This article was written by contributor Harry Ward
The dementia crisis is one close to my heart. As an Alzheimer’s Research UK (ARUK) Community Speaker with familial experience of Alzheimer’s, I can vouch for the charity’s fantastic work and the disease’s destructive effects. However, my personal story is just one of many. Around 900,000 people have dementia in the UK today, while 1 in 3 children born today will develop the disease. Given such high rates, the UK can now be said to be facing a dementia crisis. There is no ‘cure’ for this disease, yet it generates care costs upwards of £34.7bn a year, with that number expected to rise to over £94bn by 2040. Moreover, the disease is mounting ever increasing pressures on the NHS’s resources and a faltering social care system.
The crisis, however, has been greatly exacerbated by Covid-19, whereby a quarter of people dying from covid also had dementia. Due to social restrictions fewer people have had access to their GP, meaning later diagnosis and longer waits for support. Furthermore, a third of dementia researchers have said that they could leave the profession as a result of the pandemic.
While charities like ARUK and Alzheimer’s Society do superb work to help to solve the dementia crisis in the U, it will take government policy action to bring about conclusive positive change. This article considers two key policy areas: dementia research and adult social care. It explores past and current UK policy direction, before assessing what improvements must be made and recommends certain policies.
Firstly, let’s consider dementia research. The UK prides itself on leading the way in this policy area. Then Prime Minister David Cameron published his ‘Challenge on Dementia’ in 2015, setting out government policy aims to be achieved by 2020. One such commitment was to spend £300m on dementia research over the 5 year period. This commitment was in-fact surpassed. Building on this success, the Conservative 2019 General Election manifesto included a promise to double dementia research funding over the next decade. This would result in an extra £800m for dementia research over the next 10 years. However, this promise has not been kept. There has been no further commitment or strategy for how the money will be invested. In fact, between 2018-19 and 2019-20, dementia research funding has fallen.
So, where to go from here? Primarily, the manifesto promise needs to be upheld. Dementia is a crisis which can be solved, at least in part, by further research funding as we search for a cure to a disease that costs so many lives and so much money in the UK each year. Charities like ARUK and Alzheimer’s Society campaign relentlessly on this issue, and while charities can influence policymakers, their demands are currently falling on deaf ears.
How do we fund this increase, especially given the cost of the pandemic? Any tax increase, on top of the current NI increase for health and social care, would be extremely unpopular currently due to the rising cost of living. Could reallocation of funding work? Labour have argued that they would ring fence 3% of GDP each year for science and research. A more proportioned policy response could be that suggested by Alzheimer’s Society, who urge the government to introduce a policy of spending 1% of the annual cost of dementia on research each year. This kind of policy would give dementia the attention it deserves. The cost is rising rapidly, as should the funding.
Secondly, social care. Caring for those who already have dementia in a more sustainable and cost-effective, yet still high quality, way is key to reducing the burden on the NHS and helping those with the disease. In the past, the UK has failed to tackle the issue of an adult social care system. The current infrastructure is struggling under the weight of increasing demand. In 2019, the All-Party Parliamentary Group on Dementia stressed the need for social care reform that recognises and reflects the needs of those with dementia as current support is inadequate and inaccessible. Plans for reform did come last year with the adult social care reform white paper. The planned reforms are extremely complex but are explained well by think tanks like the King’s Fund.
How can social care policy be improved to help those currently living with dementia? One option is to increase social care funding by introducing a ‘Dementia Fund’ to fund community care. Such a Fund would make efficient use of NHS resources and would contribute to the Department of Health and Social Care and the NHS’s joint long-term vision of integrated health and social care moving forward. Another option would be to alter the 2021 social care reforms. The reforms set a care cost cap at £86,000 meaning no one would have to pay more than that out of their own pocket to fund their care. However, this cap is too high. The poorest might still struggle to pay £86,000 and could have to sell their home to fund such care costs. This defeats the main objective of the reforms.
A final option would be to pay more attention to the paid and unpaid social care workforce. At the moment, paid social care vacancies are extremely high in England. Despite the money promised to solve the problem in the 2021 adult social care reforms, some suggest that this won’t be enough. The Government has recently relaxed immigration rules to try and fill the social care void. However, this is a very short term fix. Better policy choices would include establishing a professional body for social care workers in England to make sector more attractive via higher professionalism and management prospects. Furthermore, unpaid carers don’t get the recognition or support they deserve. This country needs a National Carer’s Strategy to ensure unpaid carers are supported. This could come from looking to other countries for policy ideas – for example, Austria offer rest bite holiday care programmes for carers while their loved ones are looked after by the state for a short period of time.
Overall, there is no quick or easy fix to the UK dementia crisis. Solving the problem will take a variety of policy measures and increased funding to ensure that those who are currently living with, and those that will develop, dementia are supported adequately and sustainably. Dementia might never get the attention of diseases like cancer, however, with an ageing population, the numbers are only going to grow, along with the social and economic consequences of a frail health and social care system.