Scottish Parliament Update May/June 2007

PARLIAMENTARY WRITTEN QUESTIONS

Alzheimer drugs - Irene Oldfather (Lab - Cunninghame South) asked the Executive whether it has any plans to review the decision taken by the National Institute for Health and Clinical Excellence to remove donepezil, rivastigmine and galantamine from the approved prescription list for the treatment of early-stage Alzheimer’s disease. Shona Robison (Minister for Public Health) the Scottish Government has no plans to review this decision.

Free personal care - Christine Grahame (SNP – South of Scotland) asked the Executive whether it will consider extending access to free personal care to the estimated 1,350 to 1650 people under the age of 65 with dementia. Shona Robison the free personal care policy was introduced to benefit people aged 65 and over, and the government is focusing its attention on addressing implementation issues arising from this policy. There are no current plans to extend this general provision to other care groups. For people under the age of 65, two forms of support are provided. Nursing care payments are available to care home residents who fully fund their care home cost, and people who have dementia or any other degenerative illness who require care, and who live in their own homes, can claim Disability Living Allowance.

Prescription charges – Charlie Gordon (Lab – Glasgow Cathcart) Asked the Executive when it will abolish prescription charges for people with chronic health conditions and whether it will list the health conditions affected. Shona Robison we remain committed to our manifesto pledge to phase out prescription charges. We are currently considering which health conditions will fall within the definition of ‘chronic condition’ and will consult on that list in due course.

Services for people with dementia – Irene Oldfather asked the Executive what importance it places on providing support service for people with dementia, if it has any plans to review dementia support services and what discussions it will have with NHS boards and local authorities about improving support services for people with dementia and their carers. Shona Robison dementia is a national priority and we place great importance on support services for people with dementia. I have asked NHS boards to provide action plans that set out how they ensure that all services meet good practice identified by unannounced visits to NHS continuing care wards.

We also have two timetabled commitments directed at further improving services for people with dementia and their carers. This includes a pilot programme on how best to improve dementia services (2008) and the development of standards for an Integrated Care Pathway (2007).

Additional general mental health timetabled initiatives including work on reducing readmissions, improving physical health, better crisis responses and improving the physical health of those with mental illness will also have a positive impact. In addition we provide financial support to a range of voluntary sector dementia services, including Dementia Services Development Centre and Alzheimer Scotland. We are also developing an Outcomes Framework for Community Care that will provide another monitor on joined up care for vulnerable people (including those with dementia). It will start in 2007-08 and be fully implemented in 2008-09. It covers areas such as user satisfaction, waiting times for assessments and service delivery, quality of assessments and reviews, emergency admissions, carers wellbeing etc. Work on benchmarking national common service definitions and measurable outcomes in health and social care are also well underway. This work will provide outcomes allowing the benchmarking and comparison of services across Scotland including those for people with dementia.

Irene Oldfather asked the Executive how it intends to improve advocacy services for dementia patients living in nursing homes. Shona Robison The Mental Health (Care and Treatment) Act 2003 places a duty on health boards and local authorities to secure the provision of appropriate independent advocacy services for all people with mental disorders, including those with dementia. Through the implementation review process the Scottish Government is actively monitoring the provision of advocacy services for all client groups. We also fund the Scottish Independent Advocacy Alliance, which promotes and supports advocacy services throughout Scotland.

Irene Oldfather asked the Executive what action it will take to increase the number of dedicated dementia nurses in hospitals. Shona Robison we have established new workforce planning arrangements in Scotland to help match the supply of staff to the workforce demand from NHS boards. Board plans published in April 2007 provide staffing projections for all staff groups to deliver their planned patient services including dementia.

Irene Oldfather asked the Executive what action it will take to ensure that NHS boards have a strategy in place for dementia patients who are admitted to hospital for treatment of an unrelated condition. Shona Robison NHS Quality Improvement Scotland is currently developing standards for an Integrated Care Pathway for dementia, which includes an accreditation process to ensure this is delivered. These standards are for all agencies and interests and will ensure patients receive comprehensive, quality care throughout the patient journey.

Irene Oldfather asked the Executive what consideration it has given to providing specialist training in dementia-related issues for care home staff. Shona Robison The Regulation of Care (Scotland) Act 2001 and its associated regulations require a care home provider to ensure that at all times suitably qualified and competent persons are working in the care home to meet the individual needs of care home residents. Staff registering with the Scottish Social Services Council (SSSC) are required to meet specific criteria, one being having an appropriate qualification for the job they are employed to carry out. The level of, and range of, acceptable qualifications is set by the SSSC. Registration of staff working in adult care home services commenced in January 2006 with managers of the service and further groups from October 2007. The on-going pilot project (Dementia Service Development Centre/Forth Valley) looking at ways to improve local services and match care better to local needs, will also be given consideration to this issue.

PARLIAMENTARY MOTIONS

Alzheimer Scotland Polish and Ukrainain Support Service – Stephan Tymkewycz (SNP – Lothians) praises Alzheimer Scotland for the work done by its Polish and Ukrainian Support Service in providing information, advice and support to people with dementia and their carers from within the eastern European communities of Scotland; notes with concern the language and cultural barriers faced by many carers and suffers from Scotland’s ethnic minority communities when attempting to access appropriate advice and support and calls for resources to be made available to ensure that support services are available to meet the specific needs of carers from other ethnic minority communities.

