Lina Gálvez – Dying in solitude

Austerity also means isolation. It is not only causing a breakdown in vital social services, but also in family structures and communities.

Lina Gálvez is Professor of Economic History and Gender Studies at Pablo de Olavide University, Seville

Cross-posted from

Translated and edited by BRAVE NEW EUROPE



In the past few weeks, there have been two cases of patients dying in the emergency departments of different hospitals in Spain. They died because medical personnel failed to intervene in time to save their lives. In both cases these patients were alone in the hospital’s emergency department. When they were called for treatment they did not respond because they were physically incapable of doing so. The emergency staff, assuming that they had left the hospital,  moved on to the next emergency.

The media have linked these tragedies to the health cuts made during Spain’s financial crisis, from which our health system has not yet recovered. That is partly because the exit from the crisis was accompanied by austerity and privatisation policies that hugely reduced the resources available to maintain essential public services.

There is more to this phenomenon than simply austerity. We need to examine more closely how our society is organised and how procedures, such as these hospital procedures, are drawn up. They are an example of the profound transformation taking place in Spanish society, without appropriate checks and balances that might have prevented such tragic events as those mentioned above.

Our hospital procedure assumes that patients will always be accompanied by at least one person, usually a relative, and usually a woman. Spanish society tends to assume that women are responsible for caring for family members. This situation has not really been altered by the massive recruitment of women into the labour market, although in Spain women still spend more than two hours more per day than men performing domestic tasks and unpaid care work. But women’s availability is no longer guaranteed and the high rates of divorce, widowhood and celibacy indicate that many people are single, living alone, and possibly pay visits to hospital alone. Procedures need to change to take account of this.

The cuts made during the financial crisis have meant more responsibilities are outsourced to families – assuming that everyone has one – for much of the care that used to be provided or facilitated by public services. This, in addition to great inequalities linked to gender, income, and the availability of family time, creates problems for those living alone, especially those who do not have a family or social network, or lack sufficient income to hire someone to take care of them.

The fact is that this breakdown of public services is happening increasingly in all individualised societies, where new technologies allow for virtual connectivity. This is a long way from the social models of the past, when the failure of a neighbour to show his face would set off alarm bells in the community.

In Spain, data from the 2017 Living Condtions Survey compared with data from 2016, show that 4.6 million people live alone, and 25.2% of households are single persons. This does not mean that these people live divorced from family or social networks, but we do need to acknowledge that the cohort is increasing. In 2016 there were 54,100 more single households than in the previous year, an increase of 1.2%.

There are no statistics that tell us of the number of people who die alone. But it is quite possible that, if nothing is done to remedy the situation, the number will increase, given the inexorable rise in the average age of the Spanish population and the low fertility rate of Spanish women – which is certainly not independent of gender inequality.

In Japan, a country with high celibacy rates, a very rapid ageing process and fertility rates almost as low as those in Spain, it is estimated that 30,000 people die alone in their homes each year. The figure for those who die alone in hospitals or residences is not known, because the statistics are based on data from the large number of companies dedicated to cleaning the apartments of people who die alone and whose bodies are usually discovered after a while. Clean-up services for deaths in such cases cost an average of $2,230 for property owners who want to get them ready to rent again. In fact, once these companies finish their work, it is as if these people never existed.

In the UK, thanks in part to the political initiative of Labour MP Jo Cox, murdered in 2016 by a man from the extreme right-wing, we know that some 9 million people claim to be isolated and have no one to talk to or share their experiences with. Prime Minister Theresa May’s government has created a minister for loneliness to deal with this problem. This minister’s brief is to develop a comprehensive strategy, produce new statistics, and carry out studies, as well as to allocate a budget to communities and the NGOs to promote activities that connect people.

For a country such as Britain which since the 1980s has been busy privatising public services, cutting subsidies for those who need them and dismantling the social structures of working communities, it is hard to see how this will work Britain is a nation who’s former prime minister, David Cameron, promoted the idea of a Big Society over Big State, while at the same time unrelentingly pursuing a neo-liberal policy of less public presence and spending.

In any case, we welcome this loneliness initiative. It is important that the social changes we are experiencing in Western societies should be the subject of specific policies that also address the growing phenomenon of isolation in increasingly populated and theoretically more interconnected societies. It is possible that the answer should be to link the development of public health and social services with the promotion of community solidarity networks, so that no one, unless it is their wish, will have to face death alone or accept that, once deceased, a cleaning company will come in and erase them also from our memory.



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