Social Care Funding

Hazel Blears Excerpts

Monday 11th February 2013 Commons Chamber

[Mr Hunt]

That is the main point of what is being announced today. We are not able, with the public finances as they are, to offer a huge amount of support, but what we can do is give the certainty that means that for the first time people will be able to plan and make provision for their social care costs. We will be one of the first countries in the world that does that, which is why this is a very encouraging and very important day for people who care about the tremendous uncertainties associated with growing old.

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

The Alzheimer’s Society has said today that capping care costs is a step in the right direction, but a £75,000 cap is so high that it will help only the few. The Secretary of State knows that there are 800,000 people in this country living with dementia now, and his announcement today, however welcome it is, does not deal with the community care costs that those people face day to day. This costs a billion pounds in, but there is £1.3 billion out of community costs to local authorities. How will he fill that gap?

[Mr Hunt]

The right hon. Lady knows well the challenge and the crisis that we face because of dementia, and she has spoken movingly on the issue. What I would say about what the Alzheimer’s Society is saying is that to look at the cap in isolation is to misunderstand these proposals. For many people with dementia, the most significant thing will be the increase from £23,000 to £123,000 in the threshold at which they get state support. That is a big step forward.

The cap is not saying that we expect people to pay £75,000 towards their care costs. We are saying that that is the maximum anyone will have to pay, which makes it possible for people to make provision in their pensions and in insurance policies. One in three of us will get dementia, and we do not know whether we will be among those one in three. This proposal will allow people to put some certainty in place—to make plans now, which means that when they are dealing with the nightmare of either themselves or someone in their family having to cope with dementia, they will not have the double whammy of having to worry about losing their house as well.

Dementia

Hazel Blears Excerpts

Thursday 10th January 2013 Commons Chamber

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

I am grateful for your guidance, Mr Deputy Speaker. It is a pleasure to follow the right hon. Member for Sutton and Cheam (Paul Burstow). In my capacity as vice-chair of the all-party parliamentary group on dementia—the right hon. Gentleman elevated me in his speech; our group is incredibly well led by Baroness Sally Greengross—I want to pay tribute to his work in this field. I appreciated his personal drive on this issue; it has made a big difference. I should like to thank the Backbench Business Committee for allocating the time for this debate. I should also like to thank all the Members here today. This is a fantastically good turn-out for a one-line Whip, Back-Bench business debate on a Thursday afternoon, and it indicates just how deeply people feel about this issue. The hon. Member for Chatham and Aylesford (Tracey Crouch) has been a tremendous help on the all-party group, and I am delighted to be vice-chair alongside her. Her personal drive and commitment have made a big difference.

Nearly 1 million people will be living with dementia by 2020, and the issue now touches the lives of virtually every family in Britain. It is a big issue for the NHS, but it is also a big issue for all the public services. I entirely endorse the right hon. Gentleman’s point that we have to join up the services right across Whitehall if we are going to make the progress that we need to make.

Ten years ago, when I was a Health Minister, it is fair to say that dementia was not at the top of the agenda for Ministers or for the NHS. As ever, there were more pressing issues, such as cancer, heart disease, waiting lists, maternity services—the list goes on. The voices raising the issue of dementia, and of care for older people more generally, were not heard as clearly then as, thankfully, they are today. This is now a massive challenge facing all of us, and I believe that increasing pressure from the public has helped to focus the minds of politicians and practitioners on what can and should be done to support those with dementia and, crucially, the people who care for them.

I also want to depart from normal practice and pay a warm tribute to the Prime Minister. He has put his personal weight behind this issue, and I know from having been a Minister that having the Prime Minister behind a project can give it momentum and get the system moving. It can provide a kick-start and a catalyst. I want to say a genuine thank you to the Prime Minister on this issue. That does not mean that there is not much more to do, and there are certainly concerns about ongoing funding issues, but having the Prime Minister say, “This is my challenge; I am behind it” will get things moving in the system.

Like most people, I got involved in this issue because someone I love has dementia. It is my mum. Over the past five years, I have seen and experienced the impact of that on her and on my dad, who, at the age of 83, is still her full-time carer. I want to raise three issues today. I want to talk about diagnosis, support in the community and the research challenge that we face.

My mum’s diagnosis was absolutely appalling. She had been having problems with her memory for about a year and a half and, like many people, she thought that it was just because she was getting older that she could not remember day-to-day details. However, when she could not remember the day of the week and when she started constantly to repeat herself, we as a family thought that she would benefit from a bit of expert advice.

Mum’s GP was not bad. He referred her to the mental health team for older people. She was just 70 at the time. What happened after that, however, was absolutely terrible. My mum and dad received a visit from a local psychiatrist whom they had never met before. She sat herself down on the settee without any formalities and proceeded to ask my mum 10 questions about the day, the date and who the Prime Minister was—I can think of lots of people who would not have known who the Prime Minister was—and after just a few minutes, announced to my mum and dad that it was very clear that my mum had Alzheimer’s. As Members can imagine, they were stunned and upset. They had no idea what that meant for them or what the future might hold. They were frightened and bewildered.

