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You and Yours - Transcript 大象传媒 Radio 4 |
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TX: 06.08.07 - Dementia PRESENTER: PETER WHITE |
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THE ATTACHED TRANSCRIPT WAS TYPED FROM A RECORDING AND NOT COPIED FROM AN ORIGINAL SCRIPT. BECAUSE OF THE RISK OF MISHEARING AND THE DIFFICULTY IN SOME CASES OF IDENTIFYING INDIVIDUAL SPEAKERS, THE 大象传媒 CANNOT VOUCH FOR ITS COMPLETE ACCURACY. WHITE The government announced this morning that in 12 months time it wants to have an all embracing strategy for treating dementia across the UK. Ministers have announced they want a transformation plan to ensure that better services are provided for dementia patients. This development, which has been very warmly welcomed by patient groups, will involve representatives of the NHS and social services sitting down together to make sure that what they call the Berlin Wall between health and social care is dismantled. Well our reporter Carolyn Atkinson is at the launch, Carolyn. ATKINSON Yes Peter the key thing that's coming out of this launch this morning is that at the moment everyone seems to be agreed that dementia care services are not what they need to be and the key thing is that they've announced this big one year strategy plan to come up with in 12 months time something that can solve or begin to solve this problem and they're trying to bridge this gap between the NHS and social services. They've got on board two key people leading this strategy: Professor Sube Banerjee is, if you like, the NHS side of things, he's from the Institute of Psychiatry and Jenny Owen, who's the Association of Directors of Adult Social Services, is going to lead the social care side of things. And fundamentally there's also a key group of people, if you like, the users, the carers, the people who are on the ground living with dementia or looking after people with dementia who will be sort of running a stakeholder side of things so that all of these groups can join up, be put together and come up with a big strategy. Now there are three key areas: One is awareness, because at the moment there's a general feeling that dementia is still very stigmatised in society, people don't want to get a diagnosis of dementia because they don't think there's anything they can do about that and they want people to be aware so that rather than just thinking oh granny's got - losing her memory or it's just old age, that in fact it could be dementia and that something can and should be done about it. The other key area: Early diagnosis. At the moment there's quite a shocking statistic that only 30% of people with dementia actually have a diagnosis and that diagnosis usually comes very late on in the process. So all those early years when things can be done time is missed, people don't get help that they can and the key to that - their families don't get the help either. And thirdly the area they're going to look at is the quality of the treatment, so everything from services in memory clinics, in drug treatments, in the training of staff - so people like district nurses, carers, GPs - are all very more increasingly trained up to recognise dementia and do something about it. And the key thing to all of this is dignity for the person with dementia, dignity is the key word. WHITE And why this strategy and why now - has this time got a particular significance? ATKINSON Well I think it's fair to say the government's realised that dementia is in a crisis, there have been two major reports very recently in the last six months. We know that 600,000 people have dementia in the UK at the moment, that figure is going to soar. The two reports I mentioned: First was called Dementia UK, it was produced by the Alzheimer's Society back in February and for the first time they crunched the numbers and basically came up with some very startling facts and there was a big warning in there - unless something is done now it's going to be too late and already the cost to the state of dementia is more than stroke/heart disease and cancer put together. So that just shows how big an issue it is. Also dementia has a huge impact on other areas - 80% of people living in nursing homes have dementia, hospitals have an awful lot of people with dementia - and the message coming out of today is that really they need to be somewhere else other than hospital. The second key report was the National Audit Office report, that was only a month ago, and that also put the spotlight on this unfolding dementia crisis. Again another stark warning saying that the government, in conjunction with the health and the social care sectors, have to put dementia centre stage. WHITE Carolyn Atkinson, thank you so much. And we're also at the launch and in our radio car now is the care services minister Ivan Lewis and also Jenny Owen is the - from the Association of Directors of Adult Social Services or ADASS who, as we've heard, will head up the social services part of the strategy. Minister, Ivan Lewis, you accept, you've said on this programme before, that the current system is failing people with dementia so what will this first ever national dementia strategy do to change that? LEWIS Well first of all we've got to recognise that we're living in a changing society where people are living longer and longer and in doing so have more challenging conditions like dementia. We have to look at this from the perspective of a husband or a wife or a son or a daughter, seeing a loved one deteriorating before their eyes in some of the most challenging and difficult circumstances. But what we want to see is a system where people feel in the health service and the social care system is on their side rather than a system they feel that they're constantly battling with. We want to see GPs diagnose this condition appropriately and make sure people get access to treatment as quickly as possible. And we also want to make sure that the services that are made available are of the highest possible quality with dignity and respect at their heart. And also recognise the tremendous emotional pressure this puts on relatives and it puts on relationships. You know we've prioritised in this country, quite rightly, heart, cancer and stroke care, I believe dementia needs to be up there, every bit as important in terms of the challenges that now face our health service and social care system. WHITE But of course you know as well as I do that we can talk about getting rid of stigma and taking conditions out of the shadows till we're blue in the face, will it mean more resources for dementia patients and have you in fact done a deal in the upcoming spending revenue, because that's where it will need to come from? LEWIS Well of course that will be part of the deliberations that we consider. But let's be clear about this - one of the shocking things that's come out reports in this area is that there's an awful lot of money already being spent that could be spent more effectively. I've always