Dementia Services in Ukraine

Debate between Rupa Huq and Gary Streeter

Wednesday 10th January 2024 Westminster Hall

[Sir Gary Streeter]

The hon. Member makes a very strong point in support of my case that the Government could perhaps support the project we are talking about today and make a real difference to people on ground. I am conscious of time, but once I have finished my formal speech I will read some current testimonies from families of dementia sufferers in Ukraine, to further underline the reasons to bring forward this proposal.

Dementia care in Ukraine before the war lacked strategy, trained professionals, infrastructure and support for people with dementia and their carers. Russian attacks have attacked fundamental services, including power, water, hospitals and so on, so the situation for many people with dementia in Ukraine is now dire. Many older people have refused to leave their homes; meanwhile many women have left with their families, leaving a lack of carers. Specific data on the number of people living with dementia, their location and their needs is lacking. The urgent need now is to build systems and structures to support people living with dementia and their families in both urban and rural Ukraine.

There is no available capacity for dementia sufferers within the Ukrainian healthcare system and there also exists no national programme to advise or support the families and carers of those affected. Nezabutni engaged in a consultation with the Ukrainian Government on this issue in 2021. Although the need has been recognised, perhaps understandably, there has been no progress on the proposal from either the Ministry of Health or the Ministry of Social Policy in Ukraine since that consultation.

It is likely that hundreds of thousands of dementia sufferers in Ukraine are impacted by the insecurity and the bombing to a greater extent than their non-afflicted peers. They are unable to access formal medical support through Government medical services. The proposal that the team would like to put in place is a programme to be delivered in three phases. Phase 1 is to carry out groundwork in-country, which will take approximately four months. Phase 2 is to set up and pilot the work programme and is roughly one year in length. Phase 3 is the main programme delivery, which will take two years.

The project will engage with key stakeholders in Ukraine identified by the team, including clinical, academic, charity and Government expertise in health, social care and support. There will also be engagement with international partners, including the WHO, Alzheimer’s Europe, Alzheimer’s Australia and Alzheimer’s USA.

During phase 1, it is envisaged that a UK team of dementia specialists will visit Ukraine, hopefully during 2024, to meet the stakeholders; to review the existing systems and structures; to ensure that its training and support programmes are embedded in Ukrainian practice and culture; to review existing data on diagnosing dementia and care and support; to carry out rapid needs assessment on key training and support priorities; to agree the organisational structure for the programmes to come; and then to report the agreed plans for the subsequent phases.

Phase 2 envisages the setting up and piloting of work programmes. It involves establishing a national training and support co-ordination team, hosted by Nezabutni, to manage the training and support programme, to undertake the in-country needs assessment and priority setting and to agree and document key deliverables. It would also establish a dementia training and support unit, which would agree the delivery systems for the programme, including digital systems, plan a programme of training and awareness courses, and plan and pilot the roll-out in urban and rural settings.

However, the project would then move on to the all-important delivery phase, which would see dementia training and support rolled out across the country, using both digital and traditional efforts—in particular, training doctors, nurses, health workers, social services and care workers in updated dementia awareness and knowledge. It would involve the development of a range of courses for people living with dementia and their carers, alongside raising general awareness and support. Finally, there would be a period of monitoring and evaluating the training outcomes and the time, cost and quality of the training. I know the Minister is keen that anything supported by the Government should be properly evaluated, and that is very much part of our thinking.

What would this excellent work cost? The answer is very little for the likely benefits returned. It is estimated that phase 1 would cost around £150,000, which would include the work undertaken by the Ukrainian charity and its staff and the cost of the visit by three members of the UK team, who are likely to be Ian Sheriff, Professor Rupert Jones and a project manager, to carry out all the stakeholder engagement described previously. For phase 2, the estimated cost is £250,000. For phase 3, the cost would be determined during phase 2.

My simple request to the Minister today is for his Department to be willing to fund the cost of phase 1 to enable this project to get off the ground, whereupon funding applications to others will be made. Of course, we would be delighted if the Foreign, Commonwealth and Development Office would like to engage more fully with the project throughout its length. The cost would be small change compared with the sums we are spending on munitions for Ukraine, and the project would make a massive difference to many lives. It needs the sort of funding that might come from a departmental underspend, or possibly from an under-utilised budget for the mission in Kyiv or elsewhere. The Minister is looking askance at me, but he and I know that these things sometimes get discovered.

I hope the Minister will confirm that his Department is willing to discuss our proposal with members of the UK team to see whether a way forward can be found. The project embraces the best principles of active citizenship, which the Foreign Secretary might describe as “big society”—dedicated professionals having the compassion and drive to use their expertise to benefit people in a troubled part of the world who are less well off, and to put together a coherent, professional plan that will make a real difference. All they need is a little help from the Government to get things up and running.

