Dementia Care

Debbie Abrahams Excerpts

Tuesday 3rd June 2025 Commons Chamber

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

I congratulate the hon. Member for South Devon (Caroline Voaden) on securing this important debate and on her excellent speech, and I wish her father-in-law and cousin all the very best.

I have been the co-chair of the all-party parliamentary group on dementia for the past 10 years. Like my co-chair, Baroness Angela Browning, I became involved because of a loved one who had acquired the disease. In my case, it was my mum, who was also called Angela and who was diagnosed with Alzheimer’s disease at 64; along with my stepfather and brother, I cared for her until she died in 2012. After her death, I became a dementia friends champion—the first MP to do so—which allowed me to do a number of dementia friends sessions. As a consequence, we have hundreds of people involved in Oldham, and have set up a dementia-friendly Oldham, with an annual memory walk and lots of other groups that support families affected by dementia. I am very proud of that.

I appreciate that the Government have yet to publish any plans on dementia, but given that dementia, as we have heard today, is the leading cause of death in the UK—above heart disease and above cancer—and affects nearly 1 million people, with an equivalent number of carers, I know that the Minister will give it the focus and attention it deserves. We have also heard that a quarter of NHS beds are occupied by someone with dementia who is fit and able to be discharged, but who cannot be discharged because of the crisis in social care.

[Helen Maguire (Epsom and Ewell) (LD)]

People with degenerative conditions stay under consultant care, but after 18 months my constituent with Alzheimer’s was discharged with no monitoring and no access to specialist nurses unless referred by a very lengthy GP process. He told me that he feels abandoned. Does the hon. Lady agree that dementia must be treated as seriously as other long-term conditions, and that everyone with dementia should have access to a specialist nurse and an annual health and care review?

[Debbie Abrahams]

That is a very long question. I certainly believe that we need to improve care. Dementia is obviously an umbrella term for several different diseases, and we cannot make recommendations that apply to each specific disease; I think that has unfortunately not had the airing that it might have.

The APPG has undertaken a number of inquiries of which I am incredibly proud. A few years ago, we published “Workforce Matters”, which is still very relevant today. We have heard some of the recommendations around specialist care. Unfortunately, we have a postcode lottery; the APPG heard some fantastic examples of care, but also some not-so-great examples. There was also a survey of nearly 2,000 people. There is still lots to do there, and I hope the Minister will look at those recommendations. Our “Raising the Barriers” report around the inequalities in dementia diagnosis also needs further attention. Those inequalities are not just by geography, but by different cohorts of people.

In my last minute or so, I will talk about prevention, as we have heard only a little reference to that. With young-onset dementia, we are able to track the start of changes in people’s brains from the age of 30 that are associated with different cognitive diseases. What is good for our heart is also good for our head, but there are other things to consider, including reducing air pollution. We know that smoking and heart disease is a real no-no, as is obesity and high blood pressure. It is also important to be on top of hearing loss and related issues. Excess alcohol consumption is another factor; fewer than 14 units a week is the guidance for a healthy life, but 18 is excessive.

Social isolation is really bad for dementia, as is traumatic brain injury. I am supporting Football Families for Justice, which is run by Nobby Stiles’s son, to try to get compensation and support for footballers who have been affected by their sport throughout their careers and are suffering from brain diseases as a consequence. We are calling on football authorities to take responsibility. Footballers are now paid fantastically well, but that was not the case in the past and we need to make sure that those players are cared for; this is an occupational disease.

--- Later in debate ---

[Dr Luke Evans (Hinckley and Bosworth) (Con)]

I think we have established that dementia is a thief, not once but twice: first of the mind, then of the memories, leaving the greatest pain not with the sufferer but with those who remember. I thank the hon. Member for South Devon (Caroline Voaden) for securing such an important debate and for speaking so passionately and openly about her story, as did many across this House. I also thank the Alzheimer’s Society, Alzheimer’s Research UK, Dementia UK and all those people who advocate for dementia and their families. As we have heard, there are 1 million people living with dementia in the UK, and that figure is projected to rise to 1.4 million by 2040. One in six hospital beds are occupied by dementia patients, and dementia sufferers are three times more likely to see their GP. Modelling suggests that 70% of care home residents are people living with dementia.

In this House I often enjoyed the tired lines from the then Opposition about how the Conservatives never did enough on x or y or z. As Labour Members are ably demonstrating, it is easy to stand across the aisle and say that nothing is ever enough, but as they are learning, delivering in the real world is far harder than demanding from the sidelines. On dementia, the Conservative Government led from the front with more funding, better diagnosis and a national commitment to change lives. We all agree that we must continue to do more, but to do that we need direction and action, and that is what we are exploring here today, almost one year on from the introduction of a Labour Government.

