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Air Passengers With Dementia

Volume 611: debated on Tuesday 14 June 2016

Motion made, and Question proposed, That this House do now adjourn.—(Stephen Barclay.)

Thank you, Mr Deputy Speaker, for giving me the opportunity to discuss the important provisions for air passengers with dementia. The last time I was fortunate enough to have an Adjournment debate in this House was last November, when I launched my campaign to save the humble hedgehog. Members may be interested to know that 37,000 people have now signed that petition and we have until August to get the figure up to 100,000. I am hopeful, and I would be grateful if anyone who thinks that a debate on that issue would be useful would sign the petition. I hope that this evening we will be able to make the same amount of excellent progress on dealing with dementia as we have on saving Mrs. Tiggy-Winkle.

Let me give hon. Members the background on dementia. The word “dementia” is scary to many people, conjuring up all sorts of frightening thoughts and visions. Everyone knows someone who has been affected by dementia. Indeed, the hon. Member for Bolsover (Mr Skinner) recently said that one of his greatest fears was to end up suffering from it. The Alzheimer’s Society states that the term “dementia”

“describes a set of symptoms that may include memory loss and difficulties with thinking, problem-solving or language”.

A person with dementia will have severe cognitive symptoms, including: day-to-day memory loss; difficulties concentrating, planning or organising; difficulties conversing; problems judging distances; losing track of their orientation; and changes in their mood. It is a progressive illness, and gradually those symptoms will become more severe. It was predicted in 2015 that about 850,000 people in the UK were suffering from dementia. One in 14 people over the age of 65 suffers from the illness, but it is not just over-65s who suffer from it; people can also get it when they are in their 40s.

While scientists around the world, and especially in the UK, investigate how to combat this condition, excellent work has been taking place to help those with the illness to live lives that are as unrestricted as possible. That is where this evening’s Adjournment debate topic comes in. Inspirational work has been taking place to help people with dementia who travel by air. I wish to pay a special tribute to Ian Sherriff from Plymouth University for all his hard work, and not only on this angle of the dementia debate—I am also thinking of his wider work on helping those suffering with this illness. Ian is the chairman of the air transport group, which was set up by the Prime Minister with a remit to gain a better understanding about people who have dementia and travel by air. As one can imagine, this situation can be quite difficult. If one has an elderly parent or an elderly relative who needs to take an aircraft somewhere, they need to be looked after, and we need to make sure that that happens. The air transport group comprises experts, representatives from airlines, cabin crew members, airports, the Alzheimer's Society, Plymouth, Exeter and Bournemouth Universities and security experts. It is a truly diverse, cross-section of people who have first-hand experience of dealing with those who suffer from dementia. The group will send an interim report to the Prime Minister’s dementia-friendly communities challenge group before the end of this year. I know that the Minister of State, Department for Transport, my hon. Friend the Member for Scarborough and Whitby (Mr Goodwill) is well aware of the excellent work that the air transport group has been doing, having met its members and myself in his Department towards the end of last year, and indeed on several other occasions. We are all incredibly grateful for the time that he has put into this and the interest he has taken.

Airports play an important role in helping people with dementia when they travel. Gatwick airport has been revolutionary in the way that it helps passengers with this condition. People who suffer from hidden disabilities, such as dementia, mental health conditions or autism, should be able to live a full life without fear of losing their dignity. That is why I am so pleased with Gatwick airport and the work that it has undertaken to help those living with hidden disabilities. I urge other airports around the country—and indeed internationally—to take a keen interest in this and to deliver some kind of action as well.

I had to rush to get to this debate, so I thank the hon. Gentleman for giving way. My brother was very seriously injured in a motorbike accident and has brain injuries. Last week, my mother went with him to ensure that he got special attention on the plane and at the airport. By the way, there is a legal obligation on airports to look after anyone who is mentally or physically disabled. There are many people out there who do not know that. In bringing this very important debate to the Chamber for consideration, the hon. Gentleman has raised awareness of this whole issue. When the Minister responds, perhaps he will confirm that there is a legal obligation on airports. Legally, the airports have to help these people get their luggage checked in, and we need to ensure that they do that.

