We need to talk about ‘national plans’ for dementia


The opening gambit for anyone criticising plans in health and social care was to mention at the first opportunity Stalinist Russia.

That is of course a ‘cheap shot’.

Would a rose by another name smell as sweet?  The Department of Health published in 2009 a dementia ‘strategy’ which set out important goals, and has published subsequently different documents under different names such as “The Prime Minister Dementia Challenge” or “The 2020 Implementation Plan”.

It is perhaps time to face facts. Talk is cheap. It’s much easier to talk about ‘England is the best place to live with dementia’ than to put an adequate level of funding into the NHS or social care.

It is easier to say you have amassed X million ‘Dementia Friends’ without thoroughly looking at the impact of what this new level of knowledge has been, for the general public, in a coherent review.

I can’t help thinking that the main beneficiaries of national plans are not people like me, care partners of persons living with dementia. Nor indeed do I think the main beneficiaries are people living with dementia.

Sadly I think the main beneficiaries are the consultants who seem stuck in a rotating door of commissions from charities churning out these reports every other year.

I ‘googled’ some of the reports for fun earlier this afternoon, and unsurprisingly found the same sort of stuff being regurgitated at regular intervals, such as ‘dementia awareness’, ‘investing money in dementia research’, ‘building dementia friendly communities’, ‘educating the workforce’.

People who regularly appear in conferences or in charity meetings know this language well. I was reminded that in the ‘G8 dementia’ initiative a cure or a disease-modifying drug would be presented to the world by 2025.

I was bemused at the list of different WHO/UN initiatives done in the name of people of dementia over the years, listed in the newly published WHO report on ‘national plans’.

The ‘big selling point’ of these national plans is that we can all learn from each other.

And how exactly? What are we learning about how doctors from The Gambia diagnose dementia diffeerently from Venezuela? What do we deduce from the different ratios of private / public funding and how this impacts on dementia care in the UK compared to France?

Do we get anything meaningful from these national plans about ‘workforce planning’?

Does anyone actually believe that people largely live with only one diagnosis, that of dementia? Are we still further defining people by the name of their diagnosis rather than their actual needs including disabilities?

Dementia charities deal only in dementia. That is their brand.

For all the big words about ‘civil society’, we clearly have a problem with the way ‘the State’ ‘business’ and ‘other’ can collude with each other to generate competitive advantage, to the point of being near-monopolistic in providing ‘dementia friendliness’ for example.

And why might you get prescribed cholinesterase drugs in one country and not another?

I’m of course not saying that dementia charities have no impact. I concede they fund research, based on monies (some in part given by people thinking that a cure is ’round the corner’).

And their senior officers will have no problem getting future recognition or employment.

The stakeholder groups get a mention – but it’s merely that.

I recognise marketing when I see it. ‘Dementia plans’ are the worst type of lazy man’s campaigning device, and in fact possibly do more damage than good – divert funds into projects being seen to doing something worthwhile rather than actually improving the experience of people with dementia or care partners.

Is the UK fundamentally a better place from having so many new Dementia Friends? We don’t know as the study has never been published.

A revolving door gravy train. Pure and simple.