The next item is the debate on the Health, Social Care and Sport Committee's report on loneliness and isolation. I call on Dai Lloyd to move the motion. Dai.

Motion NDM6654 Dai Lloyd

To propose that the National Assembly for Wales:

Notes the report of the Health, Social Care and Sport Committee on loneliness and isolation, which was laid in the Table Office on 7 December 2017.

Motion moved.

Thank you very much, Deputy Presiding Officer. I'm very pleased to open this debate today on the Health, Social Care and Sport Committee's report on loneliness and isolation. As we all know, loneliness and isolation affect anyone at any stage in their lives. There is evidence to suggest that loneliness and isolation can have a significant impact on our physical and mental health. It can cause depression, sleep issues and even cardiac problems. I’m sure that we’ve all heard the statistic that experiencing loneliness and isolation can be as bad for you as smoking 15 cigarettes a day. So, by reducing the number of people who experience these issues, we should help to reduce the demand for health and social services.

The committee agreed that one of our early priorities would be to look at the scale, cause and impact of loneliness and isolation. While we are acutely aware that many other groups of people experience feelings of loneliness and isolation, this inquiry has predominantly focused on older people. Wales has a higher percentage of older people within its population than any other part of the UK. We hear that 18 per cent of people in the UK feel lonely 'always' or 'often', which is the equivalent of almost 458,000 people here in Wales. This figure is particularly worrying as we were told that many older people are too embarrassed to admit to feelings of loneliness. The figure could, in fact, be significantly higher.

Between January and March last year, we ran a public consultation. We received 39 written responses, representing a range of healthcare organisations, professional groups and third sector organisations. We heard oral evidence from a number of witnesses, and I took part in a Facebook Live broadcast to launch the inquiry, encouraging viewers to share their thoughts on the prevalence of loneliness and isolation and the potential causes. 

Committee members also took part in focus group sessions in Newport as part of the Senedd@Newport programme. We met with people experiencing loneliness and isolation and those involved in initiatives to support them. It was with great pleasure that we were able to return to Horton’s Coffee House in December to launch our report and to hear from this same group of people about what they thought of our findings. I would like to thank everyone who contributed to our inquiry.

Now, turning to the conclusions and recommendations of the committee, we’ve made six recommendations to the Welsh Government, which we hope will contribute towards delivering the solutions needed to address this important issue. I would like to thank the Minister for the positive response to the committee’s work.

Our first recommendation relates to the Welsh Government’s commitment to develop a cross-government, national approach to tackling loneliness and isolation. We welcome this commitment, however, we are concerned that it is not due to be delivered until 2019, by which time so many more of our older citizens will have experienced the adverse effects of loneliness and isolation.

The importance of addressing loneliness and isolation cannot be underestimated, particularly given its impact on health and social care services. Given the increasingly ageing population of Wales, action is needed now to prevent the situation worsening. We are particularly concerned about the over-80s age group.

As I’ve mentioned, proportionately, Wales has more people in this age range than any other part of the UK. People in this group can potentially be at greater risk of becoming lonely and socially isolated as a result of increasingly complex health needs and limited mobility, which in turn impacts on their ability to engage in a wide range of social activities.

We have, therefore, recommended that the Welsh Government review the timescales for the development of its strategy, with a view to publication before 2019, which the Minister has partially accepted. We recognise the scale and breadth of the challenge ahead of us in tackling this issue and we welcome the Minister’s commitment to keep this timescale under review and to take action, where possible, earlier than 2019. 

A number of respondents to our inquiry commented on the ways in which loneliness and isolation affects the use of public services. For example, we heard that people experiencing loneliness and isolation are more likely to visit their GP, to take higher rates of medication, to be at a greater risk of falls, to have a greater likelihood of entering residential care, and to make more use of accident and emergency services. 

Many of these services are already available; we need to concentrate on raising awareness and facilitating access to them. We heard that low-level intervention for people experiencing loneliness and isolation could be of benefit. Ironically, the restrictions on public sector finances mean that it's these services that are most likely to be cut. There was also a suggestion that interventions of this kind could lead to savings for the public purse in the long term. However, there's no robust evidence at present to support this suggestion. We've therefore suggested that the Welsh Government should undertake or commission work to assess the impact of loneliness and isolation on health and well-being, and whether people experiencing these issues make increased use of public services. That was recommendation 3.

As the Minister notes in his response to the recommendation, avoiding an escalation in people's needs to a point where they become chronic and long-term is central to reducing avoidable pressure on public services. I am grateful for the acceptance of this recommendation and commitment to supplement the evidence provided to the committee through commissioning independent targeted research on the use made of public services by people experiencing loneliness and isolation and the associated costs of this.

Recommendation 4 relates to funding for the voluntary sector. The pivotal role of voluntary groups in providing the wide range of activities and support that help address loneliness and isolation is widely acknowledged, and we were impressed by much of the work that we heard about. Voluntary bodies are uniquely placed to respond to the needs of local communities and to draw on local resources, such as volunteer staff. However, the short-term nature of these funding schemes and the complexity of obtaining a grant can present a challenge to these smaller organisations. Too often, successful projects are forced to close when funding ceases. We therefore believe that funding needs to offer greater continuity and stability to voluntary sector services—for at least three years—if they are to have an enduring impact in local communities.

It's disappointing that the Minister has only partially accepted this recommendation, as we heard from those providing these vital services how staff motivation can be affected by small-scale and short-term funding, and the need to regularly seek new sources of funding. However, I do welcome his assurance that the development of an approach to tackle loneliness and isolation will include further work with the voluntary sector and local government to determine what more can be done to establish financial stability for key services.

