Dementia Care

Freddie van Mierlo Excerpts

Tuesday 3rd June 2025 Commons Chamber

[Freddie van Mierlo (Henley and Thame) (LD)]

I congratulate my hon. Friend the Member for South Devon (Caroline Voaden) on securing this very important debate. There is hardly a healthcare issue so big that we do not talk enough about as dementia. Perhaps that is because it is one of the most feared diseases, for understandable reasons.

For decade upon decade—unlike cancer, for example—there has been very little tangible scientific progress, until recently. As the chair of the all-party parliamentary group on access to medicines and medical devices, I will focus my remarks on those treatments. Breakthroughs are coming through thick and fast, with the UK’s Medicines and Healthcare products Regulatory Agency approving two disease-modifying therapies in 2024 for Alzheimer’s. Those medicines chart a path to a time when Alzheimer’s and other forms of dementia are a treatable condition that can be delayed to the point where it is, for all intents and purposes, cured. That is incredibly exciting for families such as mine with a history of Alzheimer’s, and more is on the way.

More than 100 medicines are being investigated, so it is a matter of not if, but when new medicines come forward, yet the UK is not ready. The alarm has been raised, but no one is listening. The last Government were asleep at the wheel, and I fear that this Government are too. Moving from a system focused entirely on care to prevention and treatment will require a monumental shift in thinking that breaks down departmental silos and redistributes budget to treatment. We know that reversing brain damage is nigh impossible, but preventing it is not. That is why early detection and diagnosis are so critical.

Dementia begins without symptoms as early as people’s 40s or 50s. We need to identify those people before the onset of decline, but that requires a system with sufficient diagnostic capacity. That means improved GP waiting times, increased capacity at memory clinics and a massive increase in magnetic resonance imaging, positron emission tomography and lumbar puncture test capacity. The lack of capital investment in our NHS has left us dangerously exposed, with the lowest number of MRI scanners per capita in the OECD. The UK has 6.1 systems per million people. In Germany, the rate is 30.5. Emerging diagnostics, including the blood biomarkers being investigated at the Warneford in Oxfordshire, need to be embraced alongside getting the basics right.

The Government must also look actively at how the National Institute for Health and Care Excellence assesses new medicines in dementia. Both lecanemab and donanemab were approved by the MHRA and then rejected by NICE on the same day. That means the MHRA believes these medicines are safe and effective, but NICE believes them too expensive for the NHS, because it fails to consider the economic and social benefits, including savings to informal care.

Do we want a system where those who can pay privately for medicines that delay dementia get treatment, and those who cannot, do not? Even when a new therapy is approved by the MHRA, given the green light by NICE and by some miracle we have diagnostic capacity, patients still may not get their hands on it. Depending on how a new medicine is delivered, we may not have enough infusion capacity. If it is a pill, we will be in luck, but we cannot bank on that. The truth is that the NHS cannot cope with the innovation we all want in dementia. My message to the Government is simple: get ready.

I hope the Minister for Care will take note of one final point: please stop punting problems down to the ICBs. My recent written parliamentary question, asking what steps the Government are taking to increase the number of Alzheimer’s disease specialists, was answered by him yesterday, and he said:

“The provision of dementia health care services is the responsibility of local integrated care boards”.

[Gregory Stafford (Farnham and Bordon) (Con)]

The hon. Member is making a powerful speech, especially with that last point. Is he, like me, concerned that ICBs will have their funding cut by 50%? Dementia will be one of the many conditions that will suffer because of that.

[Freddie van Mierlo]

Like the hon. Member, I am incredibly frustrated that whenever I put concerns to the Minister, I get pointed towards the ICBs, and when I talk to the ICBs, they tell me to talk to the Minister. There must be responsibility within our system. The Minister has been in politics for longer than me, but I hope he will allow me to offer him a little advice. It is not the ICBs that the people of this country are angry with when it comes to not getting the treatment they deserve; it is the Government. They expect the Government to take responsibility, not pass the buck.

Mental Health Bill [Lords]

Freddie van Mierlo Excerpts

2nd reading
Monday 19th May 2025 Commons Chamber

[Dr Chambers]

My hon. Friend will not be surprised that I agree with her; she may as well have read the next bit of my speech. She is completely right. Farmers, those working in agriculture, military veterans and their families, mothers in the first year after childbirth, people living in poverty and the LGBTQ+ community are just a few of the groups that we know are at heightened risk.

We already take a proactive approach when it comes to physical health; we have targeted cancer screenings for at-risk demographics. We should take the same approach to mental health. That is why the Liberal Democrats have long called for properly resourced community mental health hubs, which could reach people before they reached crisis point. We are also calling, as my hon. Friend just did, for regular mental health check-ups at key life stages—for example, when someone has just given birth or just been discharged from the Army.

