Deaths in Mental Health Settings

Hazel Blears Excerpts

Friday 27th February 2015 Commons Chamber

[The Parliamentary Under-Secretary of State for Health (Jane Ellison)]

I congratulate my hon. Friend the Member for Broxbourne (Mr Walker) on securing this debate on the investigation of deaths in mental health settings. He has shown considerable interest in this area of policy over many years, and has championed the thorough investigation of deaths of people in custody settings. I commend him for his valuable work. It is important that he gives a voice here in Parliament to people who feel, on occasion, voiceless. He has spoken out on the human rights of those detained in custody, and of their families. He alluded to a recent meeting with some of the affected families, who I am sure are appreciative of his efforts on their behalf.

In my hon. Friend’s thoughtful speech, he stressed the need for vigorous and transparent investigations of deaths in all custody settings. He has highlighted to all of us the distress endured by the families of people who have died, especially when it seems that the death may have been preventable, and how important it is that mental health providers ensure that the investigation does not cause further distress. He also rightly highlighted the need for investigations to be held in a timely manner, and for families to be informed and involved throughout. It is important that investigation findings are clear and indicate what can be done to prevent future deaths, so that families have the comfort of knowing that their loved ones did not die in vain and that lessons have been learned.

My hon. Friend highlighted the report by the charity INQUEST, which calls for better investigations of deaths in mental health settings and makes a number of recommendations for change. I will turn to each of those recommendations and make comments, but I first wish to make some more general points about the ways in which the Government are trying to respond to the issue of mental health crises, and about work involving the police. It is good to be joined on the Front Bench by the Minister for Policing, Criminal Justice and Victims, who is showing his interest in this important subject.

Although today’s debate focuses on investigating the deaths of people detained in mental health settings, it is also important that we focus our efforts on preventing people from being detained in hospital and, where we can, diverting people with mental health illness away from police custody and prison. That is why this Government have invested £33 million this year in developing early intervention services for psychosis, and in supporting people in a mental health crisis to access the right care in the right place.

Last year, we published the mental health crisis care concordat, which is an agreement between more than 20 national bodies on the care and support that people need in a mental health crisis, and we are now working with local areas to ensure that they have local action plans in place for providing that support. We are investing an extra £35 million to develop and expand liaison and diversion services to ensure that people of all ages with mental illness who come into contact with the criminal justice system have their needs identified as soon as possible and are referred to appropriate mental health services.

[Hazel Blears (Salford and Eccles) (Lab)]

I am grateful to the hon. Member for Broxbourne (Mr Walker) for raising this issue in the House. Clearly, it is a matter of significance to our communities. Is the Minister aware of the excellent work being done by Greater Manchester police and by the chief constable, Peter Fahy, around the whole issue of mental health? Sir Peter is very concerned that his officers do not have the necessary skills—this is exactly what the hon. Gentleman said in his contribution—to deal with many circumstances, so the pressure on the police forces is intense. I am delighted that the Policing Minister and the Health Minister are here today. A greater degree of integration at local level would be extremely helpful in ensuring that we get the right people in the right place with the right skills to support the people the hon. Gentleman mentioned.

[Jane Ellison]

As ever, the right hon. Lady makes an extremely good point. My right hon. Friend the Policing Minister has confirmed that he has been to Greater Manchester and seen the work in progress. I will touch on street triage, which is an aspect of the work going on in this area, but first let me say that the right hon. Lady is absolutely right. As a constituency Member, I have been out on a Friday night with my local police’s rapid response team. Very caring young police officers have stressed to me the importance of not only equipping them with skills, but ensuring that they are not asked to do things that are not part of their core duties, and that they get proper support to deal with people in a sensitive way. The right hon. Lady’s point was very well made.

Police forces are piloting a street triage initiative, in which mental health professionals travel with police officers on patrol, providing on-the-spot help to people with possible mental health needs who come into contact with the police. There have been positive results in the Leicestershire pilot area, where street triage has led to a reduction in detentions under section 136 of the Mental Health Act 1983. I know from a Backbench Business debate a few weeks ago that that is an impressive reduction in detentions, and the right hon. Lady mentioned progress in her area, too.

We are also investing a further £30 million next year to further develop liaison psychiatry services to support people with mental illness in accident and emergency and when being treated for physical illness in a general hospital setting. As well as focusing on preventing people from being detained in mental health settings, we must also look at preventing avoidable harm and deaths when people find themselves in hospital. My hon. Friend the Member for Broxbourne mentioned that.

INQUEST’s report highlights the issue of suicides in mental health settings. Earlier this year, the Government announced our ambition for the NHS to adopt a zero suicide strategy to reduce dramatically suicides in health settings and in the community. At the beginning of the year, we also laid before Parliament the revised Mental Health Act 1983 code of practice, which comes into effect from April and strengthens our commitment to safeguarding the rights of people detained under the Act. The revised code of practice gives greater prominence to the need for better and more rigorous risk assessments, and for care planning that is centred around the patient and involves their carers and relatives wherever possible. That picks up on the well-made point from my hon. Friend about the need to involve families and to ensure that patients are treated in safe environments.

Let me turn to the recommendations in INQUEST’s report. The first concerned the system for investigating deaths and the matter of independence. Coroners’ inquests provide independent investigation, and we must consider the evidence carefully to inform how we improve the quality and independence of investigations in mental health settings. It is right that we focus on improving the way deaths in such settings are investigated. Clear guidance should be given to the NHS to improve the integrity and quality of investigations.

NHS England is reviewing the NHS serious incident framework, which describes how serious incidents, including deaths, should be reported, investigated and learned from to prevent them happening again. I understand that NHS England is finalising the guidance and have been advised that it is being reviewed by the chief nursing officer. This is an opportunity to re-emphasise the responsibilities of providers and commissioners by holding providers to account for how they respond to serious incidents, and holding commissioners to account for overseeing the response to ensure that it is objective, proportionate and timely.

Secondly, the report recommends the proper and meaningful involvement of families in the investigation of deaths, so that it is on a par with the way in which deaths in other custody settings are investigated. NHS England’s guidance on managing investigations in the NHS will set out the commissioner’s responsibility for ensuring that all those affected by an incident are involved, and that the investigation is conducted in an open and honest manner. The commissioner will also have the opportunity to inform the terms of reference of the investigation, and can consider and will be consulted on the investigation’s findings. The efforts to engage those affected by the incident should also be recorded in the response to the investigation. It is therefore essential that people should be able to not just liaise with the family, but demonstrate how they have done so, and record how they did it.

Thirdly, the report recommends the better collation and publication of statistics on deaths in mental health settings, including further details on the circumstances and characteristics of the death. I was struck by what my hon. Friend said about some of the uncertainties in this regard, and about the need for people to be transparent about something so important. I am aware that the Care Quality Commission is piloting ways to improve how it collects and analyses data, in partnership with NHS England. That can help to improve the way the CQC monitors the Mental Health Act.

I understand that the Care Quality Commission is looking at how it might link data from hospital episode statistics and from the mental health and learning disabilities data set to enable better cross-referencing of the information it receives through notifications of deaths, which should help it to improve the availability of data at a national level so that it supports policy responses to deaths in detention. That important work is ongoing.

