Health and Care Bill

Baroness Bakewell Excerpts

Lords Hansard - Part 2 & Committee stage
Thursday 13th January 2022 Lords Chamber

[Baroness Hollins (CB)]

My Lords, it is a pleasure to follow the noble Lord, Lord Bradley, and I support those amendments with respect to mental health. My Amendments 27 and 39 would provide for the addition of an expert in learning disability and autism on each integrated care board and ensure that the learning disability and autism lead was a person with knowledge and understanding of what good health and support look like for people with a learning disability and for autistic people.

As a starting point, this proposal has already been pledged by the Government in both the NHS long-term plan and the autism strategy, the latter stating:

“We also expect that all Integrated Care Boards, which will be established by the proposed Health and Care Bill, will focus on autism and learning disabilities at the highest level, for example by having a named executive lead for autism and learning disability.”


The reason for the Government’s firm commitment is that people with a learning disability and autistic people are among those who stand to benefit most from the integrated approach that the Bill seeks to implement. These are people whose needs frequently span health and social care systems. They are one of the largest recipient groups in terms of cost of health and social care provision and therefore a cohort with one of the greatest stakes in the effective integration of these two systems.

People with a learning disability experience huge health inequalities—very relevant to discussion on the first group of amendments today. On average, the life expectancy of men and women with a learning disability is 14 and 18 years shorter than for the general population respectively. Thirty-eight per cent of people with a learning disability die from an avoidable cause as against only 9% in the comparison population. These inequalities have been hugely exacerbated during the pandemic, with death rates of up to six times higher than among the general population, according to Public Health England. People with Down’s syndrome were identified as being at as high a risk as the over-80s. Yet they have had inappropriate DNACPRs put on their hospital records without their consent and had catastrophic reductions in care and support during the past two years, which will take years to recover from. There has been much greater reliance on family carers, who are too often dismissed as difficult by poorly trained health and social care decision-makers.

It is not learning disability and autism that are the cause; it is the situation that they are in as a result of ineffective plans and ineffective responses to their needs. Learning disability and autism, as well as foetal alcohol spectrum disorder—a much underdiagnosed and poorly understood condition but related to the groups I am speaking about—are lifelong states of being, but they are unequal states of being. Having a learning disability or being an autistic person is not like having cancer. People with learning disabilities and autistic people also get cancer; they also have a much higher prevalence of mental health problems.

The work I am overseeing for the Department of Health and Social Care places the major responsibility for inappropriate and lengthy detentions in long-term segregation under the Mental Health Act at the door of commissioners. It is a commissioning failure in the main. Some commissioners have relied on the availability of crisis admissions rather than collaborating to develop essential community services, including housing and skill support, social prescribing of meaningful activities and other innovative wellness approaches.

This is an urgent appeal to the Government to clearly signal a requirement for competent and accountable commissioning for people with a learning disability and autistic people. There is a lot of money being wasted at the moment through very poor commissioning. Please can we get it right this time?

[Baroness Bakewell (Lab)]

My Lords, before I address my Amendment 28, giving my support to my noble friend Lady Thornton, I wish to endorse the other amendments that are calling for representatives of particular groups—we just heard mention of two. I particularly endorse all those, especially as I am taking rather an oblique approach to this debate, which is not reflected in the other amendments.

Last year, there was a report in America that, increasingly, hospitals there were closing. The report said that hospitals were seen as businesses; a fifth of hospitals in America are run for profit, and globally, private equity investment in healthcare has tripled since 2015. In 2019, some $60 billion were spent on acquisitions. Globally, that includes—indeed, targets—us and the NHS. Where does that affect us? Increasing inroads are being made into the National Health Service by Centene and its subsidiary Operose, which now own 70 surgeries around this country. From Leeds to Luton, from Doncaster to Newport Pagnell, from Nottingham to Southend and many more, Centene now owns and runs for profit surgeries formerly owned and run by NHS doctors. It is now the biggest single provider of GP surgeries in this country. It has further designs on the existing fabric of the NHS, seeking to have its representatives sitting on the boards of CCGs, making decisions about the deployment of NHS funding. This is a direction of travel that needs to be monitored and checked. Safeguards must be written into the Bill against this takeover.

