Dementia

Lord Weir of Ballyholme Excerpts

Thursday 18th January 2024 Grand Committee

[Lord Weir of Ballyholme (DUP)]

My Lords, as both a member of the APPG and formerly a carer for my late mother, who suffered from vascular dementia, I welcome this debate and thank the noble Baroness, Lady Browning, for bringing it forward.

We are facing a tsunami of additional care needs in this country as a result of dementia, and it will require a step change from government, of what whatever political complexion. A myriad of solutions is required—some of them have been outlined today—but the noble Baroness, Lady Browning, was right to highlight a key component: parity of esteem between healthcare and social care.

Some of the implications of that lack of parity at present can be seen. It has been mentioned already that 45% of the social care workforce does not have direct training in dementia. The number of vacancies within social care is estimated to be 192,000, because there is a difficulty with both recruitment and retention of staff. The implication for individual dementia patients and their families across the country is a postcode lottery where both the quantity and the quality of care are deeply variable. For many of those families, the gap in what can be provided to them means that what they get simply does not cover the needs of the individual patient, and, somehow, they have to cope both financially and from a caring point of view to fill that gap.

If we can meet this issue of parity, there are a number of benefits. First, in many ways, we are facing an even greater difficulty than the official estimates of numbers show. Fortunately, we are beginning to see some solutions. New drugs are likely to appear in the near future, and they will at the very least slow the progress of dementia. That is a very good thing—it will mean that people live longer—but the implication of it is that, ultimately, we will probably have a lot more people with dementia. It will also shift the pressures from healthcare directly and to a much greater extent on to social care.

Secondly, parity will act as a driver for a much more joined-up approach to tackling dementia. In Northern Ireland, healthcare and social care have always been under one department and one system. That is not necessarily a panacea, but no one in Northern Ireland would try to disaggregate those two elements—it is perhaps one of the rare occasions when the rest of the country could learn something from Northern Ireland.

Thirdly, as indicated, parity would have major financial implications for the country’s healthcare. Too many people are unnecessarily in hospital and too many are not only admitted to hospital when they do not need to be but bed-blocking because there is nowhere to place them. Most of all, it will increase choice for families. For many who have dementia, being in hospital or in a residential home is either a choice they make or, from a practical point of view, there is not really an alternative. However, on many occasions, it has been forced on people because they do not have the choice.

Dealing with the issue of parity between healthcare and social care will be a key driver in ensuring that we can look after those with dementia and their families to meet the needs not just of now but of the future.