Fourthly, the report recommended that coroners’ inquests be more robust. I have shared the report with the Ministry of Justice, and I am sure that the Chief Coroner will read it with interest. The fact that my right hon. Friend the Policing Minister is here on the Front Bench demonstrates that—

A and E (Major Incidents)

Hazel Blears Excerpts

Wednesday 7th January 2015 Commons Chamber

[Mr Hunt]

I am very happy to do that and I am aware of the significant pressures at the Princess Alexandra. I thank my hon. Friend for the way in which he is supporting staff in his local hospital, getting behind local plans. It is a mistake to say that there is always a new national initiative. Lots of people in the NHS have been saying over the past few days that they do not want new national initiatives. They want exactly what my hon. Friend is doing; they want people to support their local NHS and not to turn it into a political football.

[Hazel Blears (Salford and Eccles) (Lab)]

On Monday evening, the trust of Salford Royal hospital, which, as the Secretary of State knows, is an excellent hospital, declared a major incident. I am pleased to say that the pressure has been dealt with and it has now been lifted, but it is clear to me that many of the thousands of elderly and frail people in hospital have dementia, which means that they stay longer and are readmitted more often. I welcome the better care fund, but it will not be enough. There needs to be a whole systems change to prevent people from being admitted in the first place, with better support and more action by GPs. We need to get on with that urgently.

[Mr Hunt]

I agree entirely with the right hon. Lady. The better care fund is a first step, but it is only a first step. It is happening from this April, but we have the NHS England five-year forward view, which is the long-term plan to improve community care. I agree that Salford Royal is an excellent hospital. It had £3.5 million to help it deal with winter pressures this year, but it is also a good example of how integrated care between the acute trust and local community services can make a real difference, and it is delivering some of the safest care in the country.

Care Bill [Lords]

Hazel Blears Excerpts

Monday 10th March 2014 Commons Chamber

[Sir Tony Baldry (Banbury) (Con)]

I am not quite sure who to be bad-tempered with. As the House knows, I am not characteristically bad-tempered, but I think my bad temper should probably be directed at the usual channels, given that the timetable motion went through on the nod. We have to deal with 21 new clauses and 20 amendments on an important Bill in two hours, which by my calculation allows three minutes per clause or amendment. The hon. Member for Leicester West (Liz Kendall) spoke perfectly reasonably, given the number of amendments that have been tabled, but it is impossible to do justice to all this in two hours. The usual channels should bear in mind that some of us feel rather bad-tempered about the time provision. These things, as we all know, are agreed between the usual channels; it is not one side or the other that is responsible.

I wish to speak briefly about new clause 3. The Bill does fantastic things for carers, and I think it would be a real tragedy if, once the Bill completes its passage, carers or their advocates felt that it was a missed opportunity. I shall not repeat what my right hon. Friend the Member for Sutton and Cheam (Paul Burstow) said. The Minister will doubtless say that clause 6 and the duty to co-operate deal with this point. Clearly, the duty to co-operate is very important for local authorities and the NHS. In the past, GPs may not have sought to identify carers as well as they could because they did not think there was much they could do for them. Now they will be able to ensure that there is a carer’s assessment. If the Minister intends to resist new clause 3, could he seek to ensure that we have statutory guidance for the NHS on the services that it should provide for carers?

I fully understand that for those aged over 75 the aim will be to have named clinicians, and those clinicians should, as part of their duty, ensure that carers are identified, but of course many carers, including young carers, are under the age of 75. It would be a real pity if the Bill missed this opportunity on carers. If we could have some statutory guidance on what the Minister, the Department and all of us expect the NHS to do to identify carers, we can then have a quick rendition of the “Hallelujah Chorus” and I will not be so grumpy.

[Hazel Blears (Salford and Eccles) (Lab)]

I shall do my best not to be grumpy and to be as quick as the right hon. Member for Banbury (Sir Tony Baldry). I wish to speak in support of new clauses 9 and 19. New clause 9 has support across the breadth of organisations from the Association of Directors of Adult Social Services to the Care and Support Alliance. It makes fundamental good sense, when setting up a new system, to have the ability to have an annual report about whether there is sufficient money in the system. Whichever Government are in charge, we need to know that. We are in danger of willing the ends but not the means for social care, and we have to make sure that this issue is kept under close review.

We all support the two fundamental principles of the Bill, which are about promoting individual well-being and moving towards a more preventive system. Those are commendable and high ideals, but if we do not have the funding in the system to be able to deliver them, the Bill will not achieve the potential that we all know is there.

I spoke on Second Reading about transformation, and I look forward to welcoming the Minister to Salford on Wednesday to show him how we are transforming the system for dementia care in the city by bringing together £97 million of our total health and social care budgets to try to squeeze every bit of impact out of every last penny to give better care for people with dementia. I hope he will be impressed, but more than that I hope he will help us to do this with his better care fund. That fund should be used for the transformation of our services at a time of austerity when we need more money in the system.

The second part of the new clause is about having a five-yearly review of eligibility criteria, which is essential—to be frank, I would like to see that happen more often than every five years. Eligibility criteria are now set at “substantial” instead of “moderate”, which means that in Salford 1,000 fewer families are being helped, and the heartache and misery that that causes are enormous. It also goes against the second fundamental principle of the Bill. If we do not have eligibility criteria at the right level, how can we transform the system to be preventive? If we only pick up people when they are in crisis, they are escalated into the acute sector, which costs a fortune. If we invest in lower level community-based interventions by social enterprises and voluntary groups, we can save money in the acute sector.

[Meg Munn]

Does my right hon. Friend agree that even when people’s needs are substantial, they are often not getting the support they need because the local authorities are not recognising that low level services, such as shopping and cleaning, help to support the care that is being provided by families? The Government need to have clear guidance on this.

[Hazel Blears]

My hon. Friend, as ever, makes an extremely worthwhile and practical point. Simply having the words in statute does not always portray the real position on the ground. A small intervention can often help to stop things becoming a crisis.

Oral Answers to Questions

Hazel Blears Excerpts

Tuesday 25th February 2014 Commons Chamber

[Mr Hunt]

May I congratulate my hon. Friend on the campaigning work he does in his constituency on health matters? I commend the Eastern Cheshire clinical commissioning group for its “Caring Together” programme and for the fact that Cheshire was selected as one of the 14 integrated care pioneers. I hope that it will blaze a trail in joining up the barriers that have bedevilled our health and social care system for too long, so that his constituents are not pushed from pillar to post because of arguments about budgets and people can be discharged on time. I think his area is blazing a trail.

[Hazel Blears (Salford and Eccles) (Lab)]

The national dementia strategy has been fundamental in improving care for many frail and elderly people with dementia living in the community. The strategy is due to expire in April—in two months’ time. Will the Secretary of State give a commitment to the House now that the national dementia strategy will be renewed? I understand that we have the Prime Minister’s dementia challenge, but, like many of us, Prime Ministers come and go. We need a strategy and not simply the Prime Minister’s challenge.

