Dementia Care Services

Kit Malthouse Excerpts

Wednesday 9th September 2015 Westminster Hall

[Kit Malthouse (North West Hampshire) (Con)]

As a Dementia-Friendly Hampshire ambassador—I am not quite a champion, but an ambassador—I welcome the debate and remind my hon. Friend of the Government’s commitment just before the election to creating a dementia research institute somewhere in the UK within the next five years. Does he agree that it would be helpful if the Minister updated us on the funding envelope for that, and the implementation plan for it over the next four and a half years, given that time is running out for its creation? I have to declare a slight interest, as the idea was fermented at City Hall. I may have had a hand in it, and therefore have a stronger motive to see it come to fruition.

[Edward Argar]

I am grateful to my hon. Friend, and I am beginning to think that I must be careful about what I think, because yet again a Member has touched on a paragraph I was about to begin. He is absolutely right. The Government’s dementia research funding now stands at £66 million. That is double what it was in 2010, but we need to be clear that we must not stop there. I was pleased that earlier this year the Government reaffirmed their commitment to doubling the dementia research spend by 2025. That is vital, and I know that Members on both sides of the House, in the spirit of constructive support, will help to hold the Government to that. Will the Minister commit to collating information on that spend centrally, and to publishing it annually, so that we can track progress? Coming to my hon. Friend’s point, I would be grateful if the Minister updated the House on the plans for a dementia research institute to drive forward research in a truly world-leading way. I pay tribute to my hon. Friend for the work he did in City Hall, and as a Deputy Mayor, in pushing that agenda forward.

Finally and most importantly—I declare an interest as a member of the Alzheimer’s Society—I pay tribute to such organisations as the Alzheimer’s Society, Alzheimer’s Research UK, Age UK and myriad others for the work they and their members do to ensure that we in this House and society never forget this cause, and that we continue to support the tens of thousands of people with dementia—and the voluntary carers, who are the real heroes and heroines. We have a duty to recognise what they do, and to do everything we can as a country to support them. I look forward to the Minister’s comments on what we can do to support carers.

I will close by quoting from a moving and powerful article by Alice Thomson about her father’s dementia. It was published in The Times this summer. She said:

“Old age shouldn’t be seen as a humiliation but more as the other bookend to your childhood; a time when you can rely on the help and patience of others to reach the end but can also still be a central part of family and community life”.

I echo those words and ask the Minister, the Government, all of us and society as a whole to continue to rise to the challenge and to make that a reality for all those who have dementia in this country.

--- Later in debate ---

[Dr Philippa Whitford (Central Ayrshire) (SNP)]

I commend the hon. Member for Charnwood (Edward Argar) for securing this debate on what is probably one of the biggest challenges we will face over the coming decades. There is no easy answer, north or south of the border or on either side of the House. I think we all fear it. Previous generations have feared other illnesses and avoided them. They talked about consumption instead of TB, or about “the big C” instead of cancer. Most of our generation are less afraid of cancer than of Alzheimer’s. We are afraid of disappearing, or of being married to someone who simply is not who they used to be. That is a fear we all live with.

The Scottish National party welcomed the then Government’s introduction of a national dementia strategy in 2009. The Scottish strategy came in 2010. We set out clinical standards the following year and updated our strategy in 2013. We reached the 64% diagnosis target in 2013, when England was diagnosing 48% of those with dementia. I commend the fact that that has now risen to 59%, although there is obviously more work to do. Northern Ireland was diagnosing 63% of sufferers. What happens to someone when they are diagnosed? Think of the fear that we all have, and then imagine the bombshell that diagnosis is.

There is no easy answer, but we have done a few things in Scotland that we feel have worked. All our health boards now have a linked member of staff, like the cancer nurse specialists we have for breast cancer, which was my specialty. Since 2012, we have had the older persons’ acute care plan, which looks at secondary care and modern hospitals. I welcome the talk about dementia-friendly towns and villages—I will go home and throw down that challenge to my area, because that is not something I have come across.

In the past 18 months, our hospital has been completely redesigned, with colour zones and images of what everything is, instead of just words. Toilets, beds, kitchens—how to find one’s way around is all visual. We also have champions in every single ward. All that has really changed things. We have reduced length of stay from 22 days to eight days; we have reduced falls by half, and we have reduced returns to A&E from 26% to 8%. These relatively cheap, simple changes actually save a lot of money.

We obviously need more research and development, because at the end of the day families want a treatment to make early diagnosis worth while. Otherwise, what is the point? We have to be able to intervene. We can slow things down, but we want a drug that will stop dementia and reverse it. At some point further down the line, we will face the challenge of drug companies coming to us with an expensive drug that will do that. It will be important for the National Institute for Health and Care Excellence and other agencies to weigh up the sheer scale of dementia that we face and the money that could be saved by using even quite an expensive drug.

[Kit Malthouse]

One of the interesting developments over the past couple of years, which was looked at by Dennis Gillings, the international dementia envoy appointed by the G8, has been the question of whether the financial equation around the development of a drug could be changed by negotiating an international exception for its patent life, extending it by, for instance, five or 10 years. That might propel investment into research to find a cure and also make it cheaper when it does emerge, because the time for commercially exploiting it would be extended. Would the hon. Lady support such a proposal?

[Dr Whitford]

I absolutely would. In my previous life as a breast cancer surgeon, when I was also doing breast cancer immunology research, I watched what became Herceptin go from its development on the bench-top into common use. That took 21 years. This is something we often do not recognise when we moan about big pharmaceutical companies: they are investing in something that may turn out to be a mirage. The more that we can look at supported or shared R and D, the cheaper the drug will be when it finally comes to market. I would commend something like that.

The current problem is that most patients face living with dementia, and we must think about how we help them and their families to do that. We should be challenging ourselves to make dementia-friendly our surroundings and all the agencies that sufferers may interact with, whether through visual aids, through other people recognising them or, as the hon. Member for Stockport (Ann Coffey) said, through technology. The eHealth programme in Scotland is working on that, including devices in patients’ homes that it can interact with and establish whether the person is okay. Much of the care that people receive is the 15 minutes that the hon. Lady mentioned. How can we improve that? How can we ensure that the faces are not different every day? Some patients and families report 100 carers in a year. We should look at how we organise the care and remember who the real carers are: the family.

It is predicted that one in three of us will be carers for someone with dementia. We have a vested interest in ensuring that we look after them. The carer’s allowance is currently £60 a week, which does not even match jobseeker’s allowance, for a job that could be 164 hours a week, so we need to think of how we support carers and the work that they do. In Scotland, things are slightly different as we have free personal care, so the family does not pay for the carer who comes into the home. If that person has to go into a care home or nursing home, they do not pay for the personal care. The system has been expanded and deepened and actually allows us to keep more people at home for longer.

One problem is that care jobs attract lower earners. How can we motivate people and attract high-quality candidates if they are being paid the lowest possible amount?