The hon. Gentleman makes a very strong case. As he knows, I sit on the Northern Ireland Affairs Committee, and this is a discussion that we should have at some stage.

I am told that 80% of workers at Gatwick airport are dementia-friendly. Indeed, I am very keen to become a dementia friend myself, but I have a bit of work to do before that will happen. Ian Sherriff has said that he will help me with that.

Gatwick airport has come up with an option for people travelling with hidden disabilities to have a discreet sign, which demonstrates that they may need additional support as they travel through the airport.

I apologise for missing the first part of my hon. Friend’s speech. I was caught out by the early end of the Second Reading debate on the Wales Bill. I pay tribute to Gatwick airport in my constituency for its lanyard scheme, which means that those with hidden disabilities and dementia can be better assisted on their travels through the airport. Does he agree that the airport leads the way in these enhancements for passengers?

Absolutely. My hon. Friend has got that 100% right. Gatwick has been leading the way, but it will be very interesting to see how many emails and letters I get from other airports around the country and in Northern Ireland after this debate. As he says, the lanyard initiative is incredibly helpful, as it identifies those who are in need of help.

Help could also include: giving passengers more time to prepare at check-ins and security; allowing passengers to remain with their family at all times; giving passengers a more comprehensive briefing on what to expect from their travelling experience; and helping passengers to read a departure board or sign. Those are all about patience, and we must try to ensure that we can deliver that sort of help. These passengers may be low on confidence because of their conditions so these subtle yet highly helpful improvements will help passengers to get through what can be the difficult process of travelling through an airport.

As the House will know, national dementia awareness week was last month and the Alzheimer’s Society was on hand at the airport to discuss dementia with travellers and carers. That kind of education should be rolled out across the country. Today, I am calling on other airports across the UK to implement such a strategy of engagement with travellers.

I hope that my hon. Friend the Minister does not mind me speaking about this, but it is my sincere hope that should Plymouth City airport be reopened—I know that his Department is currently studying the viability of such a project—it will become the first regional dementia-friendly airport. I hope that he does not mind me taking this opportunity to press him on that.

I am delighted to report that there are airlines that are taking the issue of flying with dementia very seriously. Indeed the provision for passengers suffering with dementia are covered by both long and short-haul airlines, such as Virgin Atlantic and easyJet. I am acutely aware that easyJet is based in Crawley, in the constituency of my hon. Friend.

I should like to pay tribute to easyJet, whose largest hub is at Gatwick airport, and to Virgin Atlantic, which is headquartered in my constituency. I am fortunate to have such responsible airline companies operating from my constituency.

Flying can be an extremely stressful and uncomfortable experience, both for passengers who suffer from hidden disabilities and for their carers. I pay tribute to carers, as they have an awful lot of work to do to try to make sure that their patients—if that is the right word—are looked after and do not become flustered and so on.

As I mentioned, the lanyard initiative began about a month ago, so I have not seen any data showing the impact of the scheme, but I believe that it will be highly beneficial for travellers. Airports and airlines that show some understanding of the problem will do very much better, and they may want to put a sticker on their products saying that they operate a dementia-friendly service.

Moving forward, my hon. Friend the Minister may want to work with his international counterparts to formulate a globally recognised card or symbol that could be carried around in a passport to subtly tell airport staff and cabin crew that the traveller may need extra assistance. That is something that could be done whether we stay in or leave the European Union next month.

I was delighted to see research and a proposal by Dr Alexis Kirke of Plymouth University, which is based in my constituency, on the in-flight experience for accompanied travellers with dementia. Passenger announcements, in-flight entertainment and other ways to help travellers with hidden disabilities can go a long way towards easing the burden of travel. Proposals include making sure that announcements made during the flight are not distorted—for example, people can wait to make them until the plane has levelled off. Cabin crew are highly trained, but it is helpful to go that extra mile for someone who may be particularly distressed as a result of their condition. Music is also an effective way of helping a passenger with dementia to manage their mood. Perhaps we could have dementia-friendly entertainment systems on flights.

