We now move to the next item: the statement by the Cabinet Secretary for Health, Well-being and Sport on the consultation on the draft dementia strategic action plan for Wales. I call on the Cabinet Secretary to make his statement—Vaughan Gething.

Thank you, Presiding Officer. In October, I presented to the Assembly the second delivery plan of our 10-year cross-Government strategy, ‘Together for Mental Health’. That was launched on World Mental Health Day, 10 October. A key action within the delivery plan is the development of a dementia strategic action plan. This responds to a key commitment within our programme for government, ‘Taking Wales Forward’. It is the clear ambition of this Government to make Wales a dementia-friendly nation. I’m pleased to make further progress within the first year of this Assembly term. I launched the public consultation on the first national dementia strategic action plan for Wales at Oldwell Court in Cardiff yesterday.

The Deputy Presiding Officer (Ann Jones) took the Chair.

People living longer is, of course, something to be celebrated, but, as life expectancy improves, we know more people will develop dementia. Dementia is one of the biggest healthcare challenges that our generation faces. It’s estimated that between 40,000 and 50,000 people in Wales are currently living with dementia, although not all are diagnosed. Clearly, the impact of dementia in society is much wider when we consider carers and family members.

It is crucial that we hear from people living with or affected by dementia, just like the people I met yesterday at Oldwell Court, because we want to understand what matters most to them. We must have a clear way forward to support people with dementia and the people close to them. A number of engagement events across Wales have already taken place to hear from people living with dementia, their family members, carers, health professionals, voluntary organisations and other people with an interest in dementia. That’s been undertaken in partnership with the Alzheimer’s Society and the Dementia Engagement and Empowerment Project, widely known as DEEP, who have already engaged with over 400 people personally affected by dementia. My thanks do go to all of those who have contributed to this work, as their views and experiences have been instrumental in creating the draft plan for wider public consultation.

It’s worth recognising that no two people with dementia, or the people who support them, will have identical needs. From the pre-consultation work already undertaken, people have told us that services need to be values and rights driven, and be tailored to the individual. That support needs to be flexible to the different needs at different stages of the condition. Those sentiments have been echoed in a number of reports, including the older people’s commissioner’s report, ‘Dementia: more than just memory loss’ and the Welsh Language Commissioner’s inquiry into the Welsh language in primary care, ‘My Language, My Health’. The issues identified by these reports include a lack of knowledge and understanding of dementia amongst professionals and the public, and the need for dementia assessments and care to be accessible through the medium of Welsh. The need to ensure access to help, support and services in rural areas has also been highlighted in a report published last year by the Alzheimer’s Society.

We have, in fact, though, come a long way in realising our commitment to create a dementia-friendly nation here in Wales, but we recognise that there is, of course, more to do. Last year, we announced a number of priority areas on dementia and the steps we would take to address them. This included work on dementia risk reduction, increasing public awareness, actions to improve diagnosis rates and ensuring that support is available to people affected by dementia. The draft action plan builds on this work and contains a number of themes that we propose will require further action over the next five years. But, to ensure that the plan remains relevant and targeted, it will be formally reviewed and refreshed after three years, and the final plan will include more details on timescales, examples of notable practice and expectations for delivery.

The themes have been structured using a pathway approach, which came out strongly from the engagement that we’ve undertaken so far. Proposed areas for action include raising awareness of how to help people reduce their risk of developing dementia, or delay its onset; raising awareness and understanding of dementia through the expansion of Dementia Friends and dementia supportive communities and organisations; ensuring that dementia is recognised appropriately and that people have timely access to assessment and diagnosis; early support and treatment for people with dementia, their carers and families, following diagnosis; and the availability of increased support, whether in a person’s home, in hospital, in a care home or even at a day centre. The plan also contains a section that supports implementation. This includes a continued focus on education and training, following the recommendations included in ‘Good Work: A Dementia Learning and Development Framework for Wales’, launched last year in Hefin David’s constituency, and also continued support for research into dementia.

The formal consultation will run for three months, closing on 3 April. I am urging everyone with an interest in dementia to share their views. We would like to hear from the wider community, including businesses, faith groups and other interests. It is only by working together that we think we can build a truly dementia-friendly Wales and combat other problems, such as loneliness and isolation. The public consultation will help us to use people’s experiences and expertise to develop and deliver a robust and evidence-based action plan.

