(11 years ago)
Commons ChamberRead Hansard Text Read Debate Ministerial Extracts
Tracey Crouch (Chatham and Aylesford) (Con)
I beg to move,
That this House has considered the G8 summit on dementia.
It is a pleasure to see you in the Chair, Madam Deputy Speaker; this is the first opportunity I have had to give you my warm congratulations on your election.
I am incredibly grateful for the support of the right hon. Members for Salford and Eccles (Hazel Blears) and for Sutton and Cheam (Paul Burstow), and others, for helping to secure this debate. I thank the Backbench Business Committee for allowing Members time to contribute—albeit briefly—to a debate on what many believe is one of the most important issues facing our health and social care system in the future. I shall keep my opening comments as brief as possible, as I know that others wish to speak, but it is important to congratulate the Prime Minister on using the opportunity of hosting the G8 summit on 11 December to focus on international efforts to prevent, delay and effectively treat dementia. The debate will allow parliamentarians an opportunity to shape discussions at the summit, following on from wider and commendable consultation with the public. Collaboration, which is at the heart of the conference, is the basis of my contribution to the debate.
Before addressing the specifics, it is important to set out the global perspective. Dementia affects more than 35 million people worldwide and is now considered to be one of the greatest global health challenges of our time. It is estimated that, by 2050, more than 150 million people will suffer from dementia.
Hon. Members will have seen the devastating human cost of dementia if not in their families, then in their constituencies. We know of the suffering of those with the condition and those who become carers for their loved ones. However, we perhaps do not so obviously see the huge economic effects of dementia, the worldwide cost of which is estimated to be about £400 billion, which is the equivalent of 1% of world gross domestic product. Without urgent action, that figure will increase in line with the number of people who are anticipated to get dementia, which is why global collaboration is essential. The more we can do together globally, the better the outcomes we can secure nationally.
Mr Simon Burns (Chelmsford) (Con)
My hon. Friend makes an extremely important point. Does she accept, however, that it is equally important to do more on seeking diagnoses? About 350,000 people in this country are undiagnosed and go without the help and support that those who have been diagnosed receive.
Tracey Crouch
I agree entirely with my hon. Friend. The all-party group on dementia recently produced a report on diagnosis. Shockingly, only about 42% of people get diagnosed, which leaves a massive diagnosis gap. The earlier people are diagnosed, the better their treatment and pathways.
Andrew Miller (Ellesmere Port and Neston) (Lab)
I congratulate the hon. Lady on introducing the debate. I hope she will hear later some of the evidence that the Science and Technology Committee has taken on variant Creutzfeldt-Jakob disease, and of the important work of the Medical Research Council prion unit, which could lead to exciting new possibilities for the treatment and diagnosis of people with all sorts of dementia. Does she agree that it is important to maintain such research programmes?
Tracey Crouch
I agree entirely with the hon. Gentleman, and I will hear more later of the initiatives his Committee is examining. The importance of research is very much the basis of my speech.
Hon. Members may talk about many aspects of dementia, but I shall address four, the first of which is investment. The statistics are gloomy, but there is a good-news story underlying the negative numbers: people are living longer and people can live well with dementia. We need to capitalise on best practice and ensure that we maximise people’s ability to maintain long-term well-being, despite their debilitating condition. Although we do not have a cure for dementia, we have come on leaps and bounds in recent years. A cure is hopefully no longer a lifetime away, but to ensure that we make that cure happen, we need to take action.
Dementia costs the UK economy £23 billion a year, which is more than cancer, stroke or heart disease, but the annual research spend on dementia is about £51 million. The research spend on cancer is £521 million —10 times more—yet dementia costs society much more than cancer annually. I therefore welcome the increase in investment in dementia research through the Government’s themed initiatives, which has resulted in Government investment more than doubling over four years. However, the investment comes from a low base and represents less than 1% of the overall science budget.
Zac Goldsmith (Richmond Park) (Con)
I congratulate my hon. Friend on securing this important debate. It is widely believed—it has recently been widely reported in scientific journals, including by scientists who will take part in the G8 meeting—that up to half of all Alzheimer’s cases can be attributed to modifiable and therefore preventable risk factors. If that is the case, and there seems to a general consensus along those lines, does she share my disappointment that, as far as I can see, none of the additional £22 million allocated for dementia research has been spent on prevention research?
Tracey Crouch
I am sure that the Minister will have heard the good point that my hon. Friend makes. I would like to concentrate on the fact that there has been an increase in investment for research. There are various reasons why we need research, and I am sure the Minister will address my hon. Friend’s comments in his response.
Huw Irranca-Davies (Ogmore) (Lab)
The hon. Lady rightly talks about the low investment base from which we are starting on dementia research and prevention. One way to make limited resources go further is to co-ordinate properly and better across the regions and nations of the UK. There is good work going on in Wales, but that is also from a low base.
Tracey Crouch
I agree entirely with the hon. Gentleman. We need greater co-operation and collaboration across the world, and if that is needed across the world, we certainly need it at home.
We should recognise that the USA is committed to spending $550 million on dementia research, which is a reflection of the importance of the condition to its society. To be frank, however, the combined investment by the USA and the UK is small fry compared with the investment in research by the pharmaceutical industry. Any collaboration needs to include the global pharma leaders to ensure that they are financing research, bringing together their world-leading scientists and helping to achieve the breakthrough in the prevention and treatment of dementia that we all want. One of the most important outcomes I would like from the G8 summit is a long-term commitment to double investment in research to provide stable and predictable funding so that we can get closer to finding a cure and improved care.
Mrs Madeleine Moon (Bridgend) (Lab)
Does the hon. Lady agree that part of the problem is the fact that we use the term “dementia” as if it is just one thing? There are many dementias and we must not focus just on Alzheimer’s. We must be aware of frontotemporal dementias, which affect younger people in particular, and ensure there is funding for research into that.
Tracey Crouch
I agree entirely. This is something that blights many conditions, including cancer. We talk about cancer investment, but there is little or no research funding for some cancers. Mesothelioma is a classic example, about which there is a debate on Monday.
