Sir Jeremy Wright
MP for Kenilworth and Southam · Conservative · United Kingdom
“I applaud my right hon. Friend’s passion and clarity on this issue. On the subject of democratic accountability, he knows that if, as the hon.”
“I welcome the intent that the Secretary of State has set out this afternoon, and the urgency with which she will require the relevant companies to act.”
“The Electoral Commission has made no formal assessment of this. It would be a matter for Parliament to introduce such legal protections. It is prescribed in law that poll cards and ballot papers must be provided in English or Welsh, but there are no other prescribed language requirements relating to election materials.”
“We can all cynically speculate about the reasons why this sudden about-turn has taken place this week, but, as my hon. Friend the Member for West Suffolk (Nick Timothy), who spoke from the Front Bench, said earlier, it is our job to scrutinise this legislation and to ensure that whatever we put in place does justice to the determination o…”
“In today’s version of the amendment paper, for the first time, that amendment has disappeared and been replaced not with the detailed compromise that Intelligence and Security Committee members, who have been engaged with this process, have been working towards, along with many others, but with Government amendment 157.”
“As the House would expect, we engaged with that process as diligently as we could, with no partisan politics, in an effort to make good law in the pursuit of greater state transparency while preserving our national security equities. As the hon.”
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“My point is that the argument should be, at least in part, about how many of those who are carers identify themselves as such. Many do not: they see themselves as doing right by their families, looking after family members in the way they believe is incumbent on them to do—without wishing, as she said, to make a fuss or to draw attention to what they do, and without seeking recognition or reward for it. Carers are often very modest people, with every reason not to be so. The recognition that we rightly give to them—and it should not be just annually in debates such as this; I agree with those who say that we should recognise them more frequently, more regularly and more consistently—comes not because they ask for it, but because they richly deserve it.”
“It is a great pleasure to follow my hon. Friend the Member for Upminster (Angela Watkinson) and I substantially agree with many of her points. Indeed, I agree with a great deal of what all contributors to the debate have said—including the Minister, who opened it and whom I am delighted to see still in his place. He knows better than most that this policy area requires consistency of approach, which is difficult to achieve when we have a different Minister every few months. It is a pleasure to see him still in his post. I shall make just a few points in order to allow the Minister time to respond to the debate. My first is about the number of carers, although I am in agreement with my hon. Friend that, in a sense, it does not much matter whether there are 5 million or 6 million.”
“I entirely agree, and I think that the lady my hon. Friend describes is one of those whom we should try harder to reach and offer the sort of support that we all want carers to receive.”
“We shall never be able to make the lives of those who care easy—that is beyond all of us—but we do have a responsibility to make those lives slightly less difficult, and I think that both this and the next Government should focus their attention on that.”
“We need to ensure that the respite care we provide is of sufficient quality to provide that reassurance, and that information about its quality is provided to carers so that they enjoy the break that we can offer them. My last point is about simplicity. When it comes to the benefit system, we will all have difficult decisions to make about how much can be afforded, but it is beyond question that when people look at a website or call a phone line to understand what is available, the information given must be easily digestible. Whether the advice is there or not, the actual provision of benefits needs to be simpler. That is why we have to talk about the cliff edge or the distinction between retirement and non-retirement so that there is some continuity and simplicity in the benefits that those who provide care can receive.”
“No one can do a caring job 24 hours a day, seven days a week—they simply could not cope; people need a break sometimes. A break will help them to do a better job for the rest of the time; that is well understood by everyone. It is also worth acknowledging that simple provision of respite care will not do the job, because we also need to provide for quality respite care. If we do not, it will not be a real break at all. We have all spoken to carers who tell us, “I put the person I care for into full-time care. I had a week’s holiday, but it was the worst week in my life, because I spent the entire time worrying about whether my loved one was being properly looked after.” That is not respite care.”