Ian Sherriff has informed me that the air transport group has even deployed its own version of a secret shopper, whereby a passenger suffering from dementia travelled on a flight with their carer. From what I have been told, the passenger and the carer were treated like royalty, and that is something that everyone across the industry should aspire to work towards. However, around the world, there is still much to do to ensure that hidden disabilities are treated with the same urgency and caution as physical disabilities. I pay tribute to my right hon. Friend the Prime Minister for taking a very keen interest in this, and doing a great deal of work on it.

I look forward to the Minister’s response. I have certainly been sent an awful lot of information, and I have been lobbied very hard in the past few days since the announcement on the scheduling of this debate, and I am sure that he has been lobbied too. Will he spell out the kind of help that his Department can give to the air transport group? I should be delighted if he updated the House on his Department’s progress on helping air travellers with dementia. Perhaps he could subsequently tell us how we can try to encourage the train companies to do the same thing. As I have suggested, I should be grateful if he looked further into an internationally recognised card for travellers with hidden disabilities. Will he make a commitment to mandate that all airports in the UK become at the very least hidden disability aware?

I have been involved in the fight against dementia since I was first elected to Parliament in 2010. I am delighted to be a member of the all-party parliamentary group on dementia, and I have sought to become heavily involved in the issues surrounding hidden disabilities such as dementia, mental health and autism.

This is a very personal issue for me. I had a stepmother who was taken into a home because she was suffering from dementia. Sadly, she died within the past five years. She was incredibly bright, had served at Bletchley Park and got a degree at Oxford University in the 1930s. One of the things that was very interesting about her was that while she was working at Bletchley Park, she followed a man called General Kesselring, who was in charge of the north African campaign for the Germans during the war. He was put on trial at Nuremburg and sentenced to death. The court then got hold of her translations and worked out that he probably did not know too much of what he was doing under his own command, and his sentence was therefore commuted to life imprisonment. Before my stepmother died, the Prime Minister sent her a plaque commemorating her activities at Bletchley Park.

My city, Plymouth, has been at the forefront of dementia research and Plymouth University has just employed a PhD student on the very topic of air travel for people with dementia. I understand that she will be producing a dissertation of 80,000 words. Do I want to read 80,000 words? Nevertheless, I am sure it will be incredibly good. The House will be delighted to know that my contribution will be much less than that this evening.

I hope that over time the UK will ensure that all people with hidden disabilities are treated with the dignity and respect they deserve. After all, we all grow older and we do not know whether we may suffer from dementia in the future. We must come to terms with the fact that long-term care for the elderly will probably affect all of us. I shall be interested to hear how the Government intend to move forward. The Secretary of State for Health has done an extremely good job on that. I look forward to hearing the response of my hon. Friend the Minister.

Thank you for calling me, Mr Speaker. I am grateful to my hon. Friend the Minister and my hon. Friend the Member for Plymouth, Sutton and Devonport (Oliver Colvile) for allowing me to intervene briefly.

My wife was assaulted by a dementia patient on a British Airways flight exactly a year ago. She will not be pleased that I am raising the matter. I will not go into the precise details, but it seems so relevant after what my hon. Friend has said. This time last year we were all gathering here after the general election. One of our daughters who lives in America was graduating the day after the election, so it was a bit stressful to get out to Charleston, where she is. My wife had to go ahead and I followed, and it was all wonderful. My wife was recovering from breast cancer which, thank goodness, is all right, so she was in a pretty emotional state.

Because we had been told that there would be a hung Parliament, I thought we might be returning slowly together, but because there was a Conservative majority, I had to get back more quickly than my wife. Then the nightmare started. She took a night flight with British Airways. She was at the back of the plane with two empty seats next to her. The plane was delayed and eventually, after a kerfuffle, an elderly gentleman was brought on to the plane somehow and was seated next to my wife. I will put it like that. All I will say is that when everyone nodded off, she woke up and was assaulted. I am not going to enlarge on exactly what went on.

