Dementia Care

Gregory Stafford Excerpts

Tuesday 3rd June 2025 Commons Chamber

[Freddie van Mierlo (Henley and Thame) (LD)]

I congratulate my hon. Friend the Member for South Devon (Caroline Voaden) on securing this very important debate. There is hardly a healthcare issue so big that we do not talk enough about as dementia. Perhaps that is because it is one of the most feared diseases, for understandable reasons.

For decade upon decade—unlike cancer, for example—there has been very little tangible scientific progress, until recently. As the chair of the all-party parliamentary group on access to medicines and medical devices, I will focus my remarks on those treatments. Breakthroughs are coming through thick and fast, with the UK’s Medicines and Healthcare products Regulatory Agency approving two disease-modifying therapies in 2024 for Alzheimer’s. Those medicines chart a path to a time when Alzheimer’s and other forms of dementia are a treatable condition that can be delayed to the point where it is, for all intents and purposes, cured. That is incredibly exciting for families such as mine with a history of Alzheimer’s, and more is on the way.

More than 100 medicines are being investigated, so it is a matter of not if, but when new medicines come forward, yet the UK is not ready. The alarm has been raised, but no one is listening. The last Government were asleep at the wheel, and I fear that this Government are too. Moving from a system focused entirely on care to prevention and treatment will require a monumental shift in thinking that breaks down departmental silos and redistributes budget to treatment. We know that reversing brain damage is nigh impossible, but preventing it is not. That is why early detection and diagnosis are so critical.

Dementia begins without symptoms as early as people’s 40s or 50s. We need to identify those people before the onset of decline, but that requires a system with sufficient diagnostic capacity. That means improved GP waiting times, increased capacity at memory clinics and a massive increase in magnetic resonance imaging, positron emission tomography and lumbar puncture test capacity. The lack of capital investment in our NHS has left us dangerously exposed, with the lowest number of MRI scanners per capita in the OECD. The UK has 6.1 systems per million people. In Germany, the rate is 30.5. Emerging diagnostics, including the blood biomarkers being investigated at the Warneford in Oxfordshire, need to be embraced alongside getting the basics right.

The Government must also look actively at how the National Institute for Health and Care Excellence assesses new medicines in dementia. Both lecanemab and donanemab were approved by the MHRA and then rejected by NICE on the same day. That means the MHRA believes these medicines are safe and effective, but NICE believes them too expensive for the NHS, because it fails to consider the economic and social benefits, including savings to informal care.

Do we want a system where those who can pay privately for medicines that delay dementia get treatment, and those who cannot, do not? Even when a new therapy is approved by the MHRA, given the green light by NICE and by some miracle we have diagnostic capacity, patients still may not get their hands on it. Depending on how a new medicine is delivered, we may not have enough infusion capacity. If it is a pill, we will be in luck, but we cannot bank on that. The truth is that the NHS cannot cope with the innovation we all want in dementia. My message to the Government is simple: get ready.

I hope the Minister for Care will take note of one final point: please stop punting problems down to the ICBs. My recent written parliamentary question, asking what steps the Government are taking to increase the number of Alzheimer’s disease specialists, was answered by him yesterday, and he said:

“The provision of dementia health care services is the responsibility of local integrated care boards”.

[Gregory Stafford (Farnham and Bordon) (Con)]

The hon. Member is making a powerful speech, especially with that last point. Is he, like me, concerned that ICBs will have their funding cut by 50%? Dementia will be one of the many conditions that will suffer because of that.

[Freddie van Mierlo]

Like the hon. Member, I am incredibly frustrated that whenever I put concerns to the Minister, I get pointed towards the ICBs, and when I talk to the ICBs, they tell me to talk to the Minister. There must be responsibility within our system. The Minister has been in politics for longer than me, but I hope he will allow me to offer him a little advice. It is not the ICBs that the people of this country are angry with when it comes to not getting the treatment they deserve; it is the Government. They expect the Government to take responsibility, not pass the buck.

--- Later in debate ---

[Andrew Pakes]

My hon. Friend has answered his own question, given the passion with which he has told that story; the role of young carers is a story to which the House must bear witness. I know that my hon. Friend the Minister for Care is passionate about ensuring that those who care for loved ones facing health conditions get the recognition and support they need, so I thank my hon. Friend the Member for Harlow (Chris Vince) for his question as well as the Minister, in recognition of the role he plays in this issue.

[Gregory Stafford (Farnham and Bordon) (Con)]

The hon. Gentleman’s story of his saving his local centre rings a bell with me. The Hunter Centre in Haslemere, which had been run by the Alzheimer’s Society, looked like it was going to close in 2017, but because of some great work by Anne Downing, it was saved and is now thriving—in fact, I am a patron—so I am sure that this can be done not just in the hon. Gentleman’s constituency and in mine, but across the country.

[Andrew Pakes]

I thank the hon. Gentleman for giving us such a wonderful practical example. I would correct him only by saying that it was not me that saved our centre; it was the campaigners and their families. I would like to ensure that the record represents that it was their work that saved it, rather than me as an individual MP, although I was glad to play my small role alongside their great efforts to hold me to account.

Fundamentally, care belongs in the community. It is our duty to promote and support such initiatives as I have talked about, and to ensure that the wonderful creation that is the NHS is centred on community-based care, not on top-down-based care. It is our duty to promote this and I sincerely hope that this type of provision, alongside the additional services that hon. Members have spoken so passionately about today, will be the hallmark of what comes next and will feature prominently in the 10-year plan and in the remarks that the Minister will shortly make.