The Minister for Health (Edward Argar)
In response to one of the points made by the shadow Minister, the hon. Member for Denton and Reddish (Andrew Gwynne), I would not take away from the hon. Member for Ellesmere Port and Neston (Justin Madders), who has the Adjournment debate, the honour of having the last debate before the House rises. The shadow Minister is absolutely right about the importance of the subject we are debating, and I am grateful to him, as always, for his tone and what he has said. I find myself in agreement with him perhaps more often than is good for my promotion prospects; that is one for the Whips not to note in their book.
I thank the hon. Member for Oldham East and Saddleworth (Debbie Abrahams) for securing this hugely important debate. Before I was a Minister, I had the privilege of working with her and the all-party group as one of her co-chairs. I pay tribute to her for her work and her dedication to this issue, which is one of the most important that we will debate in this House, and to the work of the all-party group and the various charities that engage with it so diligently and give so much of their time.
I hope the hon. Lady will find it encouraging that even though this policy area falls within the ministerial portfolio of my hon. Friend the Minister for Care and Mental Health—I am, therefore, taking this debate on her behalf—I still read the reports and calls for evidence that the all-party group puts out. I will turn to the dementia moonshot in a moment, but I particularly remember the report from, I think, September last year with its overall recommendation and seven subsequent recommendations. I hope it reassures the hon. Lady to know that I continue to follow very closely the important work that she and the all-party group do. I hope that she will pass on to the all-party group, and the Members of this House who serve on it, my gratitude for their work.
The hon. Member for Denton and Reddish, and indeed all hon. Members who have spoken, have highlighted in different ways either personal or constituency experience, or the work of organisations in their constituencies. As a Minister, I do not often get the opportunity to pay tribute to particular organisations in my constituency, unless I can somehow work them into debates that I am responding to. I join Members in highlighting a number of them, including the memory café, which I have visited, in Syston in my constituency. I had the privilege of visiting, pre pandemic, the Cedar Mews care home, which specialises in providing care for people with dementia, and working with local Dementia UK members in their campaign to raise the funding to secure an Admiral nurse to help people with dementia and their families in Leicestershire. We are all very familiar with Macmillan nurses, and it is important that we take this opportunity to pay tribute to the work of Admiral nurses in this context and raise their profile.
The hon. Lady will know that, like my right hon. and gallant Friend the Member for Beckenham (Bob Stewart), I am a dementia friend from my days on the all-party group. I encourage all hon. and right hon. Members who have not engaged with that process to do so. It involves undertaking an incredibly thought-provoking and valuable session, which will make hon. and right hon. Members look at these issues in a different light, however well informed they think they are. I commend that programme.
This debate on dementia research is very timely, since the Government are currently developing their new dementia strategy, as has been mentioned. The new strategy will set out our plans for dementia for future years, and it includes our ambitions for dementia research. We are working closely with patients, researchers, funders and charities to develop these plans, and we look forward to setting out—I think the shadow Minister and other hon. and right hon. Members called for this—a bold approach to the challenges of dementia.
The central recommendation in the APPG report on dementia—it has been mentioned by a number of hon. and right hon. Members—was for the Government to deliver on the election manifesto pledge on dementia research, but I know that they entirely understand the impact of the pandemic. The SNP Government in Scotland, for perfectly good reasons, have had to break their pledge to deliver a fourth dementia strategy from 2020, following their highly successful third dementia strategy because they were unable to consult and develop their plans and had to prioritise dealing with the pandemic. For exactly the same reasons, the pandemic has had the same impact on the UK Government’s focus and on the funding, which we had to put into covid over that period.
I will turn to the manifesto pledge in a minute, but I know—I may get the pronunciation wrong—that the hon. Member for Coatbridge, Chryston and Bellshill (Steven Bonnar) is a reasonable and sensible gentleman. My comments may not do him any favours with his Whips, but I know he will appreciate the impact that dealing with the pandemic had on the ability of the UK Government, and indeed the devolved Administrations, to implement their ambitious plans at the time they wanted to. However, that does not take away from the commitment of both the UK Government and the Scottish Government, now that the pandemic has receded, to get on with delivering what I know we all want to see, and I think that is a shared ambition.
I can reassure the House that we remain absolutely committed to supporting research into dementia. The funding pledge that the hon. Member for Denton and Reddish highlighted in his remarks was in the 2019 manifesto, but of course we still have some time in this Parliament to run—I believe—and it is a longer-term pledge. There is still an opportunity to deliver on that and the Government still recognise the importance of that commitment. I will turn to funding in a moment and pick up the point made by my hon. Friend the Member for Bexhill and Battle (Huw Merriman).