“Friend pointed out, one of the main differences is that the carer starts to lose something of the person they knew as the illness or condition progresses. More often than not, the person being cared for requires more and more from the carer, just as the carer is losing more and more of the one for whom they are caring. That is an extremely distressing situation to be in for anyone with a caring responsibility. We need to take account not just of the physical health needs, but of the mental health needs of those who are carers, and ensure that the risks they run—in exposure to depression and other conditions—are adequately catered for. I have a couple of final points about the specific and practical action that we can take. The first, which the Minister mentioned, is respite care. It is right to provide for the availability of such care.”
“How those people manage, I simply do not know, but we must be aware of their particular needs and requirements when we consider how best to help carers. The second group is, as my hon. Friend said, an overlapping group—those who care for people who have dementia. The Minister would be disappointed if I failed to mention dementia at some point in my remarks. It is important to recognise the particular requirements on those who care not just for people with dementia but for all who have a mental illness or disability as opposed to a physical one. I am not saying for a moment that it is easier to care for someone with a physical disability, but it is different, and there are different requirements on carers looking after someone with a mental difficulty. As my hon.”
“Rarely is it in fact taken into account as fully as we would wish by the professionals involved in their care. I wish to refer to two specific groups. The first was mentioned by my hon. Friend the Member for Upminster and, indeed, by the hon. Member for Leeds, North-West (Greg Mulholland), who both rightly highlighted the interests of young carers. It is right to pay particular attention to their needs, but equally we should not forget those at the other end of the age range. Older carers have particular needs and particular requirements. They are the ones whose health suffers disproportionately as a result of their caring responsibilities. We know that about a quarter of the 5 million or 6 million carers are of retirement age. That is a very significant number of people, and I believe that there are about 8,000 carers over the age of 90!”
“Too many carers—we all talk to them—are frustrated because they are treated as people who do not understand what is going on, when in fact the opposite is the case and the carer is the one who spends the most time with the person for whom care is being provided. He or she knows that person best, and their opinion of that person—what they need and what they will best respond to—should be fully taken into account. I take the point made by the right hon. Member for Stirling (Mrs. McGuire) that it is important to reconcile that viewpoint with the occasional desire of the person being cared for to take a different view from that of their carer on any subject. In the majority of cases, however, what the person cared for will want is for their carer’s view to be taken fully into account.”
“That should enable them to get back into work, succeed on their own terms and still maintain their caring responsibilities. Once again, it is important for carers to identify themselves to receive the recognition they deserve; in circumstances of better and greater recognition, it should be easier for them to go to their employers and ask for the flexible working they need. It should be easier for that to happen if employers automatically understand what carers do and how important it is for them to continue with it. It is also important to ensure that health and social services professionals—the people mentioned by the hon. Member for Sutton and Cheam (Mr. Burstow)—can recognise the importance of a carer’s responsibilities and a carer’s understanding of the individual for whom care is being provided.”
“I entirely agree; the hon. Gentleman is absolutely right. That is why, as I said, I was encouraged by what the Minister told us about opportunities to train those who are professionals to understand how to help those who are not professionals but who are still making a substantial contribution to the care of people we are most concerned to look after. It seems to me that this is more than a matter of gratitude or just saying thank you to carers—however much we rightly do so in the debate—because we need to offer them real and practical support. As the Minister rightly said, we must try to ensure that carers have the maximum opportunity to combine their caring responsibilities not only with a fulfilling social life but, just as importantly, with a fulfilling career.”
“May we have a debate in Government time about “phoenixism”—in other words, going out of business one day and going back into business a few days later, doing almost exactly the same thing, leaving creditors unpaid and customers without the goods and services they have paid for? Does the Leader of the House agree that the House should discuss this matter particularly now, when this pernicious practice is resulting in many of our constituents being unable to recover money they can ill afford to lose?”
“That is why I am proud to support the suggestion of the hon. Gentleman. I am hopeful that the Minister will be able to tell us that it will be taken up, for the benefit of people today and people in future years.”
