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Dementia Services

Last year, Mr. Paul Cann, the director of policy and external relations for Help the Aged, described dementia as""fast becoming the hidden epidemic of the 21st century"." The more debates that we have in this place on the matter, either in Government time, or, as in the case of this afternoon, in Opposition time, the better. The subject needs to be aired and taken extremely seriously and should, on the whole, be non-partisan and non-political, difficult though that is to believe at times. One does not need the mathematical skills that I attribute to the hon. Member for Broxtowe (Dr. Palmer) to work out that, looking at isolated demographics, the problem is set to grow rather than recede. In my constituency, 29.5 per cent. of the population is retired, against a national average for the rest of England of 17.3 per cent. In my constituency, I have the retirement destinations, as they are called, of Budleigh Salterton, Sidmouth, Exmouth and so on, so the pressures on local services are huge and set to worsen. The Government's national dementia strategy, which is a year old, is, of course, a good thing. I welcome it, although it is belated. It contains important elements that need to be expanded. In the limited time available to me, I shall try not to go over ground covered in this comprehensive debate, but I say, again, that early diagnosis is crucial in the treatment of dementia. The more these memory centres—or clinics, as some hon. Members have erroneously called them—can be rolled out across the country, so much the better. The savings that an early diagnosis can make, in terms of both human suffering and the economy, are huge and should not be underestimated. We have, again, touched on better training for GPs. Some GPs are crying out to be retrained or trained in spotting the early signs of dementia, and they should be assisted in that without delay. I wish briefly to discuss research into dementia. The hon. Member for Broxtowe said that we are in a global research environment and to an extent he is right, but it is worth pausing for a moment to remember the following:""National Institute for Health Research investment in dementia research amounted in 2007-08 to £22.2 million. The Medical Research Council (MRC) spent £10.2 million on dementia research in the same year. This total expenditure of £32.4 million amounts to some 2.5 per cent. of the combined departmental research and development and MRC expenditure for the year."—[Official Report, 5 February 2009; Vol. 487, c. 1502W.]" Those are significant figures, but they pale into insignificance when one considers the sums that are rightly spent on research into cancer and other diseases. Although we are part of the global research family, we need to examine that. I hope that the Minister will not accuse me of ignorance in quoting those figures, because they are figures that he gave me in answer to a written parliamentary question. I welcome the appointment of a dementia tsar. The Government's record in appointing tsars over the years has been about as successful as the Russians', and I hope that those tsars will not end up in the equivalent of Ekaterinburg. The appointment of Professor Alistair Burns is welcome, and I hope that he can co-ordinate the many different approaches to the treatment of dementia. My hon. Friend the Member for Tiverton and Honiton (Angela Browning), who has had to absent herself this afternoon, made an extremely good point when she said that every primary care trust should have a dementia champion who can also help to co-ordinate things on the ground. I wish to discuss a subject that we have not spent enough time on: objective 7 of the Government's national dementia strategy, which is on "Implementing the Carers' Strategy". It states:""Family carers are the most important resource available for people with dementia. Active work is needed to ensure that the provisions of the Carers' Strategy are available for carers of people with dementia. Carers have a right to an assessment of their needs and can be supported through an agreed plan to support the important role they play in the care of the person with dementia. This will include good-quality, personalised breaks. Action should also be taken to strengthen support for children who are in caring roles, ensuring that their particular needs as children are protected."" The hon. Member for Bridgend (Mrs. Moon), who is not in her place, talked about the spectrum of dementia. The hon. Member for Broxtowe, in a personalised contribution, talked about the good humour that the sufferer often has. What unites the carers is that they are often the ones who suffer most in all this. An estimated 600,000 people in the UK are acting as the primary carers for people with dementia. Two thirds of people with dementia live in their own home and one third live in a care home, thus the majority of people with dementia are probably being cared for either by professional carers or by members of their own family. It is estimated that the saving to the taxpayer is about £57 billion a year, but with that often comes a cost to the carers. Evidence has been found of carers dipping into their savings that they have put aside to help care for the person with dementia, which reduces what they have to look after themselves in later life. It has also been found that 65 per cent. of people with a caring responsibility do not identify themselves as a carer in the first year of care—such people are often referred to as the "hidden carers". It is not just that category of people who are hidden carers. An awful lot of people who still believe in the family and look after their partner—their husband or wife—would never dream of regarding themselves as carers. Such people regard themselves as being a husband and wife and it being part of their duty to look after their lifetime partner. They also deserve our support. Interestingly, and sadly, about one in five of the nation's 4.4 million careers of working age have to give up their employment in order to care. Many carers of people with dementia are older people who have physical frailty and health conditions of their own. At a dementia seminar in Exmouth earlier this year, I met one lady—she was not complaining and did not necessarily want more help from the state—who has looked after her husband for 20 or 30 years, which is a life sentence. She does not regret it in any way, but she is becoming increasingly frail and in need of support. Such people are often the unsung heroes and heroines of this tragic tale. Nearly 45 per cent. of working age carers say that they would like to work, but 38 per cent. say that they cannot work unless the right care services are in place for them. Between 40 and 50 per cent. of working carers say that a lack of flexibility and sensitivity in the delivery of services hampers them in obtaining support. I touched on the question of child carers earlier, and it is incumbent on us to take that issue seriously. Children who end up as carers often get overlooked, but their own education and passage into adulthood gets compromised in some way. I have also alluded to Admiral nurses, who are fantastic. We need more of them, as they do a magnificent job, but I shall not dwell on that point. I wish also to discuss respite care, which has been mentioned again today. Carers of people with dementia, probably more than any other category, need respite, if only to take some time off to go for a walk with the dog, to have their nails done or to go to the hairdresser. They just need to have a little bit of the life that they once had back, as that will, in turn, make them better carers. However, too often, we have seen day centres up and down the country close. The other day, I went round Stowford lodge in Sidmouth, in my constituency, which is used as a day care centre by people with dementia. Some of its bedrooms were being used as storerooms, but that is criminal. Surely this country should have a system in place whereby any beds in a purpose-built care centre should be available for overnight respite. It is incumbent on all political parties—this is a challenge for not only the current Government, but any future Government—to find a way to finance this properly in order to care for these extraordinarily vulnerable people. Charges hit people with dementia hardest for four reasons: care is more expensive in care homes and two thirds of people in them have dementia; more dementia care comes from social services, and that is means-tested; people can need care for extended periods; and end-of-life care for dementia often takes place in a care home, rather than in a hospice or hospital. It is worth making the point that if somebody with cancer needs chemotherapy or surgery, or if someone with heart disease needs a heart bypass, that is provided free on the NHS, but if someone has a disease of the brain that causes dementia, their care is often provided by the local authority and is means-tested. I do not want to revisit the case of my constituent, Mr. Mejor, on which the Minister accused me of being ignorant.