[Mr Hunt]

I can assure the right hon. Lady that this Prime Minister is here to stay. Indeed, I can also reassure her that the national dementia strategy is here to stay. As she has announced that she is stepping down at the end of this Parliament, may I thank her for her campaigning on dementia, which, I think, came from a family connection with the issue? She has attended many of my dementia meetings and the G8 dementia summit. She has made a really important contribution, and I thank her for that.

Dementia Care and Services

Hazel Blears Excerpts

Tuesday 7th January 2014 Commons Chamber

[Alec Shelbrooke]

I am most grateful to the hon. Gentleman. I am sure the Minister heard his comments and will perhaps reflect on them when he sums up the debate.

I was talking about a number of areas. First, to continue making improvements along the current trajectory, it is crucial that the national dementia strategy for England is updated from the 2009 version. That strategy identified 17 key objectives for the NHS and social services aimed at improving the commissioning of dementia services, the quality of care delivered in hospitals and care homes, developing a clear picture of research and evidence needs, and providing support for carers. Will the Minister please outline what meetings have taken place about the effectiveness of the NDSE, and say what plans he has for a formal evaluation of it?

Secondly, in spite of the obvious benefits of the national strategy, so far the Government have made no plans to renew it. I welcome the Prime Minister’s challenge on dementia, which is ambitious in its plans and places a welcome political spotlight on the issue. However, that challenge alone does not provide the breadth of detail needed to guide health and social care services to make improvements, and neither does it carry enough accountability measures, which a national strategy would do.

A new national dementia strategy, with guidance for commissioners of health and social care, GPs, hospital trusts, care homes, and others, must be published before the current strategy expires in April this year. It does not seem to be a new trend of coalition Government not to renew national strategies, because in 2011, new national strategies for cancer and chronic obstructive pulmonary disease were published, and one for hearing loss is due.

[Hazel Blears (Salford and Eccles) (Lab)]

I have been listening carefully to the hon. Gentleman who is making an eloquent and powerful case. His point about the strategy is fundamental. We have a system of different clinical commissioning groups, and a lot of fragmentation, and we need a holistic strategy that brings together the national effort. All credit to the Government for pursuing the issue, but I echo what the hon. Gentleman is saying about the need to renew the national strategy to maintain that momentum and energy, and ensure we get good services across the country. Will he join us all in continuing to press the Minister for renewal of the strategy?

[Alec Shelbrooke]

I am most grateful to the right hon. Lady, and I congratulate her on the work she does with the all-party group on dementia. She and all hon. Members will recognise that on this subject the whole House is fairly united in trying to get the Government to make those changes, regardless of whether we sit on the Government or Opposition Benches.

Our international partners, many of which attended the G8 summit in December, have ambitious long-term plans. In the US, for example, President Obama published a dementia strategy that runs until 2025, well beyond his own term as President. France has recently published its fourth dementia strategy. The economic case for having a clear directive for dementia is overwhelming. Dementia costs the UK £23 billion a year, which is more than cancer, stroke or heart disease, yet the annual research spend into dementia is about £51 million, rising to £66 million in 2015. That compares with £521 million spent on cancer.

The ambition announced at the recent G8 summit to double the spend on research in the UK by 2025 is an excellent step forward, but a new national dementia strategy that covers all aspects of dementia, including research into prevention and finding a cure, will ensure that the momentum gained from the good work undertaken by the coalition Government will be turned into improvements for people affected by dementia. To be clear, I am not suggesting that money be taken from the other crucial health causes I have mentioned; I wish merely to illustrate the numbers involved.

What plans does the Minister have to renew the current national strategy on dementia? That point was left unanswered in the Backbench Business Committee debate last year. As past statistics have shown, the introduction of a national strategy for dementia in England has caused a rise in the rate of diagnosis, although the level is still worryingly low at 48%. More needs to be done on prevention, particularly further investigation into whether the small change of introducing homocysteine level tests on the NHS could act as an early-warning sign in identifying the problem.

--- Later in debate ---

[Alec Shelbrooke]

I thank the hon. Gentleman for that intervention. He makes important points that reflect what the hon. Member for Liverpool, Walton (Steve Rotheram) said earlier: it is not just about treating the disease when it is there, but about how much preventive work can be done in the first place.

As I said at the start of my speech, I wish only that some of the strategies, diagnoses and drugs that are now available were there for my grandmother 25 years ago. I was only about 11 to 13 years old in the two years before she finally went into a home, but I realise in hindsight how her quality of life was slipping away. I talked about the toll that that took on my father when he was trying to do what was best for his mother. He would be at work all day. His mother lived in south-east London while we lived 20 miles away in Kent and he would get a phone call at 3 am from her next-door neighbour saying, “Your mother”—she was in her late 70s—“is out walking the street in her nightgown.” Those are the pressures and there was nothing in place at that time. She was still living on her own and, as her grandchildren, we would still visit her. Today, I believe that she would have had a better quality of life.

I am encouraged by some of the things that are going on. I want to draw attention to a chap called Paul Mancey and his team at Orchard Care Homes. They are located in my constituency and are developing care partnerships between charities and care providers, which is very much what my hon. Friend the Member for Bradford East (Mr Ward) was talking about. This new approach means that residents are tested for hearing loss, diabetes and dementia symptoms on entry to the care home, ensuring that appropriate care packages are put in place.

Many other care homes are developing innovative ideas, too. I am pleased to say that care homes have developed immensely since we moved my grandmother into one in the early 1990s, and even more delighted that the leading company on the development of care villages is located in my constituency. Graeme Lee and his team at Springfield Healthcare have set the bar on building a quality and comfortable dementia-friendly care village at Seacroft Grange, which is located in the constituency of the hon. Member for Leeds East (Mr Mudie).

As is often the case, however, the truly inspirational support networks are not those provided by the professionals. My hon. Friend the Member for Beckenham (Bob Stewart) talked about early diagnosis, and there are community champions. One community champion in my constituency is Peter Smith, who established the Tea Cosy Memory Café in Rothwell, which provides a welcoming place for those with dementia and their carers, as well as making Rothwell the first dementia-friendly community in Leeds.

The Alzheimer’s Society has done great work to promote awareness of dementia. Hon. Members can play a greater role, too, in raising awareness. I alluded to the fact that, like many Members, I am proud to be a dementia friend and to support the work of the Alzheimer’s Society. I urge as many Members as possible to become a dementia friend and to help the Alzheimer’s Society.

[Hazel Blears]

I am delighted that the hon. Gentleman is a dementia friend. Will he join me in encouraging all Members to make their constituency offices dementia friendly? We have just embarked on this journey. We are looking at special signage and at constituency letters to ensure that they are written in a way that people can understand, and all my constituency staff have been trained to be dementia friendly. If every Member of Parliament’s constituency office was dementia friendly, that would be a significant step forward. Perhaps we could work together on that.

--- Later in debate ---

[Norman Lamb]

That was unexpected; I have never had this happen to me before, so I apologise for looking confused! I shall carry on.