That was just the kind of brutal diagnosis that we used to hear about in relation to cancer sufferers, but here it was happening to the people I love. Suffice it to say that, after a formal complaint, we did not see that psychiatrist again, but the incident brought home to me how many people in those circumstances are subject to such hurtful and damaging insensitivity. Better dementia diagnosis has to be a priority. Yes, this is about earlier diagnosis, but it is also about sensitivity, understanding and finding the right circumstances in which to make a diagnosis that will fundamentally affect people’s lives.

Diagnosis rates in this country are low and incredibly varied. In general, just over 40% of people with dementia receive a formal diagnosis. The lowest rate is 26%, in Dorset, and the highest is nearly 70%, in Belfast. There must be a reason for such a dramatic variation. We have made little progress in recent years towards driving up diagnosis rates, yet diagnosis is key, because without it a person cannot gain access to the support services and the help that they need.

[Sir Tony Baldry (Banbury) (Con)]

Is it not part of the problem that many GPs are anxious not to diagnose dementia because they feel frustrated that they do not know what to do following such a diagnosis? They do not know what to offer the patient, and there seems to be an inclination to avoid that frustration by not making a diagnosis of dementia at all.

[Hazel Blears]

The hon. Gentleman is absolutely right. In fact, the recent all-party group inquiry into diagnosis revealed exactly that situation, which is a real concern. Many GPs are uncomfortable about making a diagnosis of dementia. They sometimes feel that such a diagnosis is pointless if the necessary drug treatments or wraparound care and support services are not available. Increasing the confidence of GPs at that point to enable them to make a diagnosis is of fundamental importance.

The figures on diagnosis are quite stunning. Only half the GPs questioned said that they had sufficient training in this area, and a third of them believed that a lack of access to drug treatments was a barrier to early diagnosis. Almost a third were not confident about making a diagnosis of dementia, and only a third felt that they had had enough training to go through the diagnosis process. Unless we tackle that, we will not get the increase in diagnosis that the Prime Minister and all of us want.

[Nick de Bois (Enfield North) (Con)]

I have listened carefully to what the right hon. Lady has said. She mentioned that Belfast had a high rate of diagnosis, at 70%. The figure in my constituency is around 36%. During her inquiry, was there any attempt to establish why best practice or prevailing factors could not be transferred and learned across the spectrum, in order to improve the situation?

[Hazel Blears]

Yes, there was. The all-party group had an interesting presentation from the Scottish Health Department. Diagnosis rates in Scotland are very high indeed, and we learned that the highly organised, managed and focused system there was driving up diagnosis. It is driven, to some extent, from the centre, and I know that that is not always popular these days, but the drive from the centre out to the GPs is really making a difference. I think that there is room for us to adopt a more driven process—it need not necessarily be more centralised—in which GPs are more accountable and in which they report back on rates of diagnosis. There is much more that we can do in that regard.

Diagnosis is a problem, but once a diagnosis has been made, the availability of support in the community becomes relevant. There are many problems in that area. Our inquiry revealed that many carers felt that nothing happened after the diagnosis, because there was no help or support available. In my area in Salford, we are lucky. We have one of the 10 national demonstration projects established under the national dementia strategy in 2009, and we are developing some really innovative services in the community. I should perhaps declare an interest: my mum attends the centre two days a week, and I sit on the strategic board that drives the process there. I have seen that when people are really committed to such projects, they can make a huge difference.

Our centre is the result of a partnership between the local authority and the Humphrey Booth charity, which has existed in Salford since the year 1600. It is a marvellous example of people working together. The centre is known as the Poppy centre, and its facilities include a dementia singing group, on a Wednesday, which attracts 150 people. That is an incredible resource. The centre also offers day centre services, art work, music, personal tailored care, a dementia café for when friends and family drop in, living history, hairdressing and hand massage. It is a wonderful place, staffed by brilliant people.

[Alison McGovern (Wirral South) (Lab)]

I apologise to my right hon. Friend and other Members because I cannot stay for the whole debate. The lesson I have learned from her expertise and from the evidence I have heard about Salford on this and other occasions is that we cannot think in the old way about how we help people with dementia; we have to be creative and provide the best range of services possible.

[Hazel Blears]

My hon. Friend is absolutely right. We are at the beginning of the kind of innovative care that she talks about. One thing we need to do is to get more young people and more young clinicians involved in this area, because that is how we will see innovation coming through.

We have a brilliant centre in Salford run by the manager Sue Skeer. There is also Sue Smyth and Nicola Fletcher, and users and carers are on our board. Margaret and Fred Pickering are an inspiration: Fred has dementia, Margaret is his carer and the whole of our practice is driven by users and carers at the centre. We are lucky, but many places have nothing like the Poppy day centre to support them.

