Meeting of the Parliament 06 January 2016
As a non-member of the committee, I welcome the opportunity to contribute to the debate.
Reading the record of the evidence-taking sessions, two points struck me about the cabinet secretary’s evidence in June last year. The first was his comment that all the answers cannot come from Government. Often, he said, it is about interpersonal relationships and issues that are well outside the control and remit of the Government, although he recognised, of course, that isolation and loneliness can lead to other problems, not least with mental and physical health. I entirely agree with that. The second point was his highlighting of the fact that loneliness and isolation can affect anybody of any age and of any social or economic status, in any circumstance. Again, I agree. Loneliness is clearly not just an affliction of the elderly. As Susan Hunter of YouthLink Scotland told the committee:
“social isolation has an effect on young people’s confidence, their self-belief, their anxiety levels, their ability to know that services are there for them and their ability to meet people for the first time.”—[Official Report, Equal Opportunities Committee, 5 March 2015; c 3.]
Loneliness is potentially universal, but it is also complex, and someone’s ability to cope with loneliness is a personal reaction, the long-term consequences of which can be considerable.
The period after Christmas and new year is undoubtedly a good time to highlight the issue of loneliness. As Marco Biagi said, tomorrow night, BBC television will broadcast a programme on precisely that topic. It will be interesting to see the reaction to the programme.
As the committee’s report makes clear, the full extent of the prevalence of social isolation for younger and older people in Scotland is not known. Much reference is made to one set of Age UK statistics, particularly the reference to the fact that half of all people aged 75 and over live alone and that 17 per cent are in contact with family friends and neighbours less than once a week. However, as many organisations have pointed out, there is a lack of comprehensive information about the prevalence of isolation and more particularly its health impacts. Although loneliness would seem likely to increase the risk of depression, for example, we really do not have much information on that, so more research on the links between social isolation and health needs would be welcome.
In relation to just one area of policy—housing—the link to social isolation is clear. Sheltered housing and care homes need a community room and facility. I was encouraged by the evidence that was given to the committee by the North Ayrshire health and social care partnership that a major refurbishment programme for sheltered housing facilities will incorporate a community hub. However, as that same evidence session made clear, the issue is not about day centres per se, but about providing focused activities. With regard to physical immobility, it means that the community in the widest sense must come to the individual and that facilities must be available for that interaction to take place. In relation to those who are able to get out and about, we should not forget the importance of transport—particularly public transport—in tackling isolation. That is why the over-60s free bus pass is important, as it helps our older citizens to feel less isolated.
Alternative models of housing, such as the one for co-housing that is promoted by the Vivarium Trust, are to be encouraged. One such project is being run in my constituency, in conjunction with Kingdom Housing. Co-housing is a concept that was promoted in Denmark and involves homes that are designed for the individual but which exist within a community that contains communal facilities that are based on the preferences and needs of its members. Communal facilities are often in the form of a common house that contains areas for leisure, socialising, office space, gardens and workshops.
Ideally, we should strive to avoid creating ghettos of old people. Let us also recognise that, for example, although a young single mum might be glad of housing, her house might be a long way from family and friends. Too often, young mums can feel isolated because of the sheer pressure of time and lack of money that too often arises.
As many speakers have already suggested, the integration of health and social care provides an opportunity to build tackling social isolation into that change, but it cannot all be about integrating budgets. It ought also to be an opportunity to ensure that, while we prioritise care at home, which might well have a profound economic impact, the need for social interaction is not forgotten in relation to helping to build more fulfilled lives.
It is also clear that carers frequently become more socially isolated because of the very demands of caring. That is an isolation that respite care will not necessarily solve. And what of the young and minorities of different types? I think that the committee is right to see the link between anti-bullying strategies and social isolation. Schools, in particular, have a key role to play. Although rates of suicide are declining, we must recognise that there is a group of young men whose isolation in the widest sense from the community places them at risk.
That perhaps brings home the fact that social isolation comes in many forms, which means that a one-size-fits-all strategy would have clear drawbacks. Indeed, any comprehensive strategy would have to be extremely nuanced.
Although I was pleased to note that the committee received a lot of submissions on the benefits of social prescribing or signposting people to services that might benefit them—all eminently sensible—I have a lot of sympathy with GPs. The Food Train might be right to suggest that the one service that a lot of people will have some interaction with is their GP. However, there are already substantial demands on GPs, so it is vital that, at the very least, clear information about local support services is made available to GPs and that GPs are not required to go out and look for it.
I welcome the committee’s report and the debate that it has stimulated.