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Dementia: Accident and Emergency

Volume 802: debated on Wednesday 11 March 2020


Asked by

To ask Her Majesty’s Government what steps they are taking as a result of the analysis published by the Alzheimer’s Society on 22 January showing a 34.5 per cent increase in the number of people with dementia being admitted to accident and emergency departments in 2017–18.

My Lords, we are implementing our Challenge on Dementia 2020 commitment to make this the best country in the world to live with dementia. The NHS long-term plan commits the NHS in England to improving the care provided to people with dementia and their carers, including through supporting people in the community and avoiding unnecessary admissions to hospital. People should receive high-quality care in hospital and be discharged in a timely and appropriate way.

I thank the Minister for his response and congratulate him on behalf of these Benches on his confirmation in his post. We look forward to continuing the good and constructive working relationship we have had with him since he took up this brief.

These findings from the Alzheimer’s Society research are truly shocking. The 34% increase in emergency admissions of dementia patients to A&E departments represents an increase of 100,000 patients over five years—the equivalent of over 1,000 patients each day. Much of this is the result of the scarcity of appropriate care support in the community or of care home places able to provide the specialist dementia care that is needed. Does this not also underline the scale of the problem the NHS faces in freeing up hospital beds to address demands from future coronavirus hospital admissions? What is the Government’s strategy for ensuring the continuing care for people with dementia in the coming months and in the longer term? Will further guidance and funding be issued to hospitals and care homes specifically to deal with this situation?

The noble Baroness will be aware that the identification of dementia patients in England has risen dramatically from 42% to 67%, which more than accounts for the increase in the Alzheimer’s Society’s numbers. We are, however, concerned about this issue and remain focused on pulling together a new challenge on dementia strategy for the next five years and on ensuring that beds are liberated in a timely and reasonable fashion.

Coronavirus is naturally a matter of high concern in our preparations. Care of existing vulnerable and lonely people and the elderly is a massive priority, and we are putting in place plans to provide that care.

My Lords, if the care of people with Alzheimer’s and other conditions is such a priority, why have the Government not responded to the Economic Affairs Committee report on social care which came out seven months ago, and why was there nothing in an otherwise excellent Budget speech on social care, which we have been promised now for year after year after year?

The noble Lord is quite right to point out the delay in providing an answer on social care. That is why the Secretary of State for Health and Social Care wrote to Peers earlier this month, initiating a round of cross-party conversations and putting in the diary the beginnings of a process to pull together cross-party agreement. That cross-party agreement is essential to providing a long-term solution to this important problem.

My Lords, I want to pick up on the point of the noble Lord, Lord Forsyth, about the lack of any extra funding for social care in the Budget. There was a reannouncement of just over £1 billion from before Christmas, but the Local Government Association states that social care generally needs about £4 billion to be able to maintain any sort of service to meet demand, which rises to £14 billion by 2030. Just saying that we are getting together to start to talk about social care problems is not enough. Where will extra money come from to remove people from hospital who do not be need to be there and to fund social care properly?

The noble Baroness is entirely right to say that this is an important issue. Short-term funding has been put in place for the best possible short-term arrangement, but this is a long-term problem that cannot be solved by any Government on their own. It requires cross-generational and cross-party agreement. That is why an important and well-organised set of engagements has been initiated. It is timetabled, and the Government have committed to action in this area.

My Lords, does the Minister agree that it is most unfortunate, to say the least, that many of the staff who are caring for patients with Alzheimer’s disease and other forms of dementia have been classified as unskilled? Most people who have experienced those services and met the staff involved recognise their skill and the contribution that they make to their fellow citizens. They should be valued.

The noble Lord makes an important point. I completely sympathise with it. Low paid does not mean unskilled or unvalued. We are looking at the classification, but I should like to communicate the value that we put on the people who care for those we love and the importance they play in our society.

My Lords, will the Minister consider a meeting of the British-Irish Council to deal specifically with the rising level of dementia cases throughout our devolved institutions, as well as England, with special reference to social care and the need for investment in it? It is urgently required.

The noble Baroness is quite right that this issue is not limited to England. The devolved Administrations are very much focused on it. I will look into the relevance and possibility of the kind of meeting she describes.

My Lords, will the Minister say what today’s announcement of a freeze on alcohol duties—a continuation of the policy that the Government have pursued since 2012—will do to aid Alzheimer’s? Will it increase it or lessen it? What research is now being done to indicate that there is a clear link?

This Government are committed to science-based policy. There is undoubtedly a link between personal behaviours and outcomes later in life. Public policy should be aligned to create the best possible outcomes for all people in Britain. The noble Lord’s points are well made and we will follow them up.