We want to make Salford a dementia-friendly community and to make sure that transport, housing, leisure and local shops are all aware of the issues around dementia. My local university in Salford is setting up a dementia centre—a collaboration between the department of the built environment, including architects, and the department of social care. Design is being looked at really seriously. A marvellous Italian Professor Ricardo Codinhoto and a wonderful nurse, Natalie Yates-Bolton have inaugurated not just the design centre at Salford university, but now a European collaboration so that we will have an international design network on how we can make dementia-friendly communities work.

My question to the Minister on dementia-friendly communities, which we hope to be in Salford and which York, Plymouth and other places are pursuing, is: what resources have the Government committed to support the work of these communities, and how will it be sustained in the long term? We can push on, but we need a resource to make it happen. Yesterday, I met Duncan Selbie, the new director of Public Health England, who is going to make dementia a national priority for public health, so there really is commitment and energy behind all this. I want to hear from the Government what they can do to help.

Let me briefly cover my second theme—I have accepted two interventions—which is about the research challenge. I met the Wellcome Trust this week, and I was hugely encouraged by its willingness to put serious research funding into this area. It is looking not just at clinical research, which it might have done in the past, but at research on “living well with dementia”, recognising the importance of a holistic approach. I was impressed, too, when I met David Lynn and Dr John Williams. They acknowledged the difficulty of this area because there is so much that we still do not know about the brain. Nevertheless, despite the failure of the recent clinical trials, the data from them could prove very useful in taking us forward to the next steps, which we hope will help us find drugs that will at least slow down or delay the onset of Alzheimer’s. What everyone who has Alzheimer’s wants is a cure; they are desperate to get some progress here.

If we have a really big push on research, I feel that progress could be made. Our scientists are some of the best in the world in this area, yet for every six scientists working on cancer, only one works on dementia. Only 2.5% of the Government’s research budget goes to dementia, with 25% going to cancer. We should look at the progress made in cancer over the last 20 or 30 years; I do not want to wait another 25 or 30 years to make the same progress for the hundreds of thousands of people who are suffering from dementia now. The Government really must press on.

There are many people out there who want to help us. Just this week, the Daily Mail featured a long article about the possible benefits of coconut oil and the work done on that at Oxford. I have no idea whether that is likely to help people. It has helped some families, but we can see from that the absolute desperation people have to try to find something that can help the life of their loved one. Research is thus a huge challenge, as is help in the community.

I want to express some concerns about where we are at the moment. It is a time of great change in the health service. We are moving from primary care trusts to clinical commissioning groups, and it could be a time of instability. I am worried about the expertise—or lack of it—in the clinical commissioning groups when it comes to commissioning for something as complex as dementia. I want every CCG to have a lead for dementia, developing expertise and knowledge so that they know how to get the best from the money available. I would like to hear the Minister say that he wants to see a dementia lead in every CCG.

My final point is about the resources available to us. Over the last three years, my local authority has faced cuts of £876,000—30% of the adult social care budget. I know the Government will say that they have put £1 billion back in and that £1 billion has been lost, but when the budget is not ring-fenced, it can easily get spent on other issues. It is virtually impossible for councils to meet their targets without looking at the adult social care budget, which is 40% of their overall expenditure. That is why we can see day centres closing. They are an essential support network, providing a lifeline for carers, yet they are being cut. I am very worried indeed—not just about local authority cuts, but about buddying services provided by Age Concern. These voluntary and third-sector groups, so essential to people, are now quite fragile.

I am sure that the future funding of social care is going to be discussed. I make a plea: please may we have the cap at a level that helps the majority of families that need to be helped? If it is set at £75,000, I will be worried that those who really need the help will not receive it.

I think we are now at a point where progress can be made of the kind that has probably not been made for years. I really hope that we can press forward on a cross-party basis. We need a long-term settlement so that we can support people at what is probably the most difficult and frightening time of their lives.

I remember what it felt like to discover that my mum had dementia and that her future would be so different from the one that her and my dad planned together. We have been lucky in that we have been able to speak up and get help and support from the fantastic caring people at the Poppy centre, but it is hard for many people who might not have a strong voice or someone to advocate on their behalf. My mum instilled in me that sense of justice and fairness, which has driven me throughout my political life. I know that she would want me to continue to fight for all those who often find themselves bewildered and powerless, and to make sure that they are treated with care and dignity. We owe them all nothing less.

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[Steve Rotheram (Liverpool, Walton) (Lab)]

Nothing I say will equal the power of the contribution of my hon. Friend the Member for Bridgend (Mrs Moon)—a personal account that I am sure will resonate far beyond this place. I congratulate members of the Backbench Business Committee on choosing this important topic for debate and praise the spirit in which Members in all parts of the House have engaged with issues of dementia.

