Dementia Care

Jonathan Brash Excerpts

Tuesday 3rd June 2025 Commons Chamber

[Mr Jonathan Brash (Hartlepool) (Lab)]

My dad was a GP in Hartlepool for 33 years. When I was young, I was never more impressed than when he would talk to me about his medical knowledge. The depth of his knowledge was extraordinary, and one of the tricks he used to be able to do at any given moment was take any two numbers I gave him and divide them or multiply them and get the answer right when I checked on the calculator. It was a rare skill, and his impact over those 33 years meant that when I went into politics the most common thing I heard on the doorstep was, “Are you the doctor’s son?” He did tell me recently that someone had asked him whether he was the MP’s dad, and I take that as a small victory.

In Hartlepool, there are 1,299 people living with dementia, and my dad is one of them. He was diagnosed with Alzheimer’s five years after he retired. Speaking to my mum, who obviously is his carer, too, we both agree that it feels like we have already gone through a form of bereavement, because the person who brought me up is not quite there any more. He is happy, and he enjoys his grandchildren, but it is different. I want to see that changed for other people, because early diagnosis is critical. My dad did not get the early diagnosis that he should have received, and we have paid the consequences as we have gone forward.

In Hartlepool, we are pioneering a new dementia strategy. I am so proud of Hartlepool borough council, because as part of that strategy, the council has committed to ensuring that 100% of its social care staff have dementia training, so that this evil disease—I do mean evil—can be caught and better treated at an earlier stage. As we have already heard from the hon. Member for South Devon (Caroline Voaden), only 29% of social care staff in this country have any form of dementia training. I impress on the Minister that that must change.

Dementia is the defining health and social care challenge of our time. It impacts one in two of us—50% of the population—either through being diagnosed ourselves, or having someone in our life diagnosed with it. Despite this reality, too many people living with dementia and their families struggle to access necessary support. The lack of an integrated care pathway often leads to families being led into fragmented and complex systems, where they can easily fall through the cracks and reach crisis point. Shockingly, one in four hospital beds is occupied by a person living with dementia, and those people face hospital readmissions at rates 50% higher than the general population. We must improve specialist dementia support, both in hospitals and in our communities. That is not just a moral imperative; it is vital for building the health service that we want, one that is fit for the future. The forthcoming 10-year health plan presents a crucial opportunity to rectify those shortcomings.

[Richard Baker (Glenrothes and Mid Fife) (Lab)]

My hon. Friend is making a powerful speech. I have worked in this area of policy and services, and I am aware that some of the most powerful advocates for change in dementia care are people with dementia themselves and their families. Does he agree that, when formulating new strategies for dementia care, people with dementia must be fully included in making those plans, based on their own experience?

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[Mr Brash]

I thank my hon. Friend for his intervention. In a completely unplanned way, the next sentence in my speech is, “It is essential that the voices of those affected by dementia are at the forefront of these NHS reforms”, so his intervention was very timely and deadly accurate.

We must ensure that the clinical support and person-centred care that reduces the risk of crises and unnecessary hospital admissions comes to the fore. To that end, I urge Government Ministers to commit to providing ringfenced funding for a dementia specialist nurse in each NHS acute trust, and to integrate specialist nurses such as Admiral nurses—I was so proud to meet them here in Parliament recently—into multidisciplinary neighbourhood health centres. With 1 million people currently living with dementia, and with that number projected to rise to 1.6 million by 2040, as we have heard today, we literally cannot afford delay. The economic impact of dementia is estimated to reach £90 billion by 2040, with 40% of care costs borne by families and unpaid carers. It is time for action.

One of the consequences of my father’s Alzheimer’s diagnosis is that that evil disease has done to him what it does to so many: it robs people of their strengths, but it exacerbates their weaknesses too. My father now struggles with travel, and despite my election in July last year, it is very unlikely that he will ever get here to see me stand in Parliament. In his name—Dr Charles Brash—I ask the Minister to act.

Oral Answers to Questions

Jonathan Brash Excerpts

Tuesday 11th February 2025 Commons Chamber

[Wes Streeting]

I just restated the Government’s commitment to ensuring that at least two thirds of people living with dementia receive a diagnosis. Our investment and reform agenda will speed up diagnostics across the board. Under the last Government, NHS planning guidance was a wish list of fantasy targets, most of which were never met. As the NHS got worse and worse, they piled on more targets to make themselves look busy. This Government are ending the micromanagement, turning our NHS around and clearing up their mess.