“June Ravenhall and others who have been mentioned show us that, even if people do not feel that they are cut out for heroism, they can show by their actions that they can stand up against almost impossible threats and demonstrate what individuals can do. That is a lesson that we could learn well in today’s society. We can say, “We can do it too” only if we know of the existence of those people and what they did. It is striking how little is known about them. Perhaps all hon. Members are struck by how little they knew about such people before they were drawn to their attention. It is important that our fellow countrymen and countrywomen know about them and what they did, so that they can believe that even in the face of overwhelming evil, they can play a part and stand up against it.”
“The lessons we can draw are clear: people may have an ordinary background and they may have unlikely qualifications for heroism, but it lies in the most unlikely places. There were many heroes in that period of our history, but not all wore a uniform. Those people did not wear a uniform and they demonstrated remarkable heroism. They tell us that it is possible, in the face of unimaginable evil, such as we saw in Europe in the 1940s, for relatively ordinary, unexpected heroes to arise and to do remarkable things. As hon. Members have said, it is right that we recognise that the threat has not gone away. Nazism and anti-Semitism are not dead, nor is hatred of the kind we have been talking about. Sometimes it sleeps, but we must always be prepared for it to reawaken, even within our own communities.”
“Although a famous journalist himself, fluent in at least two languages, Louis could find no word to describe the extent of her sustained bravery. ‘The English are not brave, - they are mad.’, was his eventual reply.” That may not have been exactly the right word to describe what June Ravenhall did, but we would all be mad were we not to take the opportunity presented to us by the lives and acts of such remarkable people to draw what lessons we can. The hon. Gentleman referred to the lessons. Those people were ordinary people doing extraordinary things. I have little doubt that if any of them knew about this debate, they would be amazed and deeply humbled. In my view, that makes them more deserving of any honours we can give them.”
“June continued to shelter him even though she knew that any discovery, or knock on the door, would lead both to her death and considerable peril for her young children. She did all that alone because her husband was in a Nazi concentration camp. We can all agree that sustained and remarkable courage of that nature deserves recognition. I share the hope of the hon. Gentleman that that recognition will begin today with whatever the Minister is able to say that the Government can do. Interestingly, when Ron Ravenhall wrote a book, which was partly about June’s life, he described how Louis Velleman explained how he felt about what June Ravenhall had done for him. I shall quote from the book: “Louis Velleman, the young Jew she saved, was asked by a Press reporter, some 44 years after the event, how brave he thought June was.”
“The trust drew my attention to June Ravenhall. The hon. Gentleman mentioned her and she also appears in the early-day motion. She originally came from Kenilworth and settled in Rugby, thereby neatly encapsulating both parts of my constituency. Her son, Ron, is a councillor in Rugby—not, I fear to say, for the right party, but one cannot have everything. Ron has been enthusiastic and dedicated in drawing out the memories of his mother. He talks about her, as well he should, with considerable pride. June Ravenhall was a British woman who moved to Holland during the war and sheltered the young Jew, Louis Velleman, who was sought by the Gestapo. Moreover, he had tuberculosis, putting not only June but her three young children at considerable risk.”
“It is a great privilege to speak in this debate, and I congratulate the hon. Member for Dumfries and Galloway (Mr. Brown) on securing it. I was equally privileged to co-sponsor early-day motion 1175, out of which this debate has come. I agree with much of what he has said, as I am sure all hon. Members present do. We are here to talk about a number of extraordinary individuals and the effect that they have had on all of us today, and will have in future. We are right to look at those individuals in some detail. We have heard already about the hon. Gentleman’s constituent. I want to say a word or two about the constituent through whom I have come to this issue. I am grateful in this, as in many other things, to the Holocaust Educational Trust, which has done a great deal to draw attention to these issues.”