We were impressed with the evidence that we heard on intergenerational contact, which can sometimes be more beneficial than contact with one's own age group. We know that there are pockets of good practice happening around Wales, and believe that the benefits of such schemes need to be evaluated, with a view to rolling them out more widely. We have therefore recommended that the Welsh Government should undertake an evaluation to assess the impact of intergenerational contact on people experiencing loneliness and isolation. That was recommendation 5. If the evaluation highlights benefits of such contact, the Welsh Government should ensure that best practice in this area is rolled out across Wales.

To conclude, I would like to turn to the issue of stigma, mentioned in recommendation 6. One of the biggest issues we came across was stigma. People are too ashamed to admit that they are lonely, so the extent of this problem could be much worse than is currently assumed. This is particularly true amongst men, who present a much higher suicide risk. We also heard about the cycle of loneliness, where people are too embarrassed to admit that they need more help and they withdraw from society. The more disengaged they become, the more likely they are to become lonely and isolated, and the less likely they are to access the help they need.

We are all very aware of the excellent work of Time to Change Wales in making it easier to talk about mental health. Our recommendation, therefore, calls for a similar campaign to change public attitudes towards loneliness and isolation. As the Minister rightly points out, although loneliness and isolation have received increased national attention through the work of groups such as the Campaign to End Loneliness, Age UK and the British Red Cross, there remains work to do to raise public awareness. So, I welcome his positive response to this recommendation, and I look forward to the development of a national awareness campaign. I look forward to the debate. Thank you very much.

Diolch. I do have a number of speakers for this debate. With the last debate, many of you actually didn't take the full five minutes, which allowed more of your colleagues to come in. So, perhaps I could just ask you to think about that and we'll try and get everybody in. Lynne Neagle.

Thank you, Deputy Presiding Officer, for the opportunity to contribute to this debate. Loneliness and isolation might have been seen as a peripheral subject a few years ago, and I am pleased that we have prioritised it in the health committee and that there is growing public awareness of the damage loneliness can do to our health. We are all becoming familiar with the public health impact of loneliness and isolation such as the often-quoted statistic that it can be as damaging for your health as smoking 15 cigarettes a day. But, I wanted to focus my remarks today on the fact that loneliness and isolation are a significant risk factor for suicide.

When Samaritans Cymru gave evidence to the committee, they said that they wanted to move the actions that are taken to tackle loneliness into a much more serious space, and I believe that is crucial, because tackling loneliness and isolation saves lives. Yesterday, I, along with other Members, attended the launch of the Samaritans Cymru report on socioeconomic disadvantage and suicidal behaviour in Wales. The report makes 10 concrete recommendations on how Wales can reduce the number of suicides. I could spend at least five minutes talking about each one, and I hope that Members will pursue the recommendations in this excellent report in the months ahead. But, as I have only five minutes, I wanted to highlight one message from the report—that community groups should be seen as a form of prevention and early intervention for loneliness, isolation and social support in Wales, and that policy solutions should be worked up to increase community participation. Being connected to others saves lives.

I really welcome the Welsh Government's commitment to tackling loneliness as a national priority, but we now need to see that translated into real action. Some Government policies in recent years have been going in a different direction. The Communities First programme was raised with the committee in evidence. Often criticised for fostering softer initiatives rather than hard-edged employment-focused ones, it is often those kinds of projects that are essential in delivering the connectedness that is so vital in tackling isolation. In September, for example, I attended the Gofal Gwent service user forum, and I met service users there with serious mental health problems, who told me that they wouldn't have been able to leave the house without the support of their local Men's Sheds group, previously funded by Communities First.  

I was grateful to Rebecca Evans as the previous Minister for her engagement with me about the threat to funding for Let's Walk Cymru. I know that she understood, as I do, that such groups are not just about physical health. For many of the walkers in my constituency, Let's Walk has been a vital way to tackle loneliness, often after the loss of a spouse. I'm delighted that the funding has been continued, but it should not have been under threat. We must make sure that our commitment to tackling loneliness cuts across Welsh Government policies.

On Friday, a lady came to my surgery who was deeply worried that the pressures on adult education funding had led to charges being introduced for people who were on benefits to attend her local art class, some of whom had disabilities. Again, for some of those people, that art class is a lifeline. Now, we all understand the massive financial pressures we face, but we need to view these decisions on an invest-to-save basis. The costs of social isolation and, indeed, suicide are much, much higher. We have to match our rhetoric on prevention with action.

I wanted to conclude by talking about young people. There is a perception that loneliness and isolation is mainly a problem for older people. It is not. Samaritans Cymru told us of a Mental Health Foundation survey that found that 18 to 34-year-olds are more likely to feel lonely often, to worry about feeling alone and to feel depressed about loneliness than the over-55s. They told us that there is increasing evidence that social media may be causing loneliness and depression in teenagers, and that a recent study on using social media for two hours a day doubled the chance of a person experiencing social isolation. The Children's Commissioner for England recently published a report into social media use by 8 to 12-year-olds called 'Life in Likes', which found that even very young children are becoming overdependent on likes and comments for social validation. It is impacting on their mental health, and that has also been a strong message in our committee inquiry into the emotional and mental health of children and young people in Wales.

This matters, not just because we want our young people to have good mental health, but because young people are a high-risk group for suicide. It is a national scandal that four schoolchildren die by suicide every week in the UK. Papyrus, the prevention of young suicide charity, as part of their campaign to reduce the number of suicides among schoolchildren, called Save the Class of 2018, have launched a campaign to raise awareness of the impact of negative social media on our young people. They have produced a very hard-hitting film called Bedtime Stories, which encourages us all to be aware of the impact of social media. I would encourage everyone here, especially those of us who are parents, to watch it. Thank you.