It is essential that research focuses on investment in infrastructure. Training and development for researchers is also crucial if we are to see swifter progress towards treatments and cures for dementia. However, it remains hard for an academic with a good idea to spin that off to a company, especially compared with the situation in America. The Government must do more to promote the commercialisation of research as these companies become a vital part of the ecosystem. Large companies and academia can then be partnered in the innovative collaborations that the Government seek.
Research on the provision of care is equally important. Four out of five people with dementia live at home. We want to keep it that way and to ensure that they can live there safely for as long as possible. Research comes in many different forms, including the identification of what works. We know that dementia costs the UK £23 billion, but arguably that money is not being spent properly or efficiently. Prevention is key. Avoiding unnecessary hospital admissions is vital to ensuring that funding is used effectively and, more importantly, makes a huge improvement in quality of life. Researching best practice in care is essential. An economic case developed by the Alzheimer’s Society estimated that if just 5% of admissions to residential care were delayed for one year as a result of dementia-friendly communities, there would be a net saving of £55 million a year across England, Wales and Northern Ireland.
There needs to be a change in the language we use when we talk about care. If we talk about weekly art lessons that are provided to help to improve cognitive function as therapy, rather than an activity, we could hope to see a change in attitude towards research and investment in this area. Many good ideas are having a positive impact in local communities. For example, Medway council, which covers part of my constituency, is promoting telecare as a means of supporting people with dementia, and there are lots of non-clinical treatments that could be further researched, such as the benefits of pets and petting animals for people with dementia, memory rooms and memory boxes. I have even heard of amazing innovative products such as wristbands that monitor someone’s usual actions so that they will detect if they have a fall. We need to consider all those things in the whole pod of research.
We should not forget to consider support for carers. Family carers of people with dementia save the economy £7 billion a year, but evidence shows that they struggle to do that, which can lead to avoidable crises in care, hospital admissions or early entry into care homes, all of which are very costly. The Dementia Action Alliance’s “Carers Call to Action” campaign, which I support, is calling for timely and tailored support for carers, whom I am sure we all agree are an important cog in the wheel of treating and providing for those with dementia.
On best practice, it is important that international collaboration includes the beneficial sharing of successes and failures. In utilising our resources, it is important that we do not duplicate unsuccessful investments and that we champion successful and effective progress. The summit should therefore ensure that all publicly funded dementia research data and results are made available, thereby allowing common factors in national research responses to be shared.
Sir Roger Gale (North Thanet) (Con)
Before my hon. Friend moves deeply into the main subject of the debate, which is the G8 summit, does she agree that we need much greater public understanding of, and support for, those who are caring for people with dementia and those with the condition, which can strike not just elderly people, but younger people? Some of us remember a former and much-loved Member of this House who, while still an MP, suffered from the disease. This is something that we have to ram home to people.
Tracey Crouch
I agree entirely with my hon. Friend. It is important to note that society has made much progress in the past 20 years and that dementia is not the taboo subject it perhaps used to be. We have changed how we think about it and now treat people with dementia much better, but we still need to get away from the idea of saying, “Nan’s gone a bit dotty.” We have to understand that something can be done about dementia and that proper care pathways exist to ensure that people can live well with it, and we have to support carers as best we can.
On the G8 summit, I turn to my final but no less important point: long-term strategies. The Prime Minister’s challenge on dementia for England has provided a welcome focus on the treatment and care of people living with dementia and the search for a cure, but there is a danger that the focus will be lost, especially as the initiative is not UK-wide but covers only England. Many countries have dementia strategies or brain bank initiatives, and the UK needs a new long-term strategy, because the current one is due to expire in 2014. I would be grateful if—not today but soon—the Minister could outline his plans to evaluate the national dementia strategy for England and tell the House when he will commit to a new strategy following the current strategy’s expiration next year. Notably, the US has a dementia strategy in place until 2025, which means that we could be left in the embarrassing situation of the UK Government leading the G8 in a discussion on dementia without a national long-term commitment comparable with that of many of their international partners.
In conclusion, it is fantastic that the UK Government, under the Prime Minister’s personal commitment, are using the G8 summit to champion a more collaborative approach to preventing, treating and curing dementia, but it is essential that the legacy of this summit goes further than the G8 and that the declaration and communiqué of the summit makes firm long-term commitments to the doubling of research funding, to sharing best practice, and to delivering an international ongoing collaboration on defeating this devastating disease, which affects so many people and their families.
Madam Deputy Speaker (Mrs Eleanor Laing)
Order. Several hon. Members have indicated that they wish to speak, but we have only one hour remaining, so I shall impose a limit of six minutes on Back-Bench speeches.
Hazel Blears (Salford and Eccles) (Lab)
It is a great pleasure to follow the hon. Member for Chatham and Aylesford (Tracey Crouch), my colleague on the all-party group. It is also a great pleasure to see you in the Chair, Madam Deputy Speaker. This is my first opportunity to contribute to a debate under your chairmanship, and I would like to congratulate you on your election.
While I am handing out congratulations, I would like to congratulate the Prime Minister, too, on the personal commitment he has shown on dementia. [Interruption.] Credit where it is due. Those who have the presidency of the G8 have an opportunity to name a subject around which they would like to mobilise the international community. In playing his card at the G8, the Prime Minister has chosen dementia. I commend him for taking that action. I believe that international collaboration will be the way to achieve the next big leap forward, particularly on the research agenda. I support what the Prime Minister said at Prime Minister’s questions yesterday—that this issue is not a matter only for world leaders, important though they are; it is a matter for every single person in the community, whether they be a world leader, a health Minister or an ordinary citizen. Everybody has a role to play.
I shall start with the people who have dementia, along with their families and their carers. When we promote policy, do collaboration or talk about international research, we must constantly remind ourselves that the people with the disease and their carers and families are usually the most expert people in the system. Therefore, the services that we provide, the quality of care and the innovations we develop have to be shaped and guided by those people. We must empower them to make their voices heard in this debate. When we bring together our creativity, our imagination and the huge brain power in the research community, we must always bring to this issue, too, our own humanity. We must remember that people with dementia are valuable and loved human beings. If we can keep that at the forefront of our minds, we will make progress and be doing absolutely the right thing.
