Examination of Witnesses (Questions 620-636)
3 FEBRUARY 2004
MR CHRIS
BAIN AND
MS HELENA
HERKLOTS
Q620 Chris Mole: Do you think there is
anything Age Concern can do to contribute to that?
Ms Herklots: Certainly in terms
of highlighting the voting power of people over 50 we are doing
a number of things. One is in terms of some of the local projects
we have across the country, which seek to involve older people,
but also try to help older people build their own confidence.
Sometimes there has been an assumption that older people can just
join in things and often that is not the case, either because
of some very basic barriers like a lack of public transport or
fear of crime. Older people may be frightened of going outside
their homes and it may be that community events are happening
in the evening and people find that a barrier; there need to be
projects which help older people to build their confidence. We
run something called a Voice and Choice course, which is
helping older people build the skills to get involved. The other
area which is really important in terms of social cohesion is
inter-generational projects. Here again we found quite a bit of
success in bringing together younger and older people and breaking
down some of the myths that they have about each other. Older
people may typically be fearful of younger people; younger people
may think of older people as "has-beens". Working with
groups, doing joint activities, whether it is computer clubs or
reminiscence projects or whatever, is a really helpful way
of beginning to build that understanding, which is a very important
first step to building that social cohesion.
Q621 Mr Clelland: Do you think local
authorities do enough to promote social cohesion through projects
involving older people?
Ms Herklots: The experience is
very patchy. In some areas there certainly is a commitment and
one of the programmes which has helped that to some degree is
the Better Government for Older People Programme, which
government has supported, which set up a number of pilot projects
across the country, with the aim of consulting and involving older
people in the development of services and in planning for ageing
populations. It is patchy and part of the problem is sometimes
the funding regime. Quite often they may be funding for new and
exciting projects but quite often local voluntary organisations
then struggle to find continuation funding. Funders will typically
like something which is new, but funding for sustained involvement
of older people and projects can be difficult. We believe one
of the things that local authorities could do, which would be
very valuable not only to older people, but to local areas more
generally, is to develop strategies for ageing populations which
look across the age spectrum and really plan ahead for the way
in which their local communities may change over the coming years.
Q622 Mr Clelland: Would you also look
across gender balance and ethnic minorities? When we went to Oldham
we visited some luncheon clubs which tended to be the women's
luncheon club or the men's luncheon club or various ethnic minorities.
How can we bring in a bit more cohesion in terms of older people's
activities?
Mr Bain: We talked earlier on
about capacity building for older people to enable them to participate
and indeed for other excluded groups, using a primarily community
development based approach. I would also argue for capacity building
for service providers and for the older people and the other excluded
groups to be part of that capacity building, to deliver the training
and awareness raising. With that you then start not only to build
links, but to build awareness on both sides, because there is
an issue amongst older people and older groups about the fact
that they do not really understand the very real issues local
authorities are facing, in terms of service delivery. If you can
get that better understanding on both sides, then you have a more
sustainable solution coming out at the end of the process.
Q623 Mr Clelland: Do you think there
is any mileage in local authorities providing incentives by making
it a condition of funding that there is more cohesion, more of
a mixture in ethnic groups and the way they work?
Ms Herklots: There is a number
of things which local authorities can do, starting at the care
level, the commissioning practices of local authorities actually
expecting providers of care services to take account of cultural
differences and to ensure that the funding is there to employ
the right people to take full account of people's religious needs,
cultural needs, for example. That is certainly helpful. In terms
of their duty to promote the wellbeing of their local communities,
some indicators there about the involvement of older people from
different groups would be really helpful. There are not really
any incentives in terms of the performance indicators which assist
the engagement of older people, so we have a situation where a
number of areas are doing it, but there is not really the policy
framework to support that, certainly not in terms of monitoring
and indicators.
Q624 Mr Cummings: Can you tell the Committee
how older people can contribute to community cohesion?
Ms Herklots: They are doing it
already to some degree. Older people do an enormous amount already
in terms of volunteering in a range of different ways, in terms
of their role as grandparents and carers, in terms of the role
of local voluntary groups. There are a number of barriers to that.
Some of the projects we are involved with, involve older people
teaching younger people. We have a kind of foster grandparent
scheme where older people provide support to children perhaps
from a deprived family who need that older mentor. There is a
number of individual projects across the country which are very
successful. The challenge is beginning to try to mainstream that
and move it from patches of good practice, into a more standard
approach.
Mr Bain: It is also about having
a change of mindset. We do tend to talk about a demographic time
bomb. To me that is an entirely inappropriate way to look at an
ageing population and the issues between ageing and older people
need to be considered as separate issues; they are not the same.
