Dementia

Alison McGovern Excerpts

Thursday 10th January 2013 Commons Chamber

[Hazel Blears]

Yes, there was. The all-party group had an interesting presentation from the Scottish Health Department. Diagnosis rates in Scotland are very high indeed, and we learned that the highly organised, managed and focused system there was driving up diagnosis. It is driven, to some extent, from the centre, and I know that that is not always popular these days, but the drive from the centre out to the GPs is really making a difference. I think that there is room for us to adopt a more driven process—it need not necessarily be more centralised—in which GPs are more accountable and in which they report back on rates of diagnosis. There is much more that we can do in that regard.

Diagnosis is a problem, but once a diagnosis has been made, the availability of support in the community becomes relevant. There are many problems in that area. Our inquiry revealed that many carers felt that nothing happened after the diagnosis, because there was no help or support available. In my area in Salford, we are lucky. We have one of the 10 national demonstration projects established under the national dementia strategy in 2009, and we are developing some really innovative services in the community. I should perhaps declare an interest: my mum attends the centre two days a week, and I sit on the strategic board that drives the process there. I have seen that when people are really committed to such projects, they can make a huge difference.

Our centre is the result of a partnership between the local authority and the Humphrey Booth charity, which has existed in Salford since the year 1600. It is a marvellous example of people working together. The centre is known as the Poppy centre, and its facilities include a dementia singing group, on a Wednesday, which attracts 150 people. That is an incredible resource. The centre also offers day centre services, art work, music, personal tailored care, a dementia café for when friends and family drop in, living history, hairdressing and hand massage. It is a wonderful place, staffed by brilliant people.

[Alison McGovern (Wirral South) (Lab)]

I apologise to my right hon. Friend and other Members because I cannot stay for the whole debate. The lesson I have learned from her expertise and from the evidence I have heard about Salford on this and other occasions is that we cannot think in the old way about how we help people with dementia; we have to be creative and provide the best range of services possible.

[Hazel Blears]

My hon. Friend is absolutely right. We are at the beginning of the kind of innovative care that she talks about. One thing we need to do is to get more young people and more young clinicians involved in this area, because that is how we will see innovation coming through.

We have a brilliant centre in Salford run by the manager Sue Skeer. There is also Sue Smyth and Nicola Fletcher, and users and carers are on our board. Margaret and Fred Pickering are an inspiration: Fred has dementia, Margaret is his carer and the whole of our practice is driven by users and carers at the centre. We are lucky, but many places have nothing like the Poppy day centre to support them.

We want to make Salford a dementia-friendly community and to make sure that transport, housing, leisure and local shops are all aware of the issues around dementia. My local university in Salford is setting up a dementia centre—a collaboration between the department of the built environment, including architects, and the department of social care. Design is being looked at really seriously. A marvellous Italian Professor Ricardo Codinhoto and a wonderful nurse, Natalie Yates-Bolton have inaugurated not just the design centre at Salford university, but now a European collaboration so that we will have an international design network on how we can make dementia-friendly communities work.

My question to the Minister on dementia-friendly communities, which we hope to be in Salford and which York, Plymouth and other places are pursuing, is: what resources have the Government committed to support the work of these communities, and how will it be sustained in the long term? We can push on, but we need a resource to make it happen. Yesterday, I met Duncan Selbie, the new director of Public Health England, who is going to make dementia a national priority for public health, so there really is commitment and energy behind all this. I want to hear from the Government what they can do to help.

Let me briefly cover my second theme—I have accepted two interventions—which is about the research challenge. I met the Wellcome Trust this week, and I was hugely encouraged by its willingness to put serious research funding into this area. It is looking not just at clinical research, which it might have done in the past, but at research on “living well with dementia”, recognising the importance of a holistic approach. I was impressed, too, when I met David Lynn and Dr John Williams. They acknowledged the difficulty of this area because there is so much that we still do not know about the brain. Nevertheless, despite the failure of the recent clinical trials, the data from them could prove very useful in taking us forward to the next steps, which we hope will help us find drugs that will at least slow down or delay the onset of Alzheimer’s. What everyone who has Alzheimer’s wants is a cure; they are desperate to get some progress here.

If we have a really big push on research, I feel that progress could be made. Our scientists are some of the best in the world in this area, yet for every six scientists working on cancer, only one works on dementia. Only 2.5% of the Government’s research budget goes to dementia, with 25% going to cancer. We should look at the progress made in cancer over the last 20 or 30 years; I do not want to wait another 25 or 30 years to make the same progress for the hundreds of thousands of people who are suffering from dementia now. The Government really must press on.

There are many people out there who want to help us. Just this week, the Daily Mail featured a long article about the possible benefits of coconut oil and the work done on that at Oxford. I have no idea whether that is likely to help people. It has helped some families, but we can see from that the absolute desperation people have to try to find something that can help the life of their loved one. Research is thus a huge challenge, as is help in the community.

I want to express some concerns about where we are at the moment. It is a time of great change in the health service. We are moving from primary care trusts to clinical commissioning groups, and it could be a time of instability. I am worried about the expertise—or lack of it—in the clinical commissioning groups when it comes to commissioning for something as complex as dementia. I want every CCG to have a lead for dementia, developing expertise and knowledge so that they know how to get the best from the money available. I would like to hear the Minister say that he wants to see a dementia lead in every CCG.

My final point is about the resources available to us. Over the last three years, my local authority has faced cuts of £876,000—30% of the adult social care budget. I know the Government will say that they have put £1 billion back in and that £1 billion has been lost, but when the budget is not ring-fenced, it can easily get spent on other issues. It is virtually impossible for councils to meet their targets without looking at the adult social care budget, which is 40% of their overall expenditure. That is why we can see day centres closing. They are an essential support network, providing a lifeline for carers, yet they are being cut. I am very worried indeed—not just about local authority cuts, but about buddying services provided by Age Concern. These voluntary and third-sector groups, so essential to people, are now quite fragile.

I am sure that the future funding of social care is going to be discussed. I make a plea: please may we have the cap at a level that helps the majority of families that need to be helped? If it is set at £75,000, I will be worried that those who really need the help will not receive it.

I think we are now at a point where progress can be made of the kind that has probably not been made for years. I really hope that we can press forward on a cross-party basis. We need a long-term settlement so that we can support people at what is probably the most difficult and frightening time of their lives.

I remember what it felt like to discover that my mum had dementia and that her future would be so different from the one that her and my dad planned together. We have been lucky in that we have been able to speak up and get help and support from the fantastic caring people at the Poppy centre, but it is hard for many people who might not have a strong voice or someone to advocate on their behalf. My mum instilled in me that sense of justice and fairness, which has driven me throughout my political life. I know that she would want me to continue to fight for all those who often find themselves bewildered and powerless, and to make sure that they are treated with care and dignity. We owe them all nothing less.