Excess Death Trends

Derek Thomas Excerpts

Tuesday 16th January 2024 Westminster Hall

[Derek Thomas (St Ives) (Con)]

I thank the hon. Member for North West Leicestershire (Andrew Bridgen) for securing the debate and for his effort to bring it to the House. I have received a significant number of emails, and the consistent theme is a lack of trust. Trust is key, and constituents have a right to know that elected representatives take them seriously and work to find out why these excess deaths are occurring. Every death is a tragedy; in each home there is devastation. We see this in all our constituencies. I have sat with several families who have lost loved ones, and I am not satisfied with the answers they have been given. We owe it to them to restore trust and to be transparent about why death rates are higher than expected.

Ignoring the issue will only increase the anxiety and distress further. People deserve answers to why the numbers are high, what the cause is, whether deaths could have been avoided and who and what were responsible. We all know people who have died. No one could realistically deny that deaths are higher than expected. Too many families are left without answers. But what is the cause? That is what needs to be established. Are these deaths attributable to covid? Is it the vaccine? Is it misdiagnosis? Is it lack of access to treatment? Is it constituents choosing to stay at home?

I have two examples. One lady, who had had cancer and seemed completely clear of it, chose not to go back for a check-up and then died quickly after that. A gentleman who had a severe lung problem was denied drugs because of gaps in the assessment of the degradation of his lungs. He died very horribly and quickly at 56 years old. As has been said, a deafening silence will not reassure our constituents or ensure that we learn and respond effectively in future health pandemics.

[Carla Lockhart (Upper Bann) (DUP)]

The hon. Member makes an important point about cancer. Operations were cancelled and treatments delayed. More and more stories are coming to the fore around vaccinations of cancer patients, how that triggered other complications and caused deaths. Does he agree that more needs to be done to investigate that?

[Derek Thomas]

I thank the hon. Lady for that intervention, and I was coming on to that. Whatever the Minister is minded to say today, a proper understanding is needed of what is behind these excess deaths and the examples that have just been given.

We seem incapable in this country of talking openly about death. It will come to all of us, but we lack the courage to discuss it openly, and the consequences are widespread. Addressing the issue openly and transparently can only help our effort to bring healing and some comfort to grieving families.

Horizon: Compensation and Convictions

Derek Thomas Excerpts

Monday 8th January 2024 Commons Chamber

[Kevin Hollinrake]

I thank the hon. Lady for her question and work on behalf of Mr Patel. If Mr Patel’s conviction was overturned in 2020, he should have received £163,000 in interim compensation, which was made available to anybody with an overturned conviction. He can also access two routes: either a fixed-sum award of £600,000 or the full assessment route. He can make a decision based on whatever level of compensation he and his advisers think he is due. One route is undoubtedly quicker than the other due to the complex nature of assessing claims. I agree with the hon. Lady about people being held accountable, as I said in my statement and in response to other Members. Picking up her point about Acton post office, Paula Vennells does not have much influence over that any more, but we can ask questions about that on the hon. Lady’s behalf.

[Derek Thomas (St Ives) (Con)]

When I first became an MP, I met two constituents who had suffered as a result of the Horizon scandal. I was struck by the utter betrayal they felt. They had lost the job they loved and that they had seen as a form of public service, serving their community for many decades. I welcome everything that the Minister has set out on future action, but may I push back gently on his suggestion that the network is in a good place today and that there was no reputational damage? In the town of Porthleven and in Newlyn, a large village, we cannot get a business to touch the Post Office. Can the Minister do more work to restore the reputation of the Post Office, so that people have the service of a sub-postmaster or sub-postmistress where they need them?

[Kevin Hollinrake]

My hon. Friend is right to point out the nature of the public service provided by sub-postmasters. The great passion and the store set by sub-postmasters, such as Jo Hamilton, about their role in the community and the service they provided to that community came across loud and clear in the ITV broadcast. It was not just about losing a job, but about losing their place in the community, so my hon. Friend is right to draw attention to that.

It is important to resolve these situations quickly now, for the reputation of the Post Office, overturning convictions and getting compensation out of the door to everyone affected by the scandal, and we are working towards that every day. The post office network is still revered across the country, so I believe it still has a strong reputation at an individual level, but we must make the network more sustainable and viable. If the network is more lucrative, that will attract more people into becoming sub-postmasters. We are working on that all the time, through initiatives such as the banking framework and other opportunities.

Elderly and Vulnerable People: Loneliness and Isolation

Derek Thomas Excerpts

Wednesday 6th December 2023 Westminster Hall

[Derek Thomas (St Ives) (Con)]

I beg to move,

That this House has considered loneliness and isolation in elderly and vulnerable people.

Imagine a room of people of all ages and demographics. In this gathering, there will be vulnerable people. It is reasonable to say that a small child is vulnerable. People with visual and hearing impairments could be described as vulnerable. People with severe learning disabilities or lifelong debilitating conditions could be described as vulnerable.

In that room full of people, we would also find those who feel vulnerable and withdrawn simply because of the way we do daily modern society. They are being left behind. They can no longer access what they may have taken for granted just a few years ago. Modern life has potentially destined many of them to a life of loneliness and isolation. I want to focus my thoughts this afternoon on those people, because their vulnerability does not need to be accommodated or catered for; it is entirely avoidable.