I have argued for some time that the growth in the number of older
people is not a social services issue; even though it is an issue
for social services, it is much wider than that. There are opportunities
around the number of fit and active older people entering into
our community which we need to take into account. There is a potential
role in the future for older people as, for example, mediators
between generations and groups, building on their experience and
knowledge and commitment and capacity which they gain over a period
of time. In order for that to happen, we need to make some sensible
judgments about what older people need in order to fulfil that
role and give them the appropriate support. They can become an
enormous resource in beginning to sort out some of the tensions
there are within communities and within society. We need to give
them the opportunity to do that.
Q625 Mr Cummings: The Committee have
been told about projects which bring young people together with
older people so that they can learn about their lives and their
experiences. How do you believe this project could be expanded?
Ms Herklots: The inter-generational
projects are beginning to develop more now. There is actually
an inter-generational network across the country and organisations
such as Age Concern and the Beth Johnson Foundation are involved
in that. We are doing our bit to try to develop good practice
and to initiate projects across the country, but there are two
issues really: one is sustainable funding. Quite often it is difficult
to get funding for projects which are seen as not necessarily
supporting those in greatest need. A lot of these projects are
about helping older people before they need a lot of help, about
helping older people contribute to their local communities and
it is very difficult to get funding for those. That is one factor.
The other factor is about help to spread good practice and ideas
and the network is beginning to do that, but it has some way to
go really. One of the important things we found from the inter-generational
work is that it is not only good in terms of social cohesion,
but it is also good in terms of the health of the older people
involved. There is a real link there between people being involved
and people feeling healthier and better. It has some very positive
spin-offs in terms of people's own health and staying independent.
Q626 Mr Cummings: How do you believe
projects could be developed which promote social cohesion, with
white students learning from older people from black and mixed
ethnic communities about their lives and cultures?
Mr Bain: I would see it as a two-way
learning process, because it would be helpful for some of those
elders to see what was happening to people.
Q627 Chairman: Are there any examples
of where that is happening? There are obviously examples of where
young people are working with older people in recording history
and things like that, but are there examples of cross-ethnic groups?
Ms Herklots: We could certainly
look to see whether we have some examples of those and send those
on to the Committee.
Q628 Mr Betts: Local authorities and
health trusts come in for some criticism that they do not always
provide services which are appropriate for older people from black
and ethnic minorities. Do you have particular concerns about that?
Do you think changes ought to be made in the way those communities
are approached?
Ms Herklots: It stems from a general
concern really about health and social care services not assessing
people as individuals all the time. That is particularly important
when people have particular religious and cultural needs and requirements.
There is more than an understanding now that things need to improve
and one council, Kent County Council, has produced a very good
guide on providing what is called culturally competent care, which
sets out some standards really in approaches to make sure that
older people, particularly if they are vulnerable and need personal
care, get the right sort of support. There are problems. We are
a long way from that being the case. We are a long way from it
being the case for older people to get individualised support
anyway, but certainly we are a long way generally from people
getting that culturally appropriate care. One of the issues there
is about commissioning. Local authorities have an opportunity,
through their commissioning practices to require of providers
that level of provision, that level of cultural sensitivity. It
is certainly not there at the moment across the board, although
there are some elements of good practice.
Q629 Mr Betts: Is there not a conflict
here between the need to provide services which are appropriate
for people in their particular community, whatever the particular
requirements and needs they have, maybe due to religious approaches
or whatever and social cohesion? Are you not almost saying that
the service which is going to be delivered to people from different
ethnic backgrounds and is going to be different and probably separate
and people will simply not mix as a result?
Mr Bain: One of the key issues
here is around discrimination and we have talked about race, faith
and cultures being one of the determinants of appropriateness,
but there are others. There is age, gender, level of disability
and so forth and awareness of how those issues are perceived in
some communities as key to getting an appropriate service. Many
of the people who receive those services suffer multiple discrimination
on a number of levels. They suffer a complex web of discrimination
which perhaps the rest of the community does not. If that were
not complex enough, it changes over time. The perception changes
over time; the role of older people in particular communities
changes over time; attitudes to age and gender and disability
change over time. We need to be far more sophisticated and understanding,
putting in place and reviewing improvement mechanisms for our
public services, otherwise what we will have is a service which
is universally applied, but is not individually tailored, which
was one of the objectives of the public service reforms.
Q630 Mr Betts: Individually tailored
services can mean services are separate for people from different
backgrounds, that you will not have a community centre where people
from the white community, extended community, black community
all mix together because they will all want separate things. How
do you go about that? Is there a tension between tailoring services
to suit the needs of individuals and particular communities and
trying to ensure there is a social cohesion, a bringing together
of people in different communities?
Ms Herklots: The challenge is
to try to do both. In a sense we are talking about specific services
for specific groups as well as trying to mainstream these issues
so that services generally are more acceptable to more groups.
