On my way home last week I read a short article in the London Evening Standard about an elderly woman who had fallen over in her home and couldn’t get up. She survived by melting ice from her fridge for six days, huddled by her oven for warmth, until somebody heard her banging on the wall.
There were so many sad and shocking things contained in such a short article that I almost just wanted to shut down and ignore it, but the fact is that these stories are not uncommon and the very last line made me angry.
Hang on? When exactly did our communities become so fractured that if you have no family then the next obvious port of call is a GP? What about neighbours, friends, or anybody else at all who isn’t paid to care? Are we so self-centred now that we are sub-contracting the very cornerstone of a civil society to a doctor’s list?
And the NHS has been complicit in this. Old age and isolation are bad for health and so it becomes a health issue. We appoint community teams, visitors and surrogate families. We campaign on loneliness as a health expense, something to be “cured”. We pump money into a struggling system to look after the people we easily could but don’t want to. Indeed we wring our hands and beg for more money to perpetuate the problem. But at what point did we decide it was better to subcontract our communities and responsibilities to the NHS than give two hoots about the welfare of our neighbours?
The idea the news story ended on was that this was a system failure, and probably a health one. Somebody fell through the cracks.
It wasn’t. It was a you-and-me failure. And this week, the fallout of the Brexit vote shows just that same problem writ large. We are a divided nation that risks barely caring if our elderly neighbour lives or dies - let alone gives up their time to speak to them about their lives, hopes and fears.
Whatever the reasons people voted either way in the EU referendum, the overriding emotion, particularly in the Remain camp, seems to be shock – we had no idea the other half other country felt so differently.
The decline of communities has been spectacularly fast in recent decades. The social binds that maintained societies for millennia are rapidly fraying. Church membership, for example, has declined from one in three adults to around one in 50 over the last century. Advances in travel, technology and globalisation mean we don’t always stay where we were born. We don’t live near our families. The UK had one of the slowest growing rates of urban populations in the world throughout the 20th century but it still saw an increase from 77% to 89% of the population moving to its cities.
The number of people living alone is now at its highest point in history by far, with some research putting the number of chronically lonely people as high as one in eight. It’s particularly acute in the elderly but far from unique to any demographic.
Whether it is correlation or causation, this has gone hand in hand with an ever increasing emphasis on freedom and individual pursuit.
We are told that the ultimate goal of life is to feed our appetites and “realise ourselves” without any reference to our family or community or anybody else at all. Even our primary schools now list their children’s rights on the class walls with little room for old fashioned concepts of service or sacrifice. In a GDP-driven world we count this personal and economic growth as ever increasing benefit. But the side effect is an old woman lapping water from the bottom of an open fridge for six days, desperately hoping that somebody out there knows she even exists.
And this crushing decay of community gives us a thin veneer of moral anonymity in dealing with this – I don’t have to deal with this - in layman’s terms, she’s not my problem.
And yet it clearly is someone’s problem. So we slap a “health” label on it and demand the NHS deal with it.
The NHS is strapped for cash and we want to blame it on all kinds of things, from underfunding to chronic disease to raised expectations. Isolation and its “treatment” are the latest on the NHS wish-list.
But perhaps the NHS needs to start putting its foot down a bit more and saying “enough”. The answer is not to retreat to a comfort zone of providing services for a fractured and careless society but to tell people that this lady’s situation was not a system failure or a health service responsibility – it was your fault. My fault. Your pursuit of yourself has caused this. When did you last chat to your elderly neighbour?
If you want a better NHS, and indeed an improvement in our national politics, you, and I, could start by very basically just loving your neighbour a bit.