I do trust that Members from all parties will recognise the work undertaken to date. I look forward to hearing the views of as many people as possible, to ensure that our final plan is ambitious and achievable, and that we do work in partnership with individuals, their families and their carers, to continue to make progress towards making Wales a genuinely dementia-friendly nation.

Thank you very much. Angela Burns.

Thank you, Deputy Presiding Officer. Cabinet Secretary, I welcome this statement immensely. I am very pleased to see that there’s a public consultation to inform the dementia strategic action plan. I do want to pick up on the paragraph where you start by saying:

‘People living longer is something to be celebrated.’

I think that, too often, the rhetoric around dementia, the rhetoric around older people, is not positive: they are bed-blockers, they are a drain on social services, and dementia is something that is going to happen to everybody and it is going to be absolutely terrible. Whereas, of course, we know that older people are to be celebrated, that they are a vital part of our community, and that dementia, if supported, if caught early, and if given the appropriate treatments, can actually be slowed and sometimes put into remission, and that people can go on to live really good live even though they have dementia—obviously not everyone, but, still, some people. So, it is to be celebrated.

I only have three questions because I am quite sure that the Chair of the cross-party group on dementia is going to have quite a significant number of questions for you, and I am very pleased to be a member of that group. When you see the outcome of this consultation, will you ensure that the action plan has clear and measurable outcomes, and a consistent data set? I think this is incredibly important because a key problem in ensuring transparent accountability is that measurements change over time, parameters can be fudged, and transparency can dissolve into opaqueness. I think that if we want to know whether or not this action plan is going to work and continue to work over the next decades, then to have a clear and consistent set of outcomes and measurables is vitally important, going forward.

My second point is, in looking at the consultation, it doesn’t propose much on delivery models. So, I wanted to have a little bit of an understanding from you on whether you will be seeking to rely quite significantly on co-production with third sector organisations; or will you be looking to increase the intervention by Welsh Government by, say, increasing the numbers of support workers; or will you be putting much of this responsibility onto health or on to social services or local councils; or will you be looking to deliver through the partnership boards?

Finally, given the severity of the dementia issue in terms of the fact that it is now one of the biggest killers of people in Wales, and given that it is also one of the main reasons why sufferers and carers suffer so badly from isolation and loneliness, which of course impacts on their mental and physical well-being even more, do you think that the targets that you have in the plan are ambitious enough? They don’t bring us in line with other countries. I do appreciate that it is always hard to go from one level to another, but a 3 per cent increase year after year—is that going to actually get us to where we want to be quickly enough, or can you look to improving those targets? Dementia kills more people than almost any other disease in Wales, and we really need to get a grip of it.

Thank you for the questions and comments, and I agree: as I said in my statement, we should celebrate the fact that more of us live longer. Our challenge always is: how do we live healthily and live well for longer as well? Part of the point you made earlier about reducing our risk or delaying the onset of dementia is that there is lots and lots of evidence about how we can help ourselves to live longer. We talked lots in the last term—but not so much this term—about the fact that the Caerphilly study shows us an awful lot, not just about the theory but about the practical reality of what each of us can do to make different choices about how we live our lives, to live a healthier life, to reduce our risk of having dementia or, indeed, to delay the onset. There are also major public health factors in a whole range of other conditions too, in the way that we can reduce those particular challenges for us, not just for the health of the nation, but for individuals as well. And that’s part of what we want to try and move to in writing this plan, about having different bodies talking about the same messages about what each of us could and should do, as well as what we then expect of each other within our communities, but also of public services and the private sector as well.

And I think that this goes back to the point you made about the actions for different partners, because there will be things for the health service to do. We were talking about diagnosis rates, so, a range of people obviously have to be a big part of that, but also in social care, in the care and provision and the way that we expect the social services and well-being Act to be implemented progressively, there are sections in the action plans being consulted upon about what we expect to see happen. As that Act is implemented, the third sector will be not just champions and advocates, they provide services—they’re commissioned to provide those services in different parts of the sector. But there’s an awful lot in here, as I say, about us as a society and as a nation, and what each of us will do, as individual employers in this room, with our staff and the way we all deal with our constituents, the way that we talk, to the way that businesses and the wider communities are actually genuinely friendly and understanding of, you know, the significant number of people who live with us now and will do in the future as well.

