Hansard

I begin by thanking Irene Oldfather not only for securing this evening's debate but, more important, for her tireless and tenacious work in trying to help many thousands of our fellow citizens. I declare an interest: my father-in-law suffers from dementia. Such people are not alone when Irene Oldfather is in this chamber. I want to put my thanks to her on record.

I also thank others, even though—like me—they may not be so involved and may not attend so many meetings of the cross-party group on Alzheimer's. I am proud to be a member of that group. The work of Parliament is enhanced by the work of cross-party groups, which place experts from outside Parliament alongside MSPs of all parties to work together on issues that we consider to be important and urgent.

Few Scottish health issues can be more important than dementia. It is a growing problem, and demographics show clearly that the situation will get worse. The Government acknowledges that, which I welcome.

The cross-party group's report contains six recommendations, all of which have real merit, and behind the recommendations stands a good body of work. After the services that are provided by health boards in Scotland were considered, it became clear that no health board is doing enough for people with dementia.

This evening we have focused on accident and emergency services, but wider issues arise when we consider how the health service as a whole deals with people with dementia when they meet personnel whom they do not normally meet. Before he entered a care home, it was suggested to my father-in-law that he should have an operation on his eyes. The operation would have meant that he had to sit with his head held still in a particular position for three or four months. When it was pointed out to another member of staff that he was in his eighties, had dementia, and could not stay still for more than two minutes, it became clear that, in the health service, the left hand did not know what the right hand was doing. Later, the issue was addressed and resolved.

It is not only in accident and emergency units that issues arise. The system that allows such issues to be flagged up should be much more effective than it is at present.

When dealing with a patient with dementia, professionals must listen to families and carers, who will know much more about how their loved one is affected by this dreadful condition—for example, by mood swings. Richard Simpson is right to say that the effects can come out as aggression towards families and staff.

Accident and emergency services have to be improved. It is quite unacceptable that a person with dementia should have to sit in a waiting room for hours; it may even be impossible for them to do so. Staff training is required—because people with dementia have a greater chance of falling, it is likely that they will make up 25 per cent of the patients in an accident and emergency unit. Every member of staff should therefore have some form of dementia training.

We should not underestimate the importance of preventing as many falls as possible and we should do what we can to prevent hospital admissions in the first place. However, we all know that, no matter how much we care for a relative, and no matter how good a care package is put in place by social workers and local health professionals, such falls and such disorientation will always be highly likely, because of the nature of dementia.

It is important that the Government takes on board what we have said about dementia-trained nurses, but it is almost more important that training is embedded more generally for all staff in the health service, given the nature of the problem. We must also try to minimise the number of interactions that older people, particularly those with dementia, must go through. Our watchword at all times should be "dignity"—the dignity of the human condition. Dementia strips that from people, so we must build into the health service measures that give people their dignity at all times.