Health: Neurological Conditions

Baroness Greengross Excerpts

Monday 11th October 2010 Lords Chamber

[Baroness Greengross]

My Lords, first, I congratulate the noble Baroness, Lady Gardner. I found her initial comments, as always, very informative and very moving. I am so pleased that we are able to have this short debate.

Often allied health professionals are under-recognised but their role is absolutely key to the way in which patients, particularly those living with neurological diseases, are cared for. Many of them with progressive and incurable diseases such as motor neurone disease, multiple sclerosis, Huntingdon’s disease or Parkinson’s disease face very long-term physical and psychosocial challenges, which can last for years or decades with long periods of dependency.

The role of allied health professionals must be better recognised. They can ensure that people with a neurological condition receive adequate nutrition; that their communication skills are maintained; that cardiac and respiratory functions are maintained, as the noble Baroness, Lady Finlay, has identified; and that respiratory functioning, bowel motility and skin integrity can be dealt with. They often co-ordinate care within a multidisciplinary team, which is very important. They are also frequently the first contact practitioner who can access the range of care which a patient needs over a long period.

In community settings, hospitals, residential care or wherever, dieticians also have a key role to play. They can often prevent a problem that can cause significant complications, and can compromise quality of life and lead, as has been said, to considerable cost for the health and social care system.

I am privileged to head up a think tank, the International Longevity Centre, in the UK, which looks at the implications of demographic change and ageing on our society. The IRC has often tried to raise awareness among policy-makers and the general public to the risk of malnutrition and dehydration for many of the most vulnerable members of our society. In the next couple of months, it will publish work on the importance of speech therapists. From a summary of the literature, it is clear to me that the vast majority of policy initiatives relating to speech and language therapy focus on children and younger people, which is terribly important, but despite our growing ageing population only 20 per cent of speech therapists currently focus on older people. I hope that the Minister can look at this issue, as it demonstrates an imbalance.

The IRC will highlight the need for an increased number of speech and language therapists for older people with neurological conditions. I would also like to highlight, as has the noble Baroness, Lady Finlay, the importance of occupational therapists, who very often enable older people who have suffered a stroke or who have dementia to regain some of the skills they previously had in daily living. The importance of that cannot be overemphasised. I declare an interest as president of the College of Occupational Therapists.

Just because we cannot alter the disease progression of many neurological conditions, we must not assume that nothing more can be done. It is because of that inevitability that we must do everything possible to alleviate the symptoms and offer appropriate psychological and spiritual support to patients. Allied health professionals have a key role to play in that respect.

We also need to ensure that we adequately support this group of healthcare professionals. Some neurological diseases, particularly those that apply to older people, can evoke rather negative attitudes. That is perhaps because they are linked to our mortality—we would rather not think about them and rather that they went away. Given the growing number of people who suffer from dementia, it is important that we raise awareness of this type of condition across the sector. It is also important that those who work in the allied health professions have the basic training in dementia care, among other neurological conditions, and know how to manage these difficult diseases as they progress in the huge number of patients who suffer from them. Training in dementia care and in the management of dementia should form an integral component in all the training for allied health professionals and for their career development. We must recognise the crucial importance of their work and ensure that they can meet the difficult situations that they will face with appropriate skills, training and recognition.