[Debbie Abrahams]

Can the shadow Minister remind us about the commitment in the 2019 Conservative manifesto on the dementia moonshot and tell us if and when that was delivered?

[Dr Evans]

If the hon. Lady will bear with me, I am going to canter through what we have done in the past 14 years, because it was, after all, under the premiership of Lord Cameron that the challenge on dementia set the ambition for England to be

“the best country in the world for dementia care and support and for people with dementia, their carers and families to live”.

So, on to the point. In 2012, the then Prime Minister set the challenge to make us a global leader and increase awareness and research. This included the dementia friends initiative—a public campaign to boost understanding, over 1 million dementia friends trained by 2015 and increased research funding, which doubled from 2010 to 2015. In 2015, the Prime Minister’s challenge on dementia 2020 set national goals for diagnosis rates, care quality and research impact, including a national target for dementia diagnosis rates of 66.7%, which was met in 2015.

In 2016 and 2017, the UK Dementia Research Institute, launched under Theresa May, was a flagship initiative backed by £290 million from the Government and charities. This actually delivered £300 million in dementia research and innovation by March 2020, a full year ahead of schedule. We had the NHS long-term plan in 2019, which committed to enhancing diagnosis. In 2019 we also had the dementia moonshot pledge from Boris Johnson, with an extra £160 million. This was followed up in 2022 with the Dame Barbara Windsor dementia mission—a £95 million fund to accelerate research into treatment and early diagnosis. Of course, the pandemic hit and we had the recovery, and that is why the Government set out the 2023 major conditions strategy, which would have included dementia.

There is therefore a question for this Government as to the priority they have given to dementia since taking office, and it is worth looking at why concerns are being raised. This Government, rightly so in their own right, did not opt to proceed with the major conditions strategy. That might surprise some Members, as we heard the current Minister, the hon. Member for Bristol South (Karin Smyth), who is in her place, call for a dedicated dementia strategy a number of times when she was in opposition. Only last year, she said the following in a Westminster Hall debate on new dementia treatments:

“As my hon. Friend the Member for Oldham East and Saddleworth said, it is disappointing that the Government shelved the plans for a dedicated dementia strategy. England remains the only nation without a specific dementia plan. That is very short-term thinking, and it would be interesting to hear from the Minister about that. In 2022, I said:

‘We cannot give confidence to people suffering with dementia and their carers without a much clearer plan that is in place very quickly.’—[Official Report, 14 June 2022; Vol. 716, c. 141.]

That remains the case today.” —[Official Report, 11 January 2024; Vol. 743, c. 192WH.]

So I would like to ask the Minister: does he stand by these comments and can we therefore expect a dedicated dementia strategy? It is easy for the Conservative side of the House to understand that governing is difficult. Good intentions make fine Opposition speeches until they collide with reality. Does the Minister plan to carry on with a dedicated strategy, and would he be kind enough to confirm that today?

On the topic of strategies and comments made by Labour Ministers before they took office, I note that in a Westminster Hall debate on inequalities in dementia services only in May last year, less than a week before the general election was called, the shadow Health Minister and now the independent hon. Member for Gorton and Denton (Andrew Gwynne) promised a carers strategy. He said that carers are

“a vital part of the fight against dementia, and they will be at the heart of Labour’s plans in Government. There will be a carers strategy under the next Labour Government, because we value the vital work our carers do. It will be a cross-Government strategy with the Department for Work and Pensions, Department for Education and the future of work review all feeding into it along with the Department of Health and Social Care. There is a brighter future for those living with dementia and their families and carers. Labour will deliver it.”—[Official Report, 16 May 2024; Vol. 750, c. 228WH.]

That is a laudable aim.

However, since the election, it appears that all is not quite as it seems. In an oral question in the other place in November, Baroness Merron made it clear that she had

“not committed to a national carers strategy”,

stating,

“I do have to say to the noble Baroness that I have not committed to a national carers strategy. However, in our joined-up approach, we will certainly be looking at what is needed. That will be very much part of our considerations on the workforce strategy, which Minister Karin Smyth will be leading on. It is crucial to the delivery of services.”—[Official Report, House of Lords, 19 November 2024; Vol. 841, c. 107.]

I therefore ask the Minister today whether specific plans are still in place for a national care strategy.

--- Later in debate ---

[Caroline Voaden]

I do not think there is much to add, but I want to thank all the Members who have come here today and shared their personal experiences of dementia affecting family members and loved ones. I know it is not an easy thing to do, and we all have really difficult experiences. It has been very moving to hear those personal stories. We have a Minister who deeply feels these issues and understands what dementia means and the impact on the wider family.

