Dementia Care Services

Jane Ellison Excerpts

Wednesday 9th September 2015 Westminster Hall

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

It is a pleasure to serve under your chairmanship, Mr Davies. I congratulate the hon. Member for Charnwood (Edward Argar) on securing this debate, on his excellent speech and on how he approached the debate, engaging and seeking consensus. I look forward to working with him over this Parliament as co-chair of the all-party parliamentary group on dementia.

I speak today not only the behalf of the Opposition, but as someone with personal experience of caring for someone with Alzheimer’s disease. My mum was 64 when she was diagnosed and I provided her care. I have spoken about it in the past, but it has certainly informed my view and led me to want to champion the Alzheimer’s Society and working together on this issue.

I will keep my comments brief because much has already been said about the challenge that our society faces. As has been said, 850,000 people are currently living with dementia in the UK, and the number is set to reach 1 million by the end of this Parliament. It is a distressing disease because of the impact not only on the person living with the condition, but on the carers, as it affects relationships with loved ones. I was lucky that my mum was in good health for much of the time, but the first time she could not recognise me really did have an impact.

As has been mentioned, the previous Labour Government made much progress on dementia. They launched the first ever national dementia strategy, which began the process of establishing memory clinics, providing better training for staff and improving the quality of dementia care for people in hospitals. They appointed the first national clinical director for dementia and commissioned a quality standard for dementia from the then National Institute for Health and Clinical Excellence. The current Government have built on that work, and I am delighted to support the Prime Minister’s challenge. There has also been welcome progress on the number of people with dementia receiving a diagnosis. However, I want to mention three areas where we need to push for more progress.

First is awareness. People are often frightened of dementia because they think nothing can be done, but it is important to remember that, although there is currently no cure, people living with dementia can live well with the right level of support. Like so many who spoke in today’s debate, I have been a big supporter of the Dementia Friends programme. Politicians have a responsibility to lead by example in this area, and I was pleased to see that the Minister recently underwent her training.

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

A year ago!

[Debbie Abrahams]

Fantastic. As the first MP to become a Dementia Friends champion, I ran a Dementia Friends session in Parliament to launch the “dementia-friendly parliament” last year.

We have also heard about the importance of involving young people. A lot of work has been done in my constituency, where, for example, the youth council has received training to be Dementia Friends. Making Oldham a dementia-friendly community is a priority of mine and, after starting with just a few hundred, we now have 2,000 Dementia Friends. I am proud that Oldham is one of more than 100 communities across the country that is working towards becoming dementia friendly, but we need to go further. Our ambition should be to ensure that everyone living with dementia feels included in their community and feels that they have control over their lives.

Secondly, we need improvements in the quality of care and support for people with dementia and their carers, which, as we heard today, is just not good enough in some parts of the country. Too often, people with dementia receive no care and their families get no support. Over the last Parliament, cuts of £3.5 billion were made to adult social care services, which have had a real impact on people with dementia and their families. Some 87% of social services departments can provide care only for people with critical or substantial need. For example, I called on a woman in her late 70s in the middle of the afternoon during one of my regular door knocks. She opened the door, looking dishevelled and confused, and had an empty bubble pack of medication in her hands. Her first words to me were, “I don’t know what I have to do.” I was able to call the pharmacy and to get support for her, but what if I had not been there? She obviously needed support and was not getting it.

Councils are doing their best to save money through changing the way that care is provided and working more closely with the NHS, but the scale of the cuts is forcing many to cut the support that would have helped to keep people out of hospital. As a consequence, more and more people with dementia are ending up in hospital, with some estimates suggesting that one in four hospital beds are occupied by someone with dementia. The NHS has also seen delayed discharges from hospital hit a record high in recent months, costing some £526 million since 2010. Once people are in hospital the support is simply not in place in the community to enable them to return home.

In 2009 the then Health Secretary, my right hon. Friend the Member for Leigh (Andy Burnham), called for national care services to be developed and to be provided on the same basis as for health. He has repeated that call. We will not be able to improve the quality of dementia services until we find a solution to the funding crisis facing social care.

At a meeting with the Saddleworth carers group in my constituency, I listened to predominantly elderly carers describing the hundreds of hours of often back-breaking work that they were providing for their loved ones. They did that because no support or respite was available. How are they meant to cope? Given that the Government have delayed the implementation of the care cap until 2020, or possibly later, and have gone back on their promise to raise the £118,000 assets threshold before someone has to pay for their own care, will the Minister tell us what assessment has been done to estimate the number of families with a family member with dementia who will be affected by that between now and 2020? In addition, is the Minister committed to the Alzheimer’s Society proposal to drive up the quality of residential care for people with dementia? If so, how is that being monitored, for example in the use of anti-psychotics?

My final point is about research. Research for a cure for dementia provides hope for people in the future. In addition, however, we must focus research into the cause and prevention of the different forms of dementia, and into how we can best care for people who are living with dementia today. The Government’s commitment to double dementia research by 2025 is welcome, but we are starting from a low baseline. Other countries have shown much greater ambition.

Last month Alzheimer’s Disease International called for a significant upscale in research support, given the 35% increase in the global cost of dementia since 2010. It estimated that by 2018 the cost will have increased to $1 trillion, equivalent in size to the 18th largest economy in the world. Will the Minister report on the progress made, as has been asked by other Members?

--- Later in debate ---

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

We have had some excellent contributions this afternoon. I will be unable to answer the questions of the shadow Minister, the hon. Member for Oldham East and Saddleworth (Debbie Abrahams), because unfortunately she took several minutes of my time, but I will do my best to respond to the points made by my hon. Friend the Member for Charnwood (Edward Argar), who brilliantly introduced the debate. He follows a distinguished predecessor in the health field and Charnwood has clearly found another health champion. It was a terrific speech and there were excellent contributions from other Members.