The impact of the pandemic has been significant, and of course people with dementia, and their families and carers, have been very hard hit by its effects and by the necessary measures to combat it. I do not think anyone could have put it more effectively and more movingly than the hon. Member for Ochil and South Perthshire (John Nicolson) who, in order to help our understanding, shared with the House—I know it will have been difficult—and therefore with the country, his experiences and those of his mother Marion. I pay huge tribute to him for his courage and bravery in talking about something that I know will still be very painful. From what he and Madam Deputy Speaker, the right hon. Member for Epping Forest (Dame Eleanor Laing), said at the time, I know how close he was to his mother. Sadly, I never met Marion, but I get the impression that she was a wonderful and amazing lady. I pay tribute to him for his courage.
Edward Argar
The hon. Gentleman is absolutely right, and I think he speaks for thousands across this country who will have had a similar experience during the course of the pandemic. We must never forget every one of the people lost during this pandemic, whatever medical reason caused that, and we must never forget the families and carers of those with dementia.
As we have heard from hon. and right hon. Members—the hon. Member for Oldham East and Saddleworth talked about her mother, as did the hon. Member for Ealing Central and Acton (Dr Huq), who is no longer in her place—the challenge and the impact of dementia are huge. Dementia is a heartbreaking condition that, sadly, impacts many of us, or will do, either directly or through family and friends. More than 850,000 people in the UK have dementia, and they are supported by a similar number of carers, many of whom are older people themselves, and we must never forget the debt we owe to each and every one of them. Of course, in a sense they do not see it as our owing them a debt. They do it out of love for their relatives and their friends, and that possibly even adds to the gratitude that we as a country should show them in recognition of what they do.
Hon. Members have mentioned the Office for National Statistics data on deaths due to dementia and Alzheimer’s disease in 2019, and the hon. Member for Oldham East and Saddleworth made a very important point. In common parlance and commentary, people talk about Alzheimer’s as dementia and dementia as a single disease, but she is right to talk about dementia as an overarching term for a variety of diseases. I will return to education and awareness-raising. ONS statistics show that in 2019 deaths attributed to dementia decreased for the first time since 2009, but they remained the leading cause of death, accounting for 12.5% of all registered deaths in that year.
On the point that I was making to the hon. Lady, there are three key elements that we as a society and as a country need to look at. First, we need to raise people’s awareness and understanding of dementia. We want to have a society in which we all think and feel differently about dementia; one where there is less fear, stigma and discrimination and more understanding. While many thousands of people have dementia, we must not see it as an inevitable part of ageing. I will return to that.
In the past 20 to 30 years, we have seen a breaking down of the taboo and unwillingness to speak about cancer, for example. As a society and as individuals, we talk much more in our national and individual discourse about cancer and what we can do to help prevent it, to treat it, and to make people feel less alone when they have a cancer diagnosis. We have made progress on dementia, but we still have a long way to go to raise that awareness and have that national debate. All hon. Members play a huge role in stimulating that debate, and today’s debate has helped to do that.
To return to the heart of the matter, perhaps one reason why people do not engage with it or talk about it—they may feel frightened—is that although with cancer we know that there are diagnostic tests and that every day we are making new discoveries that help increase the opportunity to find a cure and treat it or so that people can live longer and well with it, we are not there yet with dementia. I suspect that there is an element of people thinking, “Well, if I get the answer and nothing really can be done, do I want to know?” The short answer is that it is always better to know, because that allows the person to plan and have those conversations. Through knowing, they can also help advance that research. However, I understand the entirely human reaction of people thinking, “Maybe I’d prefer not to know.” We need to continue that conversation.
The second hugely important aspect is support and care for people with dementia and for those who care for them. While we seek to improve prevention and diagnosis as well as seeking that cure, we need to ensure that those living with dementia and those who are supporting them feel that they in turn are supported. We are determined to support those living with dementia to live the fullest possible life for as long as possible and to support those who care for them.
Alongside that, the third element—in a sense, this is the crux of some of the speeches and the debate—is research into testing and diagnosis. While it is not often the case, I think that hon. Members in the Chamber are as one in seeking one goal: the day we find a cure for dementia—or, at the very least, something that can delay it or treat it.
