Meeting of the Parliament 01 March 2023 [Draft]
Dementia is the on-going decline of brain functioning, typically presenting as memory loss, the slowing of thinking speed, the loss of mental sharpness and the mixing up of words. Dementia often leads to trouble with speech, low mood, anger and difficulty with carrying out basic daily activities.
The most common type of dementia is Alzheimer’s disease, which is progressive, with symptoms developing gradually over many years until eventually they become severe. Symptoms include: personality changes, such as someone becoming aggressive, demanding and suspicious of others; hallucinations and delusions; and low mood and anxiety. Partners, family and friends can all become strangers.
All too often, close family members sacrifice their own wellbeing to ensure that a loved one gets the best care that they can give. As a general practitioner, I often hear about changing roles in relationships, such as children having to become the parents and take responsibility for financial matters, or a partner having to be the main carer. It can all be quite overwhelming, as Stephen Kerr highlighted when he talked about his mother.
As we get older and our health changes, it is really worth considering setting up continuing and welfare powers of attorney. That involves having a conversation with loved ones about their needs and wishes, because it can be difficult to do that once there is a diagnosis of dementia.
According to Public Health Scotland, as of 2015, up to 90,000 people in Scotland were affected by dementia, of whom around 3,000 were under the age of 65. The number of people dying with dementia is rising. Fifteen years ago, there were 3,200 deaths but the number has doubled in just a decade. Marie Curie expects that, by 2040, dementia will be the main underlying cause of death, with 19,200 deaths per annum—a threefold increase in 17 years.
I think that all members can agree that we need a more robust dementia strategy in place, with actions and measurable outcomes, and that that should be a priority for Government. Dementia policy cannot be tinkered with.
I also think that we can all support the principle that people who are living with dementia must be supported to live their lives as they want to live them, for as long as they can do so, and that, when they approach the end of life, they should have access to the most appropriate care, advice and support. Access to palliative and end-of-life support should be a significant component of our dementia strategy.
A key priority of the Scottish National Party Scottish Government’s previous dementia strategy was the extension of access to post-diagnostic support. However, delivery was poor. Fewer than half the people who were newly diagnosed with dementia were offered post-diagnosis support. The Western Isles had the worst rate, at 28.5 per cent.
The SNP Government also announced that the management of an individual’s care and support would sit in primary care and be led by a dementia link worker, so that people would receive timely aid. Then it cut £65 million from the primary care budget. The SNP has been in charge of primary care services for 15 years, but 42 per cent of GP practices report that demand substantially exceeds capacity, and 34 per cent of practices have at least one GP vacancy. The British Medical Association estimates that Scotland is short of 312 full-time-equivalent GPs, and, according to the Auditor General for Scotland, the SNP is nowhere near on track to increase the GP headcount by 800 by 2027.
That is the SNP in action: big on announcements, light on delivery. The SNP-Green Government has cut £70 million from social care—services that offer crucial support to those suffering from dementia.
Whoever is health secretary or in the minister’s chair after 27 March must get real. Failures in the context of primary care, delayed discharge and social care have all had severe consequences for the quality of the care on which people with dementia and their families rely.
We need to find solutions. That entails political decisions about policy and resources. Platitudes will not wash, and nor will self-congratulatory statements from those on the Government benches.