Supported by: Brian Adam, Bashir Ahmad, Christina McKelvie, Hugh O'Donnell, Angela Constance, Roseanna Cunningham, Joe FitzPatrick, Christine Grahame, Robin Harper, Bill Kidd, Stuart McMillan, Alex Neil, Irene Oldfather, Mary Scanlon, Elaine Smith, Sandra White, Dr Bill Wilson, Dr Alasdair Allan, Patrick Harvie, Bob Doris, Rob Gibson, Gil Paterson

Dementia Awareness Week 2007 – Irene Oldfather (Lab – Cunninghame South) acknowledges that Dementia Awareness Week takes place between 4 and 8 June 2007; welcomes representatives from Alzheimer Scotland to the Garden Lobby of the Parliament during that week where they will host an exhibition to raise awareness of the disease; is aware that in 2007 there are over 60,000 people in Scotland diagnosed with Alzheimer’s disease and that 1,350 to 1,650 of these people are under 65; notes with concern that with an ageing population this figure is set to increase and that Alzheimer Scotland predicts that by 2031 there will be approximately 102,000 to 114,000 people with dementia; recognises that there is a need for the Scottish Executive to take decisive action now to accommodate this increasingly vulnerable group in our society; welcomes the publication on 4 June 2007 of Alzheimer Scotland’s latest report, The Dementia Epidemic – where Scotland is now and the challenges ahead; notes that the report highlights the large and rapidly-growing number of people with dementia in Scotland and the economic impact that this has today and will have in the future; recognises that there are steps that everyone can take to reduce the risk of developing Alzheimer’s disease; welcomes Alzheimer Scotland’s latest information campaign, Good for you, good for you brain, which emphasises the small but significant lifestyle changes that people can make to reduce the risk, such as eating healthily, staying mentally and physically active and maintaining social networks; but accepts that it is the responsibility of government to implement strategies to better accommodate the needs of dementia suffers and their families, and therefore calls on the Scottish Executive to increase funding for care services, both in the immediate and longer term, improve training in dementia care, restore the availability of drug treatments to people with mild Alzheimer’s disease and make dementia a national priority.

Supported by: Dr Elaine Murray, Hugh O'Donnell, Michael McMahon, Bashir Ahmad, Jackie Baillie, Sarah Boyack, Malcolm Chisholm, Ross Finnie, George Foulkes, Marlyn Glen, Trish Godman, Iain Gray, Robin Harper, James Kelly, John Lamont, Marilyn Livingstone, Margo MacDonald, Liam McArthur, John Park, David Stewart, Mr Jamie Stone, Sandra White, Robert Brown, Bill Butler, Jackson Carlaw, Cathie Craigie, Hugh Henry, Cathy Jamieson, Johann Lamont, Ken Macintosh, Duncan McNeil, Alex Neil, Elaine Smith, David Whitton, Rhona Brankin, Dr Bill Wilson, Patrick Harvie

Younger patients with dementia – Dr Ian McKee (SNP – Lothian) notes that in Lothian region there are between 170 and 225 people under the age of 65 with dementia and between 1,350 and 1,650 across Scotland and, recognising the heavy burden that falls to those caring for anyone with dementia and the special needs of younger patients with this condition, considers that benefits of free personal care for the elderly should also be applied to this group.

Supported by: Bashir Ahmad, Roseanna Cunningham, Bob Doris, Joe FitzPatrick, Christine Grahame, Robin Harper, Bill Kidd, Christina McKelvie, Stuart McMillan, Alex Neil, Irene Oldfather, Mr Jamie Stone, Sandra White, John Wilson, Rob Gibson, Dr Bill Wilson, Michael Matheson, Dave Thompson, Jamie Hepburn

MINISTERS QUESTION TIME

Prescription charges – Margo MacDonald (Ind – Lothians) asked the Executive the time table for the abolishion of prescription charges. Shona Robison the immediate abolition of prescription charges for people with chronic conditions was a manifesto commitment and we are currently considering options for how best to take that forward. It will be as inclusive as possible and we hope to be in a position to introduce changes around April 2008.

PARLIAMENTARY DEBATES

Free personal care – Thursday 14 June

Alzheimer Scotland issued MSPs with a briefing on our main concerns around free personal care ahead of the debate. Dr Richard Simpson (Lab – Mid Scotland and Fife) spoke about how important free personal care was for older people with dementia for addressing the discrimination that existed for older people having to pay for personal care in nursing homes whilst those in hospitals did not. Ian McKee (SNP – Lothians) spoke about it being unfair that younger people with dementia are not eligible for free personal care. Nicola Sturgeon (Deputy First Minister and Cabinet Secretary for Health and Wellbeing) said that the policy was broadly working but that there were variations in how the policy was being implemented in different parts of Scotland. The Executive has promised:

• An independent review under Lord Sutherland to investigate the level and distribution of resources to local authorities, which will report in March 2008.
• Clarification of a number of issues including rules on charging for food preparation, assistance with medication, waiting lists and a more balanced approach to eligibility criteria. Some of which may require additional legislation.
• Increase the level of payments for free personal and nursing care in care homes in line with inflation from April 2008.

Health and wellbeing – Thursday 28 June
This debate covered a broad range of health and welfare issues. Nicola Sturgeon reiterated the Executive’s manifesto commitment to make services for people with dementia a national priority and called on cross party support to achieve it. Ms Sturgeon also said that the Executive want to make rapid, significant and sustainable improvements in support for carers, including respite care.