This topic is particularly close to my heart. Anyone who has watched helplessly as a loved one battles with dementia, often forgetting your name and your relationship to them, knows the agony that is felt and the feeling of hopelessness. As people will know from their own experiences, it is all the more painful when it is a close relative, especially when, as in my own case, it is your own mother who is suffering from this cruel condition. Words cannot begin to describe the heartbreak of seeing a vacant expression etched across the face of a person once so full of vibrancy as they struggle to fathom what is going on or why they feel in such a strange state of confusion.

As I was coming to terms with my own mum’s condition and the fact that this condition had stolen her mind, I was left with the same unanswered questions that thousands are now asking: why was she not diagnosed earlier? Why did not my brothers, sisters and I recognise the signs earlier? Why was there not better advice on the different treatments available? Why was the support that she received from relevant authorities at best patchy but at worst totally inadequate? My mum was not lucky enough to have had the expert advice, care or treatment that is available today when she died.

We can ill afford to kick social care into the long grass and avoid the realities of an ageing population that will undoubtedly present challenges for dementia health care professionals in future. With no new treatments having been released on to the market for 10 years, it was right for the Prime Minister to guarantee money for research by the Alzheimer’s Society following the work of the national dementia strategy presented to this place by my right hon. Friend the Member for Kingston upon Hull West and Hessle (Alan Johnson) and rightly highlighted by the right hon. Member for Sutton and Cheam (Paul Burstow) in his opening speech.

Today I want to talk about ways in which the city of Liverpool is sourcing innovative treatments for dementia. It is estimated that the number of people in Liverpool with dementia will rise from 4,382 in 2010 to 5,209 in 2021, ranking the city third highest in the north-west. Alarmingly, of those in Liverpool who were suffering from dementia in 2010, only 51% had actually received a diagnosis. That means that almost half of our city’s dementia sufferers were unknowingly living with this debilitating condition. That is why in our city we have decided to tackle dementia head on as part of Liverpool’s decade of health and well-being, which was officially launched in 2010.

Although most hospitals treat dementia patients by using a group of medications called—I wrote this down earlier thinking it would be easy to deliver in Parliament— cholinesterase inhibitors or the drugs donepezil and memantine, in Liverpool we have tried and successfully tested the use of art and culture in dementia treatment. Our non-pharmaceutical approach to dementia treatment is a unique model and one that other cites and regions across the country may wish to follow as they cope with increasing demand on decreasing resources.

After Liverpool’s highly successful year as the European capital of culture in 2008, we worked with international partners to collate evidence that proved that art and culture have the potential to improve well-being and have a positive role to play in mental health care.

Museums and art galleries are the gatekeepers to history. They play a crucial role in society, which is to protect and preserve what has gone before so that we can learn for the future. During our evidence-gathering we received a report entitled, “Museums of the Mind”, which encouraged museums to think about the role that they could play in their local communities with regard to mental health issues more broadly. National Museums Liverpool recognised the growing problem with dementia in our city and decided that it wanted to work specifically on the issue, drawing on the expertise of the Museum of Modern Art in New York, which ran an internationally acclaimed programme where gallery staff engaged with individuals living with dementia. And so House of Memories was born on Merseyside.

The scheme is training and delivering programmes built around the objects, archives and stories held in the Museum of Liverpool. The idea is to provide social and health-care staff with new skills and resources to share with people living with dementia and to promote and enhance their well-being and quality of life as a potential alternative to medication.

As the total cost of dementia to the UK economy rose to a staggering £23 billion in 2012—a figure that is unsustainable in an age of austerity that has been extended to 2017 by this Government—the work of National Museums Liverpool is a blueprint for other cities and regions to follow as we look to improve dementia care and reduce the cost to the NHS. As always, however, funding pressures are endangering the future of such innovative programmes. I believe that Liverpool’s non-pharmaceutical approach can and should be adopted by other cities and regions in the United Kingdom, thereby saving millions of pounds for the NHS.

One of the most worrying aspects of dementia care is the fact that public awareness of dementia remains scandalously low and that we as a society almost ignorantly allow dementia to be excused as nothing more than the ravages of old age. Liverpool therefore began by drawing together a partnership of major businesses from a variety of sectors that went beyond health care professionals and included many organisations from our thriving cultural sector. This meant that Tate Liverpool, the Bluecoat and the Liverpool biennial festival worked alongside Liverpool universities, Age Concern, BBC Radio Merseyside, the police and fire services and charities such as Dare to Care and Crossroads Care.

Last year the decision was taken by Liverpool Hope university, in conjunction with the chief executives and managers of Liverpool city council, the Alzheimer’s Society, NHS Merseyside, Mersey Care NHS Trust, Royal Liverpool and Broadgreen University Hospital NHS Trust, Liverpool Community Health NHS Trust and Age Concern Liverpool and Sefton, to dedicate 2013 as the year of dementia, as part of Liverpool’s decade of health and well-being.

