digital inclusion strategy since 2014, yet so much of our lives is online now. We can all give anecdotal evidence and examples from our own lives, but the statistics show an increase in average monthly data usage of 731% since the 2014 strategy was published. As many of us do more and more on our smartphones, it is easy to forget that more than 3 million people aged 65 or over do not use one, and 1.6 million do not even possess a mobile phone.

Another point that tends not to get much airtime is the dramatic shift in how some letter and small parcel delivery companies have evolved their business. The delivery man or woman rarely takes time to wait for someone to answer the door or even check if anyone is in. Instead, they use their technology to record the delivery and move on to the next address. Although it is not the job of delivery drivers to look after the wellbeing of residents, this is another aspect of human interaction lost to people who might not see anyone from one day to the next.

We are all familiar with the recent campaign against ticket office closures on the rail network, and we will remember the argument that 86% of train tickets are now bought online. However, we need to remember who is buying the other 14%—or, as is the case in Penzance, who is buying the third of tickets that are sold in the ticket office. As one of my constituents wrote to me when Penzance ticket office was under threat,

“Not everyone has computers or mobile phones, especially in Cornwall where mobile reception can be poor and many older people aren’t computer-savvy. The staff in Penzance are professional, kind and thoughtful. They demonstrate an understanding of levels of ability both physical and mental. They are never impatient or unkind and frequently find a much better deal than friends do online!”

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

The hon. Member is making an excellent speech that really strikes a chord with all of us. In my constituency, and indeed in the whole of the north of Scotland, the Bank of Scotland has announced that it will remove all its mobile banks. One can imagine what that means for old and vulnerable people experiencing loneliness in my vast and scattered constituency. That is why I will be raising the matter repeatedly in this place.

[Derek Thomas]

I appreciate that intervention. I was in a meeting this morning about finances, and there was an audible desire to get everything digital—that is, until we start thinking about the very people we are showing we care for today. They will never be in that space, and will never be confident or comfortable, or even feel—I will cover this later—that the risks of banking online are worth taking.

As we race towards a potentially digital-only platform, it is our job, and the Government’s job, to pause and ask who will miss out or be left behind, and to ensure that that does not happen. As I have said, my main concern is those whose loneliness and isolation can be completely avoided if we get this right. Although change is welcome, we must be sensitive, take people with us, and accommodate those who cannot jump on in the same way that perhaps we can.

The testimony about ticket offices given to the train companies’ consultation persuaded the Government that they should ask train operators to withdraw their proposals. People object to moving everything online. Indeed, they might not even be able to do that. There will always be some people who struggle with the internet, and they need to be catered for. . I want the Department for Transport’s example to be followed by all Departments, and I ask the Minister to take a lead on that. We have protected elderly people who cannot navigate the internet but want to navigate a journey to see friends or relatives; now we need to help them to navigate their day-to-day lives.

As public services increasingly move online, day-to-day essentials such as banking, making an NHS appointment or even paying for parking become more difficult for those who are offline. All Government services should be accessible to those who are not online. At the moment, many councils provide no offline access to housing benefit, council tax reductions, rebates or blue badge applications. That is completely unacceptable.

Last month, I asked the Secretary of State for Transport whether he will ensure that people without internet access can use Driver and Vehicle Licensing Agency services, such as paying road tax or renewing their driving licences, after the DVLA contract with the Post Office expires in March next year. The response was that the “vast majority” of licences were renewed online, and there was no guarantee that the contract would be renewed.

I recognise that there is a commercial discussion to be had about the cost of renewing the contract, but the Government should factor in the cost to older people whose social lives depend on the ability to drive—as is the case for many in rural constituencies such as mine, as was referred to earlier—and the cost to the Post Office itself. Six million customers access DVLA services across post office counters, and half of them pay in cash. Removing those services from post offices will not just impact vulnerable people, but remove an important source of revenue for such vital and often very rural services, which provide people with access where it is not otherwise available.

Post offices have always been important to rural communities. They have become even more important as a backstop for those who cannot access essential cash, postal and Government services elsewhere. Recent research found that only 47% of those aged 65 and over said they could find an alternative way of accessing pensions and social benefits. The Government should be doing everything they can to support the network. Access to cash is essential for elderly people, many of whom cannot or will not bank online. Even those older people who are comfortable with email feel uncomfortable banking online or transferring money electronically. We have heard many examples from our constituents of fraud and scams, which quite rightly concern more vulnerable people. Age UK’s research shows that 27% of people over 65 manage their accounts via a branch or physical location such as a post office.

Without banking services, those who do not bank online are cut adrift and are less able to participate in society, so the roll-out of banking hubs must increase at pace to avoid leaving communities to become banking deserts. At the moment, Link will consider a banking hub only after all commercial banks have left, as they have in St Ives and Helston, in my constituency. Helston Town Council and others deserve credit for convincing Link to provide the town with a banking hub. It will open next year, but that means that the town will have been without a bank for a whole year. There should be a more proactive approach that ensures that no one is left without a counter service.

If nothing else, the Government should ensure that all Government services are easily accessible to everyone, even those without access to the internet, and nowhere more so than in the NHS. Last week, I had an email from an 81-year-old constituent. His wife, who is not computer literate, received an email that she did not understand. Luckily, he was able to cope, but he complained that he had to jump through hoops to download a document even to understand what the email was about. Other older people do not have a helpful spouse. As my constituent wrote:

“I find it staggering that the NHS in Cornwall insist on trying to communicate with patients via email, text messages and mobile phone—when some of us don’t have a signal or are too old to deal with so called improved services. Frankly, a simple telephone call would suffice or at least if any form of communication contained a telephone number.”

Because of the work we do for our constituents, we all know that “improved services” are not necessarily improved. Last month, the journal BMJ Quality & Safety carried a report about the safety incidents resulting from remote consultations: missed, inaccurate or delayed diagnoses; delayed referrals; and underestimates of severity or urgency.

But even when remote consultations are medically justified, they do nothing to combat social isolation. A face-to-face consultation is more than an evidence gathering exercise: it can be the only social interaction many older people have. I met with a number of people from the Penwith 50+ Forum last Saturday, and one lady made a very important point. She said that when she went to see her GP face to face, he picked up other medical conditions of which she was completely unaware and which could not have been picked up on an online or telephone consultation. In the long run, social isolation will cost the NHS and the Government more. Loneliness is associated with an increased risk of high blood pressure and reduced immunity against infections. It increases the risk of coronary heart disease by 29% and the risk of stroke by 32%. We know that loneliness can be as dangerous as obesity or smoking: it increases the risk of early mortality by 26%.

I recognise that I have covered a lot of ground, but it needs to be said that the Government have the ability to fix this and help many of our older and vulnerable constituents to avoid a very bleak existence. As the Government consult on eliminating smoking altogether, for example, will the Minister commit to a similarly aggressive approach to tackling loneliness? Will he engage with Age UK, the British Red Cross, and others who are concerned about the current direction of travel and make a proper assessment of how many of our constituents, especially those over 65, are impacted by so many services moving online? In conclusion, I am convinced that the loneliness and vulnerability that so many people face would be eliminated if we responded adequately and effectively to this challenge.