Examination of Witnesses (Questions 260-271)
Baroness Greengross, Professor Anthea Tinker, Dr
Roger Orpwood and Professor Garth Johnson
7 DECEMBER 2004
Q260Lord Mitchell: As an ancient entrepreneur
let me comment on that. I think that it is all a question of disposable
income, and in some ways the 70 and 80-year olds are the last
of an era of a whole section of the population that have not typically
had a large amount of disposable income. I may be wrong on this
but that is my instinct on that. I think that the baby boomers
are moving towards that with more disposable income. I think that
is going to change dramatically because manufacturers respond
to markets, they respond to opportunities, and if there is a segment
there that has a lot of money to spend they will react very quickly.
I am just interested whether in the United States, where presumably
people in that segment have got more money to spend, there are
more products available for people in that area. I do not know
the answer but I just wonder.
Baroness Greengross: I do not think there are.
I think we know all about that. I do not think there are more.
You get now wheelie shoppers and things because more people use
them. You do get those things in our shops now and you are right,
that the baby boomers are in the new market, the mass market and
that this is only a question of us trying to hurry up the process
of it happening.
Dr Orpwood: There is a kind of acceptance of
technology by the baby boomer generation which was not there for
their predecessors. They are much more accepting of pieces of
technology to support their daily activities rather than personal
care from another individual.
Baroness Finlay of Llandaff: As you were
talking I was wondering whether we are just a disability averse
society rather than a gadgets-for-living society. Perhaps there
is a fundamental shift that needs to happen in attitude towards
living rather than disability equals decline equals heading towards
death, a perception which there is in the life of so many people,
in order to get the entrepreneur to pick up the marketing. Perhaps
gadgets-for-living might be the next Mothercare.
Q261Baroness Walmsley: Going back to what you
were saying earlier, why are the manufacturers of these aids so
much more sensitive to the need for a mass market and evidence
before they try anything out than, for example, the food retailing
industry? There is not a big market for pickled walnuts but you
can still get them in Sainsbury's. The food manufacturers are
constantly trying new products. If they work they keep them and
if they do not, unfortunately for those of us who happen to like
them, they discontinue them. Why is it? What is the difference?
Professor Johnson: They do not have to invest
in R&D. There is no research for pickled walnuts.
Lord Soulsby of Swaffham Prior: There
jolly well is. I do it myself.
Q262Baroness Walmsley: There are many products
that you see launched and then they disappear and the food technologists
will have developed those products, so it is not a matter of there
not having been any R&D behind them, but they are floated
and if they do not work they disappear, and if they do work you
see them carry on on the shelves. I am not clear about why there
is such a difference between the manufacturers, or potential manufacturers,
of some of these aids for living, or gadgets-for-living, to use
Baroness Finlay's phrase, which I think she is going to patent,
and the food retailers.
Professor Johnson: The final market size in
that case is important. If your pickled walnuts really are a success
you may sell them to 10 million people quite easily, but if you
produce some modified wheelchair device which is better for manoeuvring
in bathrooms, you will probably only sell perhaps a thousand or
a few thousand.
Q263Baroness Walmsley: But I bet you make a
lot more profit on your wheelchair than you will on a jar of pickled
walnuts.
Professor Johnson: I do not know that that is
true, because there tends to be a monopoly of purchasers who hold
prices down.
Q264Baroness Walmsley: Ah; that might be a point.
Professor Tinker: Also, the baby boomer generation
will be much more used to labour-saving devices and if we market
them that way, as labour-saving, these sensors and things which
come under assistive technology, alarms and so on, they will be
much more acceptable. Just think about the acceptability of a
mobile phone now, which has transformed the lives of some people,
for example, in residential care homes who now can make a phone
call in privacy; they do not have to go to the open hall to talk
their daughter or whatever. I think it is partly a generation
thing which may hopefully change.
Dr Orpwood: Also, there is an awful lot of very
small companies in the whole assistive technology field. If you
go to the major shows and exhibitions that these companies put
on you get a large number of companies which are two or three
or four-men bands making a living out of one or two products.
For them, to introduce something fairly novel is a major investment
and if it does fail it is something which is going to have a major
impact on their business. Okay; there are other companies around
who are much larger and who are able to take those kinds of risks
more easily, but yes, the point you make is a valid one about
why they are more risk averse than some sectors.
