10.23 am
Mike Penning (Hemel Hempstead) (Con): I join other hon. Members in congratulating the hon. Member for Twickenham (Dr. Cable) on securing this debate. As we have already heard, it runs on the back of the debate on 24 October 2007, which was secured by my hon. Friend the Member for Rugby and Kenilworth (Jeremy Wright). My hon. Friend has not vanished; he is acting as Whip on the Health and Social Care Bill Committee. I understand that he apologised before he left us.
We need to address this massively serious area of public health. I congratulate the hon. Member for Twickenham on raising not only the very important issue of his own constituency but also the excellent work that Age Concern and others have done in this field over recent months. I want to take this opportunity to praise Age Concern for its report and the work it has been doing. I know that the Minister has read the report, and I wonder whether he will respond to the 35 points that the organisation has raised in its summary and conclusion. Will the Minister let us know how many of those recommendations he will accept and how many he will reject?
I am conscious that this is not a bipartisan debate; it is too serious for that. I am also conscious that, on this issue, we are seeking guidance from the Minister about how he intends to take forward certain issues. I am sure that he will consider the constituency problems of the hon. Member for Twickenham, but there are other issues. Following the speech and the comments made by the Minister last summer, he built up expectation levels among those who care for older people with mental health problems. Some 3.4 million older people may be suffering from mental health disease. That means that about one fifth of the population is involved in caring for such people. That is a very large lobbying group. It is also a very vocal group, who will demand concrete proposals from the Minister to back up the comments that he made in the summer.
I will quickly comment on some of the interventions. My hon. Friend the Member for Castle Point (Bob Spink) raised a very important point, even though the hon. Member for Twickenham did not quite grasp what he was referring to. We all get correspondence about people who need specialist equipment, and this particular issue is very relevant to those who are looking after and caring for people with mental illness in their older age.
My hon. Friend the Member for Rugby and Kenilworth is a member of the all-party parliamentary group on dementia which, as I am sure the Minister knows, is about to take evidence on the usefulness of the medication that is being used in this area. From the evidence I have seen, I have grave concerns about it. A witness statement from the Age Concern report said:
“I went to my doctor and he suggested Prozac. I told him no medication, especially Prozac. He’s a nice enough guy usually, but when I said I just wanted to talk to someone, he totally patronised me.”
I partly understand where the GPs are coming from. Given the time scales within which they have to operate, it is very difficult to treat someone who comes in suffering from depression. I think that depression is the forgotten subject in this area and it needs to be highlighted. It is very difficult when someone says to the doctor, “I need some time to talk to you.” We need to find ways in which that person can get the help that they need, rather than offering them the simplistic solution of putting them on drugs, to which they will almost certainly become addicted in the short term. In the long term, the drugs could have an even more adverse effect on their health. I look forward to the conclusions of the report from the all-party parliamentary group on dementia.
On Christmas day, I had the honour of visiting my local acute hospital. I visited the 14 wards that were open and the accident and emergency department. On many of the medical wards, half the beds were empty. When I spoke to the sister in charge of the wards she said that wherever possible they had sent people home over Christmas. I think that we all understand that. I noticed that the vast majority of the people still in hospital were elderly and, clearly, in most cases, suffering from some degree of mental health problems. In many cases, people with mental health problems had gone home over Christmas because they had loved ones and carers to look after them. For those who did not go home, the lack of provision within the NHS is stark. All too many of our wards are full of people who should not be there, but in a specialist unit being cared for by experts.
The hon. Member for Twickenham alluded to the time, some 40 years ago, when he first went on to a ward to work. In 1973, just before I joined the armed forces, I spent a year working at my local hospital on the geriatric ward, as it was known then. That is not a derogatory term; it is exactly what it was. I, too, at such a young age was astounded by the dedication and professionalism of those who looked after the patients. As we have heard, people were often unable to thank them or give them the credit that they deserved. Today, we may change the terminology that we use, but having gone round the different facilities that look after those with mental health problems, particularly among the older generation, in my constituency, I pay tribute to those who specialise in this field, whether in the public or private sector. In my constituency, Robin Hood house specialises in patients with dementia.
There is an issue that we have not had an opportunity to discuss this morning, and perhaps the Minister will write to me if he does not have the relevant figures before him. Each time I visit the different facilities it has been put to me that the age profile of people suffering from dementia, and Alzheimer’s in particular, is lowering, so that people in their early 60s are suffering from dementia. I appreciate that dementia is a catch-all term and that there are many different areas, but clearly something is going on. Have the Government been looking into any research in that respect?