Liverpool’s ability to make a difference for dementia patients would not be possible were it not for the excellent work of the Alzheimer’s Society. When I was the lord mayor of Liverpool, I chose the Alzheimer’s Society as one of my five sponsored charities and was extremely proud to award it with its largest ever cheque at that time of £115,000, in recognition of the vital work it does in our city.

[Hazel Blears]

My hon. Friend is making an incredibly innovative speech about developments in Liverpool. He mentioned the Alzheimer’s Society. Does he agree that without the drive, commitment and imagination of the Alzheimer’s Society, we would not be seeing the current progress and momentum?

[Steve Rotheram]

My right hon. Friend is right. It is not until somebody who is close to you needs the support of services such as those provided by the Alzheimer’s Society that you understand just how good and supportive they are. When I gave the Alzheimer’s Society that money as lord mayor, I also gave money to Alder Hey children’s hospital. It is much easier to raise money for sick children than for people whom some others see as just getting a bit old and going a bit loopy. That was one of the accusations against my mother. People said, “She’ll be okay, she’s just losing it a bit!” That is not the same thing as dementia. That is why it is important to raise awareness of dementia and why it is fantastic to see that this debate has been so well subscribed to.

In Liverpool, the Alzheimer’s Society facilitates services for dementia patients that use art and culture to assist sufferers and their carers in better understanding the condition. For instance, dance therapy is offered which invites

“movers and shakers of all ages to come and enjoy themselves and shake off the shackles of dementia”.

Additionally, multi-sensory stimulation is provided through art therapy and music therapy, which stimulate emotional, social and cognitive connections between dementia patients, their carers and their families. There is also a memory clinic, like those mentioned by the hon. Member for Chatham and Aylesford (Tracey Crouch), in Walton in my constituency, which is a weekly meeting that offers support, advice and guidance to sufferers and their loved ones.

In other words, Liverpool is dedicated to a creative approach to stimulate rather than medicate dementia patients wherever possible, and to prolong their quality of life as much as is possible. I hope that Members will use the example set by Liverpool to encourage similar partnerships across the cities, towns and communities in their regions. A recent participant in National Museums Liverpool’s House of Memories scheme recalled a lesson that they had learned as a member of the programme, which MPs may wish to consider on leaving this debate:

“The House of Memories scheme has enabled me to come into the world of the person living with dementia, rather than expect them to enter mine. After today, my approach will be very different.”

By changing the emphasis of dementia treatment to a more pioneering approach such as the one successfully tried and tested in Liverpool, we can begin to change the stigma of dementia and improve patients’ lives. In doing so, we can aim to educate sufferers about the advantages of owning up to the problems that they face and improve the rates of early diagnosis, while at the same time ensuring that the wider public are more aware of the early signs of the condition. Only then can we, as a society, forgive our collective ignorance and really begin to support our patients and dedicated carers in tackling this country’s fastest growing health priority.

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[Sarah Newton]

My hon. Friend makes his point well. I know that other hon. Members have very worthwhile points to make, so I do not wish to take up too much of the limited time available. However, I wish to make just a few points about how we in Cornwall are rising to the Prime Minister’s dementia challenge. It is right for us to set strategies nationally and to agree nationally on the overall frameworks to tackle one of the greatest challenges of our century. However, it is also important to look for the solutions locally. We should set the strategies nationally but enable everybody in communities around the country to come together to find their solutions. As the right hon. Member for Sutton and Cheam (Paul Burstow) rightly said in his opening remarks, we will all have to rise to the challenge. Every single part of society and every part of the public sector has its role to play. Indeed, as my hon. Friend the Member for Chatham and Aylesford said, the private sector, including supermarkets and other organisations in the public domain, has an important role.

What have we done in Cornwall of which I am so proud and which I want to share with right hon. and hon. Members? Let us start with the NHS, because when people seek a diagnosis that is where they start off on their journey with dementia. We have set up the Kernow clinical commissioning group, which is very successful and has got off to a flying start. It has attracted a large sum from the dementia challenge—well over £500,000. What is it doing with that money? It is working very effectively in partnership with other parts of the public sector, voluntary organisations and other parts of the NHS to ensure that there is an integrated, joined-up approach in Cornwall.

The CCG has targeted an issue mentioned by many Members, which is the need to ensure that everybody working in health and social care is properly trained, from carers through to doctors and nurses in the acute sector, to ensure that they are aware of dementia and how to talk to and relate to the people with this condition with whom they come into contact, as well as their families, friends and informal carers. The group is also using the money to ensure, among other things, that from the moment of diagnosis of dementia through to the end of life, sadly, there is a named individual available for that person and their family and carers. Obviously, it is early days as it just got the funding in November, but its ambitions are very important and will make a real difference to the quality of life of families in Cornwall.

