Dementia Care

Simon Hoare Excerpts

Tuesday 3rd June 2025 Commons Chamber

[Sir Alec Shelbrooke (Wetherby and Easingwold) (Con)]

It is a genuine pleasure to follow the hon. Member for Hartlepool (Mr Brash), who has hit the nail on the head when it comes to how terrible this disease is.

Forty years ago this August, my paternal grandfather was dying of lung cancer. My father went to the hospital with him. The day went on and on, and eventually, my grandfather said to my father, “Go and give your mother a call—let her know where we are at.” She answered the phone, and my dad said, “Just to let you know, mum, we’re delayed at the hospital. Dad and I are going to be late.” She said, “Oh, I’ve not seen your father in three weeks.” At that point, he said, his blood ran cold. Tragically, my grandfather died just two weeks later. The funeral came, and the funeral went. My grandmother constantly asked, “Where have all these flowers come from?”

Within four years, my grandmother had to go into a nursing home. Making the right decisions during those four years put a huge strain on my father. “Do we sell the house? How are we going to pay for the care?” My grandmother was walking the streets at 3 am. She was leaving the gas on. Neighbours were saying, “The whole street is going to be destroyed. Derek, you have got to do something.” Then she was put into the home. What I have found during my work on dementia is that that is often the pattern. The spouse, or the partner, protects his or her spouse or partner. They pick up the slack—and this is such a ratcheting disease, which comes so slowly, that they do not realise that they are under more and more pressure and taking on more and more work.

Tragically again, in 2019, my father-in-law died suddenly, and it soon became apparent that he had been hiding my mother-in-law’s dementia. My mother-in-law is doing very well: she has a carer, and on some days she is still pretty sparky. She was a formidable woman in her time. She is 87 years old now. She still remembers me, and there is an important point there: I will be the person she forgets next, because I was the last in. I say to my wife, “For as long as she remembers me, we are still in a roughly good place.” That is quite a sad statement, is it not? It is sad that we are moving down that road.

However, I was inspired by something I saw shortly after I was elected, in 2010 or 2011, at a dementia café down in Rothwell. I went there when it first opened, and I quickly became aware of the support that it was giving people, and of how much they appreciated it. That brings me back to what the hon. Member for Hartlepool said about how cruel this disease is. Because people are gradually supporting their loved ones more and more, they reach a point at which there is enormous pressure. They are not going to take a step back, go on to Google or try to get on to the local Facebook to try and work out what is going on locally. People do not know what is going on out there, and that was even more true 10 or so years ago.

A huge number of voluntary organisations take clients. Let me name just two in my constituency: Wetherby in Support of the Elderly—WISE—and the Easingwold Hub Club. They provide a huge amount of support for people with dementia, but dozens of other voluntary organisations supply an incredible service that helps to take the pressure off carers, who are also able to take their loved ones out, which in itself can be stimulating. That gave me an idea, and I created the Dementia Directory and one of the first dementia-friendly constituencies. The directory breaks up the constituency up into parts, and lists all the events that are going on. We are working on the new one now. It is a complex process; it is a bit of a spider’s web, because we find one event and then another is off, and then another is off. We try not to miss any, but inevitably we do.

It is because the last directory had such a huge and positive impact that we are preparing this one for the new constituency, following the boundary change. All that we need now is the sponsorship that will enable it to be printed and posted. It will make a difference, because, as the hon. Member for Hartlepool said, this is a terribly cruel disease. There is a statement that upsets and annoys me greatly: “It is not such a bad disease, because the person who has it does not know they have it.” That is an awful thing to say. I can never hold back a tear when I see the advertisement in which a chap sitting on the end of the bed says to his wife, “I want to go home.” How many of us, as children, became homesick? I was homesick when I went to university. It is a terrifying thought that as you get older you will not know your partner, and you will be constantly homesick.

For Members who may not know this, I have a tip, because I have done dementia training. When I went to a care home, there was an elderly lady of about 90, who said, “I don’t like it here. They never let me see my parents. I just wish they’d let me see my father.” I had been told to get into a memory of the person and mention somewhere their relative may be, so I said, “Well, your father’s down at the allotment.” She said, “Oh, yes, that’s right,” and she calmed down. Do not argue with those people, because that will just make them more upset, but try to take them back to a memory.

As well the directory being used to notice events, it highlights things that may help, such as hydration. One of the things that happens with elderly people is that they do not want to keep going to the toilet and they get worried about doing so, so they are often quite sparky in the morning when they have had a cup of tea, but by 3 o’clock they are getting memory lapses because they have not drunk enough. That is also something we have to tell people.