“Gentleman’s argument is, as I suspect it may be, that these things are in themselves pernicious, it can be explained why they are pernicious in the context of the recognisable law in this country in respect of establishing who is liable for damages?”
“I should make it clear that I am not a practising lawyer, and I certainly did not practise in the field of personal injury. What I ask my hon. Friend to consider in the context of his remarks is clause 2(3), which, as I have no doubt that the hon. Member for Hendon has spelt out very clearly, clearly states the following: “It is not necessary for a person seeking damages in respect of asbestos-related pleural thickening or asbestosis to prove that it has caused, is causing or is likely to cause impairment of that person’s physical condition.” Does my hon. Friend agree that that is an extraordinarily sweeping statement and that it would be more helpful, in the context of this debate, if it could be a little more closely defined, so that if the hon.”
“I do not wish to add to my hon. Friend’s unease, but I suspect that I might be about to do so. Does he agree that what we should really be dealing with in this Bill is any impairment of the person’s mental or psychiatric condition and that that is really what the hon. Member for Hendon is describing? Is he not focusing his Bill on the wrong target? We should not be talking about a physical condition that may or may not have any further effects; we should be focusing on the effects. If the person has a recognisable mental impairment or a psychiatric effect caused by the worry that the hon. Gentleman has described—I am perfectly prepared to accept that that may be a worthwhile cause of action—it is that which is the cause of action, not a physical condition that may or may not lead to that harm.”
“It is an important part of the country’s response to a challenge of staggering scale. Hon. Members will know the numbers, but they are worth repeating. In the UK, 700,000 people have dementia, and that number will double in 30 years. Dementia costs us £17 billion a year, more than the cost of cancer, heart disease and stroke combined, and that sum will treble in 30 years.”
“Gentleman wants to debate the strategy in the House, he can use the usual channels to arrange for such a debate on a Liberal Democrat Opposition day, but I am very happy to debate the strategy because it is an excellent strategy that has been welcomed across the country.” —[ Official Report , 24 March 2009; Vol. 490, c. 153.] Yet despite the Minister’s enthusiasm for a debate on the strategy and, I am sure, his delight at having the opportunity to respond to one today, it should not have been left to me, with the indulgence of Mr. Speaker, to initiate it. The Government’s apparent reluctance to debate their own strategy is mystifying because it seems that they can be justifiably proud of it. It is a huge step forward for those with dementia, those who care for them, and those who campaign for them.”
“1516.] No debate was forthcoming, so the hon. Member for Leeds, North-West (Greg Mulholland)—I am delighted to see him in his place—asked whether we could have a debate in Government time to talk about this important initiative, but the Leader of the House replied: “These issues are important, and this might, perhaps, be the subject of a Westminster Hall debate. —[ Official Report , 5 March 2009; Vol. 488, c. 995.] Indeed they might. The hon. Gentleman, not to be daunted, returned to the matter at Health questions, when the Minister said: “If the hon.”
“I am delighted to open this debate, but I would rather have listened to the Minister do so on the Floor of the House in a Government debate in Government time on this Government strategy. Such a debate has been asked for, as you know, Mr. Bercow, several times. I asked for one during business questions recently, when the Leader of the House responded: “I shall take that as a suggestion for a future topical debate.” —[ Official Report , 5 February 2009; Vol. 487, c. 986.] My hon. Friend the Member for Rutland and Melton (Alan Duncan) raised the matter again the following week, also at business questions, when the Leader of the House said: “I will look at the forthcoming business of the House and see whether we have enough opportunities to debate those important issues”. —[ Official Report , 12 February 2009; Vol. 487, c.”
“The point that I do want to draw from that quote is the sequence to which it refers, of a review of anti-psychotic drugs coming before the strategy’s publication. That sequence is important because if, as we concluded in the report, the overuse of those drugs is a serious problem for people with dementia and the solution is to be found in better training of staff, more frequent reviews of medication and closer involvement of family and friends in prescribing, among other things, all of which are central to other objectives of the national dementia strategy, it would surely be sensible to integrate the response to the over-prescription of anti-psychotic drugs into the strategy itself.”