I would like to see properly trained dementia nurses in every GP surgery and acute hospital trust in this country, so that we can keep these people at home, look after them, look after their carers, and support the people who love them and do an incredible job. I pay tribute to the hundreds of organisations all over the country that are doing amazing work, many of them on a voluntary basis.

Question put and agreed to.

Resolved,

That this House has considered dementia care.

[Debbie Abrahams]

On a point of order, Madam Deputy Speaker. In his response to my question about the dementia moonshot, I think the shadow Minister, the hon. Member for Hinckley and Bosworth (Dr Evans), might have got his figures wrong. Could you advise me on how we can correct the record?

[Madam Deputy Speaker (Judith Cummins)]

I thank the hon. Member for raising that point of order. It is not a matter for the Chair, but she has put her point on the record.

Oral Answers to Questions

Debbie Abrahams Excerpts

Tuesday 11th February 2025 Commons Chamber

[Stephen Kinnock]

From the roundtable discussions, and from subsequent discussions we have been having with the sector, it is clear that we need to look at the long-term funding issue. We faced a cliff edge towards the end of last year. That is not the right way to do things. We must start getting the funding discussions moving so that, well in advance of the end of this financial year, the funding situation for the palliative and hospice sector is much clearer.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

8. What steps he is taking to reduce inequalities in healthcare.

[The Parliamentary Under-Secretary of State for Health and Social Care (Ashley Dalton)]

Lord Darzi’s report laid bare the shocking health inequalities in our country. It is completely unacceptable that in Britain in 2025, maternal mortality rates for black women are more than double those of white women and life expectancy at birth for females in Blackpool is eight years less than in Kensington and Chelsea. Reducing inequalities in elective care was identified as a key priority in the planning guidance and mandate that the NHS published last month, and further measures to address these inequalities in our country will be at the heart of our 10-year health plan, which will be published in the spring.

[Debbie Abrahams]

In 2013, the then coalition Government reduced the health inequalities weighting in the NHS formula, with the result that less money went to deprived areas. That was despite evidence that between 2001 and 2011, every £10 million invested in such areas resulted in four fewer men and two fewer women dying early. Can my hon. Friend reassure Government Members that that health inequalities weighting will be reinstated so that we can ensure that deprived areas get the funding they need and that lives are saved?

[Ashley Dalton]

The Government mandate to NHS England was published on 30 January and makes the importance of tackling health inequalities clear. NHS England has an existing programme that targets the most deprived 20% of the population, with the aim of reducing health inequalities. I can reassure my hon. Friend, who has been a determined campaigner on inequalities, that the health inequalities weighting has not been withdrawn. The funding in question, which amounted to £200 million, has been incorporated into the main integrated care board allocation. The weighting of that health inequalities adjustment has been increased from 10% to 10.2%, so that the ICBs still benefit from that extra investment, with funding redistributed to areas with the poorest health outcomes, based on measures of avoidable mortality provided by the Office for National Statistics.

Health and Adult Social Care Reform

Debbie Abrahams Excerpts

Monday 6th January 2025 Commons Chamber

[Wes Streeting]

I was grateful to staff at Derriford hospital for showing me at first hand the emergency department pressures when I visited just before Christmas. I have also visited Derriford at the height of summer, when it experiences high pressures. There are year-round difficulties at Derriford, and I thank the staff and leadership of the hospital for what they are doing in difficult circumstances. We will come forward shortly with the timetable for the new hospitals programme. I expect that it will be published sooner than the Conservatives apologise for their appalling record.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

I welcome my right hon. Friend’s statement, but can he expand a bit more on the new agreement with the private sector? For example, he mentioned that the surgical hubs will be delivered solely by the private sector, but what arrangements will there be for emergency care, when the occasion arises?

[Wes Streeting]

Some of the new capacity announced in today’s elective reform plan will come through the independent sector, and some of that new capacity will be in the NHS. It is our ambition to rebuild the NHS so that it is available for everyone where and when they need it, and we will work with the independent sector. We are publishing full details of our independent sector agreement, so that people can see the deal that we have reached, and the sensible and effective partnership, including safeguards and protections, that we have come to. I look forward to working with the sector to make sure that everyone, whatever their income and background, can get faster access to care.

NHS Performance: Darzi Investigation

Debbie Abrahams Excerpts

Monday 7th October 2024 Commons Chamber

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

I will be brief. I think there is general consensus on Lord Darzi’s review of the issues facing the NHS, but in spite of what the shadow Minister says, staff morale is low, particularly when compared with 2010. It has never been so low. I express my gratitude to and solidarity with all the staff, clinical and non-clinical, for the work they do.