Another issue that has been mentioned today is the lack of care from some nurses in parts of the acute sector. I want to share with hon. Friends a great initiative in the Royal Cornwall hospital, which is our only acute hospital in Cornwall. The friends of the Royal Cornwall hospital, who have worked so well with nurses, doctors and managers over a long period, are addressing some of the issues raised today. They have a very good system of mealtime companions, specially trained volunteers who work alongside care assistants and nursing staff. When the staff are too busy, they provide the extra time, care, compassion and consideration that needs to be given to a range of patients, including those with dementia, to ensure that they have a drink and something to eat. The hospital is also open to family members and others at mealtimes. I recommend that hon. Friends take that issue up with their hospital trusts and use the example of Royal Cornwall, which has clearly found a way around the problem.

The voluntary sector and society as a whole will have a hugely important part to play. Like many other hon. Members who have spoken, I am involved with the memory café in my constituency, in Falmouth. There are 24 other memory cafés in Cornwall and they are really important. People with dementia and other memory loss conditions, their families and their carers can come along to a safe, supportive environment, have some fun and do some interesting activities, talk to each other and get information. That is very important.

In Cornwall, we are fundraising for Admiral nurses. Those Members who have Admiral nurses in their constituencies will know the very important work they do to support families in much the same way as Macmillan nurses support cancer patients and their families. Admiral nurses provide an invaluable service for people with dementia and I shall be working hard alongside those who are fundraising so that we soon, I hope, have Admiral nurses in Cornwall.

I could talk about a lot of things, but for the sake of brevity let me simply say that many of the activities I have mentioned must be co-ordinated and planned. I want to reassure my Opposition colleagues that that is possible. Our health and wellbeing board in Cornwall has got off to a really good start. It works very closely with public health providers and all the different parts of the community, from housing to environmental health, to pull together a strategy for dementia and turn the good ideas and aspirations into action. I see the reforms to the NHS giving a great deal of power to doctors, other health professionals and people across the public sector to come together to work in partnership to deliver local solutions that work for communities. Salford is quite different from Cornwall and we all need to work together to find what works in our communities.

A great deal of good work has been going on in Cornwall and will continue in years to come, but I am not complacent. We are a part of the country with a fast- ageing population and have yet to find ways to diagnose dementia accurately. We have some of the lowest levels of detection of dementia. I will work hard with colleagues in Cornwall in all sectors to drive that up.

[Hazel Blears]

Like the hon. Lady, I am keen to foster the sense of consensus and cross-party working on this essential issue, but the elephant in the room in this debate is the severe cuts that have had to be made to local authority social care over the past three years—nearly £1 million in Salford. I wonder how in her community in Cornwall, which will be facing similar issues, she is dealing with the impact of substantial cuts in day-to-day care.

[Sarah Newton]

I thank the right hon. Lady for that question, because it gives me a good opportunity to praise Cornwall council. Undoubtedly all local authorities are facing tough decisions as a result of having to make cuts. There have been no politics in this debate so I will not go on to say why we are faced with the mess and why we have to make those difficult decisions, which I am sure we would rather not have to make. Cornwall council has not cut at all its expenditure on adult social care.

It gives me great pride to be able to stand up here and publicly thank Cornwall council for that. It is making sure that every penny that it receives from the Government—every single penny of the extra money to integrate NHS services with Cornwall council’s adult social care service—and the entitlement money and the money for carers’ respite is being spent. The council is not cutting front-line services for the most vulnerable people. The current settlement coming from the Government is increasing the amount of money into Cornwall for further improving and integrating the quality of care between adult social care and the NHS.

Those of us who have been around this subject and who have been campaigning on it for years, which includes many of the Members in the Chamber, know that the future lies in joined-up, integrated services. It is not about throwing ever more millions of pounds at the problems. It is about being smarter and wiser and linking all those services around the patient, the carers and the families. That is what is going on in Cornwall.

To summarise, I am in no doubt about the challenges that we face and I am not at all complacent. We need to build on the very good momentum and leadership shown by the Prime Minister on the issue to ensure that every family and everyone suffering from the condition gets the best possible care from us.

Oral Answers to Questions

Hazel Blears Excerpts

Tuesday 27th November 2012 Commons Chamber

[Norman Lamb]

I am grateful to my right hon. Friend for that question. Atlases of variation are an important way of raising standards and we will be discussing their future use with the new commissioning organisations. He is also right to highlight the absolute importance of having parity of esteem between physical and mental health. The Government’s mandate makes it absolutely clear that there must be parity between mental and physical health services.

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

There are 800,000 people in this country who are living with the effects of Alzheimer’s and dementia. For some of those people, challenging behaviour is a serious issue. Will the Minister ensure that every clinical commissioning group has a lead for dementia in the mental health field so that that can be taken seriously in every community in the country?