“We made several recommendations about how such overuse might be reduced, so we were pleased that the Department of Health press release of 19 June 2008, which announced the consultation on the national dementia strategy, stated: “The Government’s announcement today includes a number of immediate actions, as well as other proposals which will be consulted on over the coming months. These include: An immediate review”— that was first in the list— “into the prescribing and use of anti-psychotic drugs to treat sufferers of dementia. This work will be completed before the publication of the National Dementia Strategy in the Autumn.” We know that the timetable for publishing the strategy itself was subject to change, although I do not want to cover that this morning.”
“Some form of ‘kite-marking’ of good practice would assist commissioners and care providers in selecting effective training.” That seems to understate the problem. If the market for training expands, as it must, so will the number of signs above doors stating “dementia trainers”. There must be a way to distinguish which training providers offer a product of the requisite quality, and again I hope that the Minister can offer us some reassurance on that. I would also like some reassurance on anti-psychotic drugs. As the Minister knows, the all-party group produced a report on the subject last year, which concluded that the over-prescription of such drugs for people with dementia was widespread and had very damaging consequences.”
“We have therefore made such change a longer-term goal that needs to follow a period of at least two years detailed consultation and joint development work co-ordinated by the Department but including all training providers.” I hope that the Minister can reassure me that the sense of urgency that should run through this part of the strategy is present in Government thinking. If the Government are to succeed—I fervently hope that they will—in persuading providers and commissioners of care to pay much more attention to the need for the caring work force to understand dementia better, we must ask who will provide the necessary training. The strategy deals with that on page 29 and states: “There is currently a range of training and education providers in dementia care but there is no nationally recognised system of quality assurance.”
“Surely we must have such training for all those who work with the elderly throughout the health and social care sectors, and we must have it soon. That is why I am worried about what the strategy impact assessment says. Paragraph 5.109 on page 30 states that “in developing the strategy we have become aware of the complexity in making change to undergraduate and vocational curricula and in terms of securing the ability to deliver training in social care settings, especially those that are outsourced or provided by private companies.”
“Objective 13 of the strategy refers to “An informed and effective workforce for people with dementia”. As the Minister knows, the all-party group on dementia, which I chair, is working on an inquiry into the training needs of those who provide care for people with dementia in residential care homes or in their own homes. I do not want to pre-empt any conclusions, but I want to make some personal comments about a matter that is crucial to the strategy’s success. Given that two thirds of the care home population is estimated to have some form of dementia, it is shocking that no training in dementia is required for those who work in care homes. How can good quality care be provided to those people if those providing it have no real understanding of the condition?”
“Encouragingly, the Government have said that they intend to look at the training of general practitioners, so that those who are often confronted first with the early signs of developing dementia may have more confidence to make the appropriate diagnosis. Perhaps the Minister will update us on precisely what is to be done. We all recognise that general practitioners are just that—general practitioners—and cannot be expert in every condition. They must also have the opportunity to refer to specialists, as the strategy states. It is crucial that, following diagnosis, appropriate advice and support is offered, and I am pleased that the strategy both recommends that and recognises that the voluntary sector has a lot to offer in fulfilling that role. It is not only GPs who need more training.”
“But now that we have the strategy and it stands in the glare of new-found and welcome public attention, it is vital that it stands up to scrutiny, so we must discuss what happens next: how will the strategy be put into practice? I hope that the debate will focus on that. The national dementia strategy is wide-ranging, as it should be, and I cannot do justice today to everything in it, so I shall concentrate on several aspects of what it seeks to achieve. I shall begin in a logical place—diagnosis. The strategy recognises that we do not diagnose dementia as often and as early as we should. Unless a sufferer’s dementia is identified, none of the strategy comes into play.”