It makes sense to understand the success—and, indeed, sometimes the failures—of the current strategy and the Prime Minister’s challenge before designing what follows on afterwards. It is absolutely clear—I have tried to demonstrate this on other occasions—that something must follow; there must be a continuation. This disease has such a profound impact on people and on society that we have to keep developing our understanding and maintaining the momentum.

[Hazel Blears]

I am grateful for the Minister’s commitment that there will be a follow-on from the dementia strategy. He is right to look at what has worked and what might not have worked quite so well. My concern is that whatever comes next must find a way of uniting the whole system. In proceedings on the Care Bill, we debated integration and how important it was, particularly for dementia, because it will save us money. When the Minister looks at the next set of strategies, I urge him to bear in mind that the country must not have in place a set of fragmented relationships that are not bringing the system together to make things better for people with dementia and their carers. The economic impact on the country is also important.

[Norman Lamb]

I very much agree with the right hon. Lady on that. I think that what she argues for is developing. We are not there yet, but it is important that we have developed this ambition to achieve a diagnosis rate of two thirds, which encourages every part of the system to focus on what it needs to do. It is not a nationally imposed arbitrary target; it was based on getting every part of the system to think about what it can achieve by setting ambitious objectives. Collectively, that amounts to an ambition to achieve a two-thirds diagnosis rate, but in itself, of course, a two-thirds diagnosis rate is not good enough. We should not be satisfied when we achieve that; we have to press on. We know that the community in Gnosall has a diagnosis rate of close to 100%, so we should not be satisfied until everyone is getting properly diagnosed on a timely basis. I agree with the right hon. Lady’s point. Under the new system, with the health reforms making clinicians much more involved in the commissioning of care locally, there is a greater chance of getting the engagement of general practice across the country than we perhaps had in the past through the primary care trust route.

--- Later in debate ---

[Norman Lamb]

My hon. Friend is absolutely right and there are still GPs who do not really believe in the importance of a timely diagnosis. I have heard GPs say, “What’s the point, because it will make no difference?” However, we know it does make a massive difference not only to the person with dementia but to the rest of their family, in understanding the condition and what they can do to help. Education among GPs is incredibly important, and attitudes are changing but we still have a way to go.

Clinical commissioning groups are working with their local councils and other partners to better understand how widespread dementia is in their communities, including among people living in local care homes. This will mean they can identify and support people with dementia in a timely way. GPs are now able to use the new directed enhanced service to improve the diagnosis of dementia by asking people in certain at-risk groups about their memory. This proactive approach should help to identify patients who are showing the early signs of dementia.

Health Education England has prioritised dementia training and has already delivered 100,000 dementia-trained staff. Again, ensuring the work force within health and care have a proper understanding of dementia is critically important.

[Hazel Blears]

I am pleased the Minister has now come on to the area of the work force. He will know that many of the carers in this area are paid the national minimum wage if they are lucky. Many of them are on zero-hours contracts. Many of them do not get paid for travelling between the appointments they undertake. We ask them to do some of the most difficult work that one can ever imagine but the rewards and the training and support they get is minimal. Is the Minister committed to tackling some of these issues in the care sector, which in my view are unacceptable?

[Norman Lamb]

I feel as strongly as the right hon. Lady does about this. We can never get good care on the back of exploiting very low-paid workers. It is not acceptable to not pay a care worker when they are travelling from one home to another. That is a breach of the minimum wage legislation unless their rate overall comes above that level. HMRC has specifically targeted the care sector and has found quite widespread abuse of, or failure to comply with, the national minimum wage. It is very important that it is complied with.

It is also important for councils commissioning care to be absolutely clear with those they contract with that they expect total compliance with the law. If a council is commissioning in a way which almost becomes complicit in a breach of the law, that is completely unacceptable. Some of the commissioning around the country is very poor and we have got to move on from commissioning on these 15-minute, short-time periods resulting from contracts being opened up for bids and there being a race to the bottom with the cheapest offer winning the contract. We have got to move on to commissioning for quality and for better outcomes.

Wiltshire has now introduced commissioning for home care based on outcomes and quality. One of the care providers now pays salaries to its care staff. So the whole attitude and approach changes and the incentive on the care provider is to improve care, not to get away with the quickest possible care visit.

It comes down very often to the way in which the care is commissioned. That is what has to change and we are working with the Association of Directors of Adult Social Services and the Local Government Association to change the way in which commissioning is undertaken. There is also an amendment to the Care Bill which will require that commissioning takes into account an individual’s well-being. Councils cannot commission on the basis of 15 minutes of care when important care work needs to be undertaken. They will not meet their obligation under the Care Bill if they are doing it in that way. That change will also help to drive up standards. Care workers need to be respected. They do incredibly important work, and they are undervalued by society.

Since 2009-10, Government-funded dementia research in England has almost doubled, from £28.2 million to £52.2 million in 2012-13. Over the same period, funding by the charitable sector has increased, from £4.2 million to £6.8 million in the case of Alzheimer’s Research UK and from £2 million to £5.3 million in the case of the Alzheimer’s Society. In July 2012, a call for research proposals received a large number of applications, the quality of which exceeded expectations. Six projects, worth a combined £20 million, will look at areas including: living well with dementia; dementia-associated visual impairment; understanding community aspects of dementia; and promoting independence and managing agitation in people with dementia.

The hon. Member for Liverpool, Walton (Steve Rotheram) made the point about doing research into how we can prevent the onset of dementia in the first place. We know that vascular dementia is often related to lifestyle, including factors such as heart condition, smoking and alcohol consumption. If we can understand better how to prevent dementia from occurring, we will achieve a massive advance. Research needs to focus on that as well as on finding a cure and on living better with dementia, which is another critical area of research. It is essential that we do all this collaboratively and internationally. We cannot simply find all the results by ourselves, here in the UK. There needs to be an international effort.

The coalition Government have clearly demonstrated their commitment to dementia, but there is a massive amount still to do. We are not looking inwards to solve the problems that we are facing. At the G8, we brought the world together to work collaboratively and to look for solutions. By leading the way with the G8 summit, and with our own domestic agenda of the Prime Minister’s challenge, the UK is mobilising all available resources. We should be proud of the leadership we have shown as a nation to date, but as ever, we will continue to push much further, and we must never be complacent.

Question put and agreed to.

Care Bill [Lords]

Hazel Blears Excerpts

Monday 16th December 2013 Commons Chamber

[Mr Hunt]

I want to make some progress.

At Committee stage, we intend to table amendments to enable the creation of a £3.8 billion better care fund in 2015-16. That represents the first significant step any Government have ever taken to integrate the health and social care systems.

[Hazel Blears (Salford and Eccles) (Lab)]

rose—

[Barbara Keeley]

rose—

[Mr Hunt]

I will give way in a moment, but let me make some progress first.

I commend the right hon. Member for Leigh (Andy Burnham) for championing integration, although he chose not to do anything about it when he was in office. How, then, when a Government take steps to do that for the first time, can he possibly justify not supporting it?

[Hazel Blears]

At a time of austerity, when there is very little public money around, the need for innovation and creativity is much greater. On reflection, does the Secretary of State regret not being more ambitious in the Bill about the full integration of health and social care in order to maximise the impact for those who need care and support—unlike my right hon. Friend the shadow Secretary of State for Health, who has talked about whole person care and full integration?