Why does it matter, just as long as patients have good and free treatment at the point of need? What is the reputation of Centene in America? It is not good. Indeed, it is regularly embroiled in lawsuits from either patients or shareholders, and the sums are not small. In June last year, Centene had to pay a fine of $88 million to the state of Ohio for overcharging on its Medicare department. This is one of many. Since 2000, there have been 174 recorded penalties for contract-related offences against Centene and its subsidiaries. That enterprise is now active in this country and targeting our NHS. It is not a fit company to be part of our health service. I therefore ask the Minister for safeguards to be written into the Bill against such people being represented on our boards. When I raised this at Second Reading, the Minister replied that there was no chance of us selling the NHS. We do not need to: they are buying us.

[Lord Davies of Brixton (Lab)]

My Lords, I will not detain the Committee in speaking to my Amendment 30. In truth, I am speaking in favour of my noble friend Lady Thornton’s Amendment 29. I could claim that my amendment has the virtue of being shorter but perhaps brevity is not always a virtue. Amendment 29 also makes the important point that it is the sub-committees and committees of the ICBs that will be crucial. The substantive point is that the Government have to accept that the amendment agreed in the Commons is totally inadequate. It depends on matters of judgment. We want a clear specification of who is appropriate to be a member of those bodies.

Health and Care Bill

Baroness Bakewell Excerpts

2nd reading
Tuesday 7th December 2021 Lords Chamber

[Baroness Bakewell (Lab)]

My Lords, I welcome a Bill that brings together the National Health Service and social care. How could I not? It is a long overdue development. However, I have serious reservations about the Bill’s direction of travel. I fear that the reforms set out here will fragment and disconnect the NHS from the very people—the patients—it was created to serve. The proliferation of protest groups and increasing numbers of petitions, as well as individual cases to challenge existing changes being taken all the way to the High Court, all bear witness to a popular groundswell of opposition to what is happening.

There also comes a warning this week from former Health Secretary Jeremy Hunt about the risk of equity-funded investment in care homes. When the motive is profit, he says, standards of care are squeezed. The NHS motive is exclusively private care—and so we come to the continuing inroads made into the NHS by Centene, America’s leading health insurance company and its subsidiaries in this country under Operose. They have been steadily buying up surgeries around the country and including them on their schedule of profit-making enterprises designed to offer good returns to their global shareholders.

Anyone with any knowledge of American healthcare, whether first-hand or reported, will know how expensive it is. The level of your care depends on the level of your insurance; without insurance, you can be refused care. The New Yorker recently reported that American hospitals are closing at a rate of 30 a year. It reported that, increasingly, hospitals are seen as businesses—that

“a fifth of hospitals are now run for profit, and, globally, private-equity investment in health care has tripled since 2015.”

In 2019, according to this report, some £60 billion was spent on acquisitions globally. That “globally” includes—indeed targets—us and our NHS.

Centene and its British subsidiary Operose now own 70 surgeries around the country, from Leeds to Luton, from Doncaster to Newport Pagnell, from Nottingham to Southend, and in many other areas, Centene/Operose now owns and runs for profit surgeries formerly owned and run by NHS doctors. It is now the biggest provider of GP services in the country. It has further designs on the existing fabric of the NHS, seeking to have its representatives sitting on the boards of CCGs, and making decisions about the deployment of NHS funding. This is a direction of travel that needs to be monitored and checked—and it will be.

Why does all this matter, as long as patients have good and free treatment at the point of delivery, wherever they need it? What is the reputation of the company Centene in America? It is not good. Since the year 2000, there have been 174 recorded penalties against Centene, its subsidiaries and its agents for contract-related offences against its patients. The fines paid by Centene go into millions—billions—of dollars. This is not a fit company to be part of the NHS. I repeat the Government’s campaigning cry: “Take back control”—of our NHS.

NHS: Primary Care Surgeries

Baroness Bakewell Excerpts

Wednesday 24th November 2021 Lords Chamber

Asked by

[Baroness Bakewell]

To ask Her Majesty’s Government what steps they are taking to prevent the takeover of National Health Service primary care surgeries in the United Kingdom by American health insurance companies.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Kamall) (Con)]

The Government are clear that the NHS is not and never will be for sale to the private sector, whether overseas or domestic. Regardless of whether a service is run by an individual, a partnership or any other organisation, all providers of NHS core medical services are subject to the same requirements, regulations and standards. Patients will continue to receive high-quality care, free at the point of use.