How many Members in this Chamber, when they said they were going to speak in this debate—they do not have to put their hands up—had somebody say, “Oh, don’t forget to go there”? Everybody seems to know what dementia is, but nobody really knows what it is. It is a real paradox. Everybody makes that comment, “Don’t forget,” but do they really understand the depth and impact of this disease? Dementia includes Alzheimer’s disease. I recently read a book about Ronald Reagan, which at the end said that he did not open his eyes for the last four years of his life. Just think about that, and what this terrible disease does to people and all the impact it has.

This debate is about dementia care, and several contributions have been made about things the Government can do. I raised this issue back in 2012-13, and the then Prime Minister, David Cameron, did put funding into research for dementia. The trouble is that we have learned how to preserve all the organs of our body with medical research and medical advances, but we have never bothered with the brain. The blunt truth is that, before this disease had the prevalence it now has, most people were dead before they got it. However, there is something we can do all do as Members of Parliament in our constituencies, and that is to draw together all the voluntary organisations that give such relief to families and help to stimulate the sufferer along the way.

[Simon Hoare (North Dorset) (Con)]

My right hon. Friend is making a characteristically powerful and informed speech. He mentioned the importance of the role of volunteers, which I think the whole House will recognise. Does he, however, share my concern that, with an ageing population, we seem to be seeing a smaller cohort of people prepared to step up to volunteer? Across the Government and across this place, a noble endeavour to embark upon would be to champion and encourage more people to get involved with volunteering outside the usual catchment or cohort, because otherwise, in the not-too-distant future, these vital organisations will be so short of volunteers that they will not be able to do the jobs they need to do.

[Sir Alec Shelbrooke]

I am most grateful to my hon. Friend, who does indeed make an important comment. My constituency of Wetherby and Easingwold has an older demographic, and that will become more acute over time. He is right to say that there is a dedicated band of volunteers, but most of the people who do the voluntary work during daytime are of an age to be retired. There are people who I think do an incredible job in supporting people—they really do—and they deserve nothing but our gratitude and thanks.

As I have said, there is something positive that we really can do as Members of Parliament, so I urge everyone when they are back in their constituencies to look at what goes on and see what they can do to promote it. I promise them that it will make a transformational difference not just to the lives of the people affected, but to their lives as Members of Parliament in doing what they can do for their local community, which is why we are all here in the first place.

Tobacco and Vapes Bill

Simon Hoare Excerpts

2nd reading
Tuesday 26th November 2024 Commons Chamber

[Wes Streeting]

I can not only imagine it, but I recently experienced a similar situation. There I was in Barkingside Sainsbury’s one evening, only weeks ago, buying a bottle of wine to have with dinner and, to my surprise, I was asked for my ID. I am afraid it is just a burden that those of us with youthful vim and vigour in our early 40s have to bear, and it is a price I am willing to pay—for good moisturiser. However, there is a serious point. Along with many others that I am sure we will encounter during the passage of the Bill, this is one of the cynical arguments being deployed by the mendacious smoking lobby, which would have us believe that, decades hence, there will be people who are at the margins—one aged 41 and one aged 40, for example—being asked for ID on the sale of cigarettes. The point is that the Bill will create a smokefree generation. Young people growing up in our country today will not be smokers, because we will have stopped the start. We will do everything we can to support adults who are currently smoking, because the vast majority want to break the habit but struggle to do so.

[Simon Hoare (North Dorset) (Con)]

If only proof of age was still asked of me.

The Secretary of State knows that I support the Bill and will vote for it this evening, but he will know that rural pubs are increasingly marginal in their operations. He has referred to further powers, post consultation, that may stop smoking outside in particular places once the Bill is on the statute book. Will he put the minds of rural MPs, from across the House, at rest by saying that he does not envisage at any point, either now or post-Royal Assent, the inclusion of a ban on smoking outside rural pubs? That would be a further nail in their business model at a time when we need them.

[Wes Streeting]

I was going to address that point later in my speech, but let me address it now. It is not often that a Government comment on leaks or welcome the events following a leak; I do not want to encourage future leaks, either. However, it is well known and a matter of accurate reporting, in this case, that we were considering an extension of the ban on outdoor smoking to include outdoor hospitality, including pubs, as the hon. Gentleman mentioned. Because of that leak, representations were heard from Members from across the House, including the hon. Gentleman, my hon. Friend the Member for Great Grimsby and Cleethorpes (Melanie Onn) and others. We took those representations very seriously because we know the hospitality industry has been through a torrid time, and not just in rural communities. I accept that rural pubs face a big challenge, but even high street pubs in towns and cities are struggling.

