Health Inequalities

Derek Thomas Excerpts

Wednesday 20th March 2019 Westminster Hall

[Derek Thomas (St Ives) (Con)]

I congratulate my hon. Friend the Member for Telford (Lucy Allan) on securing the debate. This is such an important subject. A Cornish MP absolutely understands health inequalities and the lack of funding to target them. In Cornwall, there is no shortage of examples of health inequalities. I will mention just a few issues: vascular disease, including diabetes, kidney disease, dental health problems, skin cancer, diagnosis times for people with severe conditions, including ankylosing spondylitis—I chair the relevant all-party parliamentary group for that—and mental health services. It is clear that in Cornwall there are inequalities in all those areas.

My hon. Friend was right to address the need to allow funds to be targeted towards health inequalities. As a Member for Cornwall, which has long been underfunded compared with the rest of England, or at least the English average, I fully support that. However, in the short time that I have this afternoon, I would like to address a different aspect of health inequality—dementia. Dementia is a disease, but it is not primarily treated by the NHS. It is a Government commitment to provide NHS services free at the point of use. If someone has a stroke, heart problems, cancer or flu, the NHS will treat them free of charge. If someone has dementia, a recognised disease, it can cost tens of thousands of pounds—I learned today that it can cost up to £100,000—to get the care that they need.

I am suggesting that it would be in the interest of the Government, the Department of Health and Social Care and certainly those who are concerned about social care budgets to make dementia an NHS problem, rather than a problem for social care. According to the Alzheimer’s Society, which is about to launch a call for a fund for dementia, 50,000 avoidable hospital admissions happen simply because we do not adequately care for those with dementia or for those who care for them. Failing dementia care services could be avoided. According to independent reports, 23% of all services for dementia are failing. That sounds quite dramatic, and it is dramatic when one sits with a person who has cared for a loved one and who has also been in hospital because she cannot cope with being awake every night and trying to ensure that her husband does not turn on the stove, fall out of bed or fall down the stairs. Where we have failing services, because the issue is not properly dealt with within the NHS family, we really have problems and we cannot fully understand how severe the problems are.

People who treat dementia patients would be adequately trained if this disease were brought within the NHS window, the NHS envelope. We would be able to ensure that everyone who cared for someone with dementia was adequately trained. Independent reports say that 38% of carers who care for people with dementia have not been trained in the disease or all the things associated with Alzheimer’s or dementia.

I have welcomed and am so pleased with the commitment to the 10-year plan for the NHS. It is time, and this is an opportunity, to address health inequalities and to treat dementia as a disease within the NHS and one to be treated by the NHS. I would therefore like us, as we develop the plan, to create a recognised pathway of care for those with dementia and to ensure that all those providing care are adequately trained in dementia care and all that goes with it. Clearly, that will have a cost, but I believe that it is the right way to care for people, many of whom have served this nation for such a long time during their lives.

My father-in-law suffered full frontal dementia for many years—for 10 years—and it was such a battle to get the support that he needed. Even when he was completely dependent and could not do anything for himself, he was still cared for within social care and not the NHS. That was the case right up to the day he died, even though he died of pneumonia. That was a few years ago, but it is one example of how we do not fully understand dementia. Stories are hidden at the moment, but by dealing with dementia within the NHS as a disease, we could really help people to reduce so much of the harm and the inequality that we have talked about. We could do something fantastic and make better use of the money that is available to care for those we all care about.

--- Later in debate ---

[Jackie Doyle-Price]

I have been in close consultation about that issue with the recently departed Minister of State for Disabled People, Health and Work, my hon. Friend the Member for Truro and Falmouth (Sarah Newton). She has really challenged the DWP to look after people who are vulnerable, and put in place safeguarding policies for them, so I confirm to the hon. Member for Central Ayrshire that that discussion is taking place.

My hon. Friend the Member for St Ives (Derek Thomas) raised the issue of dementia. Clearly, dementia has a big impact on the number of years in which people can enjoy a healthy life, and we must get that right. For that reason, we have introduced the ageing society grand challenge, which is focused on narrowing those inequalities. My hon. Friend is right that we must have better integration with social care; there have been a lot of moves towards better integration between local authorities and the NHS, and that must continue.

The hon. Member for Washington and Sunderland West (Mrs Hodgson) referred to public health cuts. We have tackled those through the NHS forward plan, and have said that this is an area in which we expect the NHS to focus and work collaboratively with local government, specifically highlighting health visitors and the wider public health agenda. My answer to the hon. Lady’s point is “watch this space”, but we recognise that we spend less if we spend wisely, which has to be about getting the system to work better.

[Derek Thomas]

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[Dr Whitford]

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