So, it isn’t just one set of partners; that goes back into how we’ll have consistent data and measures for success. Some of these will be easier to measure than others. How people feel that they are supported, for example, is more difficult to measure in the same way that we might want to measure, for example, diagnosis rates and have harder data about what is being done in different parts of it. But I do want to see commentary on what’s in the plan and how we then have meaningful measures, because we do know—and this is being perfectly honest—that, in the past, each of us has signed up to saying the Government should do, the Government should measure different parts of activity, but they don’t always tell us a great deal that is useful, and I really do think, in the end, if you want something that is both, as I say, realistic and ambitious at the same time, that does mean that the measures that we have and the way we want to produce that information has got to be meaningful and useful. Otherwise, we could measure activity in a way that is easy to say we’re measuring something but not really telling us anything of value.

And on your final point about diagnosis and the 3 per cent year-on-year increase, I think that is quite ambitious, actually, and if we achieve it, we’ll see a progressive and increasing number of people coming into services and actually receiving services and, hopefully, receiving more help. But, if people have a different view, then they should say that during the consultation. And it’s then also about having an ambition, as I say, that is achievable. What I don’t want to do is to set a level of ambition that may look great on paper but we don’t then have the services scaled up to deliver and we set our staff up and our services up to fail then, and that can’t be the right thing. It’s got to be about how we further improve what is a real and current significant challenge for health, social care and our nation and will be more so in the future.

I’m very pleased that we now have a strategy that we can give due attention to through the consultation, to strengthen it and to build on what we have before us, by including the experiences of those people who genuinely know what needs to be done, namely the families of those who have dementia. I know that the majority of us here in the Chamber have heard plenty of heartbreaking stories of people who feel that they failed to access the care that they feel should be a fundamental right for someone with dementia: the woman who had to stay on a ward in a hospital for months with a relatively simple infection because there was a failure to put an appropriate package of care in place in her community; the carers who can’t arrange care for even a short period of time to have a break; those who feel that the kind of day care that’s vital for them isn’t available. It’s the voices of those people, the families and those who have dementia themselves, that I want to hear coming through in the final strategy, following this consultation. I’m sure that the Cabinet Secretary would agree with that.

I only had five questions. Two have already been asked by Angela Burns, so I’ll ask them as rhetorical questions, even though we know what the Cabinet Secretary has in mind in that regard. It’s important to have a balance between being ambitious and being realistic, but I will ask whether this 3 per cent increase in diagnosis on an annual basis is something that the Cabinet Secretary genuinely feels couldn’t be improved upon, because that will only take us, in five years, to the situation where Northern Ireland is at present.

The other rhetorical question is how to measure success, ultimately, because it’s the action that’s important here, the effect that this strategy will have on people the length and breadth of Wales. Is the Cabinet Secretary clear in his mind that he will be able to look back and say, ‘Yes, this has worked’ or ‘This hasn’t worked’?

Three questions to which we may receive specific answers: is there an intention to develop further the preventative side, to invest genuinely in opportunities, for example, to exercise to delay or reduce dementia symptoms, and not just to draw attention and raise awareness of the kind that the Cabinet Secretary mentioned a few minutes ago? In terms of diagnosis in the Welsh language, as the Alzheimer’s Society has said, I very much welcome the plan and the intention to improve things somehow, but when will we have, from the Government as well as from others, as part of the consultation, more detail on what is being considered here?

Finally, the rural aspect of dementia care. Does the Cabinet Secretary expect that this final strategy on dementia will give us a fuller picture and clearer picture of the specific issues that stem from the needs of dementia care in rural Wales? As I say, I welcome the fact that we do now have this draft strategy to work from; the challenge now is that we would have a final strategy that is going to be able to achieve these very warm words on which we can all agree to make Wales a genuinely dementia-friendly nation.

