ALSTON, England — It was not until Trevor Robinson received a lette r notifying him of a missed appointment at the hospital that he realized he had not spoken to another human being in more than six weeks.
Mr. Robinson, a 77-year-old retired landscape gardener, had spent most of t hat time alone, sitting on his favorite frayed leather recliner looking out the window at the moorland surrounding his cottage in the northwestern cou nty of Cumbria.
“When you spend every second by yourself, you lose track of time, ” he said as tears trickled down his face. “I feel lonely, very lonely, and bored.”
Mr. Robinson’s isolation, shared by thousands of older people in Br itain, is the result of a chain of cause-and-effect that stretches from rur al Cumbria to the halls of power in London. He used to ride a subsidized bu s to town until the local council discontinued the route. The council was r esponding to steep budget cutbacks stemming from the Conservative-led gover nment’s decade-long austerity program.
Even as austerity has sliced through nearly every aspect of British life, t he government has protected high-profile benefits for older people, and it has raised the state pension on a more generous basis than previous adminis trations.
But a free bus pass is of little use if buses no longer reach you, and many retired people have discovered that apparently minor cuts — the el imination of a bus route, the closing of a tiny health care center, communi ty center or post office — can profoundly upend their lives.
The effects are especially pronounced in rural areas, where the isolation o f older residents has emerged as one of the greatest, and largely hidden, c osts of local councils’ straitened budgets, with funding slashed by half nationwide since 2010, the National Audit Office has found.
Cumbria, Land of Beauty and Poverty
While experts say these problems are common to much of Britain’s co untryside, they are particularly severe in Cumbria. Best known for its Lake District National Park and historic lakeside mansions, it is also one of t he poorest rural areas in England.
Twenty-nine of its communities are among the 10 percent most deprived natio nwide. Household income levels trail the national average in all but one di strict.
And by 2020, nearly a quarter of Cumbria’s residents will be over 6 5 — 5 percentage points higher than in 2008 and double the proporti on projected for London. Half of those have long-term health problems or di sabilities.
Cumbria has had problems since its lead and zinc mines closed in the 1960s. But they have been amplified by austerity. This year, Cumbria County Counc il plans to cut about $23 million from its budget to cushion a steady drop in funding from the national government — to $17.7 million this yea r from nearly $200 million in 2012.
By 2021, the council expects the grant to disappear entirely, despite recen t declarations by Conservative Party leaders that the austerity era is over . In April last year, Cumbria put up its local council tax by 4 percent, th e first rise in several years, after the government eased restrictions on s uch increases.
“It’s always been expensive to deliver services to rural co mmunities because the population is so spread out,” said Peter Thor nton, the council’s deputy leader and cabinet member for finance. “But since the central government cuts that started in 2010 this be comes more of a challenge each year.”
The council’s first major cut to services came in 2014: ending bus subsidies. It saved around 9 million pounds, around $12 million, a year, an d lost about 60 percent of the area’s bus services.
“But we are starting to rethink ways of providing transport,? ? Mr. Thornton said. “There’s increasing recognition of h ow these cuts have contributed to the problem of rural isolation and the im pact on people’s mental health.”
Bus cuts are also becoming a national issue. The leader of the opposition L abour Party, Jeremy Corbyn, proposed last month to spend £1.3 billion, or about $1.7 billion, to restore lost services.
Until recent years, the quality of life for seniors had steadily improved. From a high point in the mid-1990s, the poverty rate among older people had declined, the Joseph RowntreeFoundation says, falling to 13 percent in 201 2-13 before rising to 16 percent in 2015-16. But one in six pensioners rema in in poverty, and the rate has started to increase.
“After positive progress, it is worrying that the number of pension ers living in poverty is once again on the rise,” said Caroline Abr ahams, charity director at Age UK, Britain’s largest charity workin g with older people. And with the slowdown in economic growth associated wi th Britain’s tortured withdrawal from the European Union, the gover nment is facing renewed budgetary strains.
A Steadily Shrinking Life
Five years ago, Mr. Robinson used to take a bus to the city of Carlisle, ab out 40 minutes away, where he shopped at his favorite grocery store, Morris on’s, shot darts at a club and played cards and watched television with his best friend, Billy.