Our approach to public health always has to weigh up the upside benefits to public health against the downside consequences elsewhere. It is not in the national interest to see our high streets further suffer, so I reassure the hon. Member for North Dorset (Simon Hoare) and the hospitality industry—although I think it feels reassured on this already—that we will not be consulting on extending the powers to outdoor hospitality spaces. I hope that reassures people, as we embark on consultation on the measures that I am outlining today, that the Government listen, engage and consult seriously. Consultation is genuine with this Government.

--- Later in debate ---

[Simon Hoare (North Dorset) (Con)]

I welcome this Bill, and I think the country should welcome it and salute the Government for effectively taking on the Bill—they have polished and finessed some elements—that was introduced by my right hon. Friend the Member for Louth and Horncastle (Victoria Atkins) under the previous Government. The gracious remarks of the Secretary of State in his opening speech will have resonated on the Conservative Benches and been appreciated.

A lot has happened in our country’s relationship with tobacco. I am pretty certain that had we known in the past what we know now about the harms of tobacco for so many thousands of our citizens, both societally and in terms of health, Queen Elizabeth would have probably said to the merchant adventurers, “Thank you very much for bringing it over, but please take it back.” It would not have taken root, but it has done. We have moved through a time when medics were paid by the industry to tell us of the beneficial effects of tobacco—for example, the idea that menthol was good for clearing people’s lungs. As we know, the medical profession has very much changed its tune. Rather like the hon. Member for Bury St Edmunds and Stowmarket (Peter Prinsley), my late father-in-law was an ENT surgeon, and I well remember talking to him about the devastating impacts that he saw on people’s health and the cost that such terrible and avoidable conditions can have, both to the economy and to the health service.

As I mentioned to the Secretary of State, I am no longer asked for proof of ID when I go into shops to buy anything. However, I can well remember that as a young schoolboy —this just goes to show how this country’s relationship with tobacco has changed—the headmaster at my local primary school seemed to be addicted to Piccadilly cigarettes. I do not know whether they are still made, but it was my job every morning—I obviously had a trustworthy face—to trot up Wyndham Crescent, go round the corner into Severn Road, go into Tony’s, the newsagent, and pick up either 20 or 40. I knew it was going to be a bad day if my headmaster needed two packets of 20. It is amazing that a nine-year-old schoolboy could be given cigarettes, but so trusting was Tony, the newsagent, that we did not have to pay. We did that on Fridays, and there was always 10p left over, which would allow me to have a comic, two packets of crisps or a bag of Chewits. When I say this to my children, who are either in or approaching their teenage years, they look at me with glee but also as though I am talking about a different age, which of course I am. What on earth can we buy for 10p these days?

As I said in my intervention on the Secretary of State, I welcome the Bill. I was grateful to him and to the Under-Secretary of State for Health and Social Care, the hon. Member for Gorton and Denton (Andrew Gwynne), for a brief conversation we had today about the Government’s intention not to include within the scope of this Bill—or, indeed, in any future consultation—a prohibition on smoking outside a hospitality venue. I entirely take the Secretary of State’s point that it is not just the rural hospitality sector that would be affected, but a number of publicans in my constituency have said to me that it really would be the death knell for their business if smokers were not allowed to have a cigarette and a pint outside the pub, in the designated smoking area. Their businesses are very marginal, as the Minister knows and as the Secretary of State recognises, so I am grateful to them for that.

The licences that the Bill envisages will be useful for providing a record of who is doing what, where, for the benefit of officialdom in its many guises, but I urge the Government—and local government, if this gets passported down to it—not to see those licences as a cash cow. They should not be a profit centre, and the requirements to secure a licence should not be onerous. The constraints of the Bill are clear. Hon. Members have asked why, if smoking is so bad, we do not just stop sales completely. The Government are not going down that route, so those who are going about a legal business should not be made to feel like criminals or societal pariahs for selling what is still a legal product to those who are legally entitled to purchase it.

I disagree almost fundamentally with the assessment of vaping from the hon. Member for Newcastle upon Tyne East and Wallsend (Mary Glindon). I have three kids at our local high school, and too many of their cohort have got entrapped into vaping, brought in by the colours, the flavours, the smells, the packaging and the novelty factor. I understand entirely the intention for vaping to be a passport away from tobacco, but for too many, it seems to be an entry to smoking, and then moves them on to tobacco. That is entirely not what was envisaged, so I support fundamentally the robust approach that the Bill takes to the vaping sector.

