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Dementia Sufferers

Professor Banerjee, who is leading on that, is the Department's clinical advisor on dementia. He is not a national director for dementia, and I need to give further consideration to that proposal. The difficulty is that, understandably, every area in the health service wants a national director. I have just appointed somebody in the Department to lead on autism. Previously, no official was leading on that issue, which is presenting a growing challenge for our society where children and young people are concerned. Indeed, the issue of adults with Asperger's is now raising many issues. I cannot give a cast iron commitment today, but I shall reflect on the hon. Gentleman's point. Certainly, that issue must be addressed as part of the national strategy. As David Nicholson has said, however, there is a strong case for having such a director. We have an excellent national clinical director for older people, Professor Ian Philp, who is highly regarded but who is not a dementia specialist. We will consider that possibility as part of the national strategy. Clearly, training front-line staff is crucial, and we need a combination of universal basic knowledge and highly specialist skills. However, we still have a long way to go. For example, let us consider domiciliary care workers. As more and more people choose to remain in their own homes, rather than to go into hospital or institutionalised care, more of the service will have to be provided by home care workers. We need, therefore, to have a particular look at their expertise, knowledge and sensitivity to the needs of people with dementia, which applies to all professionals. On one hand, we need some minimum knowledge among the universal professionals and system, and on the other, we need a cadre in every community of people with specialist knowledge and expertise in dementia. Finally, of course, we need to look at the relationship between national policy and leadership, and what happens on the ground with local priorities. I say gently to the hon. Member for Rugby and Kenilworth that all political parties are united around the notion of localism, devolution and of not doing things from offices in Westminster and Whitehall. As we develop the national strategy, therefore, we must consider the pressures, incentives, levers and accountability mechanisms that we can put into the system, but which will not compromise the right of people on the front line to make key decisions. We must ensure, however, that they do not neglect people with dementia, and that those with dementia and their families are given greater priority and a greater status in decisions than has been the case thus far. One of the reasons why we are debating this issue today is the lack of a national policy in the past, and another is the fact that people in local communities continually tell us that they are not getting the expert, personalised services that they need and want. Carers frequently tell us that they are not being treated with respect when decisions are being taken about dementia sufferers. We have a long way to go. The challenge is to create the right balance and dynamic between providing clear national policy, leadership, standards and objectives, and understanding that in the end we are heavily dependent on the managers and professionals on the ground to make a difference. Furthermore, putting more powers in the hands of users and their families, through individual budgets, direct payments and simply giving them a greater ability to complain and to articulate their views, will have a major impact on raising standards and the quality of care in this area, as in many others. I end by paying tribute to hon. Members for the all-party way in which they have approached this incredibly important issue. We are all committed to bringing dementia out of the shadows, and we have a solemn responsibility to those with dementia and their families and to ensure that we improve the quality of their lives.