Thank you for your comments and questions. I’ll start with where you ended, on the points about rural Wales, of course. I expect there will be comments from people from right across Wales, in both urban and rural Wales, on the reality of provision and support now, and what they want to see both in the strategy and in the delivery afterwards. There are points that both you and Angela Burns have made, not just about the vision that we have, and what is in here and what may or may not be in here. Those are points to be debated, discussed and argued and then, ultimately, we’ll have to make a choice. But it is about how they’re delivered in reality. So, that’s some of the points about measures of success and how we share information, again, which were constantly made during your contribution as well.

You will see more of this because the consultation ends on 3 April, as I said. You will then see a response with a finalised version of the action plan being produced over this calendar year and then progressively implemented. I hope that people will be able to reflect on comments that have been made through the consultation process actually having an influence on what ultimately is then going to be implemented and delivered. I reiterate again that what we have now comes from that conversation and listening to people who are living with dementia now. Not just advocates in the third sector, but individuals themselves, their families and their carers have actually had a real part to play in drawing together the current consultation proposal and we will of course be listening to them. I’m really pleased, actually, that the Alzheimer’s Society made clear that their main message yesterday following the launch was that people living with dementia have to be involved and their voices have to be heard, in telling people what their real experience is, and whether the consultation is going to reflect upon that in what we then ultimately do.

Just to your point about prevention, of course we produced the ‘Dementia: reduce your risk in 6 steps’ guidance in May 2015, and I was not the health Minister at the time—someone else was. But there are really simple points there: the points about acting now, and what we can do to reduce our risk by being active, checking our health regularly, trying new things, not smoking, only occasionally drinking alcohol—that’s a challenge for a number of Members—and by watching our weight. These are all things we laugh and joke about from time to time, but they actually have a real influence on our ultimate health outcomes now and later in life as well. So the consistent message we want to give—and I think it’s actually helpful in some ways—is that these are the same sorts of messages we give on a whole range of other public health challenges. The real issue will be: can we persuade ourselves and people in the country not just to understand what those messages are, but then how we make it easier for people to do something about those? It’s not about trying to take the fun out of life. It is about saying, ‘These things can make a difference’, and how do we help to make those healthier choices easier choices.

So, there are big challenges for all of us, but I’m cautiously optimistic about where we are now, and our ability to have in place a plan that is appropriately ambitious, realistic, and achievable. We will of course be reporting back at the three-year point as to where we are, that sense check on what we’ve done, and then to check again that we’re still in the right place in what we expect people to do, and the sort of progress that we are making.

Can I thank the Cabinet Secretary for his statement? I’m really, really pleased that we have reached this point today and, like others, I really welcome the commitment that you’ve made to ensuring that the voices, not just of families affected by dementia, but of people who are living with the condition are fully heard through this consultation. I think those are the most important voices of all: far more important than our voices, as important as it is that we speak out. I think there is a great deal to welcome in this draft strategy. I think it covers all the main areas that I would think should be covered.

I do just want to pick up on a couple of specific points. The first is diagnosis rates. I don’t think that 3 per cent a year is ambitious enough. As I’ve said before, we wouldn’t accept a 50 per cent diagnosis rate for a condition like cancer and we shouldn’t accept it for something like dementia. I hope that, as we go through the consultation, it will be possible to introduce a more ambitious diagnosis-rate target.

Of course, diagnosis targets are only valuable if you’ve actually got the support services in place for people once they’ve received the diagnosis, and I’m pleased that the strategy recognises that. Indeed, you recognise the fact that pharmacological treatments, et cetera, which can slow the progress of dementia, can only be made available to people once you’ve had that diagnosis. I think that’s very important. But there is still a lack of detail on this issue of support workers: currently 32, it’s clearly not going to be enough for the whole of Wales, especially if we do increase diagnosis rates. So, I hope that, through the consultation, we can look to improve on that.

And then just finally, on the issue of implementation, I’m really pleased that you’ve been specific about the mechanisms for monitoring the strategy in terms of the group that’s going to be set up. I hope that we will be able to know more about exactly how that will work and, in particular, the reporting mechanisms to Government with that group.

I also wanted to flag up that I’m pleased to see the high-level performance targets in the back of the document, but I think that there needs to be more detail there as well. I would like to ask you whether it is your intention, through this consultation, to actually put some milestones, in terms of actual numbers, into that section so that we can actually clearly monitor, as we go through this, how we are actually achieving against our aims.