Q265Lord Drayson: It sounds to me, listening
to you, that this has all the hallmarks of a market that is in
the very early stages of development, with small companies and
a highly fragmented market. It is because the market does not
yet understand the opportunity. As my noble friend remarked, as
the baby boomer generation comes through this will change quite
quickly. I want to pick up your point about how we can accelerate
this process given that a lot of these products take a long time
and a lot of money to develop. Is there an effective trade association,
do you think, representing companies that focus on this market?
Baroness Greengross: I have to say I am not
quite sure what market it is we are talking about, because we
have now shifted to talking about disability and if you take everybody
with a disability as well as the older person, it is already a
huge market. For example, in wheelchair technology I have seen
some wonderful examples of lightweight wheelchairs made in Japan,
but I do not know how aggressively those are marketed over here.
I just do not know.
Q266Lord Drayson: I am specifically focused
on the market defined by the impact of ageing, and so technology
investment into the environment and into products which assist
people as they get through the ageing process. Is there an effective
trade association of companies who are looking to develop products
and services which addresses that market?
Professor Tinker: There is an association, for
example, for alarm manufacturers. That is an example where they
have responded to the market and in particular one very large
one I will not say has got a monopoly but has got very extensive
coverage.
Professor Johnson: The Foundation for Assistive
Technology is a charitable organisation which essentially promotes
the use of and attempts to promote research and development in
assistive technology. It manages on a tiny budget and employs
about two people at the moment. I work with them. The British
Health Trades Association does not seem to be terribly effective
as I see it in promoting the whole industry. Those are the two
organisations which appear to represent the industry.
Q267Chairman: I would guess that one of the
issues relates to what the banks will lend money on, and they
are much more reluctant to lend money to a small three-person
company with no assets behind them than they are to, say, one
of the big multiple superstores. Since the banks are now in fact
much more interested in care homes for the elderly one gets the
impression that there is a change in perception and even the banks
are realising that there is a major market here because they are
funding all sorts of things, but it has not got through to the
assistive technology end. Maybe that is one of the points we might
pick up, that the awareness of the banks here would make a difference
in terms of who can borrow money to develop a product. One last
theme that has already been touched on and keeps coming up and
we are interested in your comments on is the extent to which the
work in which you are engaged and have knowledge of is dealing
with the problems once they have come up and they are seen as
difficulties for individuals with forms of disability or what-have-you,
as distinct from saying that there is actually a wholeness of
life which can be continued for a much longer period and some
of the focus of our energies and of the groups you represent could
go in that direction. Is there a development taking place there
or is it very much, "There is a problem. Let us see if we
can solve it"?
Dr Orpwood: A lot of the work that is coming
in, looking at things like tele-care and smart homes, for example,
has been very much focused on looking at systems which can provide
security and safety within a given environment. That is fine and
there are obviously issues there that need addressing, and a lot
of evidence is starting to accrue as to the effectiveness of this
technology. As you suggest in your comment, if you have got people
in a given environment where they are nice and safe and secure
they are not going to stick the cooker on and leave the gas pouring
out; somebody is going to sort that out, but there is much more
to their lives than just being safe and sound and secure in that
situation. I think that is recognised more and more by people
involved in that area of technology and there are programmes under
way, and we are involved in one ourselves, looking at what aspects
of quality of life, issues which older people themselves are commenting
on as being crucial to their sense of having some quality of life,
can be influenced through the use of new technology and new design.
I am sure the potential is enormous. Our own programme has got
an enormous great list of about 73 different devices that all
seem to impact on quality of life, and this was for people with
dementia so we are looking at quite a small sector of the elderly
population.
Q268Chairman: Could you give us some examples
of the potential products?
Dr Orpwood: The particular work I am talking
about started very much as a quality of life survey, so it was
looking at people with dementia, trying to see from discussions
with them, with focus groups and with their carers what kinds
of issues underpin their quality of life. A whole range of things
came out, such as social isolation, a sense of not being in control
of their lives. We pulled this lot up and we were keen to encourage
all the social sciences who were not doing that work not to think
about technology but just try to pull down the ideas that these
people were suggesting. That was a wonderful starting point for
people like Professor Johnson and myself to engage researchers
in to explore ways in which new technology can have an impact
in this area. Some of the ideas may sound slightly wacky but once
you get involved in exploring their potential and working with
people to see what impact it is having, then some of them do not
seem quite so stupid. For example, in the area of trying to reduce
social isolation there was some very nice work done in York looking
at the impact of phone conferencing on older people, trying to
give them a sense of being engaged with the local community and
having a chat through phone conferencing. Actually, phone conferencing
is not easy to do. You have got no eye contact, you have got no
means of knowing who is about to talk or whatever, and yet people
got enormous satisfaction out of that to the extent of knowing
it was coming up and dressing up because they knew they were going
to get their conference call in a moment.