[Freddie van Mierlo (Henley and Thame) (LD)]

My hon. Friend is outlining the treatment options for patients. New medicines are also incredibly important, and groundbreaking research is happening at the Warneford hospital in Oxfordshire, a mental health hospital that is in desperate need of investment. Treatment options and new medicines go hand in hand, so does he agree that the Government should get behind the Warneford and invest in it?

[Dr Chambers]

I agree with my hon. Friend and thank him for his intervention.

Mental health MOTs could help to catch at-risk people early, so that we can start treating them before the problems develop further. I am sure that for all Members present mental health issues are among the top areas in our email inboxes and our correspondence. We receive emails from desperate parents of young people who are left on waiting lists for years throughout their schooling, and from adults falling between the cracks of an overstretched system. We should probably acknowledge that these are not anomalies. They are the symptoms of a system that is under immense strain. This long-awaited Mental Health Bill is a very welcome step, but it cannot be the only step, because at the heart of our approach must be the simple principle that prevention is better than cure.

Oral Answers to Questions

Freddie van Mierlo Excerpts

Tuesday 6th May 2025 Commons Chamber

[Karin Smyth]

I absolutely join my hon. Friend in recognising the importance of supporting women’s health throughout pregnancy and into parenthood on Maternal Mental Health Day. We are committed to improving the support available, and it will form an important part of our 10-year plan. We are investing £126 million in family hubs and Start for Life services, to support parents from pregnancy to their child’s early childhood, and we will continue to work with her on this.

[Freddie van Mierlo (Henley and Thame) (LD)]

I thank the hon. Member for Aylesbury (Laura Kyrke-Smith) for her question and the Minister for her answer. I am delighted to be forming the all-party parliamentary group for fatherhood. Will the Minister outline the steps that she will take to improve perinatal mental health for fathers?

[Karin Smyth]

I congratulate the hon. Member on taking forward that work. The Minister responsible will be happy to continue to work with him in any way possible to support that work on this important aspect of parenthood.

Hospitals

Freddie van Mierlo Excerpts

Wednesday 23rd April 2025 Commons Chamber

[Freddie van Mierlo (Henley and Thame) (LD)]

Hospitals matter to everyone, but hospitals falling apart help no one—not patients, not staff and not the economy. The Government have called the NHS “broken”. They rightly blamed the Conservatives, and criticised the NHS’s management under their leadership, so why are the Government now making the same mistakes?

Under the revised new hospital programme, the building of the Royal Berkshire hospital will not commence for another decade. There is little prospect of a new Royal Berkshire to serve the communities of Henley, Reading, Newbury, Bracknell and Windsor until the 2040s. Doctors who have worked in the NHS for over 30 years believe that they will never work in modern buildings. The cancer centre alone is 164 years old.

[Sarah Dyke (Glastonbury and Somerton) (LD)]

My hon. Friend talks of members of staff with long service. A former nurse with 40 years’ experience in the NHS recently contacted me. She took her husband, who has complex needs, into hospital, as he had a hand infection, and they were forced to wait for over 12 hours in a tiny cubicle with no ventilation. It pained me to hear that story. She worked so hard for the NHS, which she felt was down on its knees. Does my hon. Friend agree that this is a damning indictment of the state of our hospitals, and that we urgently need to pursue a major 10-year capital investment programme to get them back up to speed?

[Freddie van Mierlo]

My hon. Friend is right to point out the impact of the state of the NHS on the brilliant people who work there. My sister is a nurse in the Royal Preston hospital, and she tells me just how hard it is to walk past people who are being cared for in corridors. Every week at the Royal Berkshire, an operation is cancelled due to power cuts, water supply issues, broken lifts or malfunctioning temperature controls. Those are lost appointments and lost efficiency for the NHS. Floods and sinkholes plague the foundations of the Royal Berkshire hospital, which now requires relocation, and identified suitable sites are set to be put on the market at the end of this year. Further inaction by the Government will mean that those carefully laid plans and that funding will amount to nothing.

There are also hospitals that were never considered for the programme, as my hon. Friend the Member for Oxford West and Abingdon (Layla Moran) pointed out. I recently visited the Warneford hospital in Oxford, which gives in-patient care to patients with severe mental health conditions, including schizophrenia, personality disorders and psychosis. I was shocked by the conditions that patients live in. They are in tight spaces in dark rooms, and the infrastructure is Georgian. There were rooms that reminded me of recent visits to HMP Huntercombe. I said that rather nervously to the member of staff showing me around, worried that I might offend them. They gently held my arm and said, “Freddie, why do you think we showed you these rooms?”