[Norman Lamb]

That is absolutely a priority for the Government and the right hon. Lady is right to highlight its importance. The NHS Commissioning Board will work with local clinical commissioning groups to ensure that we raise the standards of health and care services, but she is absolutely right to highlight the importance of substantially improving access to dementia services.

Care and Support

Hazel Blears Excerpts

Wednesday 11th July 2012 Commons Chamber

[Mr Lansley]

Yes, I am glad to do so. Through the work that we are doing with Skills for Health and Skills for Care, we will set out more clearly the training requirements for those undertaking care work and care assistance in the NHS. In addition, we set out in the White Paper that there should be a code of conduct, and I hope that across the service the philosophy of commissioning for quality, not simply commissioning or contracting by the minute, will help push us towards improvements in the dignity and respect with which care users are treated.

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

There are 800,000 people in this country with dementia, a devastating condition for themselves and their families. Many of them rely on the support of community-based services, which means that they are not admitted to residential care and may have a crisis that results in hospital admission. It is a false economy not to support community services. If the Secretary of State were really in touch, he would know that there are massive cuts across the country in exactly those services. Will he go back to the Chancellor now and say, “We need some money now to deal with the crisis”? Otherwise, the integration that he talks about in the White Paper will not happen and the crisis in local authority care will continue.

Oral Answers to Questions

Hazel Blears Excerpts

Tuesday 10th January 2012 Commons Chamber

[Mr Lansley]

Time does not permit me to mention all the things that could be achieved, but let me just say that we are clear about the need, for example, to tackle below-cost selling of alcohol, and we are doing that; to stimulate more community alcohol partnerships, and we are doing that; and to accelerate public understanding of the consequences of alcohol abuse, and we are doing that, not least through Change4Life, additionally, during this year. There is more, but we will say much more in our alcohol strategy soon.

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

When the Secretary of State, together with the Prime Minister, visited Salford Royal hospital last week to praise the nurse leadership, was he aware that the hospital has cut 200 posts this year and is about to cut a further 200 posts over the next two years as a result of having to take 15% out of its budget? Does he not agree that nurse leadership is important, but that we also need the nurses on the wards to be able to deliver effective patient care?

[Mr Lansley]

Of course I had an opportunity to talk to the chief executive, the nursing director and others at Salford Royal, and I was tremendously impressed, as was the Prime Minister, by the quality and leadership of the nursing, which demonstrated what he was saying about nursing—that there is best practice inside the NHS, and we need to spread it. The right hon. Lady is confusing a cost-improvement programme with a cut. I think Members on both sides of the House understand that the NHS is having to make efficiency savings, which involves shifting some resources from the acute sector and hospitals into the community. Right across the NHS, we have an increase of over £3 billion this year; next year, we have a 2.5% or 2.8% increase everywhere.

Oral Answers to Questions

Hazel Blears Excerpts

Tuesday 18th October 2011 Commons Chamber

[Mr Burns]

The hon. Gentleman raises a valid point. The NHS in England has regular contact and discussions with the NHS in other parts of the United Kingdom, and will continue to do so because both the UK and the devolved authorities can learn a considerable amount from sharing views and practice.

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

13. What recent estimate he has made of the number of midwives working in the NHS.

[The Parliamentary Under-Secretary of State for Health (Anne Milton)]

There were 20,654 full-time equivalents in June 2011—a rise of 522 or 2.6% since May 2010. That is a record.

[Hazel Blears]

The Minister might know that the midwife-led unit at Salford Royal hospital is due to open in the next few weeks, and I want to put on the record my thanks to the midwives there who carry the heaviest work load in the north-west and are doing a brilliant job. She will not know, however, that last year there were 2,500 extra births in Greater Manchester that were neither expected nor planned for, that there are current vacancies for midwives at St Mary’s hospital and that mothers are being pressured to leave hospital sometimes within two or three hours of giving birth. What assurances can she give me that the same standards of safety and quality applying at Salford Royal will be available to Salford families in the future?

[Anne Milton]

We need to ensure that they are, which is one of the reasons we have asked the Centre for Workforce Intelligence to undertake a pretty in-depth study of the nursing maternity work force during 2011-12. I can reassure the right hon. Lady that the current number of midwifery students entering training is at a record level—more than 2,500—and I join her in paying tribute to our midwives.

Oral Answers to Questions

Hazel Blears Excerpts

Tuesday 12th July 2011 Commons Chamber

[Paul Burstow]

The hon. Lady raises a question about eligibility; of course, we know from the latest figures in an ADASS survey that the majority of local authorities moved, under Labour, to “substantial” needs being the test for access to social care; that happened on her watch, not this Government’s watch. When it comes to portability, the Law Commission has made recommendations that the Government have to consider, and yes, we need to look to legislate on that.