Q269Chairman: You do not do this in your dressing
gown. Some of us saw a little bit of that a couple of weeks ago
in New York. There is one very specific thing and I would be interested
to know if there is any background research being done on this.
I am thinking of people with dementia that is beginning to come
on. One of the big things, especially if they are not 65, but
equally if they are over 65, is, "Can I continue in any form
of employment?". Is there any accessible source to which
an employer can go—and I know of cases where this has been
done on a one-to-one basis—and say, "X clearly has
the following profile. I am told that Y, Z and A will happen to
X. What kind of work pattern could I reasonably expect if I were
to keep this individual in the company?". As I say, I know
of examples where that has been done but I do not see a lot of
evidence of support which can be given so that the employer can
make knowledgeable judgements about that.
Dr Orpwood: There are two sides to that. One
is the advice of people who have an understanding of dementia
and its progression and the impact it is going to have on their
capabilities, and there are organisations around which can provide
that kind of support. The other is access to some understanding
of what support equipment there might be around, for example,
if somebody has got a developing memory problem some kind of reminder
type of device which can enable them to flag up that at half three
something has not happened. Quite often these things are stuck
on notepads and somebody will write down, "Half three you
have got a visitor", or whatever. All the device does is
make a noise so that it reminds them to think about something
that is coming up. There is quite a lot of equipment like that
around. One area that certainly hits you quite loudly, working
with people with dementia, is that there is no collective source
of information about that kind of product, there really is not.
The various databases that have been set up go quite quickly out
of date. We have had some discussions with a number of the marketing
companies in the assistive technology area to say, "Look:
there is an enormous market here. There are hundreds of products
that could be applicable to people with dementia. Why do we not
pull them together into some sort of catalogue?". I think
we are getting some success but it is amazingly hard work to try
and show them that there is a market for this kind of equipment.
People do not seem to see that there is a link between dementia
and supportive technology and that there is an enormous amount
that can be done with fairly simple pieces of equipment.
Q270Chairman: There is an assumption that it
is all or nothing, which it is not, in fact.
Dr Orpwood: Absolutely.
Q271Baroness Finlay of Llandaff: Going back
to my question about universities, do you think that the RMU,
as it has now been re-formatted, is going to help at all or hinder?
Professor Tinker: You may know more about this
than I do but I do not think the format has changed all that dramatically.
It is still going to be your four international peer reviewed
articles and the amount of research that you brought in and your
international reputation. Obviously, there are things to be said
for that but I am not sure it is going to help people like us
who are desperate to spend time disseminating and doing more research
with unsexy subjects. A lot of the things are very mundane. I
am sure you are looking at the extreme of assistive technology
and all the wonderful new gadgets and so on, but the reality for
many older people is how do you get the funding for basic adaptations,
level access showers and so on, and how do you get people to know
about them? It is very basic stuff and people like me do not have
the resources to go round the country talking about this.
Baroness Greengross: That is the key to this,
that is where the integration needs to take place, whether it
is the primary care trust or whoever has to take responsibility
under the label of continuing care or whatever it is. Somebody
has got to bring those things together because assistive technology
is only one bit. I think we said in our evidence that there are
17 million people now with some sort of chronic condition, long
term condition, and these people are not just to be thrown in
the rubbish bin. There is a lot they can do but it needs to be
brought together so that the research that is being done is not
just wasted because it is not put to good practice. If you as
the committee could influence that it would be wonderful. I am
sure you can.
Chairman: I am sure if we can we will
think it is wonderful as well. I thank you very much for what
has been a very interesting session. I will just repeat my request
that if there are points that you think you could have developed
further do let us have a response as soon as possible, because
we hope to begin to pull ideas together early in the new year.
Thank you very much.
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