Dementia

Baroness Donaghy Excerpts

Thursday 18th January 2024 Grand Committee

[Baroness Donaghy (Lab)]

My Lords, I thank the noble Baroness, Lady Browning, for initiating this debate. I look forward to the day when this debate is held in the main Chamber.

Losing a loved one while they are still alive is a particularly gruelling experience and any assumptions that one makes about diagnosis and care turn out to be wrong. For example, I had assumed that hospice care took place in hospices. I am not criticising the hospice movement, far from it; its development of care at home, particularly in London, is quite remarkable, and I pay tribute to St Christopher’s Hospice for its invaluable support to me. I had also assumed that there was a system; I was wrong again.

In the short time available, I will concentrate on diagnosis and a social care workforce strategy. As has been said, more than 250,000 people live with undiagnosed dementia in England alone. We have one of the lowest per capita ratios of MRI, CT and PET scanners in the OECD, behind Russia, Slovakia and Chile. Recent effective disease-modifying treatments are not yet approved or commissioned in our country, but, even if they are approved, they require early diagnosis of Alzheimer’s disease and, at present, only 2.2% of people receive the tests in the diagnosis process. Will the Minister tell us what steps the Government are taking to invest in diagnostic infrastructure for dementia? The Alzheimer’s Society has said that improvements in diagnosis should be part of a major condition strategy between the NHS and the Government to put in place a funded plan to improve rates beyond the national ambition of 66.7%, if possible. What plans do the Government have for a major conditions strategy?

My second point is about a social care workforce strategy. The care workforce pathway is a welcome step to improve career development and increase access to training, but it falls far short of a comprehensive long-term social care workforce strategy providing a trained workforce. There are 152,000 vacancies in the adult social care workforce, with 390,000 leaving their care jobs annually. Only 45% of care staff are recorded as having any level of training in dementia, and training is not mandatory. The Alzheimer’s Society has called for a minimum mandatory level of training in dementia for all care staff to tier 2 of the dementia training standards. Can the Minister say when a long-term social care workforce strategy might be available?

The Office for National Statistics identifies dementia as the UK’s biggest killer, with one in three people due to develop it. Why is it not on the front pages of newspapers? Why is it not a political priority? Why does it have the same level of obscurity that cancer had 50 years ago? Perhaps it is reduced to individual human misery and dread for the future, and those affected do not have the resilience to force the pace. Does the Minister think that the Government have any responsibility for this?