[Mr Hunt]

With the greatest of respect to the right hon. Lady, who, I know, played a good role in the G8 dementia summit last week, the Bill is extraordinarily ambitious. Nearly £4 billion is going into a merger of the health and social care systems. The previous Government had 13 years to do something about this and they did nothing. We are delivering. I hope, if she believes in this, that she might at least support the Bill in the Lobby tonight and not decline to support it, as her party’s amendment suggests.

The fund will ensure joint commissioning and the seamless provision of services, preventing the nightmare of people being pushed from pillar to post with no one taking responsibility. It has led to the unprecedented step of the NHS and local authorities working together in all 152 local authority areas to plan joined-up services.

--- Later in debate ---

[Hazel Blears (Salford and Eccles) (Lab)]

I should like to begin by quoting one of the Alzheimer’s Society’s ambassadors, Arlene Phillips. Talking about her father, who had Alzheimer’s, she said:

“I did everything I could to care for my dad when we discovered he had dementia. Unfortunately, the efforts of one person—or even a family—aren’t always enough. It soon became clear to me that while I could keep Dad safe when I was by his side, I couldn’t be there every minute of every day.”

The words of Arlene, and thousands like her, should provide all of us in the House, irrespective of party, with the greatest incentive to act to support those people who are suffering and need care and, crucially, their carers and families, who are the backbone of the social care system in this country.

A society should always be judged by the way in which it looks after the most vulnerable people in its communities, and it is safe to say that, over the years, we have all failed that responsibility. Today is an opportunity for us to acknowledge that, and to point out that, even today, in a modern 21st century developed industrial nation, we are still failing the people who ought to get a great deal more support and care from us than we are currently in a position to give.

The Bill is a small step forward, rather than the giant leap for mankind that I would have liked. One of the central issues is a lack of ambition. We face the biggest social challenge that any of us could possibly see, yet the Bill’s provisions, some of which are well meaning, do not, when taken together, add up to a whole system’s series of changes that result in a basic reconfiguration. The right hon. Member for Charnwood (Mr Dorrell) spoke about that, and I pay tribute to his championing of integration, change, re-engineering and being ambitious. I do not see that in this Bill.

Instead, I see some perverse incentives. If we are talking about the well-being duty and the duty to prevent, reduce and delay somebody’s need for care, how can we say that we are going to support only people with substantial and critical needs? How are we going to engage the system further up the chain, with people who are beginning to suffer, perhaps beginning to have memory problems and beginning to need social care? How are we going to incentivise the system to invest in the new commissioning in clause 5, which talks about diversity and shaping the market? How are we going to get the system to focus on that if all the focus, after £2.85 billion-worth of cuts in social care, is on how we might manage to look after the people with substantial and critical needs? We should be focusing far more upstream in the system.

[Meg Munn (Sheffield, Heeley) (Lab/Co-op)]

As my right hon. Friend has said, the backbone of care in this society is provided by friends and family. Should we not be moving towards a system that incentivises the people currently giving care to continue to do so for as long as possible by supporting them at the lowest level, not at the highest level?

[Hazel Blears]

My hon. Friend makes an extremely powerful point. I am pleased that the Bill strengthens support for carers. I draw the House’s attention to the Bill introduced by the other Member for Salford, my hon. Friend the Member for Worsley and Eccles South (Barbara Keeley), which seeks to make sure that carers have the right to stay in work and the support to be able to do that. We must consider the cost to our economy of people having to give up work in order to care. We have talked a lot today about perverse incentives and false economies, and that has absolutely been a false economy for a long time.

I wish to say a word about diversity of provision and commissioning new models of care that can help with prevention. In my city we have been working on that for a long time, and I look forward to showing the Minister some of our examples when he visits. Social adVentures is a social enterprise that helps people with mental health problems, and one of its projects is “garden needs”. It has taken control of a garden centre, and people with dementia and people with mental health problems are now attending. The way it is keeping people active in the community and able to do many more things than they would if they were isolated and at home is amazing. Unlimited Potential is another fabulous social enterprise, which stands on its own two feet, is not grant-dependent and is able to invest more money back into the community. Last week, I had the pleasure of launching a website called Really Useful Stuff, which is just what it says on the tin—it is a website where people can get aids, adaptations and kinds of social care that are modern, innovative and creative. Those are just a few examples of what is already happening in the community.

I say to the Minister that at a time when money is tight, and will be, no matter which Government are in power, the imperative to innovate and be more creative with the funds we have has never been greater. Therefore, investing, in particular, in the social enterprise sector, which often has these great ideas, and in enabling those ideas to get to scale so that provision can be made across the country, is really important. Another company in my constituency, 2ergo, has recently developed an app for the iPhone where people can see what provision is available in Salford for care, respite care and activity, and how to book it. They can book it over their iPhone—families can do that; they can help the people they are caring for. So this use of new technology is now developing apace, and, again, we have to take advantage.

I commend the Government for organising the G8 summit last week in London—an amazing event where we gathered support from countries across the world. I hope that next year we will be able to expand that to a global event examining dementia, not just one involving the G8 developed countries. Part of that G8 meeting was about how we get more research. I would like to see far more research on the quality of care. There is a lot, but not enough, research on the bioscience, but hardly any research on the interventions we do, particularly for people with dementia. We all know that “singing for the brain” has a great reputation. It helps cognitive development, as do art, drama and reminiscence work. There is no evidence base behind that, so if we are to have a better system of social care, we need better research into therapeutic interventions that work. That will enable commissioners to commission packages of care that they know will make a difference. If money is tight, we need to spend it on things that we know will be effective, and I ask the Minister to support that.

The Alzheimer’s Society has also done a lot of work on dementia-friendly communities. That is not expensive. It is a matter of mobilising the good will of local people, shops and arts centres. In Salford, a taxi firm has trained 400 drivers to look after people with dementia. Such care does not cost a lot of money if we can mobilise ordinary people in their communities. In Japan, 4.5 million people are signed up to be dementia friends. Our ambition is to have 1 million such friends. Again, I push the Government to be more ambitious to see what more we can do.

Clause 5 is about not just diversity and shaping the market, but quality, and that is an area about which we all feel passionate. How can we in this country tolerate a situation in which those who do the most difficult job in caring for our friends and family are actually some of the least regarded workers? It is utterly unacceptable to have zero-hours contracts in the social care sector. The carers who care for my dad come in for 15 minutes. They will do more if they can. They have to ring up to be assessed when they have done 12 minutes. They get no payment for travelling and no expenses for their petrol. They came out one Sunday. They started at 8 o’clock in the morning and went home at 9 o’clock at night, but because they only had five hours of 20-minute slots, they got paid only for five hours. Members should try being out on a Sunday for 13 hours and going home with five hours of minimum wage payment. It is an absolute disgrace and a scandal that we tolerate that in this country. I hope the Minister will assist in bringing such practice to an end.

