Older Persons: Human Rights and Care

Lord Cashman Excerpts

Thursday 16th November 2017 Lords Chamber

[Lord Cashman (Lab)]

My Lords, I refer your Lordships to my interests in the register and to my date of birth. I congratulate my noble friend Lord Foulkes on securing this important debate and on his excellent report. Of course, the noble Lord, Lord Balfe, will remember that I was one of the co-rapporteurs on the framework directive of 2010 from the European Parliament on combating discrimination on access to goods and services on the grounds of age, disability, sexual orientation or gender. That is still resting and blocked by Governments who do not want to take the necessary action—so there needs to be taken at national level on this important issue.

The reality is that we are failing many older people when they need us most. The Care Quality Commission’s annual state of care report of 2017 found that only 2% of adult social services were rated outstanding: 78% were good, 19% required improvement and 1% were rated as inadequate. Before we congratulate ourselves, let us remember that the 1% represents 303 locations and approximately 16,000 individuals whose care was inadequate.

The report also, importantly, reveals wide variations in quality ratings between different types of homes and services. Community social care services were rated the best overall when compared with other services. Domiciliary services and residential homes received similar ratings. However, nursing home services received the worst ratings, with 68% rated as good, 28% as needing improvement and 3% as inadequate. Within these stark statistics are hundreds and thousands of vulnerable adults whom we are failing.

I am pleased to be reminded by the noble Lord, Lord Haskel, of the issue of human rights that is predominant in this Motion. That is why I turn specifically to the issues of human rights and discrimination and other issues faced by older people—in particular, people living with HIV. The Terrence Higgins Trust report, Unchartered Territory, surveyed nearly 250 people living with HIV across the UK, all of them aged over 50. Some 58% of respondents were defined as living on or below the poverty line. Over one-third of individuals living with HIV were reliant on social security payments. Some 84% were concerned about future financial difficulties and a third of respondents were socially isolated. Some 79% were concerned about memory loss and cognitive impairment in the future and how they would cope with managing multiple health conditions.

The challenges are many and varied. There is a difference in needs and experience, depending on whether an individual was diagnosed before antiretroviral drugs were available or after. Individuals diagnosed before treatment was available were more likely to have more additional health conditions. Social care is not currently meeting the needs of people living with HIV as they grow older because they face the prospect of managing multiple long-term conditions that are made more complex by their interactions with HIV. Even those who have been able to access social care have faced discrimination from social care professionals due to their HIV status. This discrimination is fuelling myths and stigma around HIV by treating people living with HIV differently from other social care users.

The Minister and his department will also need to address discrimination faced by older LGBT people. Care providers need to recognise and respect LGBT identities and should ensure that LGBT identity is not marginalised, nor rendered invisible, and that LGBT elders are not outed deliberately or inadvertently. There are human consequences to this. Unfortunately, the problem, as evidenced in the Stonewall/YouGov research, Unhealthy Attitudes, found that a quarter of health and social care staff had never received any diversity training at all. Some 72% had not received any training on the health needs of LGBT people and, shockingly, only a quarter of staff had received any training on trans people’s healthcare. The training of health and social care staff in understanding and engaging with the particular needs of LGBT+ people is an important and deliverable objective to improve the quality of life of these people.

Time does not allow me to offer the House further examples, but I ask your Lordships to imagine what it must be like to once again have to validate your life, your love and your relationships at a time when you are vulnerable and when these have been, and should remain, the one constant in your life.