Disabled People: Dementia

Earl Howe Excerpts

Monday 11th October 2010 Lords Chamber

[Lord Ashley of Stoke]

To ask Her Majesty’s Government what steps they are taking to help people with impaired faculties, such as hearing or vision, and concurrent dementia.

[The Parliamentary Under-Secretary of State, Department of Health (Earl Howe)]

My Lords, tackling dementia is an urgent priority and the Government are committed to the delivery of better-quality care for all those with dementia. Ensuring that people with impaired faculties or disabilities receive the best type of care that they require is one of the reasons we are accelerating the pace of improvement through a focus on local delivery and accountability.

[Lord Ashley of Stoke]

I thank the noble Earl for that response. Is he aware that people with dementia who are also blind and deaf have a really difficult life? They are trapped in a kind of living hell and require urgent attention. The Minister said that the Government are accelerating the process. To what extent is that happening, and can he guarantee that the Government will support a campaign to provide all the facilities necessary for people of this kind?

[Earl Howe]

The noble Lord, Lord Ashley, as so often, is absolutely right. Those who have dementia and also suffer from sensory impairment have a particularly difficult time. That is why we have signalled, in the recently revised operating framework for the NHS, that improving dementia care will be a priority. However, the noble Lord may also like to know that we have today published a Written Ministerial Statement, which he can read in Hansard, showing that we aim to accelerate the pace of improvement in four ways in particular: by improving early diagnosis and intervention; by improving care in hospitals; by improving the care of dementia patients in care homes; and by reducing the use of anti-psychotic medications. Those are the four priorities that we think will make the most difference.

[Lord Laming]

My Lords, can the Minister inform the House what steps the Government are taking to ensure an adequate supply of community-based nurses who have been specially trained in dementia care, not least to support carers?

[Earl Howe]

My Lords, an informed and effective workforce is clearly central to the delivery of the dementia strategy. The Department of Health has recently published reports which map the current level of training, and these have been widely disseminated to key bodies involved in providing education and training. Professor Alistair Burns, who is the National Clinical Director for Dementia, is chairing an advisory group that will aim to ensure the development of proper education and training for all staff involved, and he will be engaging with all the key organisations in doing so.

[Baroness Pitkeathley]

My Lords, the Minister will be aware that family carers have two main concerns about dementia services. The first is that they are patchy and are not uniform across the country and the second is that they are not co-ordinated across acute voluntary, independent and family care. How will the Minister ensure that those two issues are better addressed under the proposals in the White Paper?

[Earl Howe]

My Lords, there are several prongs to the strategy which will be needed to meet the concern of the noble Baroness. One is to drive up quality standards through a proper tariff for these services and another is better regulation of providers. As the House will know, the NICE quality standard was published in the summer, which will improve commissioning to deliver greater efficiencies, not simply in a financial sense but also to deliver a better pathway of care for patients, with a focus on outcomes.

[Baroness Hussein-Ece]

My Lords, can my noble friend tell us whether those with special educational needs have a higher preponderance of dementia? What is being done to address those needs and to drive up standards of care, given that the All-Party Parliamentary Group on Dementia concluded that some care being given to dementia suffers is dehumanising? Can my noble friend please outline what is being done for those people with special needs who are diagnosed?

[Earl Howe]

My Lords, my noble friend has hit on an extremely sensitive and important area. My answer to her is similar to the one I gave on a previous question: we must focus on outcomes. That is the main theme of the recently published implementation paper. This morning, I was speaking to a representative of the King’s Fund, which has done tremendous work in this area. This is one aspect of its work, of which I am sure we shall be hearing more.

[The Lord Bishop of Chester]

My Lords, what policy do the Government have for supporting the learning of British sign language?

[Earl Howe]

My Lords, the right reverend Prelate rightly calls attention to the needs of those with aural disability. The Government’s plans for audiology are in gestation at the moment. Unfortunately, it is too early for me to tell him, but I shall aim to write him a letter at the earliest opportunity.

[Baroness Greengross]

My Lords, in declaring an interest as chair of the All-Party Parliamentary Group on Dementia, I ask the Minister what plans the Government have to reduce the inappropriate length of stay in hospital of many patients with dementia and other impairments. As that would result in quite a lot of savings, I ask the Government to reinvest those savings in community services.

[Earl Howe]

My Lords, the noble Baroness is right. The national dementia strategy quite rightly recognises the need to improve the quality of care for people with dementia in hospital and that is identified in the new implementation plan as one of the key priorities for action. Of course, the main priority has to be to avoid admitting dementia patients to hospital in the first place, if possible. We should admit them only when it is strictly necessary and we should discharge them at the earliest opportunity. We have set priority areas for all hospitals to take urgent action, including appointing a senior member of staff to improve the quality of care for people with dementia and to look after the training of staff in hospitals.

[Lord Touhig]

My Lords, between a half and two-thirds of people with dementia never receive a formal diagnosis. That could be improved if GP practices, the mental health services and the royal colleges were to develop dementia care pathways. That was a recommendation by the Public Accounts Committee in the other place in 2008. What progress has been made in developing those pathways?

[Earl Howe]

My Lords, progress is being made thanks to the quality standard published by NICE in the summer on dementia care. That will underpin the outcomes framework that we shall look for in the care of dementia patients. He is absolutely right in what he says: two-thirds of people with dementia never receive a diagnosis in the first place; the UK is in the bottom third of countries in Europe for diagnosis and treatment of dementia patients; and GPs do not feel adequately trained in this area. So there is a lot of work to do.