If Lord King were alive today, he would be horrified at the way that British Airways has dealt with this complaint. My wife is not someone to make a fuss, but I am. I will not let this matter drop; I shall deal with it through the small claims court. I made the complaint in June and did not get a decent reply from the executive chairman until 7 October. That is disgraceful.

The police, whom I eventually dealt with, said:

“You will be aware from our previous correspondence, that having liaised with British Airways, we were able to identify the passenger who is alleged to have assaulted”

my wife. They continued:

“We established that this male passenger is ninety years old and suffers from dementia. As part of our investigation we needed to ascertain if the suspect was fit to be dealt with by police, and further to that, to establish whether he would have an understanding of the allegation made against him.

We have since been provided with medical evidence that indicates the suspect’s dementia impacts on his ability to complete even basic mental tasks and that his dementia is likely to have impacted on his behaviour on the day of the assault.

In addition to the medical evidence, we were also able to refer to knowledge held about the suspect through previous police contact with him. The suspect has previously been reported as a missing person, and on that occasion, was located after members of the public reported him lost, disorientated and confused, wandering residential areas.”

The chairman of British Airways wrote:

“I hope you will appreciate that British Airways can only know details of a passenger’s medical condition if the passenger, or some other person acting on the passenger’s behalf, discloses this information to us. Having checked the booking record in relation to this passenger, no disclosure of any medical condition was made.

In the reports from the ground staff at Los Angeles and the cabin crew operating this flight, there was nothing in the passenger’s behaviour or bearing, other than he was obviously very elderly, to give any reason to believe that he suffered from any mental health issues. As such he was treated in the same way as any other passenger”.

It is absolute rubbish.

Then there is the final insult:

“Even had British Airways been aware of any medical condition affecting this passenger, it would have been inappropriate, and possibly in breach of data protection legislation, to disclose details to any other passenger. Additionally, we do not ordinarily consult with passengers as to who may be sat next to them during a flight.”

So there we are: my wife, at the back of the plane, is the mug. This is our national carrier—the best airline in the world, as far as I am concerned—and that is the quality of the response to someone who has been democratically elected. I therefore congratulate my hon. Friend the Member for Plymouth, Sutton and Devonport on introducing the debate, and I am totally with him on his campaign.

I start by congratulating my hon. Friend the Member for Plymouth, Sutton and Devonport (Oliver Colvile) on securing this debate about provision for air passengers with dementia. This important issue touches many of us gathered here this evening through our friends and family, and certainly through our constituents. I must admit to encouraging my hon. Friend to apply for the debate because it is important that we get the subject raised on the Floor of the House. The debate gives me an opportunity to say why the Government take this issue so seriously.

Before I do, however, let me briefly address the disturbing case raised by my hon. Friend the Member for Southend West (Sir David Amess). I will not comment on the case in detail, but it does underline why it is so important that patients with this type of problem who are travelling, particularly on long-distance journeys, have a carer with them. In almost every case when I have meet someone in relation to our role of helping people with dementia, that person is accompanied by a spouse, family member or friend who can help them. From what I have heard, it verges on the irresponsible to expect somebody with such a condition to fend for themselves on these flights.

I am aware of the case of a lady with a baby who was travelling with her mother who had dementia. This was not long after she had given birth and she was quite traumatised by being on the plane. When she was not able to cope, the airline staff had to come to help the mother and the child, so there is an onus on airline staff to be able to assist the carer as well.

Yes, absolutely. Many airlines and airports are taking the training of staff very seriously indeed.

I will start by briefly going through the statistics, some of which we have heard already. We live in an ageing world, and we Europeans are living ever longer. A Eurostat survey forecasts that in 2040, if current trends continue, 25.5% of Europe’s population will be 65 or over. In 2015, that figure was only 16%. With an ageing population, we will face new challenges. It has been estimated that more than 850,000 people in the United Kingdom suffer from dementia, and that figure is expected to rise to over 1 million by 2025. While dementia is usually linked to old age, it is not, as we have heard, solely an age-related condition. Indeed, today in our country, over 40,000 people under 65 years of age live with dementia.