Just finally, I wanted to say, there’s been this discussion about whether you should be too ambitious or whether you should be realistic: I think we should be aiming really high with this document. Anyone who’s had any contact directly with dementia will tell you that it is a game-changing experience. We know that the numbers of people who are going to have dementia make it a game-changing experience for our public services and I think we should aim for our strategy to be a game-changing strategy.

Thank you for the comments and questions. I’ll start by answering some of particularly detailed ones. I welcome the fact that you welcome the broad strategy. Of course, the point of the consultation is to hear what people have to say about it and see what can be improved and actually delivered on the back of that as well.

In particular, your points about the monitoring group on delivery, and to consider how we could potentially add milestones for progress, we think it is important that people can see what progress is being made through that, whether that’s going to be about milestones within the delivery itself, within the action plan itself, or whether it is about the monitoring group and how they report back on that and how it can be shared so that people can see the progress that is and isn’t being made. Because it is important there’s honesty about the progress that is being made. Because if I stood up and tried to claim that everything was fine and wonderful and people were seeing constituents and being told something different, well that would be very difficult, and I think the consultation would not build the trust in what we’re trying to do, because we do want to be able to talk about what progress we are making on dealing with a growing and significant challenge for all of us in every part of our public services.

We have already made investments, before the consultation has taken place, so your point about support workers is well made and it’s one that’s regularly made by a range of people. We’ve put in some more money, for example, £0.5 million into occupational therapy support and we’ve also put £800,000 into support workers in the primary care setting as well. We need to understand what impact that is having and then how we’ll actually have more staff able to provide that direct support as well.

I don’t know if you’ve seen the report yesterday, but—[Inaudible.]—were talking about what happened when their diagnosis took place for a family member several years previously, and they didn’t have that support at the point of diagnosis. Now, that is a real challenge—for the individual who has dementia being told this is a challenge that you now face, but also for the family as well. So, that’s one of the obvious points for improvement. I can say that it is better now than it was five or six years ago and more, but our challenge is how do we further improve, and how does this strategy make a real difference. That’s the point about what we want to really see happen.

So, we’ll look at the diagnosis, we’ll look at whether the rates we’ve got are ambitious enough and achievable enough and that support can go around them, but people in this room have a really important role to play as advocates and champions, and raising different issues for us in the Government as well. But also not to play down the experience of people in this room, because many people in every party have got individual experience of caring for family and friends, and so this isn’t something where there is a lack of experience and empathy in this room—not just seeing constituents, but individually too, and I’d want to see that captured in the way the consultation works, and then how we take this work forward. And, of course, I’d be very happy to come to the cross-party group at some point in the near future to understand more from members of the cross-party group and external visitors as we move through the consultation.

Thank you for your statement, Cabinet Secretary. The goal of making Wales a dementia-friendly nation is one we all share. Dementia is now the leading cause of death in Wales, and the number of people affected by dementia is expected to rise by around 40 per cent over the next decade. The fact that Welsh dementia sufferers, their families and carers can directly feed in and shape Wales’s first dementia strategy is most welcome, and I look forward to seeing the results of the consultation in due course.

Regarding the draft dementia strategy itself, I have a few questions relating to the high-level performance measures. You have set a target of ensuring that two thirds of dementia sufferers have a formal diagnosis by December 2021. How did you settle on this target, and why is it not more ambitious, given the obvious benefits a formal diagnosis brings? The strategy sets a target for the percentage of NHS staff who come in contact with the public who are trained in dementia care: the target is for three quarters of the workforce by 2019. When can we expect to see 100 per cent of NHS staff trained in the appropriate level of dementia care?

The Welsh Government rightly wants to see a reduction in the percentage of people with dementia prescribed antipsychotic medication. However, you haven’t indicated a target for that reduction. Granted, there may be a few cases where this is necessary, but all the experts agree that we should not be using these medicines to treat dementia. Cabinet Secretary, will you be using guidance to ensure that antipsychotics are only used when strictly necessary?

I welcome the fact that the strategy highlights that dementia can strike at any age and the role that alcohol can play. We need to better educate the public about the risks of alcohol-related dementia and brain damage. Cabinet Secretary, what plans do you have to increase public awareness about the fact that alcohol misuse can lead to dementia?