During Question Time yesterday I mentioned a lady called Joy Watson. I met her a little while ago. She is only 55, but she has early-onset dementia. Her family was devastated. When she went into shops, she might be a little confused over her change or what she needed to order, and the shops—and sometimes the customers—would be irritated with her, tutting and asking her to hurry up. She took to wearing a badge, which she designed herself, saying “I have got Alzheimer’s; please be patient with me”. She should not need to do that. Nowadays there is a scheme—I think it is called the purple angel scheme, and Joy is promoting it—so that people can wear a purple angel on their T-shirts as a means of raising awareness in every single part of our community.
In Salford, we have worked on this agenda for a number of years. We have just formed our dementia action alliance, with 30 organisations now committed to action plans to make us, I hope, the first dementia-friendly community in Greater Manchester. As well as health, education and housing bodies, we have the Lowry arts centre and our shopping centres included in the scheme. I think we have the first private-hire taxi firm in the country to be involved in this, Mainline Sevens taxis. It has trained 400 drivers and has an account system so that people with dementia do not have to fiddle with their money when they get in a taxi. All those groups are now dementia aware. That shows the really practical things that can be done.
On the research side, I am delighted to say that tomorrow, Salford university will launch the Salford Institute for Dementia, bringing together the faculty of health and social care with departments dealing with the built environment, computers, IT, arts and media—showing the multidisciplinary approach that will apply. That group will draw together and disseminate research on living well with dementia. I think this is a fabulous academic development.
Mrs Moon
I cannot say how much I admire my right hon. Friend’s championing of this cause. When it comes to universities, there are examples of research that have focused on ideas for prevention. We heard yesterday from Professor A. David Smith from Oxford about the vitamin B6 and B12 levels as a means of achieving this. Currently, it is not possible within the health service to have a test of homocysteine levels that would help to identify the problem. Could we not put that prevention in place; should we not be doing that now?
Hazel Blears
My hon. Friend is absolutely right. I was horrified to learn yesterday that only 0.1% of research on dementia is spent on prevention. In every other area of public policy, such as education and social mobility, we are aware of the importance of investing in prevention, but in this area there is virtually no grant support, and that must change. I understand that in Norway and Sweden, tests for dementia are the norm. They are cheap once the investment has been made in the equipment, and the vitamin B12 research looks extremely promising. I hope that when the Minister responds he will say that that is something that our own national health service should take up.
Oliver Colvile (Plymouth, Sutton and Devonport) (Con)
Is the right hon. Lady aware of the excellent work that is being done in Plymouth, not just at the university but, much more important, by the local authority and the Royal Navy at Devonport? They are taking a lead by ensuring that all their employees are aware of the dementia issue, and that, if they need time off, they can have it in order to look after their relatives.
Hazel Blears
I am delighted that the hon. Gentleman has mentioned Plymouth, because it is one of the pioneers in this area. Plymouth, Torquay, Bradford and other towns all over the country want to ensure that dementia is not something shocking that we do not know how to deal with, and that everyone is dementia-friendly and aware. They are tackling the stigma, which is a huge issue. People do not like to talk about the fact that their families and friends are afflicted with this disease.
The search for a cure is essential. No one wants to have dementia, and everyone wants to be able to cure it. However, at the G8 I want just as much importance to be ascribed to research on the quality of care. The Evington initiative, which is backed by a number of business leaders including Terry Leahy—who used to chair Tesco—and Sir Marc Bolland are putting their weight behind that initiative. They are asking two questions. First, how can we change the system so that it is driven by users and carers rather than simply by clinicians and producers? Secondly, how can we establish a good, rigorous evidence base in relation to therapeutic interventions, quality and consistency of care and tackling stigma, so that clinical commissioning groups can be confident that the services they are commissioning actually work?
I think that the research is very exciting, but we are not likely to find a cure for 10, 15 or 20 years, and in the meantime 800,000 people are living with dementia. At present, there is virtually no evidence base relating to the quality of care. “Singing for the brain” is fantastic, but does it work, and if so, why does it work? Then there are the arts, the drama, and all the memory work that goes on. We need that rigorous evidence base, so that the commissioners can take the right packages off the shelf.
Debbie Abrahams (Oldham East and Saddleworth) (Lab)
Will my hon. Friend give way?
Hazel Blears
I am afraid that I do not have enough time.
We also need research on prevention. The Alzheimer’s Society is working on a system that helps care home staff to reduce the use of anti-psychotic drugs by intervening in other ways to deal with people’s behaviour. That system is being rolled out in 150 care homes, and has reduced the use of anti-psychotic drugs by 50%. It is saving money, and it is making a huge difference. The G8 presents us with a fabulous opportunity to press for further research. I do not want it to be a one-off: I hope that there will be another summit of this kind next year. I also hope that work will continue between now and the next summit. This issue is not going away—it will be with us for a long, long time—and it would be fabulous if we could secure that international collaboration.
I invite the Minister to visit our university institute after we have launched it tomorrow, so that he can observe the fabulous work that is being done there and, perhaps, meet some of the people in Salford who are taking a whole systems approach that I think will prove helpful.
Let me end by saying that we owe a duty to every single one of the people who have dementia or are caring for people with the condition. It is the worst thing in the world to lose the person with whom you once had a connection. We have an absolute duty to do whatever we can, here in the House and in our communities, to give those people support and help.
Richard Graham (Gloucester) (Con)
It is a pleasure to follow the right hon. Member for Salford and Eccles (Hazel Blears), who has spoken so well and done so much work on this subject along with her colleagues, my hon. Friend the Member for Chatham and Aylesford (Tracey Crouch) and the right hon. Member for Sutton and Cheam (Paul Burstow). All three major parties now have at least one significant dementia champion to raise this important issue. I know that the Minister will enjoy responding to the debate, because he has covered a number of debates on the subject before. Much has been said on dementia, and much action has been taken. The right hon. Lady was right to mention the Prime Minister’s initiative and his championing of this issue. Many people are suffering as a result of dementia, not only those suffering directly from the disease, and there is still no cure, so it remains a significant challenge for science and society.
I have just a few points to add to what has already been said. The Minister will recall that I led a debate recently in Westminster Hall on what was being done about dementia in Gloucestershire and on the ways in which I believed we had adopted best practice. However, a critical question is: do we really know what best practice is? How do we measure the quality of what is being done in our local hospitals and care services? How do we measure the contribution of organisations such as the Barnwood Trust, a mental health charity specialising in these conditions which we are lucky enough to have in our area?