While we wait for that day, it is important to recognise the point made about prevention by the hon. Member for Nottingham South (Lilian Greenwood). There is much that we do know about how people can help reduce their risk of dementia through lifestyle factors and a range of other things. They may not be exclusive, but there is an opportunity for people to take simple steps that help prevent or reduce the risk of getting dementia. We need to do more to spread that message and raise awareness of that in our society. I am grateful to her for making that point, because we want to reduce the number of preventable dementia cases.
I will return to other points subsequently, but let me turn to research and the moonshot that has been mentioned. The new dementia strategy will set out our plans to tackle dementia over the coming years. I try not to be partisan, so I pay tribute to the Scottish Government’s 2017 to 2020 dementia care strategy—I think it was their third—as well as the two related workforce programmes and a range of other measures. We can always learn from each other and best practice in different parts of our Union, and we should certainly be willing to do that in a space such as this. The hon. Member for Central Ayrshire (Dr Whitford) has kindly invited me to Edinburgh to see a range of things that she wishes to showcase to me. I hope that I will be able to take her up on that offer and also see my opposite number in Scotland, Secretary Humza Yousaf.
Hon. Members raised a question about the devolved Administrations and working together. I think the hon. Member for Rutherglen and Hamilton West (Margaret Ferrier), who is no longer in her place, mentioned the joint dementia research work. We are working with the Alzheimer’s Society, Alzheimer’s Research UK and Alzheimer Scotland. We are jointly funding that work to ensure that, notwithstanding other contexts in this House where we may have debates about our Union, we are genuinely working together to deliver a positive outcome.
Increasing research spend takes time. I hope that hon. Members will recognise the impact that the past two years have had on the spending prioritisation, as we have had to focus to meet the immediacy of the covid situation. However, we have committed to invest at least £375 million in neurodegenerative disease research over the next five years. To the point made by the hon. Member for Denton and Reddish, we are working across Government to finalise outcomes from the spending review and to identify ways to significantly boost research on dementia.
With that in mind, I turn to my hon. Friend the Member for Bexhill and Battle, who says that in this context, I will always have a friend in him. I always find that I do have a friend in him; I have known him for a long time. Without straying into territory more properly reserved to the Chief Secretary and the Chancellor, let me say that there is a joint ambition across Government to continue to drive this agenda forward. Knowing my hon. Friend as I do, and watching his work as Chair of the Transport Committee, I suspect that he will not hold back in expressing his views on matters such as this, about which he is passionate.
The £5 billion investment in health-related research and development announced in the 2021 spending review reflects the Government’s broader commitment to support research into the most pressing health challenges of our time, including dementia. A number of specific points have been raised by the APPG and other Members. I will touch on as many as I can in the time available, but seek to leave five minutes for the hon. Member for Oldham East and Saddleworth, because I suspect she will want to come back on some of these points, given her work.
I turn to prevention, including what the Office for Health Improvement and Disparities will do to help reduce people’s risk of developing dementia. The APPG report recommended that the new Office for Health Improvement and Disparities launch public information campaigns on dementia risk reduction. OHID is involved in the development of the new dementia strategy, which will include proposals on prevention and risk reduction. The concept of brain health as part of encouraging people to reduce their dementia risk—going to the point made by the hon. Member for Nottingham South—is being actively explored. OHID has been working with the Alzheimer’s Society and Alzheimer’s Research UK to review public facing materials aimed at raising public awareness of dementia risk reduction.
I should take this opportunity—I fear I omitted to do so in my opening remarks—to pay tribute to Alzheimer’s Research UK, Dementia UK, the Alzheimer’s Society and the myriad local charities and groups that are working so hard to drive forward this agenda, and to support people with dementia and their families, as well as the research space. I add my tribute to that of the hon. Member for Denton and Reddish to the Greater Manchester research centre. Sadly it does not fall within my portfolio, but he and I might be dextrous in finding a reason within my portfolio that allows me to go and visit it with him jointly, which we would both enjoy.
More than 15 million people aged between 40 and 74 are eligible for an NHS health check in England, and during such a check, individuals are made aware that exercise, healthy weight, healthy diet and reduced alcohol consumption help maintain a healthy brain, and we need to continue to emphasise that message and the support that is out there through those health checks. I think it was the hon. Member for Oldham East and Saddleworth who touched on early diagnosis—it is not just about focusing on research for a cure, but on diagnosis. Timely diagnosis of dementia, as with so many other diseases, plays a hugely important part in ensuring that a person with dementia can access the advice, information, care and support that can help them plan and to live well with the condition and remain independent for as long as possible.