First, I thank my constituent, Chris Goninan, who has been the driving force behind the Penwith 50+ Forum for many years. This remarkable organisation celebrates its 20th birthday this year, after two decades of enhancing the quality of life for older people in Penwith. A vital part of improving their quality of life is tackling loneliness, whether that is through driving people to church or social events or starting a local radio station to keep them in touch. I was a district councillor when we started Penwith Radio. It is now Coast FM, but it has stuck to its core mission of connecting the local community, giving good local news, information and advice to people, and reassuring them, in their homes, about their local area and the part they play in it.

In three weeks’ time, the 50+ Forum will be hosting its Christmas lunch at Pengarth Day Centre for older people who would otherwise be spending Christmas alone. I look back with fondness at the work of the 50+ Forum. I had a role as the champion for children and young people on Penwith District Council. Together with Chris Goninan, the champion for older people, I organised intergenerational events such as car washes at the fire station in Penzance and St Buryan Garage. I also supported the St Ives 50+ Forum’s efforts to secure a minibus from the Department for Transport, which enables volunteers to ferry older people to meetings and appointments, which makes such a difference to the lived experience of many elderly people in my constituency.

It is appropriate to be holding a debate on loneliness among older people at this time, as Christmas can be the hardest time for those without family around them. According to Age UK, 1.6 million older people find Christmas day the toughest of the year, with over 1 million elderly people feeling lonely over the festive season.

Chris is among friends, as the British Red Cross has recently published a call to action on tackling loneliness and building community, which has been supported by over 90 sector partners, including Age UK, Mind and the Duke of Edinburgh’s Award. Together as a sector, they are calling for renewed national leadership on loneliness and connection, and a dedicated Minister for loneliness to lead a refreshed national strategy, overseen by the Prime Minister and supported by a cross-governmental team. The strategy would set out measurable objectives to be delivered across Government to address loneliness across all ages and among key risk groups. The sector is also calling for accountability for delivering on loneliness, and annual reporting by the UK Government, against their delivery of key strategic objectives, on how Government Departments have contributed to tackling loneliness and building connection, and national monitoring on levels of loneliness.

The Centre for Ageing Better is promoting a good home hub, which would offer practical support, advice about financial support, home assessments, trustworthy signposting—particularly to tradespeople and others who would work in the home—and support to get the most efficient and appropriate housing. This kind of model would ensure proper engagement and care that can specifically address isolation and loneliness.

Age UK is also fully engaged in the issues that Chris and his 50+ Forum friends are campaigning on, and has its own campaign, “Offline and Overlooked”, which focuses on ensuring that older people who are not online have fair and equal access to public services. An example of how Age UK is trying to address the problem is the telephone friendship service, which matches older people with a volunteer for a regular chat each week. Many older people say that the calls are the highlight of their week, and their volunteer friend might be the only person they get to speak to. In 2022, Age UK supported 239,656 telephone friendship calls, and 94% of people said that their wellbeing had improved since they started receiving the calls.

Age UK also runs the Silver Line helpline, a 24-hour, free, confidential service for older people. The Silver Line provides friendship, conversation and support for people aged 55 and over, especially those who may be experiencing loneliness and isolation. In 2022, the helpline handled 183,280 calls, but even this service is at risk, as we ditch copper landlines and switch to wi-fi-only connectivity in our homes.

There is no concern when the power supply is maintained. However, even this week, thousands of homes lost connectivity to the electricity supply due to the severe weather. I have some very concerned constituents, especially on the Lizard peninsula, who fear being completely cut off when this technology is fully adopted. I have yet to get an adequate response to inquiries that I have raised in order to reassure people that they will not be left in the dark without a phone or any means of communication. Age UK’s telephone friendship service or the Silver Line helpline is no use at all if a power cut kills people’s telephone connections.

Anyone can be lonely, but the elderly and the disabled are particularly vulnerable. One in three people over the age of 75 says that their loneliness is out of control. Life events such as the loss of a partner, combined with reduced mobility or managing on a fixed income, isolate people from social contact, which we all need to combat loneliness. Those factors can converge and reinforce themselves; loneliness affects mental health, which causes people to lose confidence in their ability to socialise, or to feel overwhelmed in social settings, and so they become more lonely.

[Dr Neil Hudson (Penrith and The Border) (Con)]

I congratulate my hon. Friend on securing a debate on this vital topic. As he will know as a fellow member of the Environment, Food and Rural Affairs Select Committee, we published our report this year on rural mental health. Rural isolation is a real risk factor, in terms the pressures it places on people’s mental health. We stress the importance of connectivity, whether physical in terms of transport, or virtual in terms of broadband or the mobile phone signal. I have been privileged to welcome new bus vehicles to my constituency—the Border Rambler and the Fellrunner vehicle—which were provided by volunteer networks and offer people a lifeline. Does he agree that it is important to support rural bus networks at central and local government level, as well as at volunteer level? They are a lifeline for people, and we should strongly support them.

[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.

--- Later in debate ---

[Derek Thomas]

I thank all colleagues for their contributions. We have covered a huge amount of ground and we have been able to demonstrate our understanding and care for lonely people of any age or demographic, wherever they live. It is heartening to hear what is going on to try to address that. I thank the Minister for his response, particularly his point that this is a cross-Government matter. One thing that concerns people is the fact that different Departments have different responsibilities, but getting all those Ministers together under his leadership is really encouraging.

Most of the tea, coffee and cake I have had as an MP has been in small community groups that are trying to address this situation. Let us demonstrate that we are on their side. The Government and all parties are determined to address this and make loneliness and isolation, where possible, a thing of the past.

Question put and agreed to.

Resolved,

That this House has considered loneliness and isolation in elderly and vulnerable people.