Dáil debates

Thursday, 28 June 2018

Other Questions

National Dementia Strategy

11:40 am

Photo of Dara CallearyDara Calleary (Mayo, Fianna Fail)
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9. To ask the Minister for Health if a new national dementia strategy is being prepared; and if he will make a statement on the matter. [28235/18]

Photo of Dara CallearyDara Calleary (Mayo, Fianna Fail)
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My question is similar and aims to tease out an update on the preparation of a new national dementia strategy. The current strategy is due to be completed this time next year, having missed most of its targets. Given the increase in dementia rates across our community, what are the Government's plans for a properly funded strategy that can be implemented?

Photo of Jim DalyJim Daly (Cork South West, Fine Gael)
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The national dementia strategy was launched in December 2014 and seeks to increase awareness and understanding of dementia, ensure timely diagnosis and intervention, and provide enhanced community-based supports and services. The strategy was developed to meet the challenges faced by the 55,000 people living with dementia in Ireland and to provide services to meet growing demand in future years. The number of people with dementia is expected to almost treble by 2046.

A mid-term review of the implementation of the strategy was published on 23 May. It indicates that half of the strategy's 35 actions have been substantially progressed, with preliminary work done on the other half. The mid-term review also contains an action plan for the work of the National Dementia Office over the next year.

A number of priority actions in the strategy were co-funded by the HSE and The Atlantic Philanthropies through the €27.5 million national dementia strategy implementation programme. These include the establishment of the National Dementia Office within the HSE, upskilling and training of GPs and primary care teams, an awareness campaign and intensive home care packages. Actions within the strategy that did not receive funding through the national dementia strategy implementation programme are also being addressed. These projects include the development of a diagnostic and post-diagnostic support pathway, the roll-out of a national network of memory technology resource rooms, the mapping of dementia-specific community-based services, and the development of a job specification for the role of key worker. Funding for some of these actions has been secured through the Dormant Accounts Fund, with the Department securing €2.28 million through the 2016 and 2017 action plans.

A large-scale external evaluation of the strategy is being conducted, the results of which will be available during the first quarter of 2019.

The Department is committed to the full implementation of the national dementia strategy and will continue to work with the National Dementia Office and stakeholders to progress the actions contained in the strategy. Until satisfactory work has been completed on actions contained in the current strategy, and because the external evaluation of the strategy has not concluded, it would not be appropriate to begin work on a new strategy.

Photo of Dara CallearyDara Calleary (Mayo, Fianna Fail)
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For each of the 55,000 people who suffer from dementia, at least three others are affected by it. They need certainty and consistency in the delivery of services, but that is not happening. We are putting these people on an appalling health journey, and the blockages and inconsistency in services throughout the country are making that journey even more difficult. It took the Minister of State's personal intervention to resolve a service issue in Mayo that Deputy Lisa Chambers and I raised at the end of last month, when the HSE was going to cut services to dementia sufferers. Families need more than ministerial intervention to give them certainty in services, though; they need a break. The lack of a properly resourced strategy is not helping.

Apart from the 55,000 dementia sufferers we know of, how many more will receive that diagnosis? People are developing dementia at a younger age. Specific cohorts within the 55,000 have additional needs, for instance, the 700 with Down's syndrome. They are all being left in abeyance because of the lack of a properly funded and deliverable strategy and the inconsistency from CHO to CHO. People with dementia should get the same level of high service no matter where they are in the country, but that is not happening.

Photo of Jim DalyJim Daly (Cork South West, Fine Gael)
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I thank the Deputy for his acknowledgement. I agree that it should not have been necessary for him to reach out to a Minister to have the issue in his county resolved.

Regarding the wider question on a new national dementia strategy, the strategy itself is not the issue. It is ambitious, and one of the key elements underpinning it is a change of culture in society so that, rather than believing that people should be locked away just because they have dementia, they should instead be accommodated in their own communities. Such a shift in attitudes highlights the significant challenges facing a strategy like this. It is not something that will happen overnight, which resources would not allow for anyway.

I want more resources to be invested in dementia services. There are no two ways about it, but dementia is the challenge of our time. We as a political body must respond in kind and up our game when it comes to resourcing the provision of services for the significantly increasing number of people affected by dementia on a daily basis, as Deputy Butler stated.

An external evaluation of the strategy is about to be concluded and I look forward to its conclusion. Once that happens, we need to continue with our current strategy and ensure its implementation.

Photo of Dara CallearyDara Calleary (Mayo, Fianna Fail)
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We do not need to change the culture, as communities are leading the response to dementia on an organic basis throughout the country. The HSE is behind the curve. It comes along and tries to shut down community-led initiatives.

A new strategy will have to be prepared without the participation of The Atlantic Philanthropies. Since there will be no rich sugar daddy anymore, the money will have to come from the taxpayer. The Minister of State should commence that work as soon as the external review is concluded. He should not be behind the curve. Most important, it must be ensured that those suffering from dementia and their families are consulted and central to the writing of the strategy and that it is not left to some HSE official who does not get the situation. It is clear that many officials do not understand what families and patients are going through, and the cross being borne by people around the country. The Minister of State needs to involve families and the organisations. They need to be central to the new strategy.

Photo of Jim DalyJim Daly (Cork South West, Fine Gael)
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We are effectively saying the same thing but, to be fair, I am not sure that people do not understand the situation. Given dementia's unfortunate and increasing prevalence, the incredible number impacted includes people who are making decisions at senior levels within the Department and HSE.

However, I take the Deputy's point that this must be a priority for resourcing. The battle is on for the budget, which I hope will be before the House in October. I accept full responsibility for the need to ensure that dementia will be a top priority in next year's health budget. I look forward to whatever support comes from the Deputy's party. Strength and leadership has been shown by Deputies Butler, Calleary and Lisa Chambers and other Members who have a stake in ensuring that we get this right. I will play my part and co-operate in full.