STATEMENT TO THE ASSEMBLY – DEMENTIA SERVICES
Mr Speaker, I am grateful for this opportunity to make a statement
to this Assembly on the important matter of dementia services in
Northern Ireland. Across the developed world there are increasing
numbers of older people. This brings with it increasing numbers of
people with dementia.
We are all agreed on the significance of the challenge posed by
our progressively aging population. Dementia is of increasing
importance to Government, to our communities, to our families and
to the individuals who have dementia – it is a major concern for us
all – the scale of the problem is increasing in accordance with our
In Northern Ireland we have the fastest growing elderly population
in the UK. Currently, over a quarter of a million men and women
are of a pensionable age, which is nearly one in six of our
population. By 2028 that will have increased to nearly one in five.
By 2050, nearly one in four.
Demographic changes have a very specific impact on demand for
Health and Social Care services. As life expectancy rises, the
number of people affected by conditions associated with old age
will increase dramatically. Based on rates from across Europe, we
may see dementia numbers rise from 19,000 currently, to around
60,000 by 2051.
We must also remember that dementia does not only affect the
elderly. There are a significant number of people with dementia
who are under 65 (early onset). Early onset dementia is especially
difficult to diagnose so the actual number is uncertain. However,
estimates suggest there could be as many as 1000 people
affected by early onset dementia in Northern Ireland. Considering
the specific needs of this group is another challenge that must be
I am very aware, that we, in this Province, provide a range of
excellent services for people with dementia – services that are
provided at a local level, which involve people living with dementia,
their carers and families, teams of professionals who provide
assessment and ongoing support, and who provide services that
are tailored to meet the changing needs of people with dementia.
The multi-disciplinary nature of this care is, I think, a tribute to our
integrated health and social care system - doctors, nurses, social
workers, voluntary sector staff, members of housing associations,
the independent sector - all combine to provide pathways of care.
And in the midst of this process we have genuine partnerships with
family members and carers, who together, enable individually
tailored programmes of care to be developed.
Better outcomes for people living with dementia can be achieved
when we come to understand how to delay the onset of dementia;
when we have better ways to diagnose it early and when we have
effective treatments for dementia alongside high quality care.
Our goal must be to ensure that people with dementia are given
every chance to live their lives to the fullest capacity and as
independently as possible.
As far as is possible people should be supported to remain in their
own homes. However, almost half of people with dementia in NI
are in care homes, with another sizeable proportion in acute
hospitals on any given day, often staying longer than other
We need to ensure that those in care homes or in hospital are
there because they need to be and that they receive appropriate
care while in these settings.
All of this leads me to why I am making this statement today. Mr.
Speaker, I am very pleased to announce the publication of the
document entitled Improving Dementia Services in Northern
Ireland – A Regional Strategy.
The Dementia Strategy has been developed at a time of increasing
pressure to address dementia issues arising from the demographic
change detailed earlier. Underpinning the development of the
Strategy has been service user and carer involvement.
The Alzheimer’s Society carried out a pre-consultation exercise
with service users and carers to help inform the Strategy at an
early stage. This was titled the ‘Listening Well’ Report.
We consulted on the draft Strategy last year. Accompanying the
public consultation was a targeted consultation with service users
and carers, carried out by the Dementia Services Development
Centre. Steps have since been taken to reflect the views
expressed during consultation and these have been reflected in
the final Strategy document which I present to you today.
Also underpinning the Strategy has been the development of a set
of Values & Principles, which are considered key to guiding the
future development of services for people with dementia and the
people who care for them. These are:
Dignity and Respect;
Justice and Equality;
Safe, Effective, Person-centred Care;
Care for Carers; and
Skills for Staff.
As you can see there has been a focus through the development
process on creating a Strategy that is centred on the person,
aimed at addressing the things that concern people the most.
For those with a diagnosis of dementia, the Strategy requires us to
look critically at the way we are delivering services. We all must
ensure that it is not only what people with dementia and their
carers have said they want and need, but that it is supported by
evidence of its effectiveness.
I want to ensure that people with dementia are treated with
awareness and respect, especially by those providing services,
and that they are supported to maintain their independence for as
long as possible.
Importantly, more needs to be done to promote the key message
that a healthy lifestyle can delay or prevent the onset of dementia
and indeed many other long-term conditions. And of course an
unhealthy lifestyle will increase people’s risk of such conditions
The key themes of this Strategy are:
Prevention - there is some scope to prevent or delay the
onset of dementia through a healthy lifestyle approach and
reduction in cardiovascular risk factors.
Raising awareness and addressing stigma associated with
Access to early diagnosis, enhancing existing memory
services to agreed commissioning standards to provide
assessment, diagnosis, information and support.
Staged approach to care and support as the condition
progresses, with the aim of maintaining daily living and
independence as far as possible.
Improving staff awareness and skills to respond
appropriately to people’s needs.
Redesign of services to shift care as far as possible to
people’s own homes and avoid admission to hospital or care
home where possible.
The need for worldwide research into causes, cure and care
for dementia and the part played by NI researchers are also
I believe that the Strategy can help shape the development of
excellent services for people with dementia.
The new mental capacity legislation, which I hope to introduce into
the Assembly next Autumn, is also likely to have an impact on
people with dementia, offering additional support and safeguards
when they are unable to make their own decisions.
Meeting the increasing demand for dementia support services will
require everyone from HSC professionals, voluntary & community
organisations, and service users and carers, to work together to
develop more efficient and effective systems of care, and to plan
and implement better treatment and support programmes.
I am confident that we have produced a practical, realistic and
achievable Strategy for people with dementia, one which is
designed to deliver the best services and support arrangements
we can, tailored to the individual’s particular needs and
circumstances. And we must always remember that simple
interventions can often have very important and significant
But, most importantly, we are not starting from scratch. Our health
and social care system, working in partnership with community and
voluntary organisations, and the independent sector represents a
skilled, knowledgeable and dedicated base from which to build.
The Strategy sets the direction of travel for improving dementia
services. I expect the HSC Board, Public Health Agency and
Trusts to reflect this in their commissioning decisions so that
services can be refocused to address the improvements required.
Mr Speaker, there would be a very strong case for additional
funding for dementia services, given the growing needs I have
explained and the pressure on families and service providers. In
an ideal world, I would allocate £6-8 million to increase aspects of
provision in the next three years. However, I am also asking all
concerned to make better use of existing resources devoted to
acute sector provision and to care homes. There is evidence that
there is room for greater efficiency in both areas – and it is simply
not possible to add new money in the present budgetary position
facing the Executive.
In closing Mr Speaker, I would like to take this opportunity to thank
the many individuals and organisations who contributed to the
development of the document. They deserve great credit for their
efforts in producing this Strategy.
I commend this Strategy to the House.