I will conclude by reading just three of a number of testimonies sent to me by family members of those with dementia in Ukraine. They speak for themselves. Yulia, who lives in Kyiv, says:

“We live in the Solomianski district of Kyiv, which was severely affected by shelling on January 2. We reside in a nine-storey building on the top floor. Our house shook, probably due to falling debris, even though we don’t live near the building where the debris fell. At the first sounds of explosions, we went into the corridor. Mom was with us. Luckily, she doesn’t fully comprehend what’s happening and doesn’t resist when we all gather in the corridor or even in the vestibule.

But over the years of full-scale war, her condition has worsened, and aggression has emerged. She might start shouting at me that the enemies are about to come. In the last such episode, she grabbed a slipper, threatened me, and demanded that I also must shout because the enemies were coming. I don’t know how to handle such situations. During the last outburst, we called an ambulance, and she was administered a sedative.”

Olga, who is also in Kyiv, says:

“As loud as the past few days have been, we haven’t heard anything like it before. Unfortunately, or fortunately, my mom doesn’t understand what’s happening. It’s impossible to take her to a shelter because she doesn’t want to sit; she constantly walks, tries to go outside somewhere, either puts on a pile of clothes or undresses. So, alarms and explosions don’t affect her, but we are hostages because we can neither take her with us nor leave her alone.”

Finally, Natalia, who is also in Kyiv, says:

“We live in the city centre. We didn’t hear the shelling of Kyiv on December 29, 2022, but it was very loud on January 2. My mum and I woke up from the explosion. She no longer understands what’s happening around her; she doesn’t react. Initially, during the full-scale war, she responded and was afraid, but then her condition deteriorated sharply, so now my mom lives in her own world. I can’t even get her to the corridor during an alarm, to a supposedly safer place. She doesn’t want to. I used to lead her out. I tried, but she would return and lie down on her bed.

I realise that it is important for me to stay calm during the shelling. If I get nervous, my mom senses it and gets anxious too. So, during alarms, I do nothing. I stay calm with her, and pray.”

[Dr Rupa Huq (in the Chair)]

The debate’s new finishing time is now quarter to 5, and the hon. Member has no right of response because it is a 30-minute wonder. I call the Minister, Andrew Mitchell, for the second debate in a row.

Oral Answers to Questions

Debate between Rupa Huq and Gary Streeter

Thursday 7th July 2016 Commons Chamber

[Dr Rupa Huq (Ealing Central and Acton) (Lab)]

4. If the Electoral Commission will make an assessment of the merits of requiring lead campaign groups in referendum campaigns to publish manifestos.

[Mr Gary Streeter (South West Devon)]

Thank you for your earlier endorsement, Mr Speaker.

The Electoral Commission is collecting information to inform its statutory report on the EU referendum, and I will pass the hon. Lady’s suggestion to it for its consideration.

[Dr Huq]

Rapidly after the referendum results, central claims on both sides evaporated—the extra spending for the NHS, the emergency punitive Budget, and the UK being the fifth largest economy—so surely, if we are ever to conduct referendums again in this country, should not the lead campaigns on both sides publish measurable claims in a manifesto, so that truth is not the casualty of the scramble for votes?

[Mr Streeter]

The Electoral Commission has no desire whatsoever—it certainly has no such power at the moment—to sit in judgment on the truthfulness of any claim made in any campaign. The hon. Lady’s idea that lead campaigns should produce manifestos is an interesting one that I will pass on to the commission for its consideration of the referendum overall.

Oral Answers to Questions

Debate between Rupa Huq and Gary Streeter

Thursday 17th December 2015 Commons Chamber

[Mr Gary Streeter (South West Devon)]

The Electoral Commission provided guidance and resources, and set performance standards for electoral registration officers to improve registration in their local area during the recent autumn canvass. The commission also ran a major public awareness campaign ahead of the May 2015 polls. The campaign resulted in more than 1.5 million additions to the register, which was more than three times the amount achieved during a similar period before the 2010 general election.

[Dr Huq]

Against the explicit advice of the Electoral Commission, the Government rushed through by a year the individual electoral registration on which the new boundaries will be based. HOPE not hate predicted that 1.9 million people will fall off the register. The hon. Gentleman has said that there has been an increase in registration, but I would like to know the net figures. It is predicted that those who will fall off the register will typically be the young, those in houses of multiple occupation, and students. What was the net result at the end of all this? It sounds like a cynical attempt to make my electors disappear.

[Mr Streeter]

The decision that the hon. Lady mentions was a matter for the Government and was taken, as she rightly says, against the advice of the Electoral Commission. I will have to write to her about net impact of that decision. The reality is that we must all do whatever we can to encourage our local electoral registration officers to contact as many people as possible, particularly in groups that are hard to reach. I am sure that the public awareness campaign in early 2016 will have great success, as it did in 2015.