As the right hon. Lady said, it would be useful if the Minister could share his thoughts on a guide to best practice, not only for commissioners—although I agree that that is important—but for MPs. Representatives of the Gloucestershire family of NHS services recently told me in a meeting that they had received an award for the care and services they provided for old people in general and for dementia sufferers in particular. That was terrific news—I am always delighted when people win an award—but it would be useful to know what we are doing best, and what is being done better in different areas, so that we can have a nice, easy frame of reference. People could then see whether their area offered a four-star or a five-star dementia service, for example, and we could assess how we might attain a higher standard if we did certain things differently.
Debbie Abrahams
Is the hon. Gentleman suggesting that, in addition to building up the evidence base through randomised controlled trials that establish a causal relationship between therapies and outcomes, some kind of action-based research would be appropriate? Such research could be carried out and interventions could be offered and evaluated while providing the service at the same time. It would be a case of learning as we went along. Does he agree that we need different approaches because of the scale of the issue that we are facing?
Richard Graham
I think I agree with the hon. Lady. Different things need to be tried. Singing and music were mentioned earlier. In my mother’s case, they were the last things she was able to relate to and enjoy before Alzheimer’s closed over her. So I agree that different things are always worth trying, and that is where the charities can play a role as well.
My first question to the Minister is: could we have star ratings for dementia services and, if so, how would we identify and measure best practice? My second point relates to how we are using the Prime Minister’s initiative to get dementia on to the G8 summit agenda for the first time. We should work with other countries on this. A number of us have received briefings suggesting that the United States and France, among others, are also doing great things in dementia research. Should we not all be able to share our findings? Perhaps we could have what is known as a global inter-operative data sharing base, so that all the work being done by organisations such as Alzheimer’s Research UK could be shared, rather than being duplicated. Effort could then be spent on taking research forward, rather than replicating it.
The aim of trying to join up what organisations around the world are doing is a key reason for the Prime Minister getting this topic on to the G8 summit agenda, and I hope that the result will be an international plan involving more pooling of thinking, research and ideas. I sense that science is beginning to feel more confident about finding solutions to this ghastly disease, and if the G8 summit can give an enormous turbo-boost to pooling research and getting closer to finding solutions, the actions of the Prime Minister and the Government will have been worth while, not only for the 800,000 people in this country who have dementia today but for the many millions who will suffer in the future.
Steve Rotheram (Liverpool, Walton) (Lab)
In my first speech in this House this year—I believe it was on 10 January when we debated dementia and mental health—I discussed my mother’s case. The debate was filled with passionate contributions from Members across the House, although I was particularly moved by the personal accounts from my hon. Friends the Members for Bridgend (Mrs Moon) and for Oldham East and Saddleworth (Debbie Abrahams).
I also spoke of my pride that a decade after my mother’s passing the city of Liverpool earmarked 2013 as the year in which it would focus efforts on dementia awareness and promote innovative approaches initiated by organisations in our city. Our work complements the findings of the report from the G8 summit on dementia. Right across the Liverpool city region, our health care providers, arts organisations and academic institutions have embraced a collaborative approach to increase awareness of dementia, early diagnosis and patient-friendly treatment, with the mission being to make dementia everybody’s business. I stand in this House proud and confident that Liverpool is well on its way towards creating dementia-friendly environments in workplaces, public areas and communities.
One of the most high-profile projects—the Prime Minister might like to bring it to the attention of G8 colleagues—is the National Museums Liverpool House of Memories project, which now has a staggering 1,000 participants. Since I spoke on the issue earlier in the year, the team, led by David Fleming, has developed its innovative approach even further, branching out into the housing sector, in partnership with local registered social landlords. In total, four north-west housing providers have joined together to fund a re-modelled initiative which has taken the House of Memories project—using art, dance, music and creativity—to 600 homes. That is set to be further expanded next year. I am pleased to report that the ambition of the House of Memories team knows no bounds. Despite our year of dementia finishing in just a few short weeks, the team already has an even more ambitious plan for 2014 to help dementia patients.
I made it clear in January that I did not see any reason why the project running in Liverpool could not be extended across every region of the UK, so it is particularly pleasing to be informed that the Minister’s Department has confirmed that £135,000 will be awarded to take the House of Memories project to the midlands region in March next year, and I thank him for that. As if that were not enough, the team are even developing an app for iPhones and iPads on behalf of, and working with, dementia sufferers, which will also be launched next spring.
The House of Memories is by no means the only successful project operational in Liverpool, so I make no apologies for bringing a number of other local initiatives to the attention of the House. The unique Sedgemoor specialist dementia support centre was opened in Norris Green, on the border of my constituency, in May, at a cost of £1.2 million. The centre features a high-tech, interactive 4D theatre, where people can immerse themselves in the sights, sounds and even the smells of the past, through old videos, cinema footage, photographs, music and even relevant scents, which trigger reaction and stimulate conversation.
There have been more highlights of Liverpool’s year of dementia. Everton in the Community, the community arm of Everton football club, is performing reminiscence work with Mersey Care. My right hon. Friend the Member for Salford and Eccles (Hazel Blears) mentioned universities, and Liverpool Hope university is providing a dementia centre of excellence, which is a physical location where members of the public, clinical services, charities, businesses and third sector organisations get the chance to meet and share expertise.
I pay particular tribute to the React service in Liverpool, the personal care services, community support service and external day services. I also praise Age UK Liverpool, Telecare, Livability and CEDAS for the work they do. Discussions are at an advanced stage to refresh the city’s joint strategy for dementia and ensure that the dementia alliance is developed and fully operational for 2014.
I urge the Minister to spend time with me, if he is going to Salford, to see first hand the differences that we are making on Merseyside. The G8 summit on dementia gives us the opportunity to push for more research into a whole host of dementias, and highlights the innovative approaches to tackle the condition—and in that Liverpool leads the way.
Paul Burstow (Sutton and Cheam) (LD)
It is a great privilege to take part in this debate and to be presided over by you, Madam Deputy Speaker, for the first time. I congratulate the hon. Member for Chatham and Aylesford (Tracey Crouch) and the right hon. Member for Salford and Eccles (Hazel Blears) on their tenacious pursuit of these issues and on ensuring that we have had two Back-Bench business debates on the subject in less than a year. That gives notice of the fact that this is an issue about which the House and its Members feel passionately and to which they want more attention paid.