[Mr Jonathan Brash (Hartlepool) (Lab)]

My dad was a GP in Hartlepool for over 30 years—the Secretary of State was kind enough to meet him the last time he was in Hartlepool—and he has Alzheimer’s. Every day, I think about why we did not spot the signs early enough to get the treatment that he needed at an earlier stage. The Alzheimer’s Society estimates that only 29% of social care workers have any form of dementia training. Does the Secretary of State agree that it is critical that we up that number and ensure that all social care workers have dementia training, to ensure early diagnosis?

[Wes Streeting]

I am grateful to my hon. Friend for his question—I know how personal this issue is for him. I was delighted to meet his father on my visit to Hartlepool, and wish him very well. I take very seriously what my hon. Friend has said about the importance of workforce training. He mentioned training for health and social care staff, which is important, but I would argue that the point applies more broadly across our society. On 6 September, the Department launched the adult social care learning and development support scheme, which allows eligible employers to claim for funding for certain training courses and qualifications, including relevant dementia training, for eligible care staff. We will continue to keep this under observation and review.

Hospice and Palliative Care

Jonathan Brash Excerpts

Monday 13th January 2025 Commons Chamber

[Mr Jonathan Brash (Hartlepool) (Lab)]

Hartlepool is incredibly lucky to be served by an amazing institution—one that has touched the lives of so many in our town. Alice House hospice and the brilliant people who work there, like hospices across the country, provide essential support to those in their final stages of life, ensuring that they receive the dignity and care they deserve.

The stark reality, though, is that Alice House alone requires £3.6 million each year to operate, with only 25% of that money coming from the Government. That means it has to raise £7,000 a day just to keep the doors open and to provide services. Any additional work beyond ordinary maintenance comes at an extra cost. As we have heard, that is a situation mirrored across the country. Dignity at end of life should not rely on charity. Rising costs and inconsistent financial support have left many hospitals struggling, forcing them to cut back their services. Indeed, Hospice UK reports that as many as 20% of hospices were cutting some level of provision, fuelling a bed crisis. Sadly, that was the case for Alice House when it closed its long-term care unit in 2023.

I welcome the Labour Government’s recognition of this financial crisis and its backing through the £126 million announced in December. While that support is welcome, we cannot be complacent. We need to ensure that the 10-year NHS plan includes long-term commitments to reforming the hospice funding model. That is essential not just to prevent another funding crisis, but to ensure that hospices can provide the essential care on which our communities rely. The need for palliative care is projected to increase by 25% over the next 25 years. We must therefore act now to ensure that our hospices can meet demand. They are not just places of care, but vital support systems that relieve pressure on our NHS, providing specialised care and training to health professionals across the board. When hospices are forced to cut services, the need for care does not disappear. It shifts directly on to our already overburdened NHS.

Life has a tendency to shape and focus one’s attention on the issues in this place. My father has Alzheimer’s. Although he is currently very well, I know that our family—me, him and my wonderful mother—are going to face a difficult future. We have a responsibility now to fix that future for everybody who will need that care in the future, and I hope that is what the Government will do.

Tobacco and Vapes Bill

Jonathan Brash Excerpts

2nd reading
Tuesday 26th November 2024 Commons Chamber

[Mr Jonathan Brash (Hartlepool) (Lab)]

It is a rare thing in politics to have a moment when there is an absolute right thing to do, but consigning smoking to the history books for our children, our grandchildren and every generation that follows is one of those times. We should be under no illusion that the decision that we take today will, at some point in the future—long after we have left this place—result in a time when nobody smokes. That will be the legacy of this decision today.

I ask the House to indulge me for a moment. Let us imagine that, at that point in the future, somebody brings forward a Bill to decriminalise smoking, and the Minister, clutching their impact assessment, tells the House that it will kill only 80,000 people a year, that it will cost our NHS £3.6 billion and that 80% of the people who take it up will be under 20. Which one of us would vote for it? Which party leader would refuse to direct their troops in such a vote? Who would argue that it is freedom of choice to smoke in those circumstances? It is nonsense. The decision we are taking today is clear and it is for the good of this country.

[Joe Robertson (Isle of Wight East) (Con)]

The hon. Member talks about choice. I agree with what he has said so far, but does he agree that, when it comes to the banning of smoking for people born after 1 January 2009, there is no removal of choice in the Bill, because they cannot smoke anyway at the moment? Therefore, there is no removal of choice from those people.