To be honest with you, what I was going to say I think both Dai and Lynne have covered extremely well. So, my message to you, Minister, is along these lines: when I took part in this committee inquiry, I was absolutely staggered to understand just how big this problem is. Not very long ago, we passed a public health Bill, and we talked about trying to make people slimmer and fitter, and make sure that there were loos everywhere, but we didn't actually talk enough about how we make sure that, no matter what age you are, you feel integrated into a society that's becoming increasingly frantic and frenetic. And I think that, for those who are not part of our inner caucus, it is worth just saying what the difference is between loneliness and isolation. I'd like to give you an example of one particular case I have at the moment.

So, you can be lonely if you are an older person and you're in a care home, and you're surrounded by loads of other people, and they're all saying, 'Come on, let's go off to the aromatherapy, and let's go and watch telly, and let's do bingo', but if you've never been a joiner-inner, if you've never been adept at building your social networks, if you've never had that emotional resilience, then why are you suddenly going to develop it at 75 or 80, or 65, or whatever it is, usually when you've lost your significant other? Because that's when the loneliness really bites.

Isolation is when you are literally missing the contact around you. You could be a farmer stuck up a track. Or, in fact, you could be like a gentleman that I have in my constituency, and he lives in a very large town—I won't identify it too much, because I don't want to give away his identity. But he lives in a little bungalow that's on the edge of a very busy road. He sees nobody. However, he sees the world: he sees the cars going by, he sees the schoolkids to queueing up for the bus, and he feels a little bit of a connection. Unfortunately, the person who owns his property is going to sell it, and he is going to be moved away. And, you know, the housing association very kindly want to go and pop him into a nice little bungalow, but where he won't see anybody, where, once that door closes, that's it; he's on his own, he is truly, truly isolated. And I will predict that that elderly gentleman, with his enormous widescreen tv—because that's all he has, and I've been to his house—because that's his companion, from nine in the morning when he switches it on until he goes to bed at night, he's just going to become more lonely, he's going to become more isolated, he's going to become more depressed, and he will eventually start having to lean on us, on our social services, on our healthcare as his health plummets. And if I took away nothing from that committee report, it was about how we need to support people in their older age.

And I do just want to pick up one point that Lynne made. Although our report, or our inquiry, focused on older people, we cannot forget the young, because the danger of social media is that we forget how to make relationships. We click on Facebook or Twitter, or whatever it is, and wow, we've got 450 friends. Of course, they're not real friends. They don't know who your mum is. They don't know if you've got a dog. They don't know what you like for your tea. But you think they're friends. And we are rearing a generation that is actually making very shallow connections. So, what happens when that young generation becomes our middle-aged generation and then our older generation? Because then they will truly understand what loneliness and isolation is all about, when they look to Facebook and actually find those 400-odd friends really, really don't exist—they're a chimera.

So, I think it's really important. And I would beg you to please bring forward your strategy as soon as possible. And in your partial acceptance of recommendation 1, when you said that, in the meantime, you would look to try to grow good projects, we saw plenty of good projects in our committee, from Men's Sheds to Ffrind i Mi to community connectors—the whole plethora. They need support, they need encouragement, they need empowerment, and I would ask you to do that.

I'm pleased to have the opportunity to contribute to this debate. Very rarely in my life, I think, have I truly felt alone. I'm very lucky in that respect, and I do hope that most people in this place would have similar experiences, although having many people around you doesn't necessarily mean that you can't also feel lonely and isolated. That is something that we learnt during our inquiry, which was certainly an education for me and, I know, to my fellow Members. What the report that we have does, of course, is remind each and every one of us, whatever our personal experiences may be, that loneliness and isolation are very serious issues that impact on very many people, and constituents of each and every one of us in this Chamber today.

I'm grateful to those who have been contacting us over the past few days before this debate. The British Association of Counselling and Psychotherapists reminds us that 25 per cent of older people can feel lonely and isolated, and that is a huge number, particularly, as we've already heard from the committee Chair, where this has an impact on people's health—it doesn't just make you feel slightly depressed, and that you'd want to have some company, but it can have a serious impact on mental and physical health. Another group that's been in touch is Age Cymru, who talked about the amenities and the resources that have been lost, or are at risk of being lost, because of financial pressures, including public transport, and that there are things that we can do to invest in tackling loneliness and isolation.

But I will just make a few comments very briefly on two specific recommendations. The final one—having a communications background, messaging is something that's very important to me. Recommendation 6 talks about awareness raising and changing attitudes towards loneliness and isolation, and addressing the stigma associated with them. I was reminded of a tweet that I saw—and I have it on the screen in front of me—it was around a month ago, a little under a month ago, from a good friend of mine, She is a well-known individual, Ffion Dafis, the actress and presenter, and what she said in her tweet, and it struck me at the time, is

'Because of the nature of my work, I have free days on occasion when I could be visiting people who are alone but I don't know who or where I should contact.'

And she makes an appeal for information, and I thought, 'Yes, how often have I heard someone say something like that?' Not very often at all, certainly by people from my own generation. There are ways in which we can all, through having awareness of loneliness and the need to tackle it, play our part in addressing that loneliness, by contacting and offering companionship to people. The response to the tweet was very interesting, with many people proposing ways in which Ffion and others could give of their time. There are organisations—chapels, health boards and charities of all sorts—that provide routes for individuals to assist people through their loneliness.

But that brings us to our first recommendation, namely the need to have a strategy in place to address loneliness, because this is the role of Government: to provide guidance and leadership to all of those organisations and individuals who understand the scale of the problem of loneliness in terms of the steps that we could be taking to address it. I'm pleased that the Government has responded positively, accepting or accepting in principle the recommendations made by our committee, but I do think that what I've heard, and what fellow Members have heard, certainly demonstrates that we do have an acute problem in Wales in terms of the scale of loneliness and isolation. My appeal is that the Government should show that leadership as soon as possible by publishing a strategy that will truly make a difference.