Last Thursday, I took part in a local dementia forum in my constituency, which was organised by the Sutton Alzheimer’s Society. It brought together a range of organisations to listen to and engage with people who are experiencing dementia—either as carers or as sufferers who have the diagnosis and are living with its consequences. That was an incredibly powerful experience. At the heart of this issue is how we ensure that people have a good life and maintain good relationships, because dementia can rob them of that. We need to think about how we can ensure that people, whether they be a professional, a carer or someone who is working in another part of the public or private services, understand and are aware of the issues about dementia. We need to build a community that is more friendly towards those who suffer from dementia. Good communication is at the heart of that. The one message that all of us who were speakers at the event got from both the carers and the people with dementia was to slow down. We were gabbling and talking at great pace, because we were trying to get across too much in too little time. With just over three minutes left, I will not manage to achieve that requirement now.
I want to take a slightly different tack from the contributions we have heard so far and argue that the G8 summit on dementia needs to address the impact dementia will have on the development of low and middle-income nations across the planet. As Dr Margaret Chan, the director-general of the World Health Organisation, says:
“The need for long-term care for people with dementia strains health and social care systems, and budgets. The catastrophic cost of care drives millions of households below the poverty line. The overwhelming number of people whose lives are altered by dementia, combined with the staggering economic burden on families and nations, makes dementia a public health priority.”
That is why having a G8 summit on it is correct.
We are living through an extraordinary time in human history. A revolution is taking place on this planet, which is remaking societies, the state and so much that we have taken for granted. It is really a revolution in terms of human survival. We are living longer, which is something that we should celebrate. It is a triumph of human ingenuity that is all too often portrayed as some sort of disaster. It is not a disaster, but something that we should celebrate.
Let me put some numbers into my argument. In 2010 it was estimated that, across the world, 35.6 million people had Alzheimer’s disease and other dementias. That number will increase to 66 million by 2015 and to 115 million by 2050. The majority of that increase will not fall in the developed world; it will be in low and middle-income countries where more than 70% of people with dementia will be living by 2050.
As I have said, the number of people with dementia in 2050 will rise to 115 million, but the number of people who will develop dementia worldwide between now and then is estimated to be 600 million, which is roughly one new case every four seconds. In the UK, the national dementia strategy, which, as we have heard, runs out next year, and the Prime Minister’s dementia challenge, on which I had the privilege of working when I was care Minister, recognise the challenge posed by dementia, that dementia is not a normal part of ageing and that concerted action is required.
The G8 summit requires a focus that is not just about the developed world’s research spend; it must also understand the impact of dementia elsewhere in the world.
Oliver Colvile
Is my right hon. Friend aware of the stigma of dementia in black and ethnic minority communities? I recently took part in an inquiry in which it became apparent that that is an issue.
Paul Burstow
The hon. Gentleman’s point is spot on and leads me on to my next point about an example of research in India. It is estimated that in 2010 there were 3.7 million people with dementia in India, which will rise to more than 14 million by 2050. Approximately half those people will be over 75 and almost 2 million will be over 90. There is a serious lack of awareness about the issues in low and middle-income countries, especially those in Africa. Almost three quarters of people with dementia will live in those countries and that is why I want to ensure that the Minister, as he feeds back into the process of preparing for the summit, will make sure that such issues are on the table.
Hazel Blears
The hon. Gentleman is bringing a new perspective to the debate and he has made me think about the commitments made on AIDS and HIV. We need only think how ambitious the world was in tackling HIV at a time when many of us thought that it was an irresolvable problem. The promises on antiretroviral drugs were hugely ambitious and the progress we have made has been tremendous. Will he join me in urging the Minister and Prime Minister to be just as ambitious on this agenda as we were on HIV/AIDS?
Paul Burstow
As a number of us have made clear, the global scale of the challenge is such that it requires the galvanisation of a global response. The summit is a unique opportunity to do that, but it must have the reach and ambition that the right hon. Lady is talking about. It could take as its model the successful work that has been done so far on HIV.
Although epidemiologists often say that the figures I am citing are undercounted, the disease is none the less regarded as the second-most burdensome chronic disease and, among all those with chronic non-communicable diseases, accounts for almost 12% of years lived with disability.
In most developing countries, the problem with dementia is hidden. I have mentioned India, and the “Dementia India Report 2010” was published by the Alzheimer’s and Related Disorders Society of India, helped partly by funding from the UK Alzheimer’s Society. It has provided invaluable insight into the prevalence of the disease and ways in which India can respond to the challenge.
Let me ask the Minister a couple of questions. The first is about the research spend. The hon. Member for Chatham and Aylesford asked about the ambition of doubling that spend every five years, but it is not good enough for just our Government to do that. We need other Governments to agree to the same thing at the G8 summit. We need to know how much is being spent in the G8 on such things. There is no published figure—that is extraordinary—and when I tried to find a figure for the debate, I could not. We need a baseline to know whether we are making progress.
This country’s leadership on such issues will be in doubt if we do not hear soon that the Government intend to have a new dementia strategy. I hope that the Minister will be able to give us some indication of when that will take place. Finally, in having such an ambition on research, we need to learn from the journey that cancer has gone on. Cancer research has for many years had ambition, reach and strategy. We have an Institute of Cancer Research and it is time this country had the same for dementia. That could deliver such a big prize for all our citizens.
Huw Irranca-Davies (Ogmore) (Lab)
I am delighted to speak in this debate on behalf of many of my constituents from all areas who have asked me to attend, listen and contribute. I will focus in particular on Wales and Wales and the G8, as well as on the importance of collaboration, but I want to thank the hon. Member for Chatham and Aylesford (Tracey Crouch), my right hon. Friend the Member for Salford and Eccles (Hazel Blears), the right hon. Member for Sutton and Cheam (Paul Burstow) and others, including my hon. Friend the Member for Liverpool, Walton (Steve Rotheram), not only for securing the debate but for championing the cause continually over a number of years. I also join them in praising the Prime Minister for putting this front and centre of the G8 summit. It is a worthy ambition, but as the right hon. Member for Sutton and Cheam set out, doing so has raised aspirations over what will be delivered. I sometimes feel for the Minister because he repeatedly faces people saying that we must do more on treatment, care, prevention and research on many conditions, but putting dementia four square at the head of the Government’s ambitions for the G8 summit shows that there is a level of desire for some real outcomes, not least of which should be long-term strategy and the co-ordination of spending internationally to make the most of it and see what more can be put into the pot. It is a once-in-a-lifetime opportunity.