Finally, Cabinet Secretary, what plans do you have to improve access to substance misuse clinics, so that we can, hopefully, prevent more people from developing alcohol-related dementia in future? Dementia is one of the biggest health challenges facing our nation, and it is therefore vital that we get this strategy right. I look forward to seeing the responses to the consultation and working with you, Cabinet Secretary, to deliver our shared aim of a dementia-friendly nation. Diolch yn fawr.

Thank you for the comments and questions. I think, in terms of trying to deal with those, I’ve answered points about diagnosis, and I’ll look forward to hearing what the consultation says about what we’ve got in the plan, and what is realistic and achievable for us to actually deliver. Part of the point we’re trying to get across is that there’s a need to have a continuing increase and improvement in the diagnosis rate, at a rate that is real and material, and to see that carry on. Now I recognise that many people will urge us to be more ambitious. We need to understand what is really coming through the door, and what is our ability then to actually improve diagnosis rates with different partners acting at different points in time. So, I’m happy to hear what the consultation has to say before we make a final choice—that is, after all, the point of having a genuine consultation.

On your point about staff and staff training, I’d like to deliver what’s in the plan, and learn from that afterwards about how we then have more NHS staff being trained and appropriately equipped. It’s also about staff in health and social care, but in a wider field as well, and that’s why the advice, the guidance, that we launched before Christmas really does make a difference. It was actually a very useful event in actually meeting people in Ysbyty Ystrad Fawr and understanding what they’d already done, the training that had taken place and the improvements in the patient experience that had taken place as a result of that training and provisions being in place.

I recognise the points you make about the use of antipsychotics and where they’re appropriate, and that’s part of the point, and we talk about it in the plan, but I particularly want to deal with your comments about substance misuse. There’s something here about the join-up between the different plans and strategies that we have, recognising we do talk about substance misuse and the plans that we have to improve substance misuse provision to help people to get through that as well, and, in particular, the way that alcohol-related brain damage crosses a number of different areas of activity. We know that there is some work that we’ve been supporting in and around Ogmore in looking at this particular issue in terms of the treatment, the provision and the research, but also Members who were here in the previous Assembly will have heard me discuss some of the work that’s been taking place, for example, in the Liverpool and the Glasgow areas as well. It’s important we continue to learn from other parts of the UK about what is likely to be a continuing challenge. More and more people are going to be coming through doors with alcohol-related challenges, and in this area in particular as well, and lots of those people will actually be more affluent groups of people coming in with alcohol-related challenges in dementia. So, we’ve got to think about how we deal with a range of our different challenges, understand what the current evidence is about what is effective, and then how that impacts obviously on diagnosis, but actually on treatment and provision that we need to have, which will be different in the future to what we have now, as well.

Thank you for your statement, Cabinet Secretary, and thanks also to the Dementia Engagement and Empowerment Project and the Alzheimer’s Society, who have assisted you with this. I know their work in my own region is very valuable indeed. Three things: I was very pleased with the recognition of the need for Welsh language speakers, whose rights are, of course, already recognised in the Social Services and Well-being (Wales) Act 2014, but can you confirm that provision of services, or assistance, really, in other languages will also be considered closely? I think, in this situation, the question of language is less one of abstract right and one of meeting needs. And I don’t think it needs to be about a great chunk of Government machinery, but I think it is down to Government and us as Assembly Members to ensure that those needs are met.

I’d also be interested to know what you actually mean by ‘raising awareness’, because I’m curious to know what that’s likely to look like within public services. Are you considering, for example, identifying dementia friends at all levels of public service, whether that’s the chief executive of a council or even a private bus company, because, of course, public services extend beyond the public sector, and this strategy needs to reach that far as well?

And then, just finally, the impact on social services, and I fully appreciate that this strategy’s entirely about the needs of people with dementia and those who support them, but we also have to consider those who are available to help provide what meets those needs, and how this strategy will help local authorities in particular relieve pressure on social services in certain places in order to be able to provide more support in other places within social services. And while the focus should absolutely be on the needs of people with dementia, actually those who are providing the services also need to have due weight given to their views, too. Thank you.