I would like to place on record my thanks to the committee clerks and all those who gave evidence to our committee during the course of our inquiry, and to our dedicated Chair. It is a sad indictment of our society when you consider that around one in five of people in Wales are lonely. Over half of people aged over 25 live alone and research by Age UK found that many older people can go five or six days without speaking to a single person. Research shows that loneliness and social isolation are as damaging to our health as smoking three quarters of a pack of cigarettes a day. Loneliness increases the chances of an early death by around 45 per cent and is associated with an increased risk of developing coronary heart disease and stroke. Lonely individuals are also at higher risk of the onset of disability and also suicide.

In a work capacity, someone once said to me, 'You're asking me to confide in you and to tell you what is wrong, but you don't know of my yesterdays or even my todays, but you can help me maybe have a better tomorrow.' It is therefore incumbent upon us all to make people feel worth while and wanted. I was therefore delighted when our committee opted to undertake an inquiry into loneliness and isolation, given the real public health concerns.

Witnesses to our inquiry all underlined the health impacts of loneliness and isolation as well as outlining the myriad causes of and contributory factors to loneliness and isolation. One thing was clear: although loneliness can strike at any age, it is particularly heartfelt in our older population. Closure of post offices, banks, local shops, community services, public toilets, and the growing trend to automation have all contributed to a situation whereby many older people go days and weeks without speaking to another human being.

We also learnt of the fantastic work being undertaken by voluntary groups across Wales to address loneliness and end isolation by providing a whole raft of activities and support services—Men's Sheds, for example. Whether it's Ffrind i Mi in south-east Wales, Welcome Visitor at Home in south-west Wales, Ponthafren in mid Wales, or Contact the Elderly in north Wales, these organisations, and hundreds like them, plug the gaps left by our shrinking social care sector. They are pivotal in addressing loneliness and isolation. It is our job to ensure that these groups are supported and funded to continue doing what they do, across every part of Wales.

Our committee recommended that the Welsh Government works with the voluntary sector and local government to secure the funding stability needed by these organisations by introducing three-year funding programmes. I had hoped the Welsh Government would fully accept all six of our recommendations. It is therefore disappointing that the Welsh Government could not fully commit to this recommendation. You accept that short-term funding can be costlier, but wish the flexibility to make short-term decisions. Short-term decisions based on financial pressures are just the sort of decisions we have to move away from.

Welsh Government are proud of their invest-to-save programme. Well, the London School of Economics have undertaken research that shows that every £1 invested in addressing loneliness and isolation can save £3 in costs to our NHS. These voluntary organisations are a lifeline to our older people and deserve Government support. I urge the Welsh Government to reconsider and to accept all of our recommendations. Diolch yn fawr.

I think I would be agreeing with virtually all the comments that have already been made this afternoon. There was a great deal of consensus in the committee, and we heard some very powerful evidence from a number of organisations and bodies that led us to our report and the recommendations in it. 

For my contribution, I just want to really make some general observations on the issues around isolation and loneliness, rather than focusing on any of the specific recommendations, because it's a huge irony, isn't it, in the days of the internet, of knowing that people can FaceTime each other from four corners of the globe, that on our very doorsteps, here in our communities, we find the problems of loneliness and isolation.

I think this partly reflects the stresses placed on the social fabric of our communities. Too much of the public realm, too many of those things that we all hold for the common good, are being sacrificed in these times of austerity, and surely it's for all of us to place a far higher premium on retaining those shared spaces that allow people to make connections with each other. And by shared spaces, I don't just mean the physical buildings, important as they are, but also those networks that bring people together. After all, it is the social networks that provide the foundations of so much care and resilience.  

So, while the inquiry established that the problems of loneliness and isolation are most commonly associated with older people, and that was very much what we concentrated on, the issues outlined in this report do affect a wide range of other groups, and Angela Burns touched on that, as did Lynne Neagle. I'm pleased that the committee will be doing some further work on this as well, but it would be good if the Minister can confirm that the Welsh Government will secure a cross-departmental approach in the forthcoming strategy that will address the wider issues of isolation and loneliness across other groups in society, including ex-service personnel, single parents, young people, as we've already heard from, to name but a few, because the report shows why investing in measures to prevent isolation and loneliness makes good economic sense for all parts of Government. 

We've already heard about invest-to-save—that's been mentioned by a number of speakers today—and this is an invest-to-save activity. If we can help to provide people with stronger networks, then we're less likely to have to tackle the acute deterioration of physical and mental health conditions associated with this problem, conditions that in the most extreme circumstances, as Lynne Neagle has already said, can lead to the tragedy of suicide and other forms of self-harm. 

Now, as Dai Lloyd mentioned in his opening remarks, one of the most enlightening areas of our inquiry for me was the importance—it was evidenced—of inter-generational contact as a simple cost-effective, and I'll use the word 'therapy', for want of a better word. That allows me, I think, to briefly mention a project that I had some personal involvement with that showed the value of that inter-generational activity. 

Shortly before Christmas, Merthyr and Tredegar Only Boys Aloud choir visited care homes in the area to sing Christmas songs and carols with residents as part of their Home for Christmas initiative, linking young and older people together through music and song. And I had the great pleasure of joining those young boys to sing a song or two at the Greenhill Manor Care Home in Merthyr Tydfil. The main point of that was to give me the chance  to witness the mutual pleasure of older and younger people joined together in the simple joy of music and song. And what I saw there was joy and healing in progress, and for a few short hours people enjoying social connections, irrespective of their age. It was an absolute pleasure to witness it, and it was a pleasure to be part of it. 