Staff told me that cramped conditions make it difficult to take breaks during the day. One worker showed me their windowless cupboard office—hardly great for their own mental health. Staff also told me how working in Georgian buildings impacts the quality of their work. Sight lines in common rooms are obstructed by pillars; rooms are difficult to heat; and security is difficult to maintain. A new Warneford would cost a fraction of the price of a physical health hospital, and the Government promised to put mental health on the same footing as physical health, so why does the revised new hospital programme not include a single mental health facility?

Both the Warneford and the Royal Berkshire have been devastated by the Government’s lack of foresight. The cuts to hospital spending are a decision made to save money, but that is a false economy. Over the next 10 years, repairs to the Royal Berkshire hospital are projected to cost £400 million—a quarter of the cost of a new hospital. Add to that the many other neglected hospitals, and the loss is unthinkable. Proper investment in modern infrastructure is needed now.

In my constituency we have the Townlands Memorial hospital, which shows how good the NHS can be with modern infrastructure. Anyone who receives care there, whether through the Royal Berkshire NHS foundation trust or the Oxford Health NHS foundation trust, sings its praises. It hosts over 30 specialities and plans to expand further. Let us give our hospitals the chance to excel.

[Several hon. Members rose—]

National Cancer Plan

Freddie van Mierlo Excerpts

Tuesday 4th February 2025 Commons Chamber

[Andrew Gwynne]

I cannot even begin to think what it would be like to lose a child full stop, but to lose them to cancer would be horrific for their parents. I pay tribute to Lorraine for all the campaigning she has done on this. I am more than happy to meet my hon. Friend and Lorraine to talk about this, but the whole reason for putting the taskforce back on an operational footing is so that we can make the changes that she and Lorraine want to see.

[Freddie van Mierlo (Henley and Thame) (LD)]

Members across the House will be all too familiar with constituents reaching out to let them know that safe, effective new medicines are not approved by the National Institute for Health and Care Excellence. The Minister speaks of research and the need for access. Will he commit to being a critical friend of NICE, to ensure both good value for the taxpayer and good access for patients?

[Andrew Gwynne]

The hon. Gentleman makes a good point. NICE is there for a particular reason: to ensure that the drugs being developed are available on the NHS when they meet the required threshold. Of course, we want to ensure that as new treatments become available, they are available for British patients. The work that is being done with Moderna and other pharmaceutical companies will ensure that British patients have access to some of the latest treatments as they come through the pipeline.

Access to Primary Healthcare

Freddie van Mierlo Excerpts

Wednesday 16th October 2024 Commons Chamber

[Freddie van Mierlo (Henley and Thame) (LD)]

I very much welcome this debate. GPs are rightly pillars of our community—doctor remains one of the most trusted professions, perhaps unlike ours—but I want to mention some of the other key professions in the primary care sector, including practice nurses, who dedicate their lives to working on behalf of our residents.

Right now, practice nurses are working hard to deliver flu, covid, RSV and shingles jabs to many of our residents. They are the unsung heroes who keep primary care going, but their number is declining due to wage constriction. New nurses looking to boost their salaries often opt for hospital-based care because they can improve their pay packet with unsocial hours payments. Mental health nurses, healthcare assistants and social prescribers also provide essential services, and we must not forget receptionists, who bear much of the public’s frustration after 14 years of failed government. They have my thanks.

GPs are in crisis. The Tories let waiting times soar and failed to deliver a new framework contract for GPs in time, leading to industrial action. I am very concerned that in my area we have sleep-walked into a two-tier health system, with long waits for those who cannot afford private care and access for those who can. In Henley, we are seeing the first fully private GP practices and many people going for jobs with corporate insurance plans. There are now routinely four-week waits in places such as Thame, Benson, Watlington and Chalgrove, where we have seen significant housing growth. As my hon. Friend the Member for Didcot and Wantage (Olly Glover) mentioned, developer funds have been collected, but in Oxfordshire they are not being released in time to deliver the infrastructure that is needed.

I want to highlight the impact of those waits on some of the most vulnerable people. I recently spoke to my constituent Suzannah Windsburrow, a tenacious campaigner with learning difficulties, who highlighted to me just how important timely access to healthcare is for her. The collective impacts of a lack of access mean that people with learning disabilities die earlier than those without one—23 years earlier for men and 27 years earlier for women.

I very much welcome the Liberal Democrat commitments on health, and I encourage the Labour party to copy our manifesto—honestly, we won’t mind—including our commitments to ensuring that people can see a GP within seven days or, if it is urgent, 24 hours; to 8,000 more GPs; and to providing a named GP for people over 70. I also hope that Labour will copy our very important policy on delivering mental health professionals in schools.