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Health: Dementia

Volume 719: debated on Thursday 3 June 2010


Asked By

To ask Her Majesty’s Government what are their plans to implement the National Dementia Strategy.

My Lords, I beg leave to ask the Question standing in my name on the Order Paper. In doing so, I declare an interest as a member of the advisory committee on dementia research.

My Lords, dementia is one of the most important issues we face as the population ages. We are fully committed to improving the quality of care for people with dementia and their carers. We will accelerate the pace of improvement through a greater focus on local delivery and accountability, and empower citizens to hold local organisations to account.

I thank the noble Earl for that encouraging reply. How will the Care Quality Commission be strengthened and aligned with the strategy so that it can support the development of better quality social care, particularly for dementia? As I understand it, there are plans to stop the star rating system in favour of a new registration scheme.

My Lords, the Care Quality Commission is revising its current quality rating system for adult social care and is working closely with the adult social care sector to develop a more user-friendly system that provides people using services with the information they need to make decisions about their care. That is absolutely in tune with the work being done in the department on driving up quality standards in dementia care. Better information for people with dementia and their carers will enable individuals to have a good understanding of their local services, how they compare with other services and the level of quality that they can expect.

My Lords, will the Government maintain the e-learning packages developed in palliative care to enhance end-of-life care for people with dementia across health and social care, and will they respect the agreement that those packages should be rolled out in Wales? I declare an interest as the palliative care lead for Wales.

My Lords, it so happens that only yesterday I received a briefing on the e-learning programme, and I am well seized of the value attached to it by the royal colleges in particular as well as many other professional bodies.

Does the Minister agree that respite care is extremely valuable, but can he say what help there is for people whose dementia has developed into violence? What can be done for those who wish to keep such patients at home, but find themselves in a very frightening position? Can they be given any respite?

My Lords, my noble friend has raised an important issue, and one which we are giving consideration to. We recognise fully that breaks from caring are one of the top priorities for carers in terms of the sort of help they want. Supporting the physical and mental well-being of carers by giving them breaks obviously enables them to do their job more safely and effectively, and can keep families together. But where violence intrudes, it is often an intractable problem. I hope to be able to give my noble friend more details once we have given this area the thought that it deserves.

My Lords, we are at the beginning of the second year of what is in fact a five-year dementia strategy, which is what the noble Baroness, Lady Greengross, referred to in her Question. Some £150 million was earmarked for the first two years of the strategy. Is that £150 million safe, particularly the £90 million for 2010-11, and do the Government have plans to implement the rest of the five-year strategy?

My Lords, the answer to the specific question about whether the money is safe this year is yes, but we want to ensure that the strategy is sustainable over the following three years. We will do that principally by driving up quality standards through a tariff for dementia patients, by better regulation of providers and by better commissioning of services, including public health interventions. Alongside that, as I said to the noble Baroness, Lady Greengross, we plan to provide better information to people with dementia so that they have a good understanding of their local services, and local organisations will be expected to publish how they are delivering on those standards.

My Lords, the strategy is set out in an ambitious and sophisticated document that says that it is not just for five years, but that:

“There is no expectation therefore that all areas will necessarily be able to implement the Strategy within five years”.

I wonder if, even at this early stage of the coalition Government, my noble colleague has been able to identify whether all 17 objectives are to be carried forward at the same time or any priority areas that might be moved forward more quickly.

We are looking at the implementation plan at the moment. I say to my noble friend that there are perhaps four key dementia priorities for us. One is promoting awareness and early diagnosis and referral; the second is the care of people in hospital; the third is the care of those in care homes; and the fourth is a reduction in the use of anti-psychotic medication. That is not to say that the other objectives are trivial—by no means—but we think that these will yield the most tangible results in the shorter term.

My Lords, does the noble Earl accept that we are all familiar with frequent reports of research into other diseases, but much less so with research reports into dementia? Will he keep in mind the importance of developing more effective research into this growing problem?

My Lords, we will be giving increased priority to dementia research. The work of the Ministerial Advisory Group on Dementia Research, in which the noble Baroness, Lady Greengross, is playing an important part, is key to that. The group is time-limited but very focused. We anticipate that once it has completed its work the dementia research community will be better positioned to compete successfully for available funding opportunities.