Yes, I’m particularly interested in hearing from social care providers as part of the consultation on what’s in here, about the experience of their staff and about the realities of delivering and providing the service, because the mix of that provision will differ in different parts of the country as well. Sometimes, that will be appropriate to what exists there, and sometimes there may be other learning they can take from the way in which different models of care are delivered in other parts of the country. So, I really do hope that we hear directly from people providing services in the here and now, as well as those people living with it. There are a range of different stakeholders who could and should take part, and I’m interested in the widest possible range of views being provided.

On your point about not just the Welsh language but other languages, I agree with you: it is about addressing a real need. There’s plenty of evidence that people with dementia will often revert to their primary language, and their ability to speak other languages can be compromised. And so actually there is a real need here to be addressed, as opposed to a preference, and it’s important to recognise the difference there. So, that will provide differing challenges in different parts of the country, but it is something that each of our providers needs to take on board in designing and then delivering their services.

And, on the point about what it takes and what it means to be a dementia-friendly community and country, I’m pleased you make the point this is more than just public services. Actually, there is a role for people in the voluntary but also in the business sector too as well to be generally dementia friendly: the level of understanding that can be displayed, what that means for different people as well. That’s why, when you look at dementia-friendly communities, it isn’t just people in the public sector that have got involved and engaged and are making a real success; it is a much wider range of people. That’s what I tried to get over in my statement and that’s why I’m also interested in hearing from business groups as we go through the consultation, and then roll out into delivery as well.

Thank you. Julie Morgan.

Thank you, Deputy Presiding Officer; thank you for calling me to speak on this draft dementia strategy. I welcome it and I welcome the public consultation that’s taking place. I’m very pleased that people who are actually experiencing dementia will be consulted, and their families. I was very pleased to see that the importance of the wider community is recognised in the draft strategy and I think it’s absolutely essential that people suffering from dementia and their families and carers are enabled to still play a vital role in society, and that there needs to be a range of support outside the statutory services to ensure that people can maintain a good quality of life. I think it’s very good that it also recognises that this support doesn’t have to take the form of dementia-specific activities, because I think some of the most innovative ideas come from communities themselves and the best ones encourage non-dementia sufferers to mix with people who’ve got dementia, in the way that we’re talking about dementia-friendly communities, and we’ve obviously talked about what they actually are.

Before Christmas I was very privileged to attend a concert in my constituency by the Forget-me-Not Chorus. I’m sure many other Members have experienced the Forget-me-Not Chorus, and I found it an absolutely inspiring occasion, because the Forget-me-Not Chorus is made up of people who have got dementia and their carers, and they participate in pairs. They gave an absolutely unforgettable performance, where many people suffering from dementia who were unable to speak in everyday conversation, a song came back to them. In the same way as the Cabinet Secretary spoke about language coming back to people, the power of song was so strong that—. It was an unforgettable occasion. It seemed to me that that sort of activity—. It was done in conjunction with the Welsh National Opera, so the standard of singing was very high, but that is the sort of activity that I think we should be encouraging in a widespread sort of way, because it is a way for people and the carers and the relatives to participate, and you could see the joy it gave. It just seemed to me an example of the sort of provision that we could encourage, and I was very pleased that there is a choir practising in Thornhill—and there is one in the Cabinet Secretary’s own constituency and in Newport—and it’s really quite exhilarating that this is happening. I think most of the other points that I wanted to make have been covered by all the points that have been made today. But I just thought and wondered if you could comment on that sort of activity and what we can do to encourage that.

