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Dementia Services

I can certainly say to my hon. Friend that we are proud of our NHS. We also, though, value the contribution made by voluntary sector and private sector providers. We have read reports about donations given to the Conservative party; I do not know the rights and wrongs of that. However, I do know that it raises a question about the independence of policy making by its shadow Front-Bench team. Well over a week ago, I wrote to the right hon. Member for Witney (Mr. Cameron) to ask him to give me assurances that that independence is not compromised—[Interruption.] Well, we need to know. I asked what safeguards have been put in place to remove any perception of a lack of independence. If I had had a reply to that letter, perhaps I would have been reassured by now, but I have not—am I not owed one so that I do not need to raise this matter? My hon. Friend makes an important point. It is interesting to see the company that the Conservatives are keeping, particularly people who repeat the claims about the NHS being a Stalinist creation. I entirely support the NAO's recommendation for acute hospitals to identify their clinical lead for dementia by the end of March. We are making real progress, but there is a long way to go. I can tell the House that the Minister of State, Department of Health, my hon. Friend the Member for Corby (Phil Hope), who is responsible for care services, and I are putting a determined and relentless focus on these services to achieve the transformation that we want to see. To help us, we have Martin Green as our dementia champion for the independent sector, and only last week we appointed the first ever national dementia clinical director, Professor Alistair Burns. Alistair will take forward our response to the anti-psychotics review to implement all its conclusions and recommendations, leading to reduced use of these drugs in the management of dementia. He will lead on the national audit of services and the action plans that follow. I pay tribute to my hon. Friend the Minister, who has driven forward work in this area and, indeed, commissioned that review by Sube Banerjee. As we approach the first anniversary of the strategy's launch, I am confident that we are on track to deliver our goals. I have described the NHS and social care services that I want to see in the coming years—services that are high quality and efficient, preventive and people-centred. Providing effective early support for people with dementia is a vital part of that vision. We now have the evidence to show just how crucial early invention can be. The partnerships for older people projects helped more than 250,000 older people, enhancing their quality of life, improving local working relationships and providing efficiency savings for the entire health and social care system. The evaluation of the projects was published earlier this month. It showed that through early intervention, they cut overnight stays in hospital almost by half, cut accident and emergency attendances by just under a third, and cut clinic or out-patient appointments by more than 10 per cent. For every £1 invested in prevention, there was an average saving of about £1.20 in emergency bed days. In fact, it was found that there was a £1.40 saving for secondary and tertiary prevention and a 70p saving for primary prevention services. This shows that even well-being services can deliver efficiency gains. Taken together, that makes a compelling case for changing the way in which we spend health and social care resources, as the hon. Member for Castle Point (Bob Spink) rightly said. As we reform services, we must strive to give people more choice, convenience and control over their care, to put quality at the heart of our services, and to take more early, preventive action to keep them healthy and in their own homes, which is where the vast majority of people want to be. That is what our Personal Care at Home Bill is all about. Through this Bill, we want to provide support to more than 400,000 of the most vulnerable people in our constituencies, including people with dementia, to help those with the greatest needs, who require intimate personal care in all aspects of their daily lives. In many cases, they will already have paid significant sums out of their own pocket towards the costs of their care as their condition has deteriorated. Their family and carers will have faced considerable pressure in recent times as they have battled to get the help that they need or sought to balance the demands of their own lives with looking after a loved one. The Bill will provide powers for people to receive intensive support to prevent them from developing more serious needs. It will help them remain healthy and independent in their own homes and extend their quality years of life. The Bill has two clear aims. The first is to end the lottery in home care for the most vulnerable people in our communities, and the second is to pave the way for a bigger reform of social care in the next Parliament and the creation of a national care service. There has been a long process of reform since 1997. We have committed unprecedented levels of grant increase to fund investment in local council services, achieved real success in improving service quality and introduced radical reform to personalise services, including individual budgets that give people control over their own lives. However, we know that a more radical approach is needed. The people with the highest needs still face the greatest costs, and we now have a chance to build a better future for them. People need and expect health and social care services to work more closely together. They want seamless services, and they do not want to be passed from pillar to post before they receive them.