Dementia

Neil Parish Excerpts

Thursday 10th January 2013 Commons Chamber

[Oliver Colvile (Plymouth, Sutton and Devonport) (Con)]

My hon. Friend the Member for Chatham and Aylesford (Tracey Crouch) hit the nail on the head when she made the point that everyone knows somebody who has been affected by dementia or some form of Alzheimer’s. I have a stepmother who is very elderly now—she is 93 and is in a home. The last time I went to see her, she was woken up and she looked at me, squawked and went straight back to sleep again. That is very sad—it is incredibly sad—for one simple reason. This was a woman who got a degree at Oxford in 1938, at a time when women did not get degrees. She then became an interpreter at Bletchley Park during the war and played a significant part in defending our country from Nazi oppression. For her to be in that position now is very worrying and concerning for all of us. I very much hope that she continues to have an acceptable life, and I am delighted that everyone there is most certainly going to be helpful.

I pay tribute to the hon. Members for Bridgend (Mrs Moon) and for Oldham East and Saddleworth (Debbie Abrahams), who must have found it very difficult to talk about their personal lives and experiences. I commend them both for being able to do so in this environment and for getting through it. May I also say what an honour it is to share a platform in this debate with the hon. Member for Plymouth, Moor View (Alison Seabeck)? I suspect that, between us, we will find ourselves repeating each other somewhat, although I am in the fortunate position of going first.

The issue of social care is becoming increasingly important. There has been an enormous amount of press attention on how people are cared for in the latter years of their lives. However harrowing the stories may be, they provide us with an opportunity to speak about social care and lessen the stigma that surrounds death and dying. Dementia is already a significant issue and a growing concern that should not be ignored.

I am delighted to say that I represent a constituency in a part of a city that has a really good reputation on dementia, especially through the university. An enormous amount of research is done; indeed, I am for ever getting telephone calls from Ian Sheriff—for whom I have an enormous amount of time—who rings me up and gives me advice on how we should handle this issue. However, I was surprised to find out that there are currently more clinical trials into hay fever than into some common forms of dementia. So I heard that our mutual friend the Health Secretary had announced that spending on dementia research would receive a £22 million cash injection I was incredibly grateful. More funding will most certainly need to be made available to excellent bodies around the country such as the Alzheimer’s Society and to universities such as Plymouth.

Plymouth university conducts a great deal of research into dementia and this policy area. In September the university held a very good conference, which it asked the Prime Minister to attend. Unfortunately he could not come, but we will see whether we can have another go later. Any help that the Minister, my hon. Friend the Member for North Norfolk (Norman Lamb), can give to encourage the Prime Minister to come and participate in the dementia conference would be helpful. Indeed, his lead in the dementia challenge has given the whole thing an impetus. The university also does a lot of work on community engagement and raising awareness. Indeed, shortly after Christmas I went to Stoke Damerel community college, which has done a lot of work on encouraging youngsters to become more involved in community engagement with dementia. May I also pay tribute again to HMS Drake, which is taking a big lead on dementia and ensuring that this happens elsewhere in the Ministry of Defence?

In Plymouth there are around 3,200 individuals with dementia. That figure is forecast to rise by 35% in the next 10 years, but this is just the beginning. The diagnosis rate is 39%, which it is estimated will increase by 27% before 2021. That means that a large number of people in my constituency do not have access to the care and support they need on a daily basis. The new NHS mandate commits to drive up diagnosis, which can only be a good thing for both sufferers and their families. I know that the Government want the clinical commissioning groups and the NHS Commissioning Board to work together on that aim, and I would welcome more information from my hon. Friend the Minister on what plans are in place to ensure that that happens, so that the lives of sufferers and their carers can improve.

GPs are on the front line when it comes to driving up diagnosis rates. They express their concern about mistaking the symptoms of dementia for old age. In some cases, they do not make a diagnosis of dementia because they feel that to do so is futile. I am aware that the Department of Health has put the case for a reward through proactive case finding, which is due to be consulted on this year. Is there a timetable for that consultation to begin? The sooner we start to diagnose those in need, the sooner we can start to help them.

Earlier this week, I participated in a debate on the Liverpool care pathway. We had an interesting discussion, and real concerns were raised. I told a story about a constituent who came to see me about her father. It had been decided to put him on the Liverpool care pathway, but the family were concerned because they knew nothing about that until they were told about it by one of the car park attendants at the hospital. The process was supposed to last for two days, but it went on for 12 days, and the family were very concerned about that. Will my hon. Friend the Minister have another look at that issue, just to make sure that such cases have been included in the review of the LCP?

A number of excellent facilities exist around the country, especially in Plymouth, and I want to pay tribute to St Luke’s hospice, and to the hospice movement in general, for doing a tremendous job. They are certainly appropriate places for people to spend the last few days of their lives. Given that the report on Stafford hospital is to be released shortly, however, it is clear that dementia sufferers often do not have the dignified death that we would expect for them. I am aware that we are all mortal, although I have wondered whether God might make an exception in my case, and whether I might be here for ever and a day. I know that that is not going to happen, however.

