The loneliness disease
Town &
Country Planning, March 2000
It's almost a cliché that doctors are
being bombarded by the lonely as well as people who are
actually ill. It's another cliché that, although they
just want someone to chat to, they aren't really satisfied
unless they can depart with a prescription for
antibiotics.
I'm no means of knowing whether it's true
or not, but doctors I know tell me it is. And don't let's
belittle the problem: people have to have human contact to
survive. It's just that doctors probably aren't the most
effective and cost-effective people to provide
it.
And it was one of those many areas of discussion that was left out of the so-called 'debate' about NHS funding in the freezing, flu-ridden early months of the year.
That's one way of looking at it &emdash; how doctors are having to hold the front line as the old social systems unravel. But you can also see it as one of those classic drawbacks in the current money system. We have enormous need, lots of people outside the market system &emdash; often elderly themselves &emdash; who desperately want to be useful, but no money to bring them all together. Even at the height of the 'long boom', hardly anybody is paying anybody to be friends with the housebound and elderly.
That's my excuse to talk about time banks. Because this is exactly the problem which created them and made them successful, especially in the USA where people earn 'time dollars' for helping out in their local community. Or in Japan, where people earn a time-based 'credit' called Hureai Kippu ('ticket for caring relationship').
It's not money exactly. But it measures the effort people put in, and that's often enough for them to feel appreciated &emdash; even if they don't actually spend it themselves.
But let's go back to the issue in hand. Imagine the doctors could stop giving the standard prescription for antibiotics, and give them instead a prescription for a weekly friendly visit, or a weekly lift to the supermarkets. Because that's what they're going to do in Rushey Green.
The prescriptions will go to the health centre's time bank where they will be fulfilled by volunteers earning time credits, which they can then spend on services for themselves &emdash; or give away to elderly relatives.
There are time banks in Britain already &emdash; notably the network being set up across Gloucestershire by Fair Shares. But the Rushey Green Health Centre in Lewisham is the first in the UK to link the idea to primary healthcare.
In fact, time banks in the USA, started in the health sector in more ways than one. The idea popped into the head of the eminent US lawyer Edgar Cahn, and former speechwriter for Bobby Kennedy, as he lay in hospital after a massive heart attack at the age of 44. He was trying to work out why he felt so uncomfortable being waited on hand and foot by an enormous team of nurses and doctors. It should feel wonderful, but it didn't &emdash; because he hated feeling useless.
Feeling useful, said Edgar, is a major human need which is not satisfied for everyone, by any means &emdash; especially the old, the young and the unemployed. But if you measure people's time, then almost everyone has something they can contribute to the 'bank'.
Looked at from the point of view of policy-makers, and their spending predictions, bar charts and statistics, this may not seem such a big idea. But when you're searching for untapped resources for the NHS, you could imagine Rushey Green being the first step towards unleashing the biggest untapped resource so far &emdash; human-scale local involvement by people who want to feel they are making a contribution. Or what Edgar Cahn calls 'co-production'.
I'm very excited about Rushey Green, which has its official launch this month, because I've been involved from its beginning at the New Economics Foundation. I thought it was extremely imaginative of the Kings Fund, the Lloyds-TSB Foundation and the Carnegie Trust to come up with the money to launch it. Well, I would, wouldn't I.
But actually, I kind of wonder whether this kind of idea &emdash; borrowing a new version of money to get people in touch with each other &emdash; might not be the big idea the NHS so badly needs.
David Boyle is an associate of the New Economics Foundation and the author of Funny Money (www.funny-money.co.uk)
