Part of the debate – in Westminster Hall am 10:39 am ar 16 Mawrth 2010.
Stephen O'Brien
Shadow Minister (Health)
10:39,
16 Mawrth 2010
I congratulate Mr. Burstow on securing this important debate, which succeeds a series of such debates in this House. I also congratulate my hon. Friend Tony Baldry on his predictably excellent contribution.
I welcome the opportunity to debate the dementia strategy today, and to keep up the pressure that we put on the Government in our Opposition day debate to ensure that funding for the strategy breaks free from Whitehall and primary care trust bureaucracy, and reaches patients on the front line, who live each day with the knowledge that their memory is gradually slipping away from them. Dementia is a debilitating and frightening disease, and those who suffer from it rightly want to know what action the Government are taking now to ensure that they may access appropriate care, and what research they are undertaking to discover new treatments for the disease.
It is right to pay tribute to the thousands of carers who look after loved ones, and to those charities that tirelessly campaign in the cause of those who suffer from dementia. As if a diagnosis of dementia were not enough to deal with, the last few weeks have added new cause for concern for those suffering from Alzheimer's. In addition to the National Audit Office's criticism of the Government's implementation of the dementia strategy, news headlines have been filled with reports of the Government's convoluted proposal for a death tax; the inappropriate tube-feeding of elderly and dementia patients in care homes and hospitals; and a rise in cases of malnutrition among older people in the NHS. Alongside that, there has been a political debate about how to tackle the decade-long silence from the Government on social care reform.
Against that backdrop of existing problems surrounding dementia care, we must acknowledge the scale of the challenge ahead. Of the 8.2 million people aged over 65, and the 6 million people using social care, there are currently 700,000 people diagnosed with dementia in the UK, and that figure is set to double over the next 30 years. As we consider how we might deliver better care to dementia patients, it is important to remember that without wider social care reform, the needs of dementia patients will remain unmet.
It is not only the Opposition who have concerns about the Government's implementation of the dementia strategy. As we have heard, the NAO report published in January criticised the Government on several counts for their actions since the publication of the strategy. To my mind, the NAO's findings raise three pivotal concerns. The first concern is the lack of accountability in place to ensure that PCTs spend the £60 million from the strategy for 2010-11 on dementia services. We need only look at the recent carers strategy to see how urgently that accountability is needed. Before Christmas, it emerged that the £50 million dispersed for emergency respite care this year hardly reached the front line, having been soaked up by local PCT bureaucracy, and we have had some exchanges on that.
Given that disturbing precedent, I hope that the Minister will tell us how the Government intend to ensure that they keep a grip on the allocation of resources that have been identified and earmarked for the dementia strategy. During the Opposition day debate, the response by the Secretary of State for Health was deeply worrying. On the dementia strategy, he said that he had
"given PCTs the freedom to determine their spending based on local needs."-[Hansard, 27 January 2010; Vol. 504, c. 831.]
Although autonomy for PCTs should be promoted, that does not mean that the Department should lose track of local spending decisions and have no capacity to check how central funds that are assigned for specific purposes, such as dementia, have been spent.
When the Minister, the hon. Member for Sutton and Cheam and I met the Princess Royal Trust for Carers last week, I was pleased to see the Minister make a U-turn on his line that it was up to each MP to chase up their own PCT on the issue of the carers strategy funding. [Interruption.] The Minister laughs because he is embarrassed, but he said that the PCTs would now be directly accountable to him, and the hon. Member for Sutton and Cheam was there to witness that. It is important that the Minister takes the opportunity to shed some light on how PCTs will be expected to report to him, and tells us what measures he will introduce to ensure that the accountability now in place will be maintained in the long term.
Secretary of State was originally the title given to the two officials who conducted the Royal Correspondence under Elizabeth I. Now it is the title held by some of the more important Government Ministers, for example the Secretary of State for Foreign Affairs.
Ministers make up the Government and almost all are members of the House of Lords or the House of Commons. There are three main types of Minister. Departmental Ministers are in charge of Government Departments. The Government is divided into different Departments which have responsibilities for different areas. For example the Treasury is in charge of Government spending. Departmental Ministers in the Cabinet are generally called 'Secretary of State' but some have special titles such as Chancellor of the Exchequer. Ministers of State and Junior Ministers assist the ministers in charge of the department. They normally have responsibility for a particular area within the department and are sometimes given a title that reflects this - for example Minister of Transport.
Primary care is a term used to describe community-based health services which are usually the first (and often the only) point of contact that patients make within the NHS. It covers services provided by family doctors (GPs), community and practice nurses, community therapists (physio, occupational, etc.), pharmacists, chiropodists, optometrists, and dentists.
A Primary Care Trust in the NHS is a regional body in the NHS, catering to a specific geographical region, which is responsible for providing primary care to the individuals within that area.
These primary care trusts have budgetary responsibility, and are tasked by the Department of Health with improving the health of the community, securing the provision of high quality services, and integrating health and social care locally.
The Opposition are the political parties in the House of Commons other than the largest or Government party. They are called the Opposition because they sit on the benches opposite the Government in the House of Commons Chamber. The largest of the Opposition parties is known as Her Majesty's Opposition. The role of the Official Opposition is to question and scrutinise the work of Government. The Opposition often votes against the Government. In a sense the Official Opposition is the "Government in waiting".
Whitehall is a wide road that runs through the heart of Westminster, starting at Trafalgar square and ending at Parliament. It is most often found in Hansard as a way of referring to the combined mass of central government departments, although many of them no longer have buildings on Whitehall itself.
