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Care Homes

My hon. Friend earlier drew attention to what Laing and Buisson identified—namely, fragmented training at specialist units in this country—and also rightly identified from that research the fact that many of those homes do not have formal training programmes. I hope that the Minister will say something reassuring about how the new inspection regime will ensure that that finding does not become a long-term trend. The Minister knows that for some years, I have raised questions about the appropriateness of using anti-psychotic medication in care homes, and I was pleased last year when his predecessor, the hon. Member for Bury, South (Mr. Lewis), announced a review of their use in the draft dementia strategy. The terms of the review, as I understood them at the time, were not so much to ask whether change was needed, but to plan for change. Although the review was and is long overdue, it was and is welcome, because those drugs reduce people's quality of life, increase costs due to the need to treat side effects and cut lives short. It is surprising that we tolerate the continued use of drugs off licence for a purpose that a growing body of evidence suggests is not appropriate in the long term. We know, however, that 100,000 people are routinely prescribed them and, from academic studies, that perhaps as many as 23,000 people die prematurely because of their excessive and inappropriate use. I hope the Minister will state when we might see a light at the end of that tunnel—when we will see the action plan that will produce the necessary change to practice. That brings us to the wider issue of dementia, its care management and the study that Laing and Buisson published today, identifying the training issues that we have already talked about. I want to ask the Minister about the dementia strategy, because it is not a national strategy. It is not a national must-do: it is not in the Department's strategy framework as something that must be done; it is on the framework's next tier as something to be decided locally. Local decision is generally a good thing, but, on the national strategy that the Minister has rightly advanced, I should like some clarity about timelines, because that is what my constituents expect. I want to ask about the implementation programme board, which I understand has not met yet. I assume that it will have a monitoring role, even if it will not provide an overly disciplined and prescriptive framework, because that is not the Government's intention. When will its terms of reference and membership be finalised? There is a meeting on 31 March of the other body that is responsible for such matters That must mean that the implementation programme board will not meet this month, and that yet another month will have gone by without the monitoring framework to drive the strategy forward having been published. It would be good to hear what the Minister has in mind. [Mr. Edward O'Hara in the Chair ] I shall touch briefly on nutrition. A couple of weeks ago, the hon. Member for Eddisbury (Mr. O'Brien), the official Opposition spokesperson, and I addressed a meeting organised by the British Association for Parenteral and Enteral Nutrition, which has conducted some very good research, demonstrating malnutrition's burden on our taxes. The group has created a nutrition action plan, which the Minister is considering. Until he has done so, however, he is unable to confirm whether that group will be able to continue tackling malnutrition in a multi-agency way, so it would useful if he said whether he believes that it has done a good job and whether he will allow it to continue. From written parliamentary answers, I am surprised that malnutrition data are not routinely reported to Ministers or senior officials, and that there is no regular auditing of the adequacy of data that are collected. It seems extraordinary that while we focus on obesity, we know that there is a £13 billion cost associated with malnutrition. Surely, that should be addressed.