Whenever the inquiry into Covid-19 reports, one of the big issues will be the transfer of elderly hospital patients into the care system and the resulting death toll.
No doubt the finger of blame will be pointed at some individuals, but in truth this was a systemic failure, whereby our clinical and personal care services operate separately. Unless we integrate that care, the risk of similar failures remains. So I hope and want to see all MPs collaborate to help reform the system.
Those reforms will need to include housing for the elderly. After all, poor housing costs the NHS £1.4bn every year, according to the Building Research Establishment. Equally, many people end up in care homes because they can no longer manage in their own home. An effective strategy will therefore need to improve both the quality and quantity of housing for the elderly.
There are many elements to this, such as future care packages or helping people move home, so let me look briefly at the existing housing stock and new developments.
Better homes now
First, the existing housing stock needs upgrading or adapting. Too many family homes prove difficult to manage in later life, with excess cold and the risk of falls being the most common problems. The Centre for Ageing Better reckons some 2m older households currently live in unsuitable homes.
Yet there are existing mechanisms which, if better supported, could make a real difference – for example, expanding Home Improvement Agencies or doubling investment in the Disabled Facilities Grant. It’s about delivering practical help in our communities, not grand new schemes.
Second, we need to deliver more homes which meet older people’s needs. The number of people over-65 is due to increase by 20% to 12m in just seven years from now. An acute problem is about to get even worse.
What’s needed is a clear strategy that removes the barriers to people moving, and which creates a clear regulatory framework within which investors, developers and specialist providers can operate with confidence. This strategy should be led by a cross-cutting minister able to work across both the NHS and local government.
Planning needs to explicitly allocate land for senior housing, based on specific assessments of local need. There are some excellent councils leading the way – but they are the exception.
All new homes should be built to the lifetime homes standard, to help the current elderly generation but also future generations. This is not hugely expensive, as the Commons Select Committee discovered when we investigated this issue in 2018.
A new role for town centres
I also believe that we need to rethink where we build for the elderly. For too long senior housing has been stuck at the edge of our towns. It is sadly symbolic of the priority we have placed on this issue.
However, the need for our town centres to find new purposes offers a great opportunity. Senior living could be one of those new uses in many towns, putting our elderly back in the middle of communities and creating new footfall which many consumer businesses urgently need. It won’t be right for all town centres or appealing to all of the elderly, but it could work well for many.
What matters, however, is ensuring this policy develops alongside the likely political push for integrating health and social care. Housing, especially for senior citizens, is a vital component of any healthy society. It’s time to get this right.
Mark Prisk is a former MP and housing minister