[Baroness Bakewell (Lab)]

I thank the noble Lord for that Answer. I have two points to make. Once they know what is happening, NHS staff and the public increasingly oppose this move. A group action by Islington patients is going to court to challenge the change of control to an American profit-making company. First, will the Minister respond to such a groundswell and urge the Government to stop the encroaching control of the NHS by American health insurance companies? Secondly—

[Noble Lords]

Too long.

[Baroness Bakewell (Lab)]

Centene has a bad reputation across America. Since 2000, it has paid many millions of dollars in fines for 174 contract-related offences across the States, so will Her Majesty’s Government forbid the appointment of Centene-related staff and former staff to NHS CCG boards and their sub-committees?

[Lord Kamall (Con)]

I thank the noble Baroness for her speech. In answering, as this is for judicial review, I am sure she understands that I cannot comment on it. But I saw an interesting documentary over the weekend, so let me just read some words from it:

“Yes the NHS is a public service but how it spends its vast procurement budget, how it uses IT, how it fashions new processes and pathways for patients, plainly benefit from private sector experience.”


I admit I have plagiarised these words from Tony Blair, the last Labour Prime Minister to win an election.

Covid-19: People with Learning Difficulties and Autism

Baroness Bakewell Excerpts

Monday 5th October 2020 Lords Chamber

Asked by

[Baroness Bakewell]

To ask Her Majesty’s Government what provisions they have put in place to meet the needs of those with learning difficulties and autism during the COVID-19 pandemic.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)]

My Lords, we recognise that the pandemic presents serious risks and challenges for people with a learning disability and autistic people. That is why we have increased provision of PPE and testing in social care, we have enabled access to NHS volunteer responder schemes and we have developed tailored guidance informed by stakeholders. We have made reasonable adjustments to policies and funded charities with more than £1 million to provide support. The winter plan outlines work to protect all areas of people who need care.

[Baroness Bakewell (Lab) [V]]

My Lords, I thank the Minister for that Answer. He will appreciate that, as he said, people suffering from learning difficulties have particular problems when isolated by the pandemic—terrible loneliness, depression and challenging behaviour. Their families and many agencies, such as Mencap, the National Autistic Society and Care England, feel that government oversight and greater enforcement of existing provisions are needed. Will the Minister draw attention to the urgency of this need?

[Lord Bethell (Con)]

My Lords, the noble Baroness puts it extremely well, and it is an area we are deeply concerned about. We have commissioned Public Health England to carry out an analysis of the existing data on those who have suffered under Covid. We will be reviewing that data extremely carefully to understand the phenomenon more deeply. In the meantime, the Chancellor has announced £750 million to support the charity sector in response to the pandemic. Some of that money has been targeted specifically at charities that are supporting those with learning difficulties to ensure that they get the support that they need.

Queen’s Speech

Baroness Bakewell Excerpts

Tuesday 22nd October 2019 Lords Chamber

[Baroness Bakewell (Lab)]

My Lords, I regret the cursory reference in the gracious Speech to the social care needs of the old in this country. The Minister’s statement this afternoon has been confined to sums of money, some of which have already been announced. It was money that she spoke of; there was no substantial commitment to make changes to the system at a time when so much needs to be done. I will make two points which apply to the core issues of the care of the seriously old.

First, when I served as the Voice of Older People between 2008 and 2010, I received many letters asking for help with a problem concerning residential retirement homes and villages: many elderly people had come to rely on the expertise, availability and friendship of the wardens appointed to their care. These wardens were being phased out in favour of electronic alarms, buttons and telephone responses. Years later I sat on this House’s committee looking into AI and its potential. It became clear that artificial intelligence and robotic systems would increasingly offer an efficient and economical way of caring for the isolated old. I wish to issue a warning: old people want and need human contact; it helps them fight depression and loneliness in a way that machines cannot. I ask that future provision, while making strategic use of mechanics, has written safeguards about sustaining human contact with the old and isolated.

My second point is on a larger scale and concerns the business model that underpins the provision of residential care homes across the country: this needs a major rethink. I can only hope that the repeated delay of the long-promised Green Paper is because someone somewhere has woken up to the fact that the system is broken. The well-being and sense of security of frail, old people is at the mercy of the private equity-style business model, with the risk of companies carrying heavy debt burdens and paying extremely high interest rates.

