Part of the debate – in the Senedd at 4:28 pm on 16 May 2017.
Thank you very much for your statement, Cabinet Secretary. I think Welsh Conservatives would be keen to support plans drawn up or even led by those who live with dementia, either first hand or as family members, friends or carers, and, as you say, other voluntary organisations and those who have an interest who took part in the consultation. We certainly support the rights-led approach, but I did want to press you, first of all, on the balance of the delivery mechanisms that have been referred to in the draft plan.
Now, most of the proposed key actions seem to be the responsibility of health boards, and in terms of direct medical intervention, I can see why that would be the case—diagnosis professionals, psychological and pharmaceutical support, and care for an individual, perhaps within a nursing home or another medical setting where they might be receiving assistance across a number of co-morbidities, shall we say. But with better diagnosis, there is greater scope, I think, for non-medical support, particularly early on. I think an over-emphasis on the health board, if you like, might almost be, for some people, like giving in to the fact that they’re going to need medical care. Even though that might be true later on, it certainly isn’t necessarily true early on. I’m wondering whether the early part of the support pathways that you refer to in here could be less about health board leadership and more about individuals and other partners who might be better at the whole, sort of, emotional, family support approach to things, rather than looking to the LHB for the lead all the time. I heard what you said about the third sector and I support what you say in that, actually, but the idea of co-production goes beyond even the third sector and we should be looking, perhaps, a little bit more to community structures, which include family, of course, or friends, to help with those early stages following diagnosis.
I wonder if you can tell me a little bit as well about what a future dementia support worker is going to look like. I appreciate we already have some working in a number of sectors at the moment, but the plan refers to specialist intervention for those who have dementia through alcohol or those with early onset dementia. Are we going to be talking about the same individual dementia support worker, or are we talking now about a range of dementia support workers for an individual? I’m guessing the answer to that is flexibility in responding directly to the needs of given individuals, but I’d appreciate a bit of steer on whether we’re going to need more dementia support workers, whether they will need different skills and, once again, whether they will necessarily come from within the health sector.
Clearly, a lot of work has gone into awareness raising in the general population, and I certainly welcome that, although I’m not entirely clear who is going to retain responsibility for that. But just as importantly, a lot of work seems to have gone into dementia awareness and training within the health and social services sector particularly. I’ve got two questions on the back of that.
The first is that general awareness training at population level means that a lot of us are more aware than we were before, but I think still very few of us will have the confidence or the knowledge to broach the subject with a neighbour or somebody we see regularly in the shop or the pub—somebody who’s outside our immediate family but still within our community—because not everybody is picked up through professional routes, particularly if they live alone. I’m wondering whether this plan is the place to help us, generally—you know, members of the public—be part of helping, certainly in early-stage dementia. Then the flip side of that is how more detailed training can reach public-facing activities outside the public sector—so, hospitality, retail, public transport—so that the rights you were talking about are actually capable of being fulfilled. I know there’s some fantastic examples of voluntary approaches to this, and we spoke about Tesco having its slow shopping day, for example. I think there’s more space for that.
Then, finally, the draft plan—and I think I’m quoting your speech here—says more support for carers, including ‘clear measures for respite provision’ for carers. I agree, but this is an area of policy where the words ‘rights based’ are, sort of, in many cases, simply just words, and identifying needs under the social services Act doesn’t always translate into actual support for carers—that’s an observation, it’s not a criticism. So, my question on that is: what are your thoughts on how we might all work, actually, to help deliver on rights for carers in terms of respite, and that’s cross sector and, as far as Welsh Government is concerned, cross portfolio? Thank you.