Right hon. and hon. Members have mentioned the ambition. My right hon. Friend the Member for Salford and Eccles spoke about turning the spotlight on to AIDS and HIV in the 1980s and 1990s, which really did make an unprecedented step change because there was an international focus on treatment and care. Massive interventions were made in previous decades on cancer treatment, and they had the same effect. There is a desire across the international community, especially given the opportunity provided by the G8, to have that same impetus. It is not simply an issue of spending; it is an issue of real focus and relentless drive on everything from prevention to treatment, care and research.
In Wales more than 45,000 people now have dementia, and that figure is forecast to increase to almost 60,000 by 2021. Hon. Members may be interested to know that in Wales only 38.5% have received formal diagnosis of their condition. That is lower than in other parts of the UK, which is interesting. There is good work going on within Wales. The Welsh Government published back in 2011 the national dementia vision for Wales, setting out their commitment to supporting research. The Welsh Government have also pledged to support research in dementia cause, cure and care. They offer funding opportunities to researchers who want to undertake research into dementia.
In the light of my intervention on the Minister’s speech, what is he doing to ensure that knowledge is disseminated well not only internationally but in Wales and England and other regions of the UK, that best practice is shared, and that research collaboration is streamlined properly? What is being done to co-ordinate at a government level in different parts of the UK work on dementia priorities? It would be a tragedy in times of stretched spending if there was duplication and a waste of effort all the way from social care through to research and so on. Let us make sure that it is all lined up in the right way. That is what the G8 summit can do on the international agenda as well.
Mr Philip Hollobone (Kettering) (Con)
I understand that around the world some $40 billion has been spent on dementia research, but all the drug trials have failed. The emphasis surely should be far more on prevention. Professor Smith, who was mentioned earlier, maintains that Alzheimer’s could be cut by a quarter. If he is right on that subject, that would mean massive savings on health care costs in Wales and across the rest of the country.
Huw Irranca-Davies
The hon. Gentleman makes a good point, which was also touched on by my right hon. Friend the Member for Salford and Eccles. It is a startling fact that 0.1% of funding goes into prevention. Surely there has to be greater emphasis on that, because the outcomes of prevention are so beneficial.
I am sure that the Minister is aware of what is going on in Wales. The Welsh Government’s National Institute for Social Care and Health Research funds and manages the research activity in Wales. The total spend last year was £75.7 million, of which £3.54 million was spent on biomedical research project funding. Just over 15% of the budget was awarded to researchers working on projects directly relevant to neurology research, including mental health. The same organisation awarded the Wales dementias and neurodegenerative diseases research network £743,000 over five years for its research. It is about knowing what is going on not only in Wales and different parts of the UK, but internationally so that we can co-ordinate and make the optimum use of regional, national and international spend on prevention, care, treatment and research.
My final point—it is probably one for another debate—is that we cannot divorce the strategic matters from the operational ones, and that means looking at the huge stretch in social care. There are real and intense pressures on social care, and not just on resourcing, but on staffing, staffing expertise and the necessary reform of long-term social care funding. That is probably a subject for another day, but the reality is that there are pressures on the ground affecting many people with different types of dementia and their families. There is real anxiety.
Hazel Blears
I appreciate that the debate is about the G8, but does my hon. Friend share my concern that the integrated transformation fund, the £3.8 billion that is supposed to relieve some of those pressures, brings together resources that are already being spent by local government and the NHS, so it is not actually new funding? Perhaps the Minister will address that when he responds to the debate.
Huw Irranca-Davies
I share that concern and hope that the Minister will turn his attention to it briefly. It is a major concern for the organisations and individuals out there.
In conclusion, I commend the Prime Minister for taking this initiative forward with the G8. It is a golden opportunity. Let us not miss it. Let us reach our ambition and our aspiration.
Sarah Newton (Truro and Falmouth) (Con)
I, too, congratulate the hon. Members who secured the debate on their relentless tenacity, because they always provide us with opportunities to talk about this incredibly important issue. I do not think that it is an exaggeration to say that it is one of the largest public health challenges facing the world in the 21st century.
Although I would love to take a few minutes to celebrate the work I have seen in my constituency, with constituents responding so positively to the Prime Minister’s challenge to come together as a community of health professionals, voluntary sector organisations and businesses to make it a very friendly place to live in, and to celebrate many of the improvements in the local NHS and care sector, I want to draw us back, because I will probably be the last Back-Bench Member to speak, to the particular challenges and opportunities that the G8 summit presents. I will recap on the aims of the summit, because it is very much about the research. They are to identify and agree new international approaches to dementia research; to help break down barriers within and between companies, researchers and clinicians; and to secure the type of collaboration and co-operation that he been mentioned so far.
I will focus on what more we can do on the science. The Government have committed to spending a lot more money, and we have heard about other countries committing considerable sums of money to research, but, as in so many other areas, it is about more than just the money. It will be vital at the summit to listen to the expert evidence that will be considered from clinicians, the pharmaceutical industry and researchers and to look at what the barriers are to better and more effective use of the funds available for the prevention, diagnosis and treatment of dementia.
Steve Rotheram
The hon. Lady is of course absolutely right that the science is the most important part of this, but, as I mentioned, there are also non-pharmaceutical interventions that are equally important to people who are suffering until, I hope, we can find the cure that we would all like to see.
Madam Deputy Speaker (Mrs Eleanor Laing)
Order. Hon. Members ought to note that if they wish to hear what the Minister and the Opposition Front-Bench spokesman have to say about the debate, they should not take any further interventions.
Sarah Newton
I am a member of the Science and Technology Committee, and I am delighted that my Chairman, the hon. Member for Ellesmere Port and Neston (Andrew Miller), is here and has intervened. I would like to draw the Minister’s attention to some excellent work that our Committee has been doing this year. I think that some of the reports we have published will help him to prepare for the summit. We undertook a very good investigation into clinical trials and also produced a report called “Bridging the valley of death”. Both reports highlighted a very significant issue facing research, not only in the UK but globally.