The care home market, as noble Lords will know, is currently dominated by four major care providers: HC-One, Four Seasons, Care UK and Barchester. Between them, they operate some 900 of the country’s 11,000 care homes. Some 95% of the country’s care beds are provided by the independent sector, catering for self-funders and the local authority-supported. Recent austerity cuts to local council funding and the introduction of the living wage have added to pressure on all these companies. Between 2015 and 2019 the big four declared losses totalling £900 million. In their 2017 published accounts their total debt was £2.2 million—I am quoting figures from their own statements as reported by Opus Restructuring. Noble Lords will remember that Southern Cross collapsed in 2011. Currently all four companies are up for sale. A deal for the sale of Barchester collapsed in July this year and Four Seasons put two of its top companies into administration in April this year. Now I am not a banker, and for all I know this is a really healthy state of affairs in the City, but it is not a safe, reliable model for the ongoing care of our older people.

Let us consider it from their point of view. The need for a care home often hits a family very suddenly: the death of a married partner may leave the children looking to provide for the survivor as soon as possible; a frail old person living alone may sustain a sudden injury or a sudden deterioration in health. They need to find somewhere quickly and to meet the complex financial arrangements that have to be made. There is now evidence that companies prefer to set up care homes in the country’s most affluent areas, where there will be more self-funders in their potential market. The market will thus fail to supply the needs of the poorer old, and sudden changes in company finances can leave old residents suddenly bereft and bewildered. Family decisions made quickly in the shadow of bereavement or illness can be the wrong choices, but making complaints or seeking redress is not easy when you are dependent on the staff of the care home. I hope the Minister will address the issue of embedding consumer law in the regulatory regimes of care homes.

Growing old is not an option we can exercise: the alternative is worse. No sector in our society is crying out for reform more than our care of the elderly—and, incidentally, their dedicated and underpaid care workers. Will the Government address these concerns with the greatest urgency, and can they give us a timescale?

Breast Scans

Baroness Bakewell Excerpts

Monday 19th November 2018 Lords Chamber

[Lord O'Shaughnessy]

I am happy to tell my noble friend that we are in the process of recruiting many more radiographers for the NHS, with a plan to recruit nearly 1,900 by 2021.

[Baroness Bakewell (Lab)]

My Lords, it is important that women have scans throughout their lives. They receive a reminder to go for a scan, but those reminders stop at the age of 70. The incidence of breast cancer continues after 70. Will the Minister reinstate reminders for people over that age?

[Lord O'Shaughnessy]

A trial is going on the moment, the AgeX trial, which is looking at the clinical effectiveness of breast cancer screening for women aged 71 to 73. However, that is a randomised control trial, so not all women are being invited.

Adult Social Care in England

Baroness Bakewell Excerpts

Tuesday 10th October 2017 Lords Chamber

Asked by

[Baroness Bakewell]

To ask Her Majesty’s Government how they plan to respond to today’s Care Quality Commission report on the state of Adult Social Care in England in which it states that “some 1.2 million people are not receiving the help they need, an increase of 18% on last year”.

[Baroness Bakewell (Lab)]

My Lords, I beg leave to ask a Question of which I have given private notice.

[The Parliamentary Under-Secretary of State, Department of Health (Lord O'Shaughnessy) (Con)]

My Lords, the Government are committed to improving the quality and availability of adult social care in England. That is why we passed the Care Act in 2014 to provide for the first time a national eligibility threshold for care. It is why we are investing £2 billion more in social care provision over the next three years and have plans to reform how care is funded for the long term.

[Baroness Bakewell]

My Lords, the situation in social care is deteriorating and the Government’s strategy to handle the challenge is inadequate. The situation is getting worse because of the fundamental change in the demographic of this country. Some 15,000 people are now 100 years old, and the size of that cohort is increasing. Surgeries are closing, hospitals are inadequate, and 1.2 million people are unpaid carers and themselves over the age of 65. This calls for a radical, fundamental response, rather than the usual Green Paper and sums of money. That is not enough. This country faces a crisis of demographic change.

[Lord O'Shaughnessy]

I agree in part with what the noble Baroness said in the sense that demographic change represents a big challenge. She mentioned the over-100s. The population of over-85s will double between now and 2037. As the CQC report makes clear, many of those people will have difficulty with the basic behaviours and actions they need to be able to live independently. That is the big challenge that we face. The report provides a very honest exposure of strengths and weaknesses in the current system. The strengths are there, though the noble Baroness perhaps did not give them as much credit as they deserve. The report says:

“Overall, the quality of care remains relatively stable, with the majority of all care rated as good and improvements in some services”.