I would be interested to hear the Minister’s response to the concerns raised about smuggling. One can make something illegal, prohibit it or narrow access to it, but that does not necessarily, in the first instance, choke off market demand, and people will seek it. There will clearly have to be some robust empowering of His Majesty’s Revenue and Customs agents and others to ensure that we do not see a burgeoning black market in tobacco products.

On the hon. Member for Newcastle upon Tyne East and Wallsend’s point, I remember hearing a presentation from British American Tobacco, and a point that resonated with me was that there are legal vapes, the ingredients of which we know and are listed, and then there is a huge black market for vapes, principally from China, and nobody knows what the hell is in them. I think an awful lot of parents think that those vapes are just producing steam, and have no idea about their dangerous chemical composition. I think too many teachers and headteachers also thought that, and the learning curve has been steep.

[James McMurdock (South Basildon and East Thurrock) (Reform)]

I have an interesting thought on the supply and demand issue, and the challenges it will pose from a control perspective. The hon. Gentleman paints a nice image of a day gone by when one of the kids could be sent down to the shop to pick up something for an adult, and I ask Members to consider what kind of world and country we want to live in. Do we want to live in a country where we could send one of the kids down to the shop to pick up something for us, or do we want to live in a country where we are forced to police each other’s behaviour in parks? We should think very carefully about the Government’s remit.

[Simon Hoare]

The hon. Gentleman takes me neatly to my closing point. If I understand him correctly, he is making an argument about civil liberties and freedoms. One does not have to be a libertarian to cherish freedom and liberty, as I hope we all do in this House. Libertarianism is the extreme form. It is the difference between liberty regulated and controlled—parametered, if one will—and liberty laissez-faire. It strikes me as rather incongruous for a libertarian to wish to become a lawmaker, because most laws are there to control, prohibit and regulate. It seems masochistic: “I am a free market libertarian, yet I have decided to put myself in the shackles of lawmaking in order to restrict the liberties that I cherish.” The hon. Gentleman makes a serious point, but we have to deal with society as it is, rather than as we might like it to be. Things have changed.

The ultra-libertarian would ask why we force people to wear seatbelts, as people should be free to hurl themselves through their windscreen at speed. Why do we have speed limits? The libertarian would say that we should be absolutely free to drive at whatever speed, irrespective of the conditions. I remember, back at university, hearing an eccentric American—that can sometimes be a tautology—questioning, from the extreme wing of libertarianism, the merits or otherwise of ages of sexual consent.

I suggest that all we do, and our inspiration for doing it, is benign and kindly. Too often, it is interpreted as being paternalistic and patronising, but I like what the Secretary of State said about this approach to lawmaking being in the proud one nation tradition of the Conservative party, because Tories like order, not disorder.

[Andrew Rosindell]

rose—

[Simon Hoare]

Here is a man who adores order nearly as much as he adores Margaret Thatcher.

[Andrew Rosindell]

One of my reasons for getting involved in politics is that I believe in a free society, and I believe that people should make choices about their own life. I do not believe that the state should govern how people live their life, but that does not mean I am an extreme libertarian. It just means that I believe in freedom with responsibility.

As my hon. Friend has said, attitudes to tobacco have evolved over the years. People have naturally decided not to smoke and, speaking as a Conservative, surely it is better to educate and let people make their own choices than to impose decisions on them.

[Simon Hoare]

My hon. Friend makes an important point, and I readily accept that it has a huge intellectual underpinning, but we have had public health campaigns for years on the dangers of smoking tobacco. In some instances, it has worked. We have also used taxation and the pricing mechanism. My late father told my mother that he would give up when cigarettes reached 10 shillings a packet. He eventually gave up when smoking was banned in public buildings and the like. The question that remains is: do we allow unfettered freedom if it harms only the individual who is exercising it, and step in when the exercise of that unfettered freedom has negative impacts on society?

The Secretary of State and others have dilated, perfectly correctly, on the impact on demand and supply in the national health service. A disproportionate amount of resource goes to dealing with smoking-related diseases, illnesses and conditions. We can do something about that. We know full well the negative impact of passive smoking on other people’s health, so the impact of the exercise of that liberty is not limited to the individual. I suggest respectfully that my hon. Friend the Member for Romford (Andrew Rosindell) would have a stronger point if it was limited to the individual. Then we could say, “Provide the information and let the individual take the decision.” However, that decision impacts many other people. It affects the productivity of the nation and the national health service, and the health of family and society.