It is important to ensure that, when dementia sufferers die, they are able to do so with dignity and without pain. The more work that we can do to ensure that that happens, the better. Vulnerable people need to be properly looked after, as do their carers. We need to ensure that we talk to the relatives as well, to ensure that they understand the processes involved. None of us—politicians or anyone else—likes to be ambushed, and it is important to help those family members to work their way through their suffering as well.

[Neil Parish (Tiverton and Honiton) (Con)]

My hon. Friend is making some good points. Those who care for dementia sufferers need respite care, but we do not always provide for that as well as we should. I am keen to see more respite care being provided for those who care for people with dementia.

[Oliver Colvile]

I agree with my hon. Friend. This is also about the families, who have to deal with dementia on a daily basis.

Given the appalling events at Stafford hospital, appropriate checks and balances must be put in place to ensure that people with dementia are given the proper quality of care in all hospitals. Further, it should become standard practice that the demands of someone with dementia should be listened to. It is incredibly important that we get better at listening to what they, and their families, are saying. Dementia is a complex illness, and it is often difficult to assess its onset. Whenever possible, however, conversations should be held with the individual and their loved ones about what is happening and the process that is involved. Such conversations would be useful in helping the family through the process.

Dementia is now one of the top five causes of death in the United Kingdom, and it is disappointing that the health and wellbeing boards are being a little slow to consider people’s needs. About 800,000 people in the UK have dementia, and that number is going to go up. It is said that more pressure is being put on the national health service. I do not think that is right. I think that we are making enormous strides in order to deliver better health care for our elderly. It is because we want to do more that our national health service is facing increasing levels of challenge.

For those with dementia, the changes to long-term care are crucial. I am delighted that the Government are looking at trying to take forward the Dilnot report, to which I made my own submission—I have a copy here or I could e-mail it to the Minister. That report must be viewed as a blueprint for how to go forward.

There has been increasing debate with the Treasury since the 1940s. Let me remind everyone of what happened in 1947 when the national health service, of which we are all very supportive and proud, was first set up. The other half of the equation was long-term social care. Over the last 10 or 15 years since I was a candidate for Plymouth, Sutton as it then was—it is now Plymouth, Sutton and Devonport—I have spoken about the divorce of social care from the national health service. If I have a heart attack or have cancer, I will have to deal with it one way, but if I have Alzheimer’s, Parkinson’s or dementia, it will be considered to some extent as being a separate challenge. I believe that we need to bring the two much closer together.

I have some concerns about using insurance. Every time I have had to make claims—on my car insurance, for example—I have always had some difficulty with my provider. We need to look at that, but we need to ensure that people do not see all their savings just disappearing into a black hole. That is something that we need to deal with as a country. There is a danger that the amount of money individuals are asked to pay for their care will remain far too high. We cannot hide from that in our ageing society.

At the beginning of my time in the House, I wrote a paper on the strategic defence and security review, in which I said that there were two important matters of which we needed to take notice. The first was that more money needed to be put into defence—I continue to say that—but the second was that we should devote more money to long-term care for the elderly. That was my No. 2 priority; it has to be incredibly important.

I welcome the Government’s decision to take on the global health challenge—a priority after years of neglecting this growing problem. I welcome the Prime Minister’s commitment and the leadership and extra support he has provided for people with dementia in carrying out their everyday tasks. That shows a shift in the wish to combat the stigma that surrounds dementia and to achieve greater awareness of the illness. We need to learn, too, from the ethnic minority communities that tend to work much more closely together with their families in providing care.

--- Later in debate ---

[Sarah Newton (Truro and Falmouth) (Con)]

I listened with great pleasure to my hon. Friend—I hope I can call her that—the hon. Member for Worsley and Eccles South (Barbara Keeley); I have the privilege of serving as her deputy on the all-party group on social care. I wish to echo the point she has just made, which was also so well made by my hon. Friend the Member for Chatham and Aylesford (Tracey Crouch), who played such an important role in securing today’s debate.

This is a very important occasion for us to show the collective will of hon. Members—there are so many here today—to hold the Government’s feet, and indeed the Opposition’s feet, to the fire. We need urgently to come to an all-party agreement on how to fund properly the future of care and social care in our community. I also wish to thank the right hon. Member for Salford and Eccles (Hazel Blears) for her contribution. I am sure that she will indulge me as I thank the chair of the all-party group on dementia, Baroness Greengross, who has dedicated her whole life, both in the other place and outside Parliament, to raising issues affecting older people, their families and carers so well. I thank the right hon. Member for Salford and Eccles for her part in securing this debate, which gives us such an important opportunity to de-stigmatise dementia and other mental illness.

I remember only too well that when I was a child growing up people would not talk about cancer; it was whispered about or called “the C word”. Thankfully, we can now openly talk about cancer, which is to the great benefit of sufferers, their families, their loved ones and their carers. We must quickly move to the same position for people suffering from dementia, Alzheimer’s and a range of other mental health conditions.

[Neil Parish]

I agree very much with my hon. Friend that cross-party support on how to provide long-term care for people with dementia is essential, because our population is ageing. Better medical care means that people are living longer, but of course it also means that we will have more people suffering from dementia. It is right that we accept that situation as being part of society and as something we must deal with, but we must have a way of providing the funding so that we do not take away everybody’s assets to pay for treating dementia.

[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.