Dementia

Andrew Stephenson Excerpts

Thursday 10th January 2013 Commons Chamber

[Andrew Stephenson (Pendle) (Con)]

It is a pleasure to follow the hon. Member for Bridgend (Mrs Moon). I pay tribute to her thoughtful and emotional contribution. I pay tribute also to the right hon. Members for Sutton and Cheam (Paul Burstow) and for Salford and Eccles (Hazel Blears) and to my hon. Friend the Member for Chatham and Aylesford (Tracey Crouch) for securing today’s debate and for their equally thoughtful contributions.

I shall focus my remarks on my area, Pendle, and the Lancashire Care NHS Foundation Trust’s current consultation on dementia care services across the county. In my constituency there are 1,114 people diagnosed with dementia, compared with 1,060 people in 2010. As we all know, dementia can affect anyone. It is not just an old person’s illness and we know that there are hundreds of different types of dementia, so getting the correct diagnosis is one of the biggest challenges wherever one lives in the country.

My maternal grandmother, Mary, suffered from dementia brought on by a series of strokes. Although I was only young at the time, I remember going to visit her in Withington hospital in Manchester, where after any particularly bad period she was given six weeks’ assessment. I remember the locks on the doors to the ward, for patients’ own safety, and watching as the grandmother I knew and loved slipped away from us. However, for many I have met in Pendle the emotional heartbreak is even worse, with husbands and wives diagnosed with this terrible condition in their mid to late 50s, their hopes of an enjoyable retirement together dashed, their dreams shattered.

Thankfully, the support available to dementia sufferers has improved significantly in recent years. In my constituency, although some people have raised concerns about getting the correct diagnosis from their GP, we have Memory Services, based at Maple house in Burnley general hospital, to which many people are correctly referred. With the help of Lancashire county council and the Alzheimer’s Society, East Lancashire Community Dementia Forum runs a dementia café in Colne on the fourth Thursday of every month, at the Arcadia café on Windy Bank—the importance of dementia cafés and the roles they can play has already been mentioned. Last May, I went along to the café, which runs from 2pm to 4pm, and found that providing information, advice and refreshments in a relaxed and friendly environment was a great idea for both those suffering with dementia and their carers.

In August, I was also pleased to attend a meeting of the Alzheimer’s Society’s carers support group at Walton lane community centre in Nelson. We discussed a huge range of topics, including respite facilities, the hospital beds situation, pathways to diagnosis, the difficulty for Alzheimer sufferers of qualifying for blue badges, disabled facility grants, day care and standards of care, among many other topics. Following the meeting, I took up several of the broad points with the NHS, Lancashire county council and Pendle borough council and pursued a number of individual cases. In the same month, I also attended the East Lancashire Community Dementia Forum at Brierfield library, when the focus was on short breaks and respite care.

Let me turn to Lancashire Care NHS Foundation Trust’s consultation on specialist dementia care services in Lancashire. The consultation opened on 3 December and runs until 25 February, with an opportunity for Pendle residents to discuss the options with representatives of Lancashire Care on Monday 28 January at Training 2000 in Nelson. Much of the information contained in the consultation document sounds very positive and few dementia sufferers or their carers would disagree with it. For example, it states that 83% of carers and people with dementia said that being able to live in their own home was very important to the person with dementia. It states that people with dementia should be moved as little as possible and, therefore, community or home care is the best option. It notes that significant progress has been made in Lancashire and that over the past year 93% of dementia care contacts were in the community, supported by specialist teams.

However, the consultation document goes on to state that there were trends over the past three years of reduced admissions, readmissions and lengths of stay from the population in central Lancashire. If that could be replicated across the whole county, it suggests, the demand for specialist in-patient services could be expected to decrease to the point where those admitted would make up a much smaller group, and it is likely they would only be those detained under the Mental Health Act.

On that basis, the trust proposes two options. Option 1 is to reduce the existing 65 specialist dementia in-patient beds across four sites in Lancashire to just 30 such beds on a single site. That single site would be in Blackpool, which could not possibly be further away from my constituency, which is in the Pennines on the Yorkshire border. Option 2 is to have 40 dementia in-patient beds on two specialist sites, one in Blackburn and one in Blackpool. Option 1 gets three pages of glowing support, whereas option 2 gets two pages, almost a third of which points out its “Issues”—or, should I say, “Disadvantages”?

I have in my hand the consultation document, which is available in all libraries in Pendle, Ribble valley and the rest of Lancashire. It even goes so far as to have a wonderful diagram showing the two options available—option 1 includes a nice little flower, whereas option 2 has a mucky bit of grass. Now, call me a cynic, but I remember a similar document, ironically entitled “Meeting Patients’ Needs”, being published under the previous Government. It led to our local accident and emergency department at Burnley general hospital being downgraded, despite massive and cross-party public opposition. Although I am a massive supporter of the work done by Lancashire Care, sadly, the consultation document strikes me as very similar. When reading it, I cannot help thinking that the decision in favour of Option 1 has already been taken and that the consultation is all about getting the public to rubber stamp it.

I, for one, will not be voting for Option 1. I will not be supporting the relocation—given the location of Blackpool, it can hardly be called centralising—of all specialist dementia in-patient beds, for a range of reasons. Primarily, the location is in no way central to the population served. It would be almost impossible for friends and family to get to without a car, and even then it would be a very long drive. Given the distance, it would be almost impossible for contact to be retained between the dementia sufferer and not only their family, but their community care team.

We are talking about only a small number of people who would need to use these specialist in-patient beds, but the reduction from the current 65 beds to 30 beds is too much, too soon. The Blackpool option, if approved, would be up and running in 2015, and even the consultation document admits that current usage of the 65 in-patient beds across Lancashire stands at 46, or 70% utilisation. I appreciate that redirecting resources from in-patient services to community services will help to reduce dementia admissions, but with growing dementia rates and an ageing population, just 30 beds for a county the size of Lancashire seems too few. The lack of information provided on how community services will be enhanced with redirected funding also gives me great concern.

In Lancashire, there are already at least 17,600 people aged 65 or over with dementia, and these numbers are expected to rise to more than 25,600 by 2025. We are also seeing increasing numbers under this age being correctly diagnosed with dementia. After speaking to a number of local GPs and local health commissioners in East Lancashire, I know that many of them, too, will be supporting the option of two sites with 40 beds between them rather than one with 30. I hope that other clinicians, people with dementia and their carers will also support this option and respond to the consultation before it closes on 25 February.