“I agree with the hon. Gentleman, and I hope that he listens to that part of my speech when, as he correctly predicts, I come to it a little later. He is absolutely right, and emphasises my point that we simply cannot afford to ignore dementia, yet for years we have effectively done just that. The Minister’s predecessor used to say that his objective was to bring dementia out of the shadows. With the help of campaigning groups such as the Alzheimer’s Society and some immensely courageous individuals, the Government have largely succeeded in that objective. Dementia is unquestionably higher up the political agenda than even two or three years ago.”
“That matters because the importance of research should not be underestimated. Only more research can give us effective treatments for dementia and, one day, a cure. Only more research can give those affected by dementia the hope that they so desperately need, yet in Britain we give dementia research a low priority, as the hon. Gentleman rightly said. It is worrying that, like the review of anti-psychotics, the promised research summit seems to trail further and further behind the national strategy instead of being a full and important part of it.”
“640W.] I hope that the Minister can confirm today that we will not have to wait any longer than spring this year for the results of that vital review. Unfortunately, it is not only the timetable for the anti-psychotics review that seems to be slipping. There is also the matter referred to by the hon. Member for Castle Point (Bob Spink)—research. A research summit was promised initially in the Department of Health press release of 19 June. It stated: “The government will hold a summit over the summer with key stakeholders and research organisations to consider a planned programme of research into dementia and the potential for further development.” The summit should have taken place in the summer of 2008. Here we are in the spring of 2009 and it still has not happened.”
“On 15 October, the Minister said: “The strategy”— the national dementia strategy— “is now likely to be published in mid-November, and we anticipate that the results of the anti-psychotics review will be published early in 2009.” —[ Official Report , 15 October 2008; Vol. 480, c. 1339W.] In other words, not only had the timetable slipped, but the order of events had changed. We were told then that the review of anti-psychotic drugs would take place after publication of the strategy. Then matters slipped yet further, because in answer to another written question, from my hon. Friend the Member for South Cambridgeshire (Mr. Lansley), the Minister confirmed: “The work of the review will be concluded in spring 2009.” —[ Official Report , 24 February 2009; Vol. 488, c.”
“I agree entirely. The two issues that the hon. Gentleman mentions of training and inspection—regulation, in fact—are extraordinarily important. Unless we get those right, the strategy will not fulfil its aims. If he will forgive me, I shall return to both matters, or certainly regulation, in a few moments. I just want to finish what I was saying about the review of anti-psychotic drugs. I am sorry to say that, having read carefully what the press release of 19 June said about what would be done on the review, we were somewhat disappointed by the answer to a written question from the hon. Member for Sutton and Cheam (Mr. Burstow), to whom I pay tribute for his extremely hard and long-standing work on this subject.”
“However, I ask him to take this opportunity to deal with the points that I have raised and to use this debate to discuss the next steps in addressing this fundamental challenge, which we are no longer ignoring, but which we are still some way from defeating.”
“Nor is it impossible that PCTs and local authorities will already have decided their spending plans for the next two years before even having laid eyes on the dementia strategy. If that is so, how can we be sure that the funding necessary to deliver the strategy’s objectives will be available? In conclusion, I say again that I welcome the strategy and I again congratulate the Government on introducing it. However, none of us can go on simply taking curtain calls for its existence; we must make it a reality and make it work for the people with dementia who need it. I do not doubt the Minister’s commitment to the task or the commitment of those who work with him on it, and nor do I doubt the difficulty of that task.”
“in each of 2009-10 and 2010-11, a total increase of £8.6 billion over the two years of which the dementia funding is part. PCTs have flexibility over the use of these resources in line with the operating framework.” —[ Official Report , 24 February 2009; Vol. 488, c. 640W.] The operating framework was published with the revenue allocations to which the Minister referred in that answer on 8 December 2008—almost two months before the national dementia strategy was published. It is true that the operating framework mentions dementia as one of the priorities to be determined and set locally by each PCT, but there is nothing like the detailed guidance provided by the strategy. It is clear that the £150 million mentioned in connection with the strategy is, as the hon. Gentleman said, not ring-fenced for delivery.”