I want to say something about my own local authority. My hon. Friend the Member for Worsley and Eccles South mentioned the fact that Salford has recently had to change its eligibility criteria from moderate to substantial and critical. We were the last authority in Greater Manchester to have to make that decision, and it was heartbreaking. Our social services have always merited four stars. When I was a councillor 30 years ago, cuts were bad, but we always prioritised social care and nursery care for children. The decision to change the criteria was not made lightly, and the cuts have been absolutely horrendous.

Let me again say to the Minister that we need creativity and imagination to deal with this matter. I want to draw the House’s attention to my unpaid interest in social finance, which appears in the Register of Members’ Financial Interests. We have a real opportunity to draw extra funds into the social care system. If we could have a social investment bond that aimed to keep people with dementia in their own homes for longer, we would save the NHS a fortune. People with dementia are admitted to hospital more often. They stay longer in hospital and many more of them die there. If we could mobilise social investment to offer a reward for keeping people in their own homes, funded by the savings to the NHS, we could bring in some new money, not just what we are getting from local authorities.

[Norman Lamb]

I am very interested in the right hon. Lady’s proposition, and would be happy to talk further with her about it.

[Hazel Blears]

I am grateful to the Minister for that. In these difficult times, we all have a responsibility to look at creative and innovative ways of funding and to try to carry them through. The whole area is becoming very exciting. It was the legacy that the UK agreed to take on from the G8 meeting last week. We are global leaders. We have 14 bonds in this country; America only has one. For once, we are well ahead of the United States, and I am delighted that the Minister wants to discuss that issue.

All of us could talk for at least 20 or 30 minutes on that issue. As I come to the end of my contribution, I will just say that the Bill is a step in the right direction. I am disappointed—I say this to the Minister in the kindest way I can—that we have not been more ambitious. If we want to move towards whole-person care, we will have to be much bolder than we have been. I remember when we said, “We are at our best when we are at our boldest,” and that applies in this case. Nevertheless, over the next few weeks and months, I shall keep holding the Government to account, holding their feet to the fire and pushing them on to see what more we can do. We all feel a personal, deep and emotional responsibility for the most vulnerable people in this country who look to us to care for and support them at a difficult time in their lives.

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[Norman Lamb]

I will just finish this point.

There is also a focus on protecting everyone from catastrophic care costs, ensuring that people will no longer have to sell their homes during their lifetimes to pay for care. The Bill reforms a fundamentally unfair system, drives up standards in GP surgeries, hospitals and care homes through the new chief inspectors, adds a new statutory duty of candour so that hospitals, care homes and other care providers are open with patients when mistakes are made, and introduces valuable new rights to carers. Of enormous significance is that it signals the first ever big step, as the Chair of the Select Committee said, towards joining up our health and care systems through the better care fund, which is worth £3.8 billion.

The best description of the Bill was in a letter forwarded to me by a Labour MP, which said that the Bill is a groundbreaking piece of legislation that has the potential to make a big difference for older people. Despite that, the Labour party is declining to give it its support.

[Hazel Blears]

rose—

[Barbara Keeley]

rose—

--- Later in debate ---

[Hazel Blears]

The debate this evening has been fabulous and has engaged people from across the House on one of the biggest challenges we face. Earlier in the debate I asked the Secretary of State whether, on reflection, he thought that he could have been more ambitious about the integration of health and social care. The costs to our system are now unsustainable, and this was an opportunity to seize the moment. The Minister has tinkered around the edges of integration, so may I press him to be more ambitious, to think bigger and to be more committed to greater integration that will benefit us all?

[Norman Lamb]

I note the challenge, but I have been passionate about integrating care for many years. I made the case for it on many occasions when I was my party’s spokesman in opposition, and I remember not getting much of a response from the right hon. Lady’s party when it was in government. The Bill is really ambitious and marks the potential for a fundamental change in how our system works.

The right hon. Member for Stirling (Mrs McGuire) welcomed the principles of the Bill and rightly said that it is the duty of the Opposition to challenge and to probe. However, to use her expression, I think that many Opposition Members have been “churlish” in their response, with a few honourable exceptions, including the right hon. Member for Coatbridge, Chryston and Bellshill (Mr Clarke). I say that because in 13 years, Labour had two manifesto commitments, one royal commission, another promised commission, a Select Committee report, a White Paper, a Green Paper and numerous independent reviews on the issue, and what was the net result of all that talk? Absolutely nothing. In 1997, Tony Blair told the Labour party conference:

“I don’t want our children brought up in a country where the only way pensioners can get long-term care is by selling their home.”

That is exactly what happened throughout Labour’s time in government. In contrast, the coalition Government are getting on with reform.

Even now, we have no idea what the Opposition’s policy is. The shadow Health Secretary has hinted that he prefers an all-in approach—everything free, paid for by new taxes on death and by cutting hospital beds—but he has clearly failed to persuade his own colleagues about the plan or to set out how he would pay for it. Opposition Members’ criticisms can only be of any real value if they can answer the question about how they would pay for anything that costs more. So it was good to hear the right hon. Member for Salford and Eccles, who seemed to be about the only Opposition Member who recognised the scale of the challenge that we face, whoever is in power, and the fact that we need to think afresh about where money can come from. Her ideas about innovation using social investment bonds are welcome, and I would like to talk further to her about them.

We want to reshape care and support so that it is focused on enabling people to live more independent lives and giving them a good life. The Bill provides a new framework that places people’s well-being right at the centre and empowers them to take control of their care and support. It consolidates 60 years of legislation and pulls a dozen Acts together into a single legal framework, and it has been roundly welcomed. The King’s Fund has said:

“The government’s proposals for funding reform are an important achievement against the odds in a daunting fiscal and economic climate.”

Baroness Pitkeathley of Carers UK has described the Bill as the “most significant development” in the history of the carers movement.

G8 Summit on Dementia

Hazel Blears Excerpts

Thursday 28th November 2013 Commons Chamber

[Hazel Blears (Salford and Eccles) (Lab)]

It is a great pleasure to follow the hon. Member for Chatham and Aylesford (Tracey Crouch), my colleague on the all-party group. It is also a great pleasure to see you in the Chair, Madam Deputy Speaker. This is my first opportunity to contribute to a debate under your chairmanship, and I would like to congratulate you on your election.

While I am handing out congratulations, I would like to congratulate the Prime Minister, too, on the personal commitment he has shown on dementia. [Interruption.] Credit where it is due. Those who have the presidency of the G8 have an opportunity to name a subject around which they would like to mobilise the international community. In playing his card at the G8, the Prime Minister has chosen dementia. I commend him for taking that action. I believe that international collaboration will be the way to achieve the next big leap forward, particularly on the research agenda. I support what the Prime Minister said at Prime Minister’s questions yesterday—that this issue is not a matter only for world leaders, important though they are; it is a matter for every single person in the community, whether they be a world leader, a health Minister or an ordinary citizen. Everybody has a role to play.

I shall start with the people who have dementia, along with their families and their carers. When we promote policy, do collaboration or talk about international research, we must constantly remind ourselves that the people with the disease and their carers and families are usually the most expert people in the system. Therefore, the services that we provide, the quality of care and the innovations we develop have to be shaped and guided by those people. We must empower them to make their voices heard in this debate. When we bring together our creativity, our imagination and the huge brain power in the research community, we must always bring to this issue, too, our own humanity. We must remember that people with dementia are valuable and loved human beings. If we can keep that at the forefront of our minds, we will make progress and be doing absolutely the right thing.