That ended in 2014, with the withdrawal of bus subsidies.
“I tried taking the new bus, but it only waits in Carlisle for an h our and a half before coming back,” Mr. Robinson said. “Tha t’s just not enough time to get anything done, and if you miss the bus, you’re doomed.”
Since then, Mr. Robinson has barely left the house. He spends most of his $ 175 weekly pension on food from the local store, which he gets a lift to on ce a week, and he rents a television.
“I used to buy my favorite beef lasagna and fresh veg from Morrison ’s,” he said. “But there’s not much choice in the village, so now I’m mainly eating instant soup.”
He said he called the council to inquire about transport options to the cit y, but he was told, “Sorry sir, we simply do not have the funding. ”
Mr. Robinson draws a simple lesson from all this: “You need to be r ich or upper middle class to survive in the countryside nowadays.”
Cutting Benefits, Rejecting Applications
Two years ago, barely able to walk after he developed an infection followin g bunion surgery, Mr. Robinson applied for an attendance allowance, a benef it for people over 65 who are disabled. His problem was deemed not severe e nough.
“You pay taxes your whole life thinking the government’s go ing to take care of you when you’re old and dying, but their messag e to me was loud and clear,” he said, his voice rising. “Th ey don’t give a damn.”
Many seniors and their advocates say such rejections have grown increasingl y common as welfare rules have tightened.
“General benefits are a lot harder to get than 10 years ago,? ? said Hugh Tomlinson, the deputy C.E.O. of Age UK in South Lakeland, par t of Cumbria. His clients’ rejection rate for attendance allowance, he says, has doubled in three years.
“A lot of those decisions get overturned on appeal,” Mr. To mlinson said, adding that he suspected the rejections were part of a new st rategy calculating that few older people would take that step.
“Our offices,” he said, “have had to convince a lot of people to appeal.”
Not so long ago, Mr. Robinson and other seniors could have fallen back on t heir families for help with shopping and doctor’s appointments, not to speak of simple visits. But diminished job opportunities and benefit cu ts have forced many rural young people to move to distant cities.
Trevor Robinson’s son, Liam, had to leave a rental near Alston, abo ut 25 minutes from his father’s house, when the authorities cut his benefits last year, saying he had not applied for enough jobs.
He disputes that, and points instead to Cumbria’s budget for job se eker’s allowance, which has been cut by almost two-thirds, to $11 m illion in 2016-2017 from $32 million in 2009-2010.
He says he also could not afford the heating bills, another major obstacle for rural residents, especially in high altitude areas like Alston. He now lives in subsidized housing in the city of Lancaster, about an hour and a h alf’s drive from his father.
“I miss the clean air and space of the country and being able to ch eck in on my pops,” he said. “But this is all we can afford .”
Hospitals and Nursing Homes Closing
Perhaps most disturbing for older residents is the shrinking health care se ctor, as hospitals close and doctors cluster in larger towns.
This has been driven in large part by a funding formula that measures wealt h partly on the number of cars per household — an absolute necessit y in remote areas, but not in cities.
As a result, officials say, Cumbria receives one of the lowest public healt h allocations per capita in the country, around $50 compared with about $23 5 in London.
In 2016, Alston community hospital’s inpatient unit, with its seven beds, had to close because of staffing shortages caused by its isolation a nd lack of transport. Local residents met the decision with fierce oppositi on, because the beds were often the only place where the dying could spend their final days among friends and family.
“I’ve seen two people there who were about to leave us,? ?? Steve Frogley, 69, a retired electrician, said. “Now, people in that state are all the way in Carlisle or Hexham, and it’s real ly hard for their loved ones to go and visit them.”
Carlisle and Hexham are about an hour’s drive from Alston.
The N.H.S. North Cumbria Clinical Commissioning Group announced the permane nt closing of the beds last March, saying it would treat more people at hom e.
But many in Alston seemed unconvinced.
“The hospital is sadly missed,” Mr. Frogley said. “ It’s the biggest loss to the community since I’ve been here . It would have been a wonderful place to die.”