Yes, and thank you for the comments and questions. Again, we go back to the fact that this consultation draft has been drawn up working with people living with dementia now and we’re to hear from a wider range of people through the rest of the consultation’s period of time, because this isn’t about saying that once a diagnosis is made then that is it, because, actually, lots of people live for a long time with dementia. Whether they live for a long time or a short time, there is still something about the quality of life that they have and also the families and their carers around them too. One of the most interesting parts of my visit yesterday was actually sitting down and talking to people with dementia. I played some Scrabble with them, and I didn’t win—I got moved on before the game ended, which was very disappointing, but I was listening to people, having a conversation and understanding the parts of what was still important to them and the conversations they wanted to have, and then also having a conversation with carers as well and understanding the impact for them, not just having that break and the time, but also the engagement in meaningful activities for them and their loved ones, and whether that’s the Forget-me-not organisation—. In fact, I did a Forget-me-not visit with Rebecca Evans in a previous time, when I was a Deputy Minister, meeting people in her now constituency and understanding some of the impact that has for a range of individuals, but not just individuals, but their families, their carers and all those other people who are still volunteering and making those organisations a real success. Because music, song, and a range of other activities that go into making something generally meaningful for people living with dementia, as opposed to something that’s looking to warehouse people, and keep them somewhere where we think they’re safe—and, actually, you’re de-skilling them and you’re taking away the quality of the life that they have. I think that can be quite distressing for individuals who still have a significant awareness of who they are at various different points in their journey with dementia, but also their families and carers as well. So, thinking about how we deliver that whole package of support around individuals is absolutely the way we want to be, and then to understand how we’ll do that, and who will do that, with a range of different partners. And, as you point out, the third sector in particular are a really important part of that now, and will be, again, in the future.

That just reminded me of an event. Twenty years ago, I volunteered to go to a residential home to do some carolling. We were singing all of the well-known carols, and at one point we asked the residents if they had any requests, and a lady put up her hand and said, ‘Yes, stop singing.’ Now, the reason why I mentioned that was because, afterwards, a member of staff informed us that she hadn’t spoken for a couple of years, and my point was, regardless of whether you’re a good singer or a bad singer, you can actually have quite an effect on people. But you don’t necessarily need Government to organise this for you. You can go yourself into your local community and do these things.

One of my staff attended the recent cross-party group on dementia, where those living with dementia were represented and, indeed, present. What was clear is that those living with dementia wish to remain a part of our society. They wish to help others as buddies, and they certainly wish to be heard. I note that this consultation that you’ve started appears to be along the usual Welsh Government format. So, what I wanted to know was: how can you ensure that those who need to be consulted—those who are actually using the services—are reached by this consultation, and are able to respond and are able to have their needs met? Can you highlight how this consultation has been made bespoke for that?

Regarding support services, I just wondered what your thoughts were on the merging of social services departments that are providing some of the treatments and care of dementia patients, usually in their own homes, with the NHS, in order to ensure that the left hand knows exactly what the right hand is doing, and to provide a better delivery of services for dementia patients?

Well, I’m not sure if the first point about someone who hadn’t spoken for years actually standing up and speaking when you were singing was a comment on your singing ability, or whether it’s about the impact of music on memory and triggering a reaction. But those points are well made about different activities that are not just about experience, but how you maintain someone’s ability to do things as well and making sure they don’t deteriorate at a more rapid rate.

I understand the points that are regularly made about the way that we consult, but this is a good example of listening to and working with not just the third sector and advocates and champions in designing and delivering a consultation to go out to a broader group of people, but individuals themselves, as I’ve said, because in the dementia engagement and empowerment project, those people are living with dementia themselves, and so they play a key part in terms of people who we’ve listened to in drawing up these proposals for consultation. And it’s why I’m encouraging, and other people are encouraging, the widest possible range of people to get involved and engaged. The events that we’re running we are running with the third sector, with a range of different people they’ve already worked with, who they know have this challenge now, and other people who will get diagnosed in the future as well. We won’t ever, being honest, reach 100 per cent of people. No consultation can do that. But I do think we’re going to reach a good number of people who will then tell us something of real value about their lives, how they live them, the challenges they’ve faced already, what’s worked for them, and what hasn’t, to understand what we already do now, and what we want to do better in the future to deliver better outcomes for those individuals and their families.

That goes back to your final point about merging departments between social services and/or the NHS. We’ve set out a clear agenda in the social services and well-being Act on the partnership that we expect to see happen between health and social care, and the wider third sector and individuals as well. It is about how you empower people. It is about how you reduce barriers to design services around individuals. The Minister will be doing more work on this in practical terms, working with a range of different partners, to understand how the scheme of that Act is progressively delivered over the next couple of years. And I think we’ll be in a good place later on in this term to see how successful we’ve been. We’ve made a deliberate choice not to have a structural reorganisation, but to think about we actually get outcomes for people, and that sense of partnership and real engagement, and mandating people to work together in health and social care in particular.

Thank you very much, Cabinet Secretary.