During Question Time yesterday I mentioned a lady called Joy Watson. I met her a little while ago. She is only 55, but she has early-onset dementia. Her family was devastated. When she went into shops, she might be a little confused over her change or what she needed to order, and the shops—and sometimes the customers—would be irritated with her, tutting and asking her to hurry up. She took to wearing a badge, which she designed herself, saying “I have got Alzheimer’s; please be patient with me”. She should not need to do that. Nowadays there is a scheme—I think it is called the purple angel scheme, and Joy is promoting it—so that people can wear a purple angel on their T-shirts as a means of raising awareness in every single part of our community.

In Salford, we have worked on this agenda for a number of years. We have just formed our dementia action alliance, with 30 organisations now committed to action plans to make us, I hope, the first dementia-friendly community in Greater Manchester. As well as health, education and housing bodies, we have the Lowry arts centre and our shopping centres included in the scheme. I think we have the first private-hire taxi firm in the country to be involved in this, Mainline Sevens taxis. It has trained 400 drivers and has an account system so that people with dementia do not have to fiddle with their money when they get in a taxi. All those groups are now dementia aware. That shows the really practical things that can be done.

On the research side, I am delighted to say that tomorrow, Salford university will launch the Salford Institute for Dementia, bringing together the faculty of health and social care with departments dealing with the built environment, computers, IT, arts and media—showing the multidisciplinary approach that will apply. That group will draw together and disseminate research on living well with dementia. I think this is a fabulous academic development.

[Mrs Moon]

I cannot say how much I admire my right hon. Friend’s championing of this cause. When it comes to universities, there are examples of research that have focused on ideas for prevention. We heard yesterday from Professor A. David Smith from Oxford about the vitamin B6 and B12 levels as a means of achieving this. Currently, it is not possible within the health service to have a test of homocysteine levels that would help to identify the problem. Could we not put that prevention in place; should we not be doing that now?

[Hazel Blears]

My hon. Friend is absolutely right. I was horrified to learn yesterday that only 0.1% of research on dementia is spent on prevention. In every other area of public policy, such as education and social mobility, we are aware of the importance of investing in prevention, but in this area there is virtually no grant support, and that must change. I understand that in Norway and Sweden, tests for dementia are the norm. They are cheap once the investment has been made in the equipment, and the vitamin B12 research looks extremely promising. I hope that when the Minister responds he will say that that is something that our own national health service should take up.

[Oliver Colvile (Plymouth, Sutton and Devonport) (Con)]

Is the right hon. Lady aware of the excellent work that is being done in Plymouth, not just at the university but, much more important, by the local authority and the Royal Navy at Devonport? They are taking a lead by ensuring that all their employees are aware of the dementia issue, and that, if they need time off, they can have it in order to look after their relatives.

[Hazel Blears]

I am delighted that the hon. Gentleman has mentioned Plymouth, because it is one of the pioneers in this area. Plymouth, Torquay, Bradford and other towns all over the country want to ensure that dementia is not something shocking that we do not know how to deal with, and that everyone is dementia-friendly and aware. They are tackling the stigma, which is a huge issue. People do not like to talk about the fact that their families and friends are afflicted with this disease.

The search for a cure is essential. No one wants to have dementia, and everyone wants to be able to cure it. However, at the G8 I want just as much importance to be ascribed to research on the quality of care. The Evington initiative, which is backed by a number of business leaders including Terry Leahy—who used to chair Tesco—and Sir Marc Bolland are putting their weight behind that initiative. They are asking two questions. First, how can we change the system so that it is driven by users and carers rather than simply by clinicians and producers? Secondly, how can we establish a good, rigorous evidence base in relation to therapeutic interventions, quality and consistency of care and tackling stigma, so that clinical commissioning groups can be confident that the services they are commissioning actually work?

I think that the research is very exciting, but we are not likely to find a cure for 10, 15 or 20 years, and in the meantime 800,000 people are living with dementia. At present, there is virtually no evidence base relating to the quality of care. “Singing for the brain” is fantastic, but does it work, and if so, why does it work? Then there are the arts, the drama, and all the memory work that goes on. We need that rigorous evidence base, so that the commissioners can take the right packages off the shelf.

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

Will my hon. Friend give way?

[Hazel Blears]

I am afraid that I do not have enough time.

We also need research on prevention. The Alzheimer’s Society is working on a system that helps care home staff to reduce the use of anti-psychotic drugs by intervening in other ways to deal with people’s behaviour. That system is being rolled out in 150 care homes, and has reduced the use of anti-psychotic drugs by 50%. It is saving money, and it is making a huge difference. The G8 presents us with a fabulous opportunity to press for further research. I do not want it to be a one-off: I hope that there will be another summit of this kind next year. I also hope that work will continue between now and the next summit. This issue is not going away—it will be with us for a long, long time—and it would be fabulous if we could secure that international collaboration.

I invite the Minister to visit our university institute after we have launched it tomorrow, so that he can observe the fabulous work that is being done there and, perhaps, meet some of the people in Salford who are taking a whole systems approach that I think will prove helpful.

Let me end by saying that we owe a duty to every single one of the people who have dementia or are caring for people with the condition. It is the worst thing in the world to lose the person with whom you once had a connection. We have an absolute duty to do whatever we can, here in the House and in our communities, to give those people support and help.

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[Paul Burstow]

The hon. Gentleman’s point is spot on and leads me on to my next point about an example of research in India. It is estimated that in 2010 there were 3.7 million people with dementia in India, which will rise to more than 14 million by 2050. Approximately half those people will be over 75 and almost 2 million will be over 90. There is a serious lack of awareness about the issues in low and middle-income countries, especially those in Africa. Almost three quarters of people with dementia will live in those countries and that is why I want to ensure that the Minister, as he feeds back into the process of preparing for the summit, will make sure that such issues are on the table.

[Hazel Blears]

The hon. Gentleman is bringing a new perspective to the debate and he has made me think about the commitments made on AIDS and HIV. We need only think how ambitious the world was in tackling HIV at a time when many of us thought that it was an irresolvable problem. The promises on antiretroviral drugs were hugely ambitious and the progress we have made has been tremendous. Will he join me in urging the Minister and Prime Minister to be just as ambitious on this agenda as we were on HIV/AIDS?

[Paul Burstow]

As a number of us have made clear, the global scale of the challenge is such that it requires the galvanisation of a global response. The summit is a unique opportunity to do that, but it must have the reach and ambition that the right hon. Lady is talking about. It could take as its model the successful work that has been done so far on HIV.

Although epidemiologists often say that the figures I am citing are undercounted, the disease is none the less regarded as the second-most burdensome chronic disease and, among all those with chronic non-communicable diseases, accounts for almost 12% of years lived with disability.

