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Vulnerable Older People

Volume 566: debated on Tuesday 16 July 2013

We are taking a great deal of measures to improve services for vulnerable older people, who make up the bulk of the work the NHS does, and in particular to make sure they are always treated with dignity and respect.

I thank my right hon. Friend for his answer. Earlier this year the Care Quality Commission found that people with dementia end up in hospital more often, stay longer and are more likely to die there. What can he do to encourage greater provision of good-quality specialist care places for patients with dementia in the community?

My hon. Friend makes an important point. Nearly 60% of people with dementia are in a care setting, but one of the tragedies is that many of them could continue to live healthily and happily at home for much longer if they were given the support that they needed. Often, however, that support does not arrive until it is too late, when the carer or family member is under too much pressure to be able to look after them. The dementia diagnosis rate at the beginning of this Parliament was less than 40%, but our objective is to get that up to two thirds by the end of the Parliament. Also, we want to ensure that a proper care plan is in place for the two thirds who are diagnosed, so that we can avoid the problems that my hon. Friend has highlighted.

Last week, the all-party parliamentary group on dementia published its report, “Dementia does not discriminate”, which deals particularly with the impact of dementia on people from black and minority ethnic communities. There are now 25,000 people from those communities living with dementia—far more than we expected—yet they often receive their diagnoses even later than people with dementia in the rest of the population. Will the Secretary of State fund an awareness campaign through Public Health England aimed at those communities to drive up the diagnosis rates? Will he also ensure that the clinical commissioning groups are commissioning appropriate support services in those communities so that we can provide proper services for everyone living with dementia?

I congratulate the right hon. Lady, who is a long-time campaigner on dementia issues. She has raised a really important issue, and I will certainly talk to Public Health England about raising awareness. For those groups, as for everyone, we need to ensure that there is a good care plan in place when they are diagnosed. There is some resistance in the GP community to giving a dementia diagnosis, partly because many GPs worry that not much will happen as a result. We need to ensure that there is a good plan in place, and that is particularly the case for ethnic minority communities.

Does the Secretary of State agree that areas that are grappling with the highest burdens of chronic illness and disability should receive the highest NHS allocations? Does he have any idea why the NHS Commissioning Board has rejected the advice of the Advisory Committee on Resource Allocation and decided instead to perpetuate the systematic underfunding of areas that serve older people?

My hon. Friend is absolutely right to say that NHS resources must be allocated in a way that fairly reflects the need for the NHS in every area. Rurality and age are two important factors in that regard. I can reassure him that the current allocations are not set in aspic. The problem with the recommendations from the Advisory Committee on Resource Allocation that NHS England received before was that they would have meant increasing resources to the areas with the best health outcomes at the expense of those with the worst ones. NHS England thought that that would be inconsistent with its duty to reduce health inequalities, but it is looking at the issue this year and we all hope that it will make good progress.

We all know that one of the most important drivers for improving the quality of care for vulnerable and elderly patients is to ensure the adequate training and regulation of health care assistants. That is something that Labour and Sir Robert Francis QC have called for, but that the Government have so far ducked. Will the Secretary of State now accept that crucial Francis recommendation to help to drive up care standards for the elderly and the vulnerable—yes or no?

The reasons that Robert Francis recommended statutory regulation of health care assistants were twofold. First, he wanted to ensure that people who had been involved in incidents of poor care could not pop up somewhere else in the system. Secondly, he wanted to ensure that everyone had proper training. We are going to solve both those problems, but I am not convinced that a big new national database of 300,000 people is the way to do it.