I suggest to my hon. Friend that it is an entirely Conservative instinct to say, when all the levers have been pulled and buttons pushed—when there has been public information, education and some forms of prohibition—“It has worked up to a point, but not enough and not at the right speed. We will have to do something else.” I accept that not everybody who describes themselves as a Conservative, as my hon. Friend and I both do, will make the same analysis and arrive at the same position as me. I voted for the Bill in its last iteration, and I will vote for it again today, because I think it is the next lever that we need to pull and the next button that we have to push.

[Dr Danny Chambers (Winchester) (LD)]

Does the hon. Gentleman agree that we have an NHS and a Government who are expected to provide and pay for treatment when people are ill, so there is a duty and an onus on the Government to try to keep people healthy, and to provide information about well-known dangers to people’s health? This is not about having a nanny state, but about nudging people to make the right choices, because it costs money to treat people, and we want to save money as well.

[Simon Hoare]

The hon. Gentleman makes a valid point. One can nudge, prod, push and exhort as much as one can, but the Bill is probably the final stepping stone in quite a long line of stepping stones to try to wean people off their dependency on tobacco.

The House has been generous with its time, as have you with your patience, Madam Deputy Speaker. In closing, I echo and endorse the point made by the Secretary of State and other contributors from the Government Benches: people who have an addiction are not free. They are trapped by their addiction, and that affects many areas of their life. If someone is terribly well off, they can afford the addiction to tobacco, and it will make not a jot or tittle of difference to the household budget or income, or to their standard of life—

[Andrew Rosindell]

On that point, will my hon. Friend give way?

[Simon Hoare]

I will not, I am afraid, because I want to conclude. The disproportionate hammer blow is felt by families who would describe themselves as poor, on low or fixed incomes. When the choice between feeding the addiction and feeding the children comes into play, then feeding the addiction seems to have the trump hand. The Government are right to have picked up the ball and taken the Bill forward. It is an entirely Conservative measure. This is not a restriction of liberty in the abstract. The Bill is about public health. It is about taking the data, extrapolating the facts and recognising the harms, and, as responsible legislators, responding to that to make a difference to all our communities up and down the country.

Oral Answers to Questions

Simon Hoare Excerpts

Tuesday 15th October 2024 Commons Chamber

[Andrew Gwynne]

I pay tribute to my hon. Friend for her work in this area and for setting out eloquently her own personal experiences. Of course this Government will do more to raise awareness and enable more women to access breast screening services.

[Simon Hoare (North Dorset) (Con)]

A significant impediment to improving adult social care is the split of budget and responsibility and policy between the Secretary of State’s Department and the Ministry of Housing, Communities and Local Government. Will he and colleagues work to remove that hurdle, to have better outcomes more cost-effectively delivered to improve the lives of all our constituents?

[Wes Streeting]

The hon. Gentleman is right to raise that risk. I assure him and the House that I and the Deputy Prime Minister, herself a former care worker, are working in lockstep to align strategy, policy and delivery.

Oral Answers to Questions

Simon Hoare Excerpts

Tuesday 23rd July 2024 Commons Chamber

[The Minister for Care (Stephen Kinnock)]

I thank my hon. Friend for that question and welcome him to his place. This issue is personal for me, and I am sure it is for many others across this House. A number of potential new disease-modifying drugs for Alzheimer’s are in the pipeline, including lecanemab and donanemab. We are committed to ensuring that clinically effective and cost-effective medicines reach patients in a timely and safe way. The National Institute for Health and Care Excellence is appraising lecanemab and donanemab to determine whether they will be made available in the NHS.

[Simon Hoare (North Dorset) (Con)]

Nearly 10 children a month die from brain tumours, and I know that the public health Minister takes this issue seriously. He was familiar with the work of the Brain Tumour Charity’s HeadSmart campaign. Will he agree to meet me and my fierce campaigner constituent Sacha Langton-Gilks, who lost her son to a brain tumour, to discuss how NHS England could be persuaded to do more to inform and educate parents to identify the symptoms, so that collectively we can reduce the number of deaths?

[The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)]

I am grateful to the hon. Gentleman for that question. He knows that I met his constituents when I was a shadow public health Minister, and I can confirm that I am more than happy to meet him and his constituents now that I have dropped the “shadow”.