Indeed, only 1% of services are rated inadequate. Clearly we want that percentage to be zero but it is better than in other sectors. I do not disagree with the noble Baroness about the demographic challenges we face. As I said in my first Answer, we are trying to put more funding in, to recruit more staff and raise quality now that we have this national threshold. We hope to decrease variation and then look for a long-term solution that will solve this problem that we have all been wandering around for the last 20 years.

Carers over 80: Support

Baroness Bakewell Excerpts

Monday 13th June 2016 Lords Chamber

[Lord Prior of Brampton]

The noble Baroness is absolutely right. There are many tens of thousands of children who have very substantial caring responsibilities for their parents or grandparents. The impact on their education and future careers is certainly something that the strategy will want to take into account. Of course, the Children and Families Act sets out the rights of children. We need to assess them very carefully in the forthcoming strategy.

[Baroness Bakewell (Lab)]

My Lords, can the Minister tell us how much the group of people who are carers over 80 is saving the economy by offering their services?

[Lord Prior of Brampton]

I cannot give a specific figure for those over 80 but I think that, in so far as you can monetise something like this, the total amount for all unpaid carers is estimated to be around £1.3 billion a year.

National Living Wage: Social Care

Baroness Bakewell Excerpts

Thursday 5th May 2016 Lords Chamber

[Lord Prior of Brampton]

My Lords, the Government are putting £10 billion of new money into the NHS over the five-year period. Clearly, if there is a crisis in social care, that will have a direct knock-on effect on the NHS. We fully recognise that. The CQC has an obligation to keep a very close eye on this and to produce early warnings if a major, hard-to-replace provider looks as if it is getting into financial difficulty. It is an area that we are acutely conscious of and are keeping a very close eye on.

[Baroness Bakewell (Lab)]

My Lords, when these situations have arisen before and there has been a crisis with care homes, there has been a lack of response which has resulted in old and frail people being virtually turned out of the door. This is a crisis and there is going to be a crash—the care sector has warned us that it is coming. The Government have made concessions—the precept and so on—but will they put contingency plans in place so that when the crisis actually hits, old and vulnerable people are not suddenly thrust into a crisis that they do not know how to deal with?

[Lord Prior of Brampton]

The noble Baroness is absolutely right. Our whole focus must be on the residents of these homes rather than the owners. There are a number of very highly leveraged providers in this sector, which have high levels of debt—often very expensive debt—for historical reasons. The CQC is keeping a very close watch on them. When there are early-warning signs of difficulties, the CQC and the local authorities will put in place alternative plans.

Elderly People: Powers of Attorney and Living Wills

Baroness Bakewell Excerpts

Monday 12th January 2015 Lords Chamber

Asked by

[Baroness Bakewell]

To ask Her Majesty’s Government what steps they are taking to encourage elderly people, including those with early-stage dementia, to prepare living wills and powers of attorney in anticipation of serious illness or degenerative disease.

[Baroness Bakewell (Lab)]

My Lords, I am particularly grateful for the chance to debate dementia at this time both because it is timely—the national dementia strategy came to an end last year—and because there seems to be considerable movement on both the medical and the social care fronts in the approach to dementia sufferers and their carers. I know this because last December I wrote and presented a documentary for BBC Radio 4 about the subject called, “Suppose I Lose It”, and I learnt a great deal in preparing that programme.

The dilemma at the heart of the debate as I proposed it is exemplified by the response it got. It was first referred to the Ministry of Justice as being a legal matter —just so; the lasting power of attorney is a legal document—but at my request it was rerouted to the Department of Health as primarily a medical matter. I am grateful for this, and I am particularly delighted that the noble Earl, Lord Howe, will be replying for the Government. However, in the wider world there is a risk that the matter of advanced directives and LPAs might fall between the two stools: the legal and the medical.

Let me address the medical dimension first. There is a brief and to the point leaflet available at my local surgery, entitled Worried About Your Memory? The Alzheimer’s Society report tells us that dementia is the most feared condition among the over-50s. They are both fearful of knowing and ignorant of what might happen. This leaflet refers them to the Alzheimer’s Society, Britain’s leading dementia charity. It goes on:

“The earlier you seek help, the sooner you can get information, advice and support”.