In 2016, Llywydd, I was very proud to campaign on a manifesto that committed to addressing the issues of isolation and loneliness, so I am pleased that the Government has responded positively to our report as they bring forward their strategy. And in closing, Llywydd, I also believe that in bringing forward a clear plan of action for Wales, we will pay our rightful respects to the former MP Jo Cox, and the invaluable work of the foundation established in her name, which is continuing the work of the loneliness commission that Jo established to bring about a step change in the public policy response to the UK's loneliness crisis—a crisis that all of us, and not just Government, have a duty to address.    

I'm grateful to speak today on this crucial issue, following our committee report launch at Horton's Coffee House in Newport. Loneliness and social isolation is one of the defining issues of our time, an epidemic affecting all ages in all parts of our communities.

The impact of social isolation is alarming: 75,000 people in Wales report always or often feeling lonely; loneliness can be as damaging to your health as smoking 15 cigarettes a day; it can be as risky as obesity; and it can affect anyone at any time in our lives. While these worrying statistics go a long way to show how significant the problem of loneliness is, I think it's the human stories that have really driven home the need for something to be done. Throughout our inquiry, we certainly heard those voices loud and clear. One particular story comes to my mind, which a GP shared with me. She'd been treating an elderly patient who was recovering after coming out of hospital. She had been visiting the patient once a week, and after a few weeks of regular visits, she told the woman that she had made a full recovery and no longer needed to regularly see the doctor. The woman was visibly upset to find this out. She didn't want the visits to end because the GP and the district nurses were the only people she saw from week to week. We heard other similar examples of the serious impact of social isolation and loneliness.

We know that any of us can become isolated or lonely as we grow older for many reasons, often beyond our control. Loneliness and isolation are both a cause and a consequence of problems with mental health and one that often fails to be addressed due to the stigma surrounding it. In fact, as Lynne Neagle mentioned, the report launched by the Samaritans yesterday highlighted loneliness and isolation as a risk factor for suicide.

Recommendation 6 states how vital it is that we end the stigma surrounding loneliness. Raising awareness should be the first step in tackling the issue itself. Many people don't want to be tagged with the word 'lonely', and factors can mask a root cause. We can see from our engagement throughout our inquiry that there is a significant will and essential need to tackle this problem.

Our inquiry found that much good work is already being done across Wales. We heard from many organisations throughout the consultation, and I hosted a round-table discussion with Age UK in my constituency last summer to share examples of projects that are tackling loneliness and to see how best practice can be spread.

In recommendation 4, we made clear the need for Welsh Government to work with the voluntary sector to provide stability for the services that so many depend on. So much of this work is done by volunteers. One excellent example is Ffrind i Mi. It's a service in Aneurin Bevan health board led by divisional nurse Tanya Strange, who really is a force of nature. It aims to tackle loneliness and isolation by matching volunteers to people based on their hobbies and interests. The idea is to say, 'Let me introduce you to a friend of mine.'

Ada is a prime example. Ada is 93 and became lonely and isolated after her husband died. She'd been a carer for her husband who had dementia for over 10 years and, like so many others, the commitment of caring meant that she had lost touch with her close friends. When her husband died, she found herself feeling isolated and alone. Ada was referred to Ffrind i Mi, and it helped her so much that Ada is now a volunteer, helping others who feel so isolated and lonely. She meets another woman every week for a coffee and a chat in Newport city centre, and both reap the benefits of their new friendship.

The issue does not only affect our elderly, as other Members have said. Our report is wide reaching, but doesn't even scratch the surface when it comes to loneliness amongst young people, veterans, new mothers, BME groups and the LGBT community amongst others. I was shocked when I attended the Ffrind i Mi launch to recognise a face in the video. Rob Wiltshire was two years younger than me at school and had gone on to join the army. Now a veteran in his 30s, he felt so far removed from his support network on his return to the UK that he battled with feelings of isolation and loneliness. He found Ffrind i Mi and has gone from strength to strength. But while schemes like this make an invaluable contribution to the lives of people like Ada and Rob, we need to plan for the future and take a more holistic approach to dealing with loneliness and isolation, which is highlighted in our recommendation 2, and this is vital.

Another Newport resident, Carol Beaumont, said at our inquiry launch how important it is to be able to know about services easily, for example, through community connectors, and we need to use the rich resources that we already have in our communities and ensure that information is available and accessible for people wherever they may need it. We have a proud history of community in Wales, and we know that we have the highest proportion of older people in the UK. It's a public health issue that must be a national priority, and it needs to start now. Tackling it will not only improve people's lives, but it will help reduce demands for health and social services.

Joyce Watson.

Diolch, Dirprwy Lywydd. I thank you for calling me in a long line of speakers, and I aim to be brief. I very much welcome the report and I also welcome the commitment from the Welsh Government Minister and his resolve to tackle the causes. The causes are manifold, and I'm not going to repeat all those ones that people have discussed today. But I do think that we need to remember that loneliness doesn't only reside in the elderly. Although it does reside in the elderly, it resides in any one, anywhere, of any age group, at any time, because it's, as Angela Burns so eloquently stated, very often a position you find yourself in.

But it is also connected, sometimes, to the facilities and services around you, and I have spoken here about bus regulation to try and ease the passage—I do use those words wisely—of transport for people in rural areas. Because if we can use those powers so that we don't end up in a situation where there's a stop-start position on bus travel in Mid and West Wales, with companies going bust, people can keep and maintain the companionship that they gain on public transport. The same is said of other services, like free swimming. I think it's those things that we need to join up now, where they're working for individuals, where people can access their services, their facilities and actually gain some friendship. We need to join them up together, and I hope that that will form part of what you do.

