---

Dementia Services

That is very helpful. You heard it here first, Mr. Deputy Speaker. If there is nothing by 3 June, we will be asking the Secretary of State to resign. To echo an earlier point, the Liberal Democrats are firmly committed to sitting down with both the Conservatives and the Government to find a process and a solution to the problem of funding for social care. We all need to commit to doing that in the next Parliament. The publication of the White Paper will be the time to start that process, but it will happen mainly in the new Parliament. On funding for dementia, the Alzheimer's Society has pointed out that dementia services provide excellent value for money, which is an indication that too often we do not consider the value of preventive care. In its 2007 report on dementia, the NAO highlighted that significant money was wasted because of an inadequate response to dementia, which we must take seriously. I am not going to discuss the debates on the Personal Care at Home Bill that took place two weeks ago, because the matter has been dealt with, but people with dementia, and certainly people who have dementia in its latter stages, are in the category of people who will receive care at home. However, many people with dementia are cared for by spouses, partners, friends or neighbours. I made this point in the debate on the Bill, although not specifically with regard to people with dementia, but many people may not be in the Government's figures and may not yet have come forward to say that their loved one qualifies for, and would like to receive, personal care at home. That is a note of caution, because the cost to local authorities may have been underestimated. We need a more robust assessment to include those who might wish to receive personal care at home who are not yet accounted for in the figures. When I first read the motion in the name of the hon. Member for Eddisbury and the Secretary of State's amendment, I was pleased to see that both contain a clear commitment to dealing with anti-psychotic drugs, which are sometimes known as the chemical cosh. My hon. Friend the Member for Sutton and Cheam (Mr. Burstow), who has led on that issue over a number of years, has highlighted that totally unacceptable and too-prevalent practice. According to the Alzheimer's Society report, 77 per cent. of nurse managers and nursing staff said that anti-psychotic drugs were used always or sometimes to treat people with dementia, which is huge figure. I hope it is decreasing, and it would be good to hear about progress. We want a clear commitment not only to review the use of anti-psychotic drugs, which is included in the amendment, but to stamp it out when it is not appropriate. Those drugs have been shown to shorten life, and slow response times, mobility and cognition—of course, they do nothing to treat dementia itself. People are up to three times more likely to have a stroke while under the influence of the drugs. It is frustrating that we are still talking about the matter in that way. I would like a little more from the Minister. Never mind a review; let us have action to stamp it out. Let us educate people and ensure that our most vulnerable people are not being inappropriately treated. Earlier in the debate, someone mentioned inappropriate treatment by the use of a feeding tube. We had the report earlier in the month from the Royal College of Physicians, which said that the procedure should be used only as a last resort, but was all too often being used inappropriately in care homes. The report suggested that the practice could be due to staffing constraints and budgets. Dr. John Saunders, the co-chairman of the working party, said:""In the demented patient it does not prolong life, the treatment is inappropriate and futile. It is actively unethical and dubious."" I am sure that we all agree with that, but it is thought that up to a fifth of patients with feeding tubes have them inappropriately, because either the tubes are futile or the patient could eat normally if given proper care and assistance. It is an absolute scandal that that is still going on in care homes. I ask the Minister to respond on this point and tell us whether any progress is being made. I hope that he will be able to tell us that greater progress will be made. I was amazed to learn that it is estimated that a quarter of long-term patients in hospital have some form of dementia. The medical evidence shows that the longer people with dementia are in hospital, the worse the effect on their symptoms of dementia and on their general physical health. Of course, discharge to a care home or their own homes then becomes more problematic, and there is the danger that anti-psychotic drugs are more likely to be used. I join the right hon. Member for Sheffield, Brightside (Mr. Blunkett) in paying tribute to Neil Hunt for his leadership of the Alzheimer's Society, which has produced an excellent report called "Counting the Cost". Neil Hunt has said that the NHS is not facing up to the challenge of dementia and that there is a need to improve the care given to sufferers. The report finds that supporting people with dementia to leave hospital one week sooner than they currently do would result in savings of at least £80 million a year. Such an approach differs from the usual approach taken in health and social care, but we all need to identify such savings if we are to continue with the commitment to the national dementia strategy that we all want to see. The issue of research is not directly mentioned in the motions today, but I agree with the comments made by several hon. Members that, alongside the issue of care, we need to look at the issue of research. The cost to the NHS of dementia is more than that of cancer, heart disease and strokes put together, but the budget for research is a fraction of that for cancer. We need to listen to Terry Pratchett and the Alzheimer's Society and find ways to provide better care and enable people to function and work for longer through scientific breakthroughs. I ask the Minister for reassurance that we are making progress—even if it is only slow progress, given the recession—towards the £96 million research budget that the Alzheimer's Research Trust estimates is necessary to tackle this appalling range of diseases.