At the moment we are in a situation where people will just not
come forward to services, they would not come to services unless
they felt they were specific to their culture. Therefore we need
to recognise and provide for that, but at the same time try to
build a more cohesive society and a more cohesive community and
to have the mainstream service providers, which in some areas
may well be Age Concern, doing all they can to try to ensure that
their services are more open and people are more likely to approach
them. At the moment, if we just say we want everyone to come together
and that is the approach we are going to take, that will not work.
We need to try to do both. We need to identify the needs of particular
individuals and groups and try to respond to those, as well as
work hard to try to make mainstream services more appropriate
and more sensitive. It is about trying to recognise each individual
need and that may be a need around race or culture, it may be
a need around disability or mental health or whatever. It is a
huge challenge, but it is not a question of trying to do either/or;
we need to try to do both.
Q631 Mr Betts: May I ask about interpreting
services and the importance you attach to them? Do you think they
are generally of a standard which is appropriate? Sometimes you
do hear stories of elderly people being dismissed as confused,
when actually what they cannot do is understand what is being
said to them.
Ms Herklots: We have quite a way
to go before we have interpreting services which meet what people
need. One of the issues we come across is older people going to
their GP and needing an interpreter and perhaps having a younger
person there doing the interpreting, who may not actually understand
what the older person is trying to express or is going through
in terms of the illness they are presenting. Sometimes also you
find that interpreters may be members of the family and there
may be an issue of confidentiality for the older person. They
may not want to talk about their particular problem with the member
of their family.
Q632 Chairman: Do you have any examples
of good practice across the country?
Ms Herklots: We can certainly
look to see whether we can find those.
Q633 Mr Sanders: How should the revised
guidance on community cohesion, which is coming out of the Home
Office later this year, address the needs of older people?
Ms Herklots: The single thing
it could do which would be really helpful would be to include
older people as both contributors to community cohesion and as
people who can benefit from it. This is a point generally about
policy in these areas. If older people are not specifically mentioned,
the danger is that they will get left out and ignored; not necessarily
deliberately, but simply because they have not been identified.
We should like the community cohesion guidance to include some
measures about consulting and involving other people at local
level in a way which has not been there to date.
Mr Bain: There are also issues
about how you measure effectiveness in terms of progress and there
are several qualitative measures which you can use. I have heard
somebody say that you measure the effectiveness of anti-discrimination
legislation by the absence of discriminatory outcomes. To me that
is an inadequate measure. What you need to do is talk to people
about how they feel about the public services and the community
in which they live and about the people with whom they engage
and do surveys of that, because that is the most reliable measure
of how effective social cohesion has been. Some excellent work
has been done by the Audit Commission in terms of developing measures
for social capital, which is helpful in this context. David Jones
of the Audit Commission is doing some of that. It is also something
about getting an intelligent accountability for our public services
and making sure that the accountability we have is rooted in accessible
and transparent information, above all that the accountability
is rooted in the needs of the communities we serve and the aspirations
they have, rather than is currently the situation, which is a
mixture of centrally and locally derived targets.
Q634 Mr Sanders: Is not the problem,
how you define what the older community is, because it is such
a disparate group and while some of them depend upon public services,
other older people will want nothing to do with public services?
Do they have a legitimate right to a say in how you build a cohesive
community, when maybe they have voted with their feet into a private
road, behind a gate, with private security guards and want nothing
to do with the rest of the community?
Mr Bain: It is an interesting
one. One of the things I do in my spare time is chair a primary
care trust and one of the things which was said to me was that
people were disengaged and not at all politically aware or politically
active or interested in what was happening. My reply to them was:
if you believe that just try to close something.
Q635 Chairman: Do older people really
exist?
Mr Bain: I think they do, because
we are the older people; it is everybody in this room now or in
the future.
Q636 Chairman: The reason I ask is that
you said in the regeneration initiatives that older people are
so often ignored. I have looked at quite a lot of regeneration
projects and very often the people who have been most active in
the community are over 60, but they certainly would not see themselves
as older people. They might think about catering for older people,
who might in fact be younger than they, but they would not see
themselves as older people. Is it fair to say that regeneration
projects fail to cater for the age group over 60?
Ms Herklots: The research we have
commissioned over the last few years certainly suggests that.
We have some research coming out shortly, which shows there has
been some improvement over the last two or three years, particularly
in projects which are inter-generational in focus or have a health
dimension. From our experience, it is difficult to get older people's
needs and contributions into regeneration programmes. People tend
not to define themselves as older people. The point about the
population being incredibly diverse and increasingly so does make
it clearly a challenge in terms of involvement, but no less an
important thing to strive for.
Chairman: On that note, thank you very
much for your evidence.
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