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Health and Education

I shall focus on just one aspect of today's discussion about the Government's programme of activity for the forthcoming legislative Session: the national dementia strategy, to which the Secretary of State for Health referred in his opening speech. At the outset, I should say that I fully welcome the concept of a national dementia strategy, as, I suspect, do most Members. It is immensely important, and has been for a significant time. In August 2007, the former care services Minister, the hon. Member for Bury, South (Mr. Lewis)—not the other Bury Member, the hon. Member for Bury, North (Mr. Chaytor)—said that we should work to bring dementia out of the shadows. He was entirely right to say that and I applaud the Government for acting on that impulse and arranging for a national dementia strategy to be brought forward. I hope that the House will forgive me if I cover the reasons why a national dementia strategy is so necessary and why dementia is such an important subject. The figures may be well known to hon. Members, but I will repeat them. Some 700,000 people in the UK now have dementia. That figure will probably double in the next 30 years, and the cost to the UK economy will treble during that period. That is a significant figure, because the current estimated cost to the UK economy is £17 billion a year, which is more than the cost of heart disease, stroke and cancer combined. Those are very significant figures, which is why the strategy is, as I said, extremely welcome. The strategy is welcome, at least in part, because a problem of that scale should never be ignored. That fits into the context of what other hon. Members said earlier about mental health issues more generally. It is true, and worth recognising, that people do not like to talk about mental health issues in the same way as they like to talk about physical health issues. Some stigma is attached—and that is true of dementia. It is not just recognition of the scale of the problem that we require. We also need people to have the courage to come forward and explain that it is happening to them, and how they are coping with it. In the context of dementia, one of those people is the author Terry Pratchett, who the House will know has recently revealed that he has a form of dementia. Since then, he has actively campaigned on the subject, talked a great deal about research, and described what has happened to him in terms of a tsunami that will hit the United Kingdom. He is right to talk in those terms. Two aspects of a tsunami are important, and someone who is about to be hit by one will want to know two things. First, they will want to know how big the wave that is about to hit them is; I have said a little about that. Secondly, they will want to know when it will hit. How urgent is the problem? It is with regard to the urgency of the problem that I have some difficulties with the Government's position. I have no doubt that the Government have done entirely the right thing in arranging to introduce a strategy, but I am becoming a little concerned, as I know others in the field are, that the Government's sense of urgency has started to slip. When the former care services Minister spoke about his intention to introduce a strategy, he said that he hoped that it would be available by the summer of 2008. However, the Department of Health issued a press release on 19 July that said:"““The full Strategy, to be launched in the Autumn, will have three main aims””." I shall return to those aims in a moment, but it became clear at that point that the Government wished to introduce the strategy in the autumn. We know that the Government have a very flexible concept of autumn, but we are clearly no longer in the autumn now. We then asked the current care services Minister when exactly we might expect the strategy. I asked the Secretary of State that question today, too. The Minister has said that it will be introduced shortly and, under further cross-examination, that that might mean early in the new year. I understand that things are difficult in government. Other priorities arise, and the Government sometimes find that time scales slip a little. However, an issue of such importance and urgency must be dealt with expeditiously. Those involved with dementia—those who have it, those who care for them, and the professionals working in the sector—regard the situation as urgent. They feel that they have persuaded the Government of that—indeed, the Government have made it clear that they regard dementia as a priority. With that must come a sense of urgency, but if time scales continue to slip, that urgency must fall into doubt, which would be extraordinarily regrettable. The one aspect of the strategy that I urge the Government to regard as especially important is training. Training applies to various different aspects of dementia, and in various ways to those involved with it. The draft consultation document on the dementia strategy says that it will have three main aims. The first aim will be"““to increase awareness of dementia and remove the stigma associated with it,””" the second to"““ensure early diagnosis and intervention,””" and the third to"““improve the quality of care that people with dementia receive””" There can be no argument about any of those aims, and training is key to delivering the second two. I want to talk about two aspects of training, the first of which is training for general practitioners. They are, as the name suggests, practitioners of general medicine. No one expects them to be experts in every medical condition. However, one of the problems that we face in dealing with dementia is that general practitioners are extraordinarily reluctant to make diagnoses. I suspect that the failure to make such diagnoses is in many cases down to reluctance rather than inability. It is often said—rightly, in my view—that where we are with dementia now is roughly where we were with cancer 30 or 40 years ago. There is sometimes a sense in the medical profession that it is not worth diagnosing dementia because nothing can be done. One of the problems is that that is largely true. There is currently no cure for dementia, and no effective treatments. However, it is not true that absolutely nothing can be done. Any support for or understanding of those with dementia is of such immense value to them and those who care for them that it is worth making any diagnosis as early as possible. If we expect general practitioners to make diagnoses, as we want them to, we will need to give them the training to allow them at the very least to recognise the signs, and to refer patients to a specialist medical practitioner who can then make a diagnosis.