Inequalities in Dementia Services

Debate between Debbie Abrahams and Christina Rees

Thursday 16th May 2024 Westminster Hall

[Debbie Abrahams]

I am very grateful to the hon. Member for that intervention, and I absolutely agree.

All of that underlines the importance of improving the dementia diagnosis pathway and making it work better for people living with dementia and their loved ones. The APPG has developed a series of recommendations across the core themes of dementia diagnosis, data, workforce, and public health messaging. Collectively, these recommendations outline how dementia pathways can be strengthened to enable access and quality care across all settings, communities and regions in England. I would be grateful if the Minister could say what work the Department is undertaking in those areas to reduce inequalities in the experience of dementia between localities and population groups.

I turn now to the inequality between those who have post-diagnostic support for dementia and those who do not—or, perhaps more insidiously, the gap between what people with dementia are supposed to receive and what they actually receive. Guidance states that people living with dementia should be offered a review with a healthcare professional at least once a year. However, just 25% of people with dementia who were polled by the Alzheimer’s Society said that they or their loved one had had an annual dementia review within the last 12 months, and only 16% said that they had received enough support from local services in the last 12 months. In addition, more than half said that, even if they had received an annual dementia review, it did not help them feel more able to manage their condition.

This trend continues outside primary care and in allied health professions. Over half of people with dementia who have been signposted to mental health services report having to wait up to a year for treatment. Evidence shows that mental health treatments can be effective in treating depression and anxiety symptoms associated with dementia, but just 0.002% of referrals to NHS talking therapies are for people with dementia—that is 2,000 people out of 1 million referrals.

A quarter of people with dementia wait for up to a year for occupational therapy after referral. Occupational therapy can help people to avoid dangerous falls and to live well in their own home for as long as possible. The average time spent in hospital for a hip fracture is seven days, but patients with dementia stay in hospital for up to four times longer a hip fracture. The additional cost—I know it should not be just about cost, but there is an associated cost—is almost £6,000 per patient, which is far more than the cost of an occupational therapy appointment. I have to say that I just do not get why we are prioritising things in this way.

I do not want to reduce health and social care decisions purely to finance, but the fact of the matter is that early intervention for people with dementia saves so much money. The Alzheimer’s Society reported on Monday that the cost of dementia to the UK economy is £42 billion a year, and that figure will skyrocket to £90 billion by 2040 because of our ageing population. The cost of dementia rises significantly as the condition progresses. The average cost of care for someone in the early, or milder, stages of dementia is about £28,000 a year; in the later, severe stages of dementia, it rises to well over £80,000 a year. Caring well for people with mild dementia can prevent falls and infections, which cause unnecessary hospitalisations and deconditioning, which increase the speed of deterioration in people with dementia. Early identification and increased spend in the early stages of dementia pay dividends further down the pathway.

I would like to end by putting three questions to the Minister, and I would be grateful if she could address them in her response or in writing at a later date, if that is easier for her. First, what will the Department do to ensure that where someone lives, their socioeconomic status or their ethnicity do not negatively affect their likelihood of getting a dementia diagnosis? Secondly, what will the Department do to ensure that everyone with dementia has access to high-quality, post-diagnostic care, regardless of where they live? Thirdly, it was two years ago this week that the right hon. Member for Bromsgrove (Sir Sajid Javid) announced a 10-year plan for dementia, which was then folded into the major conditions strategy. However, we still do not know when that strategy will be published. Can the Minister update us on when we can expect publication of the strategy?

Dementia is a monumental health and social care challenge, and will be the defining test of our system in the decades to come—I have absolutely no doubt of that. We have spoken in this place about planning for the next generation of dementia care in the context of the new, potentially transformative drugs that are currently under appraisal, but almost 1 million people are living with dementia in this country today, and much more can be done to get them the care and support they need and deserve at the earliest possible moment.

I would like to thank the Backbench Business Committee and those who have joined us on a Thursday afternoon when a lot is going on in Parliament. I look forward to the Minister’s response.

[Christina Rees (in the Chair)]

May I remind Members that they should bob if they wish to be called to speak?