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We write them off as vulnerable, non-sexual burdens – but the elderly are not just a problem to be solved

A new regular column, "Nurse in the City", by Brian Kellett.

Have you heard of the “pink pound”? Of course you have – you read the New Statesman. I’m guessing that you also know about the “grey pound”, the demographic that takes in the elderly of this country.

You will know about the “ticking time bomb” of the ageing population and about how pensions are becoming so expensive that many of us will have to work until we are 68 or older. The elderly are also seen as “bed-blockers” who take up hospital places (though half of their hospital beds have been cut).

As a community nurse in east London, I spend most of my working day seeing people in their homes. You learn quite quickly in this job that the elderly are just as diverse as the rest of us and that it is misleading to refer to them as a homogenous lump. I used to work in various branches of emergency medicine. Back then, I saw patients for a very short time. After many years, I decided that struggling with drunks and dealing with young people who thought that a blocked nose was an emergency worthy of an ambulance were starting to wear a bit thin. Now, I have the time to get to know my patients and they get to know me. In many cases, we are on first-name terms. And each patient is different.

There is a woman I visit who is intensely proud of how clean she keeps her house, despite living on her own and being nearly blind. She has a little rota in her head – on Wednesday morning, she mops the floor (whether it needs it or not); in the afternoon, she vacuums the carpets; on Thursday, she dusts her house from top to bottom, and so on.

Then there is the woman who lives in a very mucky house – the sort of place that has you wiping your feet on the way out – and until recently would refuse all help from us. Finally, she agreed to let some people in to give it a tidy. It’s still dirty but there’s been a big improvement. I like both of these patients equally. They show their independence in different ways; they are quite happy in their way of life.

There are also the sisters who live together and are as thick as thieves (I swear they are conspiring to do something, like in Arsenic and Old Lace) and the woman who was thrown out for marrying a man from India – her family could not stand the “shame”. They drove her not only from her family home but from the village she grew up in.

The elderly, apparently, are nonsexual. Perhaps someone should tell that to the chap who says he enjoys looking at pornography, though “nothing down there” has been working for years, or the other man who has a wife and children but still flirts with me (it probably doesn’t help that I keep insisting on looking at his naked buttocks as part of his care package).

I see atheists, Christians, Muslims, Buddhists, Sikhs and Jews. I see those with pin-sharp minds and those in the midst of dementia. I don’t need anniversaries to remind me of wars because I hear true stories about them on an almost daily basis. As I sit on the floor in front of my patients, bandaging their legs, I hear about how they became friends with German POWs, or how they drank themselves through Italy following their commander, or how they looked after their mates, or how they got to carry the “bastard big gun” because they were the tallest in their squad. For many of them, it was the formative experience of their life, not something simply to be trotted out every 25, 50 or 100 years and “celebrated”.

As I change their catheters, I listen to them talk about their time as union leaders; about strikes and how they did their best for their members. Some of them espouse political views that I disagree with. Sometimes, I nod my head and let it slide; at other times, I’ll have a good-hearted argument.

There seems to be a consensus that the elderly are vulnerable people who get abused in nursing homes, get pensions that are unsustainable, will freeze to death in a cold snap and take up valuable hospital beds, all at the expense of the “hard-working taxpayer”. But what we need to accept is that they are people and not just a problem to be solved.

Next week: Dr Phil Whitaker’s Health Matters

This article first appeared in the 19 February 2014 issue of the New Statesman, The Space Issue

Photo: Getty Images
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Why are boundary changes bad for Labour?

New boundaries, a smaller House of Commons and the shift to individual electoral registration all tilt the electoral battlefield further towards the Conservatives. Why?

The government has confirmed it will push ahead with plans to reduce the House of Commons to 600 seats from 650.  Why is that such bad news for the Labour Party? 

The damage is twofold. The switch to individual electoral registration will hurt Labour more than its rivals. . Constituency boundaries in Britain are drawn on registered electors, not by population - the average seat has around 70,000 voters but a population of 90,000, although there are significant variations within that. On the whole, at present, Labour MPs tend to have seats with fewer voters than their Conservative counterparts. These changes were halted by the Liberal Democrats in the coalition years but are now back on course.

The new, 600-member constituencies will all but eliminate those variations on mainland Britain, although the Isle of Wight, and the Scottish island constituencies will remain special cases. The net effect will be to reduce the number of Labour seats - and to make the remaining seats more marginal. (Of the 50 seats that would have been eradicated had the 2013 review taken place, 35 were held by Labour, including deputy leader Tom Watson's seat of West Bromwich East.)

Why will Labour seats become more marginal? For the most part, as seats expand, they will take on increasing numbers of suburban and rural voters, who tend to vote Conservative. The city of Leicester is a good example: currently the city sends three Labour MPs to Westminster, each with large majorities. Under boundary changes, all three could become more marginal as they take on more wards from the surrounding county. Liz Kendall's Leicester West seat is likely to have a particularly large influx of Tory voters, turning the seat - a Labour stronghold since 1945 - into a marginal. 

The pattern is fairly consistent throughout the United Kingdom - Labour safe seats either vanishing or becoming marginal or even Tory seats. On Merseyside, three seats - Frank Field's Birkenhead, a Labour seat since 1950, and two marginal Labour held seats, Wirral South and Wirral West - will become two: a safe Labour seat, and a safe Conservative seat on the Wirral. Lillian Greenwood, the Shadow Transport Secretary, would see her Nottingham seat take more of the Nottinghamshire countryside, becoming a Conservative-held marginal. 

The traffic - at least in the 2013 review - was not entirely one-way. Jane Ellison, the Tory MP for Battersea, would find herself fighting a seat with a notional Labour majority of just under 3,000, as opposed to her current majority of close to 8,000. 

But the net effect of the boundary review and the shrinking of the size of the House of Commons would be to the advantage of the Conservatives. If the 2015 election had been held using the 2013 boundaries, the Tories would have a majority of 22 – and Labour would have just 216 seats against 232 now.

It may be, however, that Labour dodges a bullet – because while the boundary changes would have given the Conservatives a bigger majority, they would have significantly fewer MPs – down to 311 from 330, a loss of 19 members of Parliament. Although the whips are attempting to steady the nerves of backbenchers about the potential loss of their seats, that the number of Conservative MPs who face involuntary retirement due to boundary changes is bigger than the party’s parliamentary majority may force a U-Turn.

That said, Labour’s relatively weak electoral showing may calm jittery Tory MPs. Two months into Ed Miliband’s leadership, Labour averaged 39 per cent in the polls. They got 31 per cent of the vote in 2015. Two months into Tony Blair’s leadership, Labour were on 53 per cent of the vote. They got 43 per cent of the vote. A month and a half into Jeremy Corbyn’s leadership, Labour is on 31 per cent of the vote.  A Blair-style drop of ten points would see the Tories net 388 seats under the new boundaries, with Labour on 131. A smaller Miliband-style drop would give the Conservatives 364, and leave Labour with 153 MPs.  

On Labour’s current trajectory, Tory MPs who lose out due to boundary changes may feel comfortable in their chances of picking up a seat elsewhere. 

Stephen Bush is editor of the Staggers, the New Statesman’s political blog. He usually writes about politics.