recognised that the current social care system, which is different than the NHS, the NHS is free, social care is means tested, that social care system does need a fresh look, we need to redefine the respective responsibilities of the government, the family and the individual. We need a new system which is fair and sustainable but there are no easy choices. WHITE We know for example - sorry - we know people can't already get the anti-dementia drugs which are known to work for some people and cost just £2.50 a day, we're of course waiting a decision on the judicial review that was brought against NICE, but I mean - so will there be more money? LEWIS Well I accept that the question of medication and drugs is a big one and there's a judicial review due to find - make its findings public very, very soon, so I'm not going to comment on that. But what is clear from speaking to families particularly is that early recognition of this condition, appropriate diagnosis and referral, and then existing services being of a higher quality, sufficiently focused on the particular problems that dementia presents - those are all the things that people need and want. Now that may require - it's true - more resources ... WHITE Will it get them, well early referral will mean more money won't it because people will get treatments early and that will cost more? LEWIS No because it ends up because of the fact that we've got late referral, we've not got early intervention, this is ending up costing the taxpayer and the state far more money than actually the condition as deteriorated. It would be better to spend that money at an earlier stage, intervene, so people can have the maximum possible quality of life and we're not spending large amounts of money chasing frankly conditions which are inappropriate and not diagnosed properly. So the argument that this is just about extra money doesn't stack up. Of course there will always be a case for saying as demography takes effect, as people live longer, we as a society are going to have to have a really big fresh look at how much of a priority we need ... WHITE But we need to be having it now don't we? LEWIS ... to older people in our society. Well that's exactly what this government is doing, we're leading a debate, we're engaging in the issues, but you shouldn't also imply to members of the public listening to this programme there are easy choices, there's going to be tough decisions that have to be made, it's about the government's responsibilities, families responsibilities and individuals and it's about fairness and affordability going forward. But I'm absolutely committed to the notion that older people need to be treated with more dignity and respect in our society. WHITE Now of course any new strategy will rely on the health and social care sectors to put into practice, as we've said, Jenny Owen, as an organisation and you've been outspoken about the crisis in social care services and the current financial squeeze, can your teams deliver better services without better funding? OWEN Well I think first of all we're delighted as an organisation to be asked to co-chair this national strategy and warmly welcome this - the launch today. What - we're well known in the association for saying that there is real squeeze on resources - resources are very tight in social care services at the moment. And we very much support the demand for a national debate and want to contribute to that national debate about how services can be funded in the future. But I would also say that it's really important that the initiatives and the policy that has been coming out of the government in the last year, which is about care closer to home, really means that we need to look at how we spend the money closer to the person - to the user and their families and their carers. So it's about how ... WHITE That will mean more people knocking on your door won't it - early diagnosis will mean people asking for services, how will you cope with that with even more people trying to access services? OWEN Early diagnosis will mean people getting better information about their condition and able to make more choices about the way in which they want their care and support to be delivered. And one of the things we're doing in adult social care at the moment is making services more flexible, more responsive to the way people want their services to be arranged. So what's really important, I think, is to think about the amount of money that is in the system - in health, social care and local government generally - and think about how we want that money to be spent around the person wherever they are. WHITE Do you mean you need some health money - some of the money that actually at the moment it goes directly on health in social care, is that what you're saying really? OWEN Well I'm saying that where the person is - if the person is in the community with that long term condition - that is where the primary care services, social care services and other housing supports and so on should be centred around that person yes. WHITE In our Exeter studio is Professor Martin Knapp who co-wrote the groundbreaking Dementia UK report for the Alzheimer's Society which Carolyn's already referred to. You warned that we're careering towards an abyss, I mean what's your reaction to this strategy, does it sounds as if it goes far enough? KNAPP Well it's excellent news and we have a strategy, that's the first thing to say, I think it's great that we've got the stakeholders involved, we've got the right people to chair the strategy, so that's good news. I think there are many issues that haven't been mentioned this morning which we still need to make sure get picked up by this group. Carers - the minister mentioned the huge responsibility, burden, that many families and other carers carry. We need to make sure that those people get the information and the support and they get the respite care that they need. I mean the other thing that comes to mind from this discussion is that we've often had good frameworks and guidelines before but we haven't had necessarily the right local implementation of those frameworks. WHITE And I must ask you briefly about funding, the minister says you know it isn't necessarily about money, it's about spending the money in the right places, do we need more money? KNAPP Well we spend a lot of money already on dementia care and there's no doubt, as the minister said, that we could spend that money in better ways by reallocating it. Whether we need more money I think is a bigger issue. We face a huge number of people with long term conditions in the future, we are going to have to allocate more money than we currently do over the next two or three decades, we have to find, as the minister said, an acceptable formula for that funding. WHITE Professor Martin Knapp, Jenny Owen and the minister, thank you very much indeed, Ivan Lewis. Back to the You and Yours homepage The 大象传媒 is not responsible for external websites |
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