Everyone with dementia should have meaningful care following diagnosis, including information on local services, access to relevant advice and support and what happens next. Carers should be made aware of and offered the opportunity for the respite and support they need. DHSC guidance is already available, titled “After diagnosis of dementia: what to expect from health and care services”. When we set out our dementia strategy, diagnosis will be a key element of that.
Medical research charities have come up in this context, too, because it is not just about the big institutions—small institutions, academic institutions and charities are all playing their part in this space. I agree with Members in the analogy they drew with the vaccines and what can be achieved and what was achieved when there is an imperative to do it. I find myself agreeing with the shadow Minister. When we put our minds to doing something as a society and a country, there are often no limits to what we can achieve, as we have seen. We must put the same focus on this issue.
We recognise that the pandemic has caused problems across the sector and that many charities are facing difficulties just as their services are needed most. Medical research charities are a vital part of our life sciences ecosystem, and they provide significant research funding and training. Importantly, they amplify the voices of patients and their families in that process. Officials at the Department have been closely liaising with the medical research charities to better understand the impact of the pandemic on them and to seek to identify how we can work together to support their research and them. In that context, just one example is that my Department, alongside the Department for Business, Energy and Industrial Strategy, has announced a £20 million support package to help support early career researchers funded by charities. That will protect that pipeline of talent coming through the research system, to which Members have referred.
We have a rich dementia research ecosystem and we need to continue to support it. Through the UK Dementia Research Institute, scientists have made huge leaps in understanding the mechanisms underlying disease progression, and researchers have developed potential new diagnostics and treatments. It is painstaking work. The hon. Lady will remember when the focus was very much on amyloids, and whether that would produce a route to that cure. Often with research it is one step forward, two steps back, two steps forward, one step back, so the sustainability of investment and focus is vital if we are to make the breakthrough that we all wish to see.
Dementias Platform UK has established technology-based networks to better understand how dementia starts and to support experimental medicine studies. As the APPG report recognises, in partnership with the Alzheimer’s Society and Alzheimer’s Research UK, people with dementia and their carers continue to be recruited via Join Dementia Research to take part in a range of important research.
Through our National Institute for Health Research, we are supporting high-quality studies on preventing dementia through interventions targeted at known risk factors, service provision, care and care technology. There are many examples, but to give one, the “Well-being and Health for People Living with Dementia”, or WHELD programme developed an intervention to improve wellbeing for people with dementia in care homes and to reduce unnecessary prescribing of anti-psychotic drugs. In the 2021 spending review, as I have alluded to, we announced that £5 billion investment in health-related research and development. That reflects our commitment to support research, including in dementia.
We have taken positive action over the past year, notwithstanding the pandemic, to lay the ground for further developments and further research. Within the National Institute for Health Research, we launched a new £9 million call inviting research proposals on the early detection of dementia using digital technology. We launched a £3.6 million research for social care call to address important social care questions relating to dementia. The hon. Member for Oldham East and Saddleworth has taken a close interest in that, both in her previous shadow ministerial role and on the all-party parliamentary group on dementia, and I think that the APPG has called for evidence on social care impacts. We launched a highlight notice on dementia that invites ambitious dementia research applications; it signals to the community that dementia is a priority area for the NIHR.
As we work across Government to finalise the outcomes of the spending review and look towards the spring, the House, the Government and the country need to retain a focus on this issue, which is one of the most testing challenges we face as a society. We are living longer, which is a great testament to advances in medical science and in its ability to fix our bodies and keep them going for longer. The ability to understand, repair and treat our brains has perhaps not moved forward at the same pace, so we are living longer with dementia. That is, in a sense, positive, but it presents challenges for society, and it is why we must retain a focus on dementia.
We need to continue to build on our successes in order to accelerate the progress on dementia research, but we cannot do that alone. We will continue to work on this across Government, and with charities and the research community. By and large, we share the objectives of the shadow Minister and his colleagues. We may disagree from time to time on how to get there, but I suspect that we have, and will retain, a common objective. Crucially, we must work with people with dementia and their families to bring forward our ambitious plans for our new dementia strategy.
It has been a great privilege and pleasure to wind up such an important debate, and to speak on a topic that is not in my ministerial portfolio, but in which I have taken such a close interest over the years. We owe it to our constituents and future generations to rise to meet the challenges of our ageing society and of dementia. We must redouble our efforts to do that; when we do, I believe that our society and our country will meet the challenge of dementia and find the cure that we all seek.