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

The Minister was present this morning at the launch of a report on dementia care by the all-party group on dementia. He will know that the key recommendation is to shift resources from acute hospital care to more preventive services in the community. What steps will he take to ensure that that shift really happens, over and above the £1 billion that has been allocated, much of which has already been spent by local authorities on plugging the gaps caused by other cuts in their budgets?

[Paul Burstow]

As the right hon. Lady was at the presentation, she will know that it was also identified that we currently spend about £8 billion on dementia services, and the Audit Commission identified that we could save at least £300 million through better use of preventive and early-intervention services. The Government have set out a very clear approach. First, we need to invest in services to provide for earlier diagnosis, because that is the best way to plan for dementia. Secondly, we need investment in services in our hospitals that shorten the length of stay and deliver good quality. Thirdly, we need care homes with the right training for staff, so that they can manage dementia and behaviour problems effectively.

Oral Answers to Questions

Hazel Blears Excerpts

Tuesday 7th June 2011 Commons Chamber

[Mr Lansley]

Among the intentions that we have made clear from the outset is our intention to reduce the running costs of management in the NHS. We propose to cut administration costs by a third in real terms, including the running costs of the commissioning consortia when they are established. There will be a constantly tight envelope for running costs, which means that whoever is working for a commissioning consortium, it must deliver value for money.

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

T7. For the 200,000 people in the country with dementia who are currently in residential care, the recent horrific events at Winterbourne View and the financial problems at Southern Cross have caused huge anxiety. The Minister is now proposing to make local authority safeguarding boards mandatory, at a time of huge cuts in social care budgets. What extra resources will he make available to ensure that the system works and protects the most vulnerable people in our country?

[The Minister of State, Department of Health (Paul Burstow)]

I think that Members throughout the House share the right hon. Lady’s concern about the events that were revealed in more detail last week. We will deal with an urgent question on one of the other matters later this afternoon. She also asked about funding for social care. In last year’s spending review we not only secured additional resources enabling us to put safeguarding boards on a statutory basis, but ensured that by 2014 an additional £2 billion would go into social services. Much of that will come via the NHS to ensure much closer working between health and social care services, which is an essential prerequisite for the delivery of better outcomes for people with dementia.

NHS White Paper

Hazel Blears Excerpts

Monday 12th July 2010 Commons Chamber

[Mr Lansley]

Yes, I am grateful to the hon. Gentleman. The number of GP-commissioning consortiums will be determined not least by GPs themselves, deciding what makes sense in their locality. He and his Cornish colleagues have often been frustrated by the way in which a top-down bureaucracy has sought to dictate to the people of Cornwall, often in specific localities, at a considerable distance from their hospital services, what services should be provided locally in places such as Hayle and Penzance. He and his constituents can be really comforted by the thought that their clinical advisers and general practitioners in local consortiums can in future make those decisions about their services.

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

Despite the tremendous improvements that have been made in Salford and Eccles over the past few years in tackling cancer and heart disease, significant inequalities remain that require substantial resources. Will the Secretary of State confirm that in shifting commissioning powers to GPs and allowing the NHS commissioning board to allocate resources, the funding formula will still properly reflect the needs and deprivation factors in areas such as mine and right across the country?

[Mr Lansley]

The White Paper makes it clear that the NHS commissioning board will be required to allocate resources across the NHS in England on the basis, as far as possible, of seeking to secure equivalent access to NHS services. That will clearly be relative to the prospective burden of disease. In tackling health inequalities, the right hon. Lady will know that we need separately to allocate resources to local health improvement plans, which will be led through local authorities, and which will enable them to create local public health strategies to secure improvements in health outcomes and to reduce health inequalities.

Oral Answers to Questions

Hazel Blears Excerpts

Tuesday 29th June 2010 Commons Chamber

[Mr Lansley]

My hon. Friend has raised an important issue. Let me make two points. First, we need to strengthen not only the local public and patient voice but the voices of GPs who are involved in commissioning, so that they can act on behalf of their patient population in commissioning the services, and design of services, that they need. Secondly, as I have made clear in the revision of the operating framework, we must look at results. When someone goes into hospital for treatment, we must consider not just their treatment in the hospital, but their subsequent rehabilitation and re-ablement. I believe that that will allow greater use of intermediate care beds in the way that my hon. Friend has described.

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

I thank the Secretary of State for agreeing to meet me—together with representatives of my local primary care trusts, local mums and midwives—to discuss maternity services in Salford. In the light of his new criteria for reconfigurations, will he confirm that he is prepared to reconsider the decision to close Salford’s maternity services, and to recognise the views of thousands of people throughout Salford and Eccles, including me, who opposed it at the time?

[Mr Lansley]

The right hon. Lady knows that we will meet to discuss the issue. However, as I said when I was in Greater Manchester, it is not for me to reconsider the application of the new criteria from 21 May. That is for local people to reconsider. It is for GPs, the public, local authorities and, indeed, PCTs in Salford and district to start thinking about what they consider to be viable and successful future services for mothers-to-be.