[Mr Brash]

The hon. Member is completely correct in what he says, and it is the proportionate way to do it. Some of the arguments that I have heard today about freedom of choice are genuinely confusing. One Member asked earlier why we do not ban sugary foods or alcohol on that basis. I say that we have to draw the line somewhere. That is an argument for the decriminalisation of everything—cocaine, heroin, you name it, let’s go for it. No, we have to draw the line somewhere and, given the statistics around smoking, it is clear that this is the right line to draw.

I do not want to say a great deal more on this issue other than to reflect on the conversations that I have had with my children. We have been on a long journey when it comes to smoking in this country. I remember telling my children that they could eat a meal in a restaurant, and that those on the table next to them, in the smoking zone, would be smoking while they ate. They thought I was mad. I remember going to school on the bus and seeing the little cigarette holders in front of me because people used to be able to smoke on the bus. My children think that is madness. I can only hope that not long in the future children will look back and think that it was mad that we smoked at all.

I was asked about this Bill soon after I was elected by a friend, who is a parent. He knew it had fallen prior to the general election. He asked, “Will it be back?” and I said, “I am confident that it will be back.” He said, “But will it be in time?” and I said, “In time for what?” He said, “In time for her” and pointed to his teenage daughter. I am pleased to say to Mark, Kim and their daughter Bella that we are bringing it back in time and that it will make a massive difference to the lives of people in this country.

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[Andrew Gwynne]

Local government will take the lead on this matter, and we will consult widely on how we bring forward the licensing regime, and on how we implement it through secondary legislation, following that consultation. An impact assessment will be prepared before the secondary legislation is introduced, but I want to work with local government across England—I am sure that ministerial counterparts in other parts of the United Kingdom seeking to bring in a licensing regime will do the same—to ensure that we get this right for local government. That includes ensuring that the cost of running a licensing regime is met by the regime itself.

[Mr Brash]

We have mentioned the fact that local government is responsible for public health. I have had our director of public health email me just today to say how supportive they are of this Bill. Local government wants this opportunity to try to improve the health of local people. The fears that local government would be under pressure are simply wrong, are they not?

[Andrew Gwynne]

My hon. Friend is absolutely right. From the engagement that I have had with members across all parties in local government—elected members, officers and directors of public health—I know that they want these measures. They are up for introducing them, and for helping us to get them right.

The hon. Member for North Shropshire raised the issue of ID checks, as did a number of others. I gently say to those who expressed a degree of scepticism that most retailers already follow recommended practice and regularly ask customers for ID. We are stopping people from ever starting smoking, and 83% of smokers start before the age of 20. That means that someone who has never previously smoked is highly unlikely to want to take up smoking later in life. Our published modelling shows that smoking rates in England for 14 to 30-year-olds could be close to 0% as early as 2050 with the measures in this Bill.

Government Policy on Health

Jonathan Brash Excerpts

Monday 9th September 2024 Commons Chamber

[Wes Streeting]

With the way that Conservative Members are carrying on, and with the smears and innuendo they are applying, I am surprised that Alan Milburn is not paying them a marketing commission. The right hon. Gentleman makes out that Alan Milburn has come into the Department and is making all the decisions. If he were up to what they are suggesting, I could not think of better word-of-mouth publicity.

There is a clear distinction between inviting people with a wide range of experience and perspectives into the Department to have policy debates and to generate ideas, and having meetings that are about transacting Government business. I can assure the right hon. Gentleman and the House that nothing commercially sensitive has been shared with Alan Milburn, and I am genuinely astonished that Conservative Members think it is inappropriate for a Secretary of State for Health and Social Care to seek views, input and advice from their predecessors. In fact, I wonder how one of my Conservative predecessors, who is coming in to see me soon, will feel about their objections.

[Mr Jonathan Brash (Hartlepool) (Lab)]

In October 2023, when I phoned my NHS dentist to get an appointment for my children, the next available appointment was in June 2024. [Interruption.] When June 2024 rolled around, they cancelled the appointment. The next available appointment is April 2025. Given my right hon. Friend’s disgraceful inheritance, does he think the Conservative party should spend a little more time reflecting on its record and a little less time asking pointless questions?

[Wes Streeting]

I wholeheartedly agree with my hon. Friend. Let the record reflect that, when he was raising the crisis that is leaving people in Hartlepool without access to NHS dentistry, Conservative Members were shouting, “What about Alan Milburn?” That says everything about their priorities, everything about their lack of remorse and contrition, and everything about why they should stay in opposition for a very long time while we sort out the state of NHS dentistry in Hartlepool and across the country.