Those are big numbers, but how do they relate to air travel? As we have heard, the word “dementia” is used to describe a set of symptoms that affect the brain. These symptoms may include memory loss or difficulties with thinking, problem solving or language, all of which will lead to everyday life becoming more and more challenging. However, suffering from dementia does not, and should not, mean that one should automatically cease to enjoy the activities we are all used to. Generation after generation, we are travelling more, exploring the world and gathering new experiences. For some, it is a lifestyle, but if one gets diagnosed with dementia, there could be a daunting decision to be made, either personally or by one’s family, to stop travelling altogether or to face a travel experience in all its complexity. For dementia sufferers, air travel, in particular, can be confusing, unnerving and even frightening. Crowded terminals, loud noises, queues, security checks, and armed policemen and women are enough to confuse a healthy person from time to time, never mind a person with a hidden disability. The term “hidden disability” is used to cover a wide variety of conditions that are not evident, such as dementia, autism, learning difficulties and hearing loss. According to Civil Aviation Authority research, as many as 7% of all British people are potentially avoiding air travel because of a hidden disability; we would like to get that number down to 0%.

On helping us to reach this goal, there is a piece of European legislation called regulation EC 1107/2008, which concerns the rights of disabled persons and persons with reduced mobility—PRMs—when travelling by air. The aim of this regulation is to ensure that such people have the same opportunities for accessing air travel as non-disabled people, and that they have the same rights to free movement, freedom of choice, and non-discrimination. To ensure that that happens, airports and airlines are required to provide assistance that is appropriate to the needs of the passenger and that enables them to move through the airport while they travel. A person with reduced mobility is defined in the regulation as

“any person whose mobility when using air transport is reduced due to any physical disability (sensory or locomotor, permanent or temporary), intellectual disability or impairment, or any other cause of disability, or age”.

The regulation does not differentiate between physical and non-physical conditions, so assistance should take into account the needs of the person who has requested it.

For passengers with a physical disability, assistance needs are quite often visible and straightforward to provide—for example, a person who uses a wheelchair will require a wheelchair and a person to push it. However, with hidden disabilities, the needs of passengers vary widely, and the provision of the service could require adaptability from the provider. Some passengers may need only information and reassurance, while others may require a one-to-one escort through the airport. This can make planning challenging for service providers. In 2015, the CAA engaged with airports on the provision of assistance to passengers with hidden disabilities and found a wide variation in practices and standards. While it was acknowledged by all that there was no “one size fits all” solution, it was concluded that airports would benefit from sharing best practice among themselves, which will help airports to standardise some practices and plan their service effectively.

Furthermore, it was concluded that it would be beneficial for the CAA to clarify what it views as the obligations under the PRM regulation. I am glad to say that the authority has been working hard on that issue and has engaged with a broad set of charities during the past year to develop guidance on the minimum expected standards and practices that all airports should adopt to comply with the regulation. The CAA has published that guidance for consultation, which is due to end in July.

I made some investigations before coming to the Chamber and understand that airline companies and airports have a legal obligation to ensure that every person with a hidden disability is looked after totally and absolutely. Is that the Minister’s understanding as well?

Transport is an international pastime and occupation, so there is a European regulation. As I have said, it applies not only to the physical disabilities of wheelchair users, the blind and people with sight disability, but to people with hidden disabilities. That is the whole point of the clarification that has been laid down, and the CAA is keen to ensure that airlines and airports discharge their obligations under the legislation.

The CAA guidance will ensure that a level of standardisation is adopted by all airports, which will bring huge benefits to this group of passengers. It sets standards not only for the actual assistance that is delivered, but for the information given to passengers before travelling and the level of training that staff are expected to be given.

The CAA has reported that the guidance has been welcomed by the airports and some of the obligations in it have already been implemented. For example, many airports—including Belfast City, Heathrow, Gatwick and Birmingham—have introduced guidance, in the form of videos, leaflets and pictures, that is specifically aimed at passengers with hidden disabilities. With that guidance, passengers and their carers can familiarise themselves with the processes beforehand, which has the potential to relieve the anxiety that some feel when facing an unknown environment. When I spoke at the Airport Operators Association dinner on 1 March, I made the issue the major theme of my comments and made a call for action from the airports.