In most developing countries, the problem with dementia is hidden. I have mentioned India, and the “Dementia India Report 2010” was published by the Alzheimer’s and Related Disorders Society of India, helped partly by funding from the UK Alzheimer’s Society. It has provided invaluable insight into the prevalence of the disease and ways in which India can respond to the challenge.

Let me ask the Minister a couple of questions. The first is about the research spend. The hon. Member for Chatham and Aylesford asked about the ambition of doubling that spend every five years, but it is not good enough for just our Government to do that. We need other Governments to agree to the same thing at the G8 summit. We need to know how much is being spent in the G8 on such things. There is no published figure—that is extraordinary—and when I tried to find a figure for the debate, I could not. We need a baseline to know whether we are making progress.

This country’s leadership on such issues will be in doubt if we do not hear soon that the Government intend to have a new dementia strategy. I hope that the Minister will be able to give us some indication of when that will take place. Finally, in having such an ambition on research, we need to learn from the journey that cancer has gone on. Cancer research has for many years had ambition, reach and strategy. We have an Institute of Cancer Research and it is time this country had the same for dementia. That could deliver such a big prize for all our citizens.

--- Later in debate ---

[Huw Irranca-Davies]

The hon. Gentleman makes a good point, which was also touched on by my right hon. Friend the Member for Salford and Eccles. It is a startling fact that 0.1% of funding goes into prevention. Surely there has to be greater emphasis on that, because the outcomes of prevention are so beneficial.

I am sure that the Minister is aware of what is going on in Wales. The Welsh Government’s National Institute for Social Care and Health Research funds and manages the research activity in Wales. The total spend last year was £75.7 million, of which £3.54 million was spent on biomedical research project funding. Just over 15% of the budget was awarded to researchers working on projects directly relevant to neurology research, including mental health. The same organisation awarded the Wales dementias and neurodegenerative diseases research network £743,000 over five years for its research. It is about knowing what is going on not only in Wales and different parts of the UK, but internationally so that we can co-ordinate and make the optimum use of regional, national and international spend on prevention, care, treatment and research.

My final point—it is probably one for another debate—is that we cannot divorce the strategic matters from the operational ones, and that means looking at the huge stretch in social care. There are real and intense pressures on social care, and not just on resourcing, but on staffing, staffing expertise and the necessary reform of long-term social care funding. That is probably a subject for another day, but the reality is that there are pressures on the ground affecting many people with different types of dementia and their families. There is real anxiety.

[Hazel Blears]

I appreciate that the debate is about the G8, but does my hon. Friend share my concern that the integrated transformation fund, the £3.8 billion that is supposed to relieve some of those pressures, brings together resources that are already being spent by local government and the NHS, so it is not actually new funding? Perhaps the Minister will address that when he responds to the debate.

[Huw Irranca-Davies]

I share that concern and hope that the Minister will turn his attention to it briefly. It is a major concern for the organisations and individuals out there.

In conclusion, I commend the Prime Minister for taking this initiative forward with the G8. It is a golden opportunity. Let us not miss it. Let us reach our ambition and our aspiration.

Mid Staffordshire NHS Foundation Trust

Hazel Blears Excerpts

Tuesday 19th November 2013 Commons Chamber

[Mr Hunt]

I agree with my hon. Friend. I hope that he will be encouraged by today’s announcement, because if in such a situation, which was an appalling tragedy, a trust is found not to have been open and transparent about something serious that has gone wrong, the fact that it risks becoming financially liable for any award made will be a major disincentive to trying to cover things up. That is a profound change, so I hope that it will comfort John’s parents to know that the kind of culture they had to fight so hard against will not be allowed to continue.

[Hazel Blears (Salford and Eccles) (Lab)]

The Secretary of State is right to highlight the need for fundamental culture change, but it is still the case that some of the most vulnerable people in our hospitals today—those with dementia—stay longer and are more likely to be readmitted and more of them die. My local hospital, Salford Royal, has recently implemented the Royal College of Nursing’s system called the triangle of care, which fully involves patients, carers and their families in the care of those with dementia. Will the Secretary of State take steps to ensure that that kind of system is implemented across the NHS?

[Mr Hunt]

I absolutely want to encourage that. I know that the right hon. Lady has campaigned a great deal on the needs of people with dementia, and I share her desire to do much better for them. Salford Royal is one of the best hospitals in the country and we should always learn from what it does, but 25% of people in hospitals now have dementia. The tragedy of what happened at Mid Staffs and of many of the stories of poor care in other hospitals that we read about is that very often they involve people with dementia, because they are the kinds of people who have been deprioritised when hospital managements have decided, for example, that they want to cut nursing inappropriately. We absolutely have to change that culture. There is now a very good system at several hospitals. People with dementia, in particular, must be helped to eat and drink at meal times. Many of us have been shocked by the stories of full trays of food being taken away because someone is unable to eat unaided. That, in particular, we need to stamp right out.

Oral Answers to Questions

Hazel Blears Excerpts

Tuesday 22nd October 2013 Commons Chamber

[Mr Hunt]

I can reassure my hon. Friend, as I am meeting some Yorkshire GPs later this week who have concerns about that very issue. The most important thing about the difficult issue of the funding formula is that it should be fair. That is why under the new legislation we have given the decision to an independent body so that it is taken at arm’s length from Ministers and so that it strikes the right balance between the issues of rurality, age and social deprivation.

[Hazel Blears (Salford and Eccles) (Lab)]

The NHS, with its massive purchasing power, can make a real difference to local areas through jobs and through supply chains. Some hospital trusts are enthusiastically implementing the Public Services (Social Value) Act 2012, including Barts and King’s. Will the Minister ensure that his new procurement strategy recognises the importance of social value?

[Dr Poulter]

The right hon. Lady makes a good point. We want improvements to the procurement process not just to save money, so that hospitals have more money to spend on the front line, but to support small and medium-sized businesses appropriately, such as by simplifying the qualifying questionnaire process, which is often too complex for small businesses to become involved in and therefore rules them out of the market. There are a lot of good things and I am happy to meet her to discuss the matter further if she would like.

Oral Answers to Questions

Hazel Blears Excerpts

Tuesday 16th July 2013 Commons Chamber

[Hazel Blears (Salford and Eccles) (Lab)]

Last week, the all-party parliamentary group on dementia published its report, “Dementia does not discriminate”, which deals particularly with the impact of dementia on people from black and minority ethnic communities. There are now 25,000 people from those communities living with dementia—far more than we expected—yet they often receive their diagnoses even later than people with dementia in the rest of the population. Will the Secretary of State fund an awareness campaign through Public Health England aimed at those communities to drive up the diagnosis rates? Will he also ensure that the clinical commissioning groups are commissioning appropriate support services in those communities so that we can provide proper services for everyone living with dementia?

[Mr Hunt]

I congratulate the right hon. Lady, who is a long-time campaigner on dementia issues. She has raised a really important issue, and I will certainly talk to Public Health England about raising awareness. For those groups, as for everyone, we need to ensure that there is a good care plan in place when they are diagnosed. There is some resistance in the GP community to giving a dementia diagnosis, partly because many GPs worry that not much will happen as a result. We need to ensure that there is a good plan in place, and that is particularly the case for ethnic minority communities.