There is a desperate need to know more and do more. Earlier diagnosis is the key that unlocks a whole raft of advice and behaviours that can help delay the progress of dementia and assist people to live well with it.

In my Radio 4 programme, the actress Prunella Scales and her husband, the actor Timothy West, spoke frankly of their 15-year journey with her dementia and how they cope with it. After 15 years, she still beats him at chess. Judging by the public response to the programme, their openness did much to promote a willingness in others to speak out and to talk openly about what dementia means in people’s lives.

The Government clearly recognise the importance of this. However, their plan to reward GP practices with a payment of £55 for each dementia diagnosis was strongly and rightly criticised by both the BMA and patients’ groups. The plan will fade out in March.

The answer must surely lie with patients themselves. A strategy should address all those large numbers of people who have reason to be fearful, to offer them the chance of an assessment at a memory clinic. But—and it is a very important “but”—they will come forward for a diagnosis only if they feel that there is something that can be done; otherwise, they may prefer to live in denial and delay getting help. In response to my programme, many people said, “But I don’t want to know. There’s nothing you can do”. That is not the right message.

What happens when you get a diagnosis of Alzheimer’s? The Alzheimer’s Society quotes a recent poll that found 90% feel unsupported after a diagnosis. The report Living and Dying with Dementia in England also stated that,

“people with dementia are not being appropriately identified for end of life care, and that they have less access to, and receive poorer quality, care than people with other terminal illnesses”.

The Dementia Action Alliance also finds the response far from satisfactory. Its recent Carers’ Call to Action makes constructive suggestions, including pre-diagnosis support from the GP; post-diagnosis education for the patient and their family; a dementia adviser or support worker to provide ongoing face-to-face personalised dementia expertise; a planned map of action for the future; and support to remain active and integrated in the community. Those are just some of the 20 suggestions. In some places, some of this is happening. In Scotland, a named link worker is made available for the first year after diagnosis. In England, the town of Crawley teaches the community’s waiters, teachers, shopkeepers and bus drivers how to recognise and then respond to dementia sufferers amongst them. We need more of these initiatives.

I now turn to the legal aspect of this debate. The encouragement of elderly people, especially those with early dementia, to write an advance directive and sign a lasting power of attorney is most important. The response package to a diagnosis refers obliquely to the need to “plan for the future”. That is left deliberately vague, I think to avoid causing pain, but the pain from not facing up to these legal matters will be the greater the longer they are not addressed. The advice needs to be more clearly and regularly spelt out, and given more emphasis.

The concept of capacity is what matters. The progress of dementia is medically unpredictable both in terms of the symptoms, and the timescale over which those symptoms progress. What matters for capacity is not the length of time since diagnosis, but the insight the person with dementia possesses at the time. Barbara Pointon, who wrote to me in response to the programme, said:

“We were only just in time. Four months later and Malcolm”—

her husband—

“could no longer sign his name”.

That was in 1993, before the Mental Health Act. She went on:

“No one told me about Lasting Powers of Attorney”—

as it was then—

“I just picked it up by chance … but it is an essential document and should be tackled early”.

However, the LPA is a long and difficult document to handle; it is also costly to register. The noble Baroness, Lady Afshar, who apologises for not being able to join the debate, teaches law and said of the LPA:

“I have found the form for giving lasting power of attorney exasperating … I had to make the application 3 times, each time needing signatures from witnesses and attorneys and all corrections have to be made in 15 working days”.

She goes on:

“I cannot see how the average little old lady would be willing to go through all these hoops”.

She is not the only Member of this House to have reported the same complaint to me, so improvements need to be made there.

The need for people with early dementia to sign such documents at the earliest moment is evident. In November last year, an International Longevity Centre report urged policymakers to ensure there are no unnecessary barriers to data sharing between health and social care services and the family, and went on to say that there needs to be,

“a major public relations programme to make more in the population at large”,

aware,

“of the ways in which they can make things easier for themselves and their loved ones by planning ahead”.

Last October, Age Scotland launched just such a national campaign, funded by the Scottish Government, urging people to take out a power of attorney. It remains to be clarified whether an LPA in Scotland will be recognised across the UK. Dementia is something we all fear for ourselves and for those we love. I ask the Minister and the Government to take steps to answer the needs expressed here with the utmost urgency and, indeed, sympathy.