NHS: Front-line and Specialised Services — Debate

Part of the debate – in the House of Lords at 5:21 pm on 13th January 2011.

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Photo of Baroness Greengross Baroness Greengross Crossbench 5:21 pm, 13th January 2011

My Lords, as chair of the All-Party Group on Dementia, I have a particular interest in dementia care. In my brief remarks, I wish to highlight the potential impact of the changes to those services.

People with dementia are major beneficiaries of effective joined-up working between health and social care. Can the Minister assure me that any changes in the current coterminosity of boundaries for commissioning health and social care will be appropriately managed for people with dementia?

One in three people over the age of 65 will die with dementia, and so for many it will be a terminal disease. Why, therefore, is dementia treated, rather than as a health issue like cancer, more as a social ill? In other words, it is more likely to get funding through social care. Thus many dementia patients are obliged to self-fund their care. Is something going to be done to remedy that?

With the implementation of the national dementia strategy we have witnessed the increasing knowledge and ability of many NHS managers in commissioning for dementia, which is absolutely essential. However, the number of people with these particular skills remains relatively small and it is a concern that the pace of structural change has the potential to undermine this progress. Can the Minister assure me that the valuable dementia commissioning expertise which has been developing recently will be retained in the system?

Lastly, GPs will in future play an increasingly important role in commissioning services for people with dementia. However, I am concerned that many GPs have too little awareness or knowledge of dementia. For example, when surveyed, only 31 per cent of GPs believed that they had received sufficient basic and post-qualification training to diagnose and manage dementia and only 47 per cent of GPs said that they had sufficient training in dementia management. Only one third of people receive a formal diagnosis of dementia. What will be done to ensure that GPs are fully capable of discharging their new commissioning responsibilities with regard to this absolutely urgent situation? I hope that the noble Earl can respond.