Can I thank the committee for actually working on this report? As the older people's champion for our party, this is a key issue, and it's something that I've worked with Sarah Rochira on. The sheer numbers of people reported as experiencing loneliness and isolation: 18 per cent of the UK population, equating to almost 458,000 people in Wales. Again, amongst older people, 25 per cent report being lonely, 27 per cent socially isolated. Seventy-five per cent of women and 66 per cent of men over 65 years of age are now living alone.

We often rush to think of older people in this regard, but this report, and evidence here today, show that this can impact on a much wider range of social groups. Our younger individuals are finding themselves worthless as a result of living alone, often resorting to social media as a means of dealing with the realities of isolation, and, quite often, this is their only means of actual communication with the outside world. LGBT and BME communities are really affected, bringing further isolation.

The cost of loneliness and isolation to our public services and productivity is £2.6 billion a year. There is a £427 million cost to our health service, not to mention the cost in real terms to the quality of life and longevity of each one of these individuals.

The relative ease and low cost of tackling this issue—and I say that because a lot of the issues we deal with here need Government resources. There's a lot we can do in terms of support, and we could all do, actually, within our own communities. Prevention is key, and the sooner we act, the better. Value for money in terms of investment is clear. The Eden Project estimates that disconnected communities cost the Welsh economy in excess of £1 billion a year in terms of lost productivity. Yet simple measures such as reinvesting in local and community transport and supporting buses, an area that has faced cuts of over £4.2 million, over 20 per cent, since 2011—. So, whilst we're talking about it, we're actually seeing negative things coming forward that are making the situation worse. On our health and social services, in particular, the impact is considerable.

Tackling these issues could prevent otherwise unnecessary GP appointments and visits, freeing up vital resources for our already stretched GPs. The additional associated health implications add to NHS pressures: depression, high blood pressure, increased risks of heart attack, stroke and dementia, to name but a few. We know that the British Red Cross estimates that the cost of increased service usage by older people experiencing loneliness as up to £12,000 per person over the next 15 years. And if you correlate that up to the numbers, we're talking—. This is a ticking time bomb.

The Eden Project has found that social cohesion currently saves £245 million annually in reduced demand on health services in Wales, and could save £681 million if action was undertaken nationwide: befriending, for example. I know I've raised it here before—is it the Silver Line? There's a phone line you can phone. Esther Rantzen started it up, and that's an extremely good project; I know people in my own constituency have used it. Intermediate care funding is used to support third sector organisations in Aberconwy, to run local friendship groups such as a regular watercolour class, and one of our local councillors now has hired a local church hall and does a monthly film show—Councillor Julie Fallon. And I'd like to pay credit to her for her initiative in ensuring that these lonely people who feel isolated can come together and watch a film together—a film that often brings back many happy memories for them. A number of groups have been identified by Alzheimer's Society Cymru.

Deputy Llywydd, last year, Fiona Phillips undertook an experiment whereby she spent five days alone to experience the effects of loneliness and isolation. After less than 24 hours without contact, she felt despondent and unimportant. By day 3, she was desolate. Day 4: tearful. And by day 5, she felt her self-worth had plummeted. This is a young lady who has a family around her. She tried the experiment for a week. It is an experiment that brought some reality into her life, and she had the support of her family. Imagine when you haven't got that family around you, so let's all do everything we can to support every single individual that is living alone and feels socially isolated.

It is grimly ironic that we're holding a debate on loneliness on Valentine's Day, but as many have noted, it's a timely debate. I did not serve on the committee, but I think that the call to action is spot on. But I am frustrated that the solutions ignore the technological shifts that other countries around the world are seizing on. The three paragraphs of the report that do address the role of technology in tackling loneliness reference microwaves as inciters of isolation, and set out social media and FaceTime as 'future technologies and innovations'. Let’s get one thing straight: social media isn’t a 'future technology'. FaceTime is eight years old. The fact that it isn’t already in widespread use through the health and social services system should be a cause for concern, but let’s not allow ourselves to set our ambitions so low.

Because whilst we dither over whether a GP can handle Skype, other countries are trialling cutting edge artificial intelligence assistants—a sort of next-generation Siri. Luke Dormehl, in his book Thinking Machines, sets out some examples. He talks of a Microsoft chatbot in China that responds to text messages that users send it, which has caught the attention of millions. Xiaoice—I believe it's pronounced—uses deep-learning techniques to scan the internet, looking at how humans interact. It uses this learning to create lifelike responses to texts that it gets sent. The bot tracks the lifestyles of its users, including if they're dating, their jobs, things they might be worried or anxious about, and refers back to these in later conversations, mimicking the behaviour of an old friend. In Japan, they’ve developed the world’s first therapeutic robot: a sociable baby seal that can look you in the eyes and which adapts its behaviour depending on how it is treated—a sort of twenty-first century Tamagotchi. The baby seal’s seeming ability to empathise with its users has been found to provide comfort, particularly amongst older people.

Now, Luke Dormehl isn’t suggesting that AI assistants will be able to replace all forms of human interaction, and neither am I, but there are clearly opportunities for technology to play a role. What troubles me in this report is that these opportunities are barely alluded to, because we should all be able to envisage how technology might help people with dementia to stay in their homes, to retain their independence for a bit longer. The tech already exists to monitor behaviour to check, for example, if people are opening and closing cupboard doors more than they normally would, or leaving a long time before using the oven, to check if their behaviour is erratic. And we can also imagine tech that notices if somebody hasn't managed to dress themselves right or that translates slurred speech. This stuff is all within reach, so we should set our attentions to explore how tech might help us to end and ameliorate loneliness.

Downplaying the role of technology in this epidemic and reducing it to simple communication devices that are already a decade out of date, I think, is deeply problematic. As part of a package of measures, technology offers us cost-effective and sustainable means of tackling isolation and loneliness, and I would implore the Minister to look into this as a matter of urgency. Diolch.