As Members will know, we have an absolutely world-class science base in our country. The main challenge facing it is to overcome regulatory environments, many of which are international, to enable it to take its first-class research across the valley of death and into the development of ways of diagnosing dementia and therapies for treating it. It is very important to learn the lessons from our very extensive inquiries to enable more of this research to be commercially developed in order to find its way into the marketplace.
Andrew Miller
Does the hon. Lady agree that it would be helpful if the Minister could revisit the Government’s response to our inquiry on clinical trials, because we could then be a world leader and show real leadership at the summit?
Sarah Newton
Only yesterday, we took evidence from Professor Collinge from University College London and Professor Ironside from Edinburgh, who are leaders in the field of degenerative brain disease. They provided us with even more compelling evidence of the increasing difficulties of getting from the research stage to being able to secure enough commitment from the pharmaceutical industry and other bodies that fund research into developing the science into diagnostic and therapeutic techniques. They reported that the pharmaceutical industry, which is a massive investor in research and its outcomes, is getting far more risk-averse and, as a result, is putting many more burdens on to the research of scientists in universities—burdens that they are not really capable of taking on board. The G8’s focus on getting the companies and clinicians, as well as researchers, around the table to look at the pathways from the science into scaleable, commercialised solutions is vital.
It is important that we do this not only in our own country but internationally, because most of the regulations are international. Where there is not international agreement, that in itself becomes a barrier to research and its commercialisation. The work done at the G8 will enable there to be much larger markets, meaning that very many more people will be helped and that money will flow into the research and make it more widely available.
The transcripts from our findings yesterday will be available in a couple of days’ time. That should give the Minister a good opportunity to look at the evidence we were given by those very eminent researchers, who are undertaking research into prions, as well as looking into developments on variant CJD, which is a form of dementia, and how that links to other types of dementia such as Alzheimer’s. We need that sort of joining up across the process to enable diagnostic and preventive procedures, and therapies, to be developed. All the various scientists—
Madam Deputy Speaker
Order. The hon. Lady heard me say that if Members wished to hear the Minister and the Opposition Front-Bench spokesman there should be no further interventions. She took a further intervention and she will have to conclude very quickly.
Sarah Newton
My last point is to urge the Minister to look to ensure at the G8 that the various scientists and the various disciplines work together.
Liz Kendall (Leicester West) (Lab)
I welcome you to the Chair, Madam Deputy Speaker, as this is the first time I have spoken since you were elected. I also warmly congratulate the hon. Member for Chatham and Aylesford (Tracey Crouch), my right hon. Friend the Member for Salford and Eccles (Hazel Blears) and the right hon. Member for Sutton and Cheam (Paul Burstow) on securing this really important debate. I am sorry that some Members have not had more of a chance to speak, because I know that they feel passionately about the subject.
Like other hon. Members, I welcome the G8 summit on dementia. It is important to be hosting the first summit dedicated to dementia when countries are facing so many other issues. It is also right because the ageing population, which includes an increasing number of people with dementia, is one of the biggest immediate and long-term challenges facing both this country and the world. Dementia already affects more than 800,000 people in the UK and that figure is set to rise to 2 million by 2050. It is estimated that more than 115 million people worldwide will be living with dementia in 40 years’ time.
Anyone whose family has experience of dementia will know how devastating the condition can be. It is therefore right that the G8 summit and the Prime Minister’s dementia challenge seek to boost national and international efforts on clinical research. Developing effective drugs and treatments is essential if we are to offer hope to people that something can be done about this terrible disease.
If we are going to address the challenge of dementia, we must face up to the equally important challenge of improving the quality of dementia care. We need to ensure that we do not neglect research into the support and services that aim to prevent the onset of dementia in the first place, which was something that many hon. Members spoke about. Although there is no certain way to prevent dementia, we know that a healthy lifestyle can lower people’s risk of getting not only dementia, but lots of other diseases, when they get older. Eating well, exercising regularly and stopping smoking may not grab the headlines in the same way as discovering a new job, nor attract research funding from institutions and companies, but ultimately they will be key to meeting the dementia challenge in the future. I hope that we will one day have a G8 summit on precisely those issues.
I want to focus my brief comments on the crucial matter of the quality of dementia care because, for my constituents and for people in my family and my friends’ families, the quality of care they receive, and the problems they have with it, represent the biggest challenge. People with dementia and their family carers are clear about what makes good dementia care. They want joined-up services and support so that they do not have to battle different parts of the system. They want care that is personalised to their individual needs. The vast majority of people with dementia want to stay living independently in their own homes for as long as possible, and families want to help to look after their loved ones as long as they get the right help and support.
Like many hon. Members, I have seen lots of inspiring examples of people working to improve care for people with dementia: day centres that provide stimulating activities such as gardening, cooking, singing and music; care homes that understand that they have to ask the families of people with severe dementia what kind of care and support they need, because those people’s memory has been taken from them; hospitals that involve families by asking them what food and activities their relative wants and needs; and, crucially, higher education institutions such as the university of Worcester, which I recently visited and is transforming staff training by getting patients to interview people who want to be student nurses, and then to develop and actually give the course, because how can NHS and social care staff know what dementia patients really need if they have not been trained in the first place?
Our loved ones will not get the quality of care we all want for them within a malnourished and depleted social care system. In fact, I think that the growing crisis in social care is the biggest threat to people suffering from dementia and the largest challenge we face. Council budgets have been under pressure for many years, but almost £2 billion has been cut from local authority budgets for older people’s social care since the Government came to power. Fewer people are getting the up-front care that they need to stay living at home. Home care visits have been shortened to barely 15 minutes, which is not enough time to get a vulnerable person with dementia up, washed, dressed and fed.
Care workers do an incredibly important job, but they are struggling. They are not paid even the minimum wage, let alone the living wage, and they are employed on zero-hours contracts. That is bad not just for people with dementia, but for taxpayers, because if those with dementia do not get the help and care they need so that they can live at home, they end up in residential or hospital care, which costs taxpayers more.