I will briefly focus on the key drivers. We have heard a little about them from the Health Secretary, particularly in terms of the Health and Social Care Act 2012. I sat on both the Bill Committees. I was aghast, having just come out of the NHS and having faced the issues. I just knew it would be catastrophic, and it was. It had an almost immediate impact on staff morale.

We must also recognise the impact of austerity between 2010 and 2018. NHS revenue budgets grew by just 1% each year—the lowest rate since the NHS was formed. That compares with growth of nearly 4% a year since then. In 2010, the Commonwealth Fund found that the NHS was one of the top-ranking health systems in the world. It was No. 1 for equity in access to healthcare; we are now ranked 10th. If we compare spending on healthcare, we are ranked 26th in the OECD. Austerity impacted not only the overall funding of the NHS, but the funding allocation formulas. The weighting for deprivation was slashed, so areas such as mine received less money, although we had greater health needs. Austerity also had an impact on other aspects of public funding and local government, and metropolitan areas such as mine were particularly badly affected. It stripped the support from people in need.

[Anna Dixon (Shipley) (Lab)]

I came into politics because of a desire to reverse growing inequalities in health and disability. In my constituency of Shipley, there is a 10-year gap in healthy life expectancy between those living in Wharfedale and their neighbours over the moor in Windhill. While lots needs to be done to tackle poor housing and poverty, there are things that the NHS can do. Does my hon. Friend agree that the NHS plan must prioritise prevention, as well as just treating sickness?

[Debbie Abrahams]

As a former public health consultant, I would obviously agree with my hon. Friend. I have similar health inequalities across Oldham. I was about to talk about the impact of other issues, such as social security cuts, which meant greater poverty, including in-work poverty and children from working families living in poverty. That has had a consequential impact on our health as a whole. We have flatlining life expectancy, and in areas such as mine, life expectancy has got worse. That impacts on our productivity and the wealth of our country.

I will briefly mention a couple of points that I know my right hon. Friend the Secretary of State recognises, and might want to consider. An annual report on the state of our health and the state of our NHS, presented to Parliament before each Budget, would pick up on the points that have been raised about cross-departmental impacts on health. We should have a prospective assessment of the impacts of the Budget and the Finance Bill on poverty and inequality, and subsequently on health and the NHS. That can be done; others are doing it. We should have a strategy to identify and address health equity issues in the NHS. We have seen a bit of that through covid, in the inequity around the use of oximeters. We should introduce something like “Improving working lives” for our staff. That had a massive effect on staff when I worked in the NHS. We need a clear commitment to the 1948 principles of the NHS, under which it is funded from general taxation, and a funding allocation based on need.

[Madam Deputy Speaker (Judith Cummins)]

I call the Liberal Democrat spokesperson.

NHS: Independent Investigation

Debbie Abrahams Excerpts

Thursday 12th September 2024 Commons Chamber

[Wes Streeting]

I can absolutely reassure the hon. Member that RAAC-impacted hospitals are a priority. We are putting safety first, and it is just a shame that when his residents had a Prime Minister in their backyard, the Conservative Government did not fix the problem.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

For the sake of openness and transparency, I will just mention that I am a former chair of an NHS trust and a public health academic. I recognise the real issues that are raised in the findings of the Darzi rapid review. I am grateful to Lord Darzi for referring in particular to the inequalities that we have experienced, and how those inequalities were laid bare during covid. Will the Health and Social Care Secretary expand on the cross-departmental work that he is doing? I agree with my hon. Friends the Members for Walthamstow (Ms Creasy) and for Eltham and Chislehurst (Clive Efford) that people’s socioeconomic circumstances drive their health status. We do not want a situation where, for every 1% increase in child poverty, six additional babies per 100,000 live births do not reach their first birthday.

[Wes Streeting]

I thank my hon. Friend for her question and congratulate her warmly on her election to the Chair of the Work and Pensions Committee. I am looking forward to sharing, through the Secretary of State for Work and Pensions, the work that our Departments are doing together, particularly on the link between mental health and unemployment and on integrating pathways. She is right about the social determinants of ill health. That is why I am genuinely excited that, through the mission-driven approach that the Prime Minister has set out, we are already bringing together Whitehall Departments, traditionally siloed, to work together on attacking those social determinants. The real game changer is genuine cross-departmental working, alongside business, civil society and all of us as active citizens, to mobilise the whole country in pursuit of that national mission, in which we will be tough on ill health, and tough on the causes of ill health, as someone might have said.