And, finally, Julie Morgan.

Thank you very much, Deputy Presiding Officer, for squeezing me in in the debate and I just wanted to say, really, that, like everyone else, I was deeply shocked at the figures that emerged. The thought that a quarter of older people in our country here in Wales feel that they are lonely, I think, is a very sobering thought, and I think that all the members of the committee felt very sobered by the extent of these figures and the fact that for the over-80s it was so much worse.

Many people have mentioned the fact that it's not just older people, and I do have particular concern about older people from the BME community and, indeed, anyone who has a language barrier, because I think that the problem of not being able to communicate easily is a huge problem for building up relationships, and I think that is something that we should be very aware of when we look into how we tackle this issue. Other people have also mentioned about the fact that Stonewall Cymru has highlighted the fact that lesbian, gay, bi and trans people are much more vulnerable to isolation and loneliness, and I know there have been some recommendations in the past about how those issues can be tackled.

So, it is something that is not restricted to older people. But I was particularly impressed by what Joyce Watson said in her speech when she spoke about the general things that can really help older people to not be isolated and not be lonely, and, of course, she mentioned transport and being able to travel around, and I think the provision of the bus pass has been one of the greatest achievements of this Assembly, because it has, in fact, freed people to be able to travel without any concern about how much money it might cost them. So, it's things like that, I think, that actually do make a universal difference, but I think are very effective, and I'd like us to think, really, of that sort of solution because there are many ways that we can mitigate against isolation and loneliness.

Toilets: lots of people have mentioned toilets. I had a huge petition collected on Whitchurch high street, mainly with older people going out and getting the signatures, to try to get a local toilet so that people would be able to go down to the high street, because so many older people have told me, 'Now there's no public toilets open there, we can't go out and we can't go shopping', so that is the wider issue. The general provision of public toilets, I think, is something that will also tackle that issue.

And, just finally, to end, I'd just like to mention some initiatives in my constituency of Cardiff North: I would like to praise Cardiff Council for their setting-up of the hubs. The two libraries in Llanishen and Llandaff North, which have been developed as hubs—developed very sensitively, very bright, very attractive, and really are an excellent place for older people to go. And then I was very pleased to visit, with the Minister, the independent living centre where we saw some of the technology that Lee Waters said in his speech—. Where, in fact, technology is being used in this centre where you can monitor if somebody gets up or if somebody opens the window, and this is happening here in Cardiff very effectively. And that was quite an inspiring visit, I thought, and I'm sure the Minister would agree—Minister, that's right. Thank you very much for squeezing me in.

That's quite all right. I call on the Minister for Children and Social Care now—Huw Irranca-Davies.

Thank you to everyone. Thank you for the opportunity to reply to this important discussion. The quality and strength of the contributions this afternoon have shown that we're doing the right thing in ensuring that loneliness and isolation are a priority for the Welsh Government.

Thank you all very much for some excellent contributions. I won't be able to do them all justice because they were so detailed and so extensive. It shows the complexity of the challenges we have in this area of tackling isolation and loneliness, but also the fact that we need to do this in an intelligent and a comprehensive and joined-up way.

What brought this home to me—as I suspect for many of us—were some of the instances we see in our own constituencies. Several years ago, at an election, knocking on the door, I met an elderly gentleman who—you could absolutely feel, tangibly, the sadness. This was somebody that I'd known from some years ago who, when his wife had passed away, had effectively locked the door. He was feeding himself, was looking after himself, but had no connection with any agencies, no support systems, was looking after himself, but was deeply, deeply sad and lonely. And it's haunted me ever since. But the flipside of that is many of the examples we've heard of today—of neighbourliness, of communities coming together, of things like the Men's Sheds movement, of simpler things that we can all do ourselves—I have to say—as well. My mum and dad used to regularly go across the road on a Sunday and take Sunday dinner to an elderly neighbour, not because they felt, in any way, pity or whatever, but because it's the sort of thing you do in good communities that thrive. Perhaps we all need it. I'll turn to some of the Government strategies and some of the things we can do from here, but it's also to do with ourselves as well and what we do individually.

I would like to thank the committee, under the chairmanship of Dai Lloyd, for this important report into the inquiry into loneliness and isolation. I think it's helpful because it adds further evidence to what has already been building up our pool of knowledge about the clearly-debilitating effects of loneliness and isolation. The point has been made by several contributors today that loneliness and isolation can affect anyone at any age for a wide variety of reasons. Understandably, this inquiry focused its initial efforts mainly on the challenges faced by older people, but it can affect all ages.

We've heard loneliness and isolation described as a public health emergency. Evidence shows—and this evidence, by the way, goes back to studies that were done in the 1920s and 1930s—that good relationships, those networks, that connectivity, whatever word we want to throw at it, keeps us happier and healthier, and those who feel lonely are more likely to see their physical health decline earlier and to die younger. We can all appreciate how important it is to feel a sense of belonging in our communities, amongst our friends, amongst our neighbours, and to feel a sense of worth, that our lives mean things to other people.

So, my written response to the committee's excellent report sets out my detailed reply to the six recommendations. I know that everybody's had a chance to read them, because they've been touched on so much today. We've accepted each recommendation either fully or, in two cases, partially. Let me just turn to those two cases where we've accepted the recommendations, but with some provisos. One of them is the timescale, as has been mentioned. We partially accepted this. The reason for this is quite clear. If we can, we will keep this under review, and, if we can bring it forward earlier than the spring of 2019, we will. But even the committee itself recognises that there's some more research and evidence gathering in certain key areas to be done. We want to do that properly, and in some areas we want to consult properly and formally as well. If that means we have to take a little bit longer, we will, but we'll keep that under review.