Dementia continues to be an absolute priority of the Government. Several hon. Members have spoken about the devastating impact of the disease, which has touched many families in our country, mine included, and I suspect those of many others in the Chamber and of those listening outside. I will not outline the scale of the challenge, because others have done so eloquently, but it is huge and it is local, national and global. This is the first debate since the launch of the Prime Minister’s challenge on dementia 2020, which builds on the success of the challenge that ran between 2012 and 2015, as others have said. We are well aware that it is only a building block and that we need to carry on and to go further. I welcome the chance to refresh our commitment to going the extra mile, for which Members have called.

We have good news on diagnosis and have made significant progress. More people than ever before are receiving a diagnosis. Without it, they would not receive the support that they need. More than 400,000 people now have the opportunity to gain access to the care and support that they require. Almost 45,000 more people have received a diagnosis of dementia than would have done had earlier trends simply continued, so that is 45,000 more people getting access to support for living well with dementia. The diagnosis rate was increased by 20 percentage points from the baseline in 2010-11 and is now around 60%. We expect to meet our target this year. I will reflect on the challenge to me to achieve ever higher diagnosis rates.

On research, we are committed to tackling dementia through our research efforts at home and abroad. I was delighted to see how many people are volunteering to participate in dementia research. We have had really good news on that recently. Through Members and to those beyond the Chamber, I thank all those people for taking part in such vital programmes.

We are already doubling research spending on dementia. That money supports world-leading major research programmes and significant investment in infrastructure. Globally, the UK is leading the way and working with partners around the world to tackle dementia, boosting investment and accelerating research through the $100 million dementia discovery fund. We obviously have a spending review coming up, but we look forward to continuing that leadership and looking at how it can be provided—potentially through an international institute on dementia research, about which we will be talking to the Department for Business, Innovation and Skills after the spending review. I hear the call, however, and welcome the contribution of my hon. Friend the Member for North West Hampshire (Kit Malthouse).

Many Members spoke about the need to raise awareness. The job has begun, but it is by no means complete—it is an ongoing challenge to build awareness of dementia throughout our society through individuals and communities. In the Chamber this afternoon we have heard some fantastic examples of people with local groups and communities who are becoming more dementia-friendly. The first Prime Minister’s challenge set a target of 20 communities; I am delighted to say that we are exceeding this with 115 communities. My hon. Friend the Member for Wealden (Nusrat Ghani) spoke about one of hers. As she highlighted, there is a great range, from cities to villages and from urban to rural. I congratulate all those who are involved in that public-spirited initiative, but we need to go further. I ask any Member who wants information about how to do that and champion it in their area to please contact me, and we will put them in touch with the Alzheimer’s Society, if they are not already. We have always had good support on that.

It was great to hear tribute paid to the emergence of dementia-friendly cafés and initiatives such as Singing for the Brain, both of which I have seen in my local area. It is great to be able to praise the people leading those initiatives. My hon. Friend the Member for Tonbridge and Malling (Tom Tugendhat) might be interested to know that one of the groups set up as part of the dementia-friendly communities strand of the Prime Minister’s dementia challenge is looking specifically at transport. He made a good point on that. It was also good to hear about the work of the local dementia café in Syston, run by the Alzheimer’s Society. I, too, echo the tributes made to the volunteers, who do such work in all our constituencies. We also provided support to the July 2015 launch of a new standard developed by the British Standards Institute, which encourages more communities to recognise what they can do to be dementia-friendly.

The first Prime Minister’s challenge included a programme to create 1 million dementia friends by March 2015. I am delighted to say that we achieved that target in February, but we want to build on that, and Members of Parliament have a great role to play in leading such work, as has been said. We are pleased that the Alzheimer’s Society has committed to reaching a total of 4 million dementia friends in coming years.

We have invested £50 million to support capital projects in health and care settings, designed to improve the environment of care for people with dementia; nearly £4 million of that was invested in the east midlands during the previous Parliament. Some great work led by Loughborough University on how we can give guidance on dementia-friendly environments is helping us to assess care environments. Some of that work has been led by patients, and there has been an encouraging start, with nearly three quarters of healthcare sites becoming dementia-friendly, including acute wards and hospices. Again, though, we want to build on that and see all such settings becoming dementia-friendly.

More than 500,000 of our dedicated NHS staff have received dementia awareness training so that patients with dementia can be better cared for. Much has been said about the vital role of social care and the people who work in it, and we recognise that key role—the hon. Member for Stockport (Ann Coffey) brought that point eloquently to life. More than 100,000 social care staff have been trained in better supporting people with dementia. Since April 2015, newly appointed healthcare assistants and social care support workers, including those supporting people with dementia and their carers, have undergone dementia training as part of their care certificate. That is encouraging, but, again, we want to build on it.

Post-diagnosis support is an area to which I give enormous consideration. It is going to be one of the big, important challenges in rising to the Prime Minister’s challenge in the next few years. My hon. Friend the Member for Charnwood is right to push us, because these are the practical ways in which we can make a real difference to people’s lives. We are committed to working on that and making sure that we provide advice and information. He mentioned Admiral nurses—again, a great example of what can be done.

There is a great deal to say about investment in future integration. On the vanguards, more are addressing the issue than perhaps my hon. Friend thought, given his concerns; perhaps we can discuss that after the debate. I liked his idea of pushing more Departments on the Dementia Friends programme and I am happy to take that up with the Cabinet Secretary to see whether we can do more there. The revised NICE standard is expected during 2017.

The Government’s commitment to the challenge is undimmed. I welcome the fact that so many new Members have been at this debate to speak about the issue. Seeing their passion to make further progress is inspiring in itself, and we will make that progress.