I want to ask about the Government’s plans because it is important that we are clear about them. I am sure that the Minister will talk about their plan to integrate services, but I want to echo a point made by my right hon. Friend the Member for Salford and Eccles. The integration transformation fund is not new money, but existing resources of £1.9 billion from clinical commission groups, with the rest coming from existing local council budgets. I think that £3.8 billion is a really unambitious amount of funding in the context of a total NHS and social care budget of £120 billion. We need the far bigger and bolder response of the full integration of NHS and social care budgets if we are to meet the challenge of our ageing population and dementia.
The G8 summit and the Prime Minister’s dementia challenge are welcome—they build on the previous Government’s approach—but the challenge needs to focus on improving the quality of care and research into prevention. I echo the important point made by hon. Members about the need for a commitment to renew the previous Government’s national dementia challenge, which expires at the end of next year, and the Prime Minister’s dementia challenge, which ends in 2015. I hope that the Minister will give such a commitment so that we can have the long-term strategy across all areas that we desperately need.
The Minister of State, Department of Health (Norman Lamb)
It is a pleasure to see you in the Chair, Madam Deputy Speaker, and I offer you my congratulations on your election, as other hon. Members have.
I find myself in a bit of an invidious situation, because it will be impossible for me to do justice to this very impressive debate in which hon. Members on both sides of the House made impassioned and effective speeches. However, I undertake to write to them to ensure that I pick up all their points. I congratulate the hon. Member for Chatham and Aylesford (Tracey Crouch) on her excellent introduction to the debate, as well as on securing it in the first place.
I have a few scatter-gun points. I would be absolutely delighted to go to Salford. I think that I am already committed to going to see the fantastic House of Memories in Liverpool, so it would be good to spend time in Salford with the right hon. Member for Salford and Eccles (Hazel Blears) and in Liverpool with the hon. Member for Liverpool, Walton (Steve Rotheram). I was interested to hear about the Science and Technology Committee’s impressive work and conclusions, which I clearly need to look at in more detail.
It is good to have real consensus in the House about the challenge that we face and what we need to do. There has rightly been praise from both sides for the Prime Minister’s identification of dementia as something that deserves his particular attention and as a matter for a summit this December during our presidency of the G8. The summit will elevate the whole issue to the global stage in just the right way.
The right hon. Member for Salford and Eccles was absolutely right to say that, in everything we do, people with dementia and their families ought to be absolutely first and foremost in our minds. It is critical to listen to them and to ensure that we act on their needs.
Someone around the world is diagnosed with dementia every four seconds. More than 35 million people have it, and as people live longer than ever, that number is set to double every 20 years. Some 58% of those people live in low and middle-income countries, and the proportion is projected to rise to 71% by 2050. My right hon. Friend the Member for Sutton and Cheam (Paul Burstow) was absolutely right to identify the challenge in the developing world. The right hon. Member for Salford and Eccles was right that dementia needs to be seen as something that requires real ambition on the same scale as that on HIV/AIDS.
Especially during the later stages of dementia, when people’s behaviour can be challenging and extraordinarily distressing for their loved ones, families face a huge emotional and practical burden. We cannot ignore the pressure on our health and care system. Incidentally, the £3.8 billion fund that has been mentioned comes from both the health system and care systems. The intention is to consolidate resources as effectively as possible. Our approach represents a clear shift from repair to prevention, and all hon. Members who spoke recognised the importance of focusing on prevention.
The shadow Minister says that she wants more ambition. When I met adult social care directors, I was struck by how many were considering pooling the whole of their budgets—[Interruption.] I do not know whether the shadow Minister can hear what I am saying with the hon. Member for Scunthorpe (Nic Dakin) sitting by her side, but my point is that there is a great deal of ambition out there.
Dementia is a major priority for the Government. The Prime Minister launched his challenge last year and he is now getting the G8 to focus on the condition. As part of our G8 presidency, the UK is hosting a summit on 11 December that will bring together health and science Ministers, the OECD, the World Health Organisation, expert researchers, pharmaceutical leaders and representatives of civil society.
There are short, medium and long-term priorities for dealing with dementia, and the first priority is to prevent it, as hon. Members have said. The hon. Member for Richmond Park (Zac Goldsmith) intervened to make a point about the importance of understanding risk factors. There is much more that we can do to prevent dementia in the first place, so gaining that understanding is critical.
The second priority is to delay the onset of symptoms and to maintain cognitive function. The third is to improve care and support for people who are affected by dementia and their carers. The hon. Member for Chatham and Aylesford made that point strongly and spoke about the value of telecare in helping people to remain independent. With first-class care and medical treatment, someone with dementia can still find purpose and pleasure in life, as can their loved ones, which is very important.
Research and innovation are critical, so I am pleased that biopharmaceuticals and other industries will be represented at the G8 summit. We need to explore how we can align our research priorities and stimulate innovation in all sectors. By the end of the summit, I hope that we will have reached two agreements: a declaration that demonstrates the extent of our shared commitment and a communiqué that outlines a plan for global action. We want to ensure that there is a legacy and that work continues beyond the summit. This must be the start, not the end. We are working with the WHO, the OECD and other partners to develop the plan.
The summit is an enormous opportunity to pool global resources and bring them to bear on the extraordinary challenge that we face. Together, I think that we can make a real difference.
Tracey Crouch
We have had a fantastic debate, but I would expect nothing less, given that this is the second debate that we have had on dementia in the Chamber. Members’ contributions on the subject, which is important to our constituents, are always incredibly passionate and varied.
The right hon. Member for Salford and Eccles (Hazel Blears) put it much better than I could by saying that we must always remember that there is a person at the centre of the debate. When we talk about global economic figures, we are talking about how we can best help somebody who is suffering from this debilitating, devastating disease and their family who are there to support them.
The Minister has heard the passion of the Members who spoke today. They have demonstrated how important this issue is to our constituents, communities and society. They have also set out the economic factors. He should go back to his Department and think carefully about how the UK should take forward its dementia strategy, which is still not forthcoming beyond 2014. We must be clear that being a global leader on this issue is about not only holding a G8 summit, but practising what we are saying back at home. The Prime Minister has the support of the House in taking this matter to the G8 summit and we all wish him well as he does so.
Question put and agreed to.
Resolved,
That this House has considered the G8 summit on dementia.