The second thing to say is quite clearly—and in the response to the committee, I said this—that doesn't mean we can't act now. We get on with doing the things. We are doing things now and we should escalate them. We should accelerate them. So, we get on with acting right now. It doesn't have to wait for a strategy in 2019. We can already take forward actions, and I'll turn to some of those in a moment.

The second aspect that we accepted, but partially, was the funding stability for the third sector. A few Members mentioned this. In an ideal world, you'd simply say, with great largesse, 'Here's the funding. Here's the stability you need for three years. Go ahead'. There are implications of that, and some of the implications of that are, well, twofold—two big examples. One is flexibility, because the third sector also will ask us for flexibility for funding for innovation, for new initiatives—the sort of things, perhaps, that Lee, you were talking about; some new drive that's needed, and it needs some pump-priming money. But the other aspect that we need to be very conscious of here is that, in trying to give that security of funding, which we will look at and we will cast our thoughts to, there, we don't want to take away anything that might be needed for emergency funding either. Because sometimes there are genuine situations where you want to use the constrained funding available to deploy in an emergency situation.

So, we need to get the proportionality right and think this through, but we will look at it, we will bring forward further work on whether funding can be provided through dedicated streams, such as, by the way, the intermediate care fund. I think that many Members are becoming increasingly aware of the innovative use of this, including, by the way, of course, the Cardiff independent living centre. I'd recommend that Members go and see that—go and see what's happening there. That is funded through ICF. Now, we will look at this and see whether, with ICF and other such streams of funding, we can give more certainty, but we need some flexibility for emergency and other funding as well.

We were pleased to accept all of the recommendations here within the report. Let me say a little bit, then, more about those investments that have been made in programmes, the initiatives being taken forward that we can already do without waiting for 2019. So, across Wales, the public services boards have assessed the impact of loneliness and isolation as part of their wider analysis of well-being. This is what we voted for within this Assembly previously—before I was here—that this approach was the right approach. The plans that underpin these now are being consulted on, and I'm keen to see myself how public services boards will put the actions in place to maximise well-being at the very heart of our communities. All the different things we've been talking about—whether it is transport, whether it's access to toilets, whether it's community connectivity, whether it's libraries, this, that and the other—that's what this is about. We cannot directly fund from central Government every little initiative and every little group in every community. We can't do it. But what we can say is, 'Here's the framework that we expect to be delivered. Here are the outcomes that we want. Now, get on with it and find the way to do it', whether that's in rural mid Wales or whether that's in the deepest south Wales valley, and so on. 

Now, public sector organisations are innovating to provide services tailored to meet individuals' needs. So, for example, the integrated care fund, a total of £60 million, supports joint working across housing, health and social care. It's designed to reduce hospital and residential care admissions and provide social care for people in ways that they want. Projects include new-build accommodation, equipment and adaptations that promote independence, that reduce isolation and that improve quality of life. And on the subject of housing, the Supporting—. I'm conscious—. I said I would never get to all of my points. I suspect that I'm in the last 30 seconds.

I think you are. You're in the last 10 seconds, actually, but go on.

I won't be able to do credit to everything. The Supporting People programme, designed to help people remain independent in their own homes, and, again, that aspect of tackling isolation—. I suspect it would be better, Deputy Presiding Officer, to refer people to the work that we're doing. Our response to the committee on the work of the committee has been done. We regard this with the seriousness that I have set out today, that we've set out in statements. We're committed to bringing forward that strategy in as rapid a timescale as we can. But we are not going to wait for that, I say to the Chair and committee members and everybody else who has contributed today. We need to get on with this and do it now. We know that it's not all to do with funding. It's to do with the way that we work on the ground and the way that we connect in our own communities. Thank you very much.

Thank you. Can I call on Dai Lloyd to reply to the debate?

Thank you very much, Deputy Presiding Officer. In the few minutes remaining, may I thank the Minister for his positive response on the timescale of the strategy? I understand the reasoning behind the funding issues as well, and I congratulate him on being flexible on bringing those responses forward earlier, because isolation and loneliness—as we’ve heard from everyone, there is agreement across the Chamber about the detrimental effects.

Lynne Neagle spoke about suicide and isolation, and the excellent work being done by the Samaritans, and the importance of community groups. Lynne also referred to the potential detrimental effects of social media, in contrast to what Lee Waters said about the positive, powerful side of developments in social media. We should be making more use of those developments. It does happen in places, as we heard from the Minister, and also from Julie Morgan. There is new technology that is being used to connect people, but at the end of the day, what gets rid of the idea of isolation and loneliness is talking to another living person.

I’ll never forget; a few years ago, I just greeted someone on the street in Swansea—I just said, 'hello' and she came to see me in the surgery the following week and that 'hello' was the only word a human being had said to her in that intervening week. In that week, she’d had nothing said to her from another person, and that’s always stayed with me. As we heard from Caroline Jones and others, people are so lonely that they go to see the nurse or the GP, as Jayne Bryant mentioned, and seeing that person, seeing those social services as well as the nurses, they see those people as a way of having a conversation—just someone to talk to. That shows the importance of communication with another living person.

Thanks to Angela Burns and Rhun for their contributions, and to Janet Finch-Saunders and Joyce Watson. It’s wonderful to have people who aren’t members of the committee making contributions as well—and there was a very powerful contribution from Dawn Bowden as well. So, congratulations to everyone who contributed, and I particularly congratulate the Minister. We’ve had a discussion of a very high standard this afternoon. I’m confident that we will see action in this area, having heard the positive response from the Minister. Thank you.

Thank you very much. The proposal is to note the committee's report. Does any Member object? No. Therefore, in accordance with Standing Order 12.36, the motion is agreed.

Motion agreed in accordance with Standing Order 12.36.