We have had discussions about whether consultation has been done correctly and not only in relation to the constituency of the hon. Member for Twickenham. He clearly touched a nerve with the Minister when he mentioned the word “consultation”. It is an emotive subject in the community. The Minister is right to say that if a small piece of the NHS, such as a ward, is being moved or small facilities are changing, there cannot be full consultation in the public arena. I think that we accept that. However, when facilities as specialist as those that we are talking about are in the same position, everyone would expect the public and those concerned, particularly the carers, to be involved in the consultation process.
As the Minister knows, I am quite critical of the way in which the consultation process has continued to be operated across the country. We do not want a consultation process to take place in which the public, the experts and the other people involved voice a view, which is then ignored, because that causes even more anxiety and concern. I know that the Minister is aware of that. In my constituency, there was a public consultation in which 86 per cent. of the consultees opposed the relevant closure, but that fact was ignored. That just causes more and more anxiety.
We are talking about the NHS, which is publicly funded by the taxpayer. It is right and proper that major changes in the infrastructure should go out to consultation and that the views expressed in that consultation should be properly listened to. It should not just be a listening exercise, after which those views are ignored. All too often we hear that the decision was made before the consultation process even started, which just causes more problems. The primary care trusts and the different relevant bodies should consider a much more open way of conducting the process early on, so that people have a better understanding of what is happening.
The figures used in today’s debate are quite shocking, but other figures, which have not been discussed, are also frightening and shocking. I passionately believe that depression among older people is one of the undiscussed, quiet areas that does not quite receive the publicity that it deserves—it is a major problem. According to figures produced by Age Concern in its report, one in four older people have symptoms of depression, but sadly only one third of those with depression ever seek medical advice or ever discuss it with their GP. Sadly, as we heard from witness statements in the report, even when they do discuss the matter with their GP, they do not receive the type of care that they deserve. That leads to a disproportionately higher suicide rate for older people. We should consider the figures in the report. It cannot be right that the older generation, who have done so much for us—the generations who follow them—have a disproportionately higher suicide rate because they are not receiving the help that they often need.
I fully understand, and I am sure that the whole House would understand, that people are often frightened of talking about the fact that they have depression or that they feel they have the early signs of Alzheimer’s or dementia. It is for us as a community to come up with ideas to assist them, so that there is no stigma in any shape or form should people feel that they have a problem or others feel that they are starting to have problems.
We have rightly praised Age Concern, Help the Aged, the Alzheimer’s Society and Mind, and there are many other groups—small and large groups in our constituencies that do so much work—which we will not have an opportunity to talk about today. However, I would like to talk in more depth about carers—the carers who do so much for their loved ones. They do so not for money and not because they have been asked to go along and help as a volunteer, but mostly because it is their loved ones who are suffering.
I, too, have family experience. By the time I was 15 or 16, my great-aunt, who was mostly responsible for bringing me up, had no idea who I was. She had no recollection at all of the wonderful life that she had lived in the 62 years before the most difficult stages of her Alzheimer’s. Sadly, she lived for nearly another 20 years. That sounds like a terrible thing to say, but she had no life. She destroyed my great-uncle’s life, but he would not let her go into a home—he would not let her be taken away. In those days, there was not much respite. There is some respite today, although there are great concerns that some respite care centres are closing as well. In my constituency, there are real problems in that respect.
Without those wonderful people, what would the state do? What would we be able to do without those generous, caring, loving people who look after their loved ones in such a way? So when they do seek help and a little respite care, it is very difficult for them to learn that units are possibly closing and that there is not the necessary back-up from acute services, which we heard about. More training is needed in the acute sector to help people with this type of medical condition when they arrive at acute facilities.
I praise the Government for the increased expenditure that is there today in the NHS. However, it is difficult for the public to understand when units are clearly closing or being reconfigured or care is being transferred to other service providers because of money. There must be a better way of sorting out the situation and funding services through the system. I accept that there is a conflict between the local government funding side and the NHS side of mental health provision, but we need much more joined-up thinking. Actually, what we need is not more joined-up thinking, but more joined-up action—action that the Minister promised. The talk has happened and perhaps the action will now start.
10.38 am
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