“The local health and social care economy then has to decide how it prioritises addressing these within the block funding, and on a value for money basis, what possibilities exist within existing funding streams for service redesign.” My point is not that it is wrong in principle for local PCTs to have a degree of discretion over how they spend their money. However, it is interesting that the Minister himself had given further clarification a few days before, on 24 February—again in answer to a written question from my hon. Friend the Member for South Cambridgeshire. He explained: “The £150 million is revenue, not capital expenditure. It is being made available as part of primary care trusts’…overall general allocations. These are increasing by 5.5 per cent.”
“He wrote to me, in part about the strategy, on 3 March, and said: “The PCT and Warwickshire County Council are planning to consider together how to deliver the Dementia Strategy through redesign of existing spend, given the financial challenges facing both the Council and the PCT currently.” That, as hon. Members might imagine, caused me some concern, given what I had read about £150 million of apparently new money, so I asked the chairman of the PCT for clarification of what he meant by that statement. In his letter of 12 March, he gave this explanation: “The money does not come ring fenced”— just as the hon. Gentleman said— “and alongside of the block funding come a number of priorities that the Government would like the local health and social care economy to address.”
“Finally and perhaps inevitably, we need, as the hon. Member for Brighton, Pavilion (David Lepper) said, to talk about money. When the national dementia strategy was published on 3 February this year, the Department of Health press release that accompanied it referred to “The first National Dementia Strategy, backed by £150 million over the first two years”. I think that most of us who read that press release assumed that that was £150 million of new money and that it was to be devoted to delivery of the dementia strategy. I am not sure that we were right to assume either of those things. I had a letter from the chairman of my local PCT.”
“In essence, CSCI told us that it was not responsible for regulating the prescription of those drugs, because drug prescribing was a health care matter, and the Healthcare Commission told us that it was not responsible for it either, because the drugs were being used in a social care setting. The creation of the Care Quality Commission, which begins work today, means that the gap has disappeared. As a regulator of both health and social care, it can, I hope, do a great deal to improve dementia care, which, as we know, awkwardly straddles the artificial boundary between the two. However, the CQC will need to focus on dementia care to make that happen. Therefore, will the Minister tell us today that dementia will be a priority for the CQC, as well as for the health and social care systems that it regulates?”
“I am always gratified to be in tune with the mood of the House, and once again the hon. Gentleman anticipates something that I am going to say. I agree entirely: it is right to be concerned about the lack of ring-fencing. There is another issue of concern, too. I am conscious of the time and that other hon. Members wish to speak, but I wish to make two more points. The lack of ring-fencing is one, but if he will forgive me, I shall deal with the other first. I hope that today marks a new dawn in the regulation of dementia care—a matter that the hon. Member for Pudsey (Mr. Truswell) raised. During the last all-party group inquiry into the overuse of anti-psychotic drugs, we took evidence from the Healthcare Commission and from the Commission for Social Care Inspection, and the gap between them was striking.”
“My hon. Friend will have heard me say that I do not object to the principle of local authorities and PCTs having discretion on how to spend their money. My point was that if the Government suggest to the wider dementia population that £150 million can be spent on the national dementia strategy, that is what should happen. However, it may not be the reality.”
“The Minister is well aware that objective 13 of the national dementia strategy is to provide “An informed and effective workforce for people with dementia”. He also knows that two thirds of the care home population has a form of dementia. Does he agree that it will be important to provide training for the entire work force in the care home and, indeed, the home care setting? When the all-party group, which I chair, has completed its inquiry into work force skills in this area, will he meet me to discuss the inquiry’s conclusions and consider how they might be included in the implementation of the strategy?”