Many airports already allow passengers with hidden disabilities to use fast-track security or are prepared to open separate security screening for those passengers upon request. Security screening has been identified in the past as one of the most stressful parts of the journey, which has the possibility of causing immense distress and anxiety.

There are other great examples of individual airports going above and beyond minimum obligations. For example, as we have heard, Gatwick airport has introduced discreet lanyards for passengers with hidden disabilities. The lanyards are a means for a person with hidden disability, such as dementia, to communicate their condition to the airport staff. That, combined with Gatwick’s commitment to provide appropriate training to all front-of-house staff, shows that there is willingness in the industry to encourage this group to travel more. More than 80% of Gatwick’s front-line staff have received dementia friends and dementia champions training, and that training is being delivered at one of this country’s biggest airports.

Gatwick is by no means the only example. Manchester airport already has special wristbands for autistic children. Norwich airport has signed an autism charter to become an autism-friendly airport. Virgin Atlantic is committed to considering the effects that long-haul flights might have on passengers with dementia, and easyJet has provided outstanding customer service to dementia sufferers, thanks to its commitment to staff receiving dementia awareness training as part of its special assistance training package.

The industry has truly embraced the challenge, and we want to see the good work spread across the sector. The UK can be proud to say that it leads in this area. We have recognised how the airport experience can feel intimidating for people with hidden disabilities. The UK and specifically the CAA, together with a few proactive UK airports, have been first to grasp that and to take action. Other European Union countries will surely follow our lead in due course.

Many of our country’s airports have reached out to the disabled charities to learn more about how they can make the experience better for people with hidden disabilities, and I strongly encourage the continuation and strengthening of this relationship. For example, the Alzheimer’s Society does a magnificent job in promoting awareness of dementia and could be an invaluable aid to the airports when they plan services.

Another group that I must mention for its substantial effort in tackling this issue is the air transport group, chaired by Ian Sherriff of Plymouth University, which is part of the Prime Minister’s rural dementia taskforce. The group, which was founded last year, has already shown remarkable commitment and speed in its task of promoting awareness in this field and encouraging travel.

Motion lapsed (Standing Order No. 9(3)).

Motion made, and Question proposed, That this House do now adjourn.—(Sarah Newton.)

The air transport group has engaged with the CAA, the airports and the airlines, and is now looking at the wider tourism field. As my hon. Friend the Member for Plymouth, Sutton and Devonport said, Plymouth University is funding a PhD student to research dementia and travel over a three-year period. A substantial amount of evidence is expected as a result of her work, and I would be delighted to meet her as part of the process. In addition to Plymouth, Exeter and Bournemouth Universities are also involved in the work of the group.

There truly is momentum behind this work and I am glad to see such progress being made. As I said, we are a leading nation in Europe in this field, but we need to keep the momentum going. The CAA’s guidance helps in setting the standards for airports and similar guidance is planned for the airlines in the near future. I encourage every operator in the industry to engage with dementia passengers and organisations, and to strive not for the base minimum, but for excellence beyond.

My hon. Friend mentioned the provision of a globally recognised card, which is a good idea. A pin badge might be even more discreet, while still being able to be seen. Indeed, people with dementia could be recognised in such a way and given special help not only in airports, but in the retail sector and in other aspects of our everyday life where it would be helpful to know, discreetly, if a person has dementia and may need a little more help if they appear confused. We certainly need to raise that idea through the European Union or the International Civil Aviation Organisation, which has an even wider reach.

As I stated at the beginning of my speech, there are hundreds of thousands of people with dementia in this country. Getting the assistance standards right, and raising awareness of what is available and what to expect when travelling, will unlock the huge potential that this group could bring to the industry. Encouraging dementia sufferers to travel in this way will make their lives and those of their carers, for whom a break from the routine can be a lifeline, that much richer, and that is worth fighting for. Once again, I thank my hon. Friend for securing this debate and providing an opportunity to discuss this important and, to many, very personal issue.

Question put and agreed to.

House adjourned.