To ask Her Majesty's Government what is their response to the Nuffield Council on Bioethics' report on the ethical issues raised by dementia; and whether its recommendations will be incorporated into the National Dementia Strategy.
Baroness Thornton: The Government welcome the excellent report by the Nuffield Council, which sets out an ethical framework for dementia. I am pleased to tell the noble and right reverend Lord that the national dementia strategy makes it clear that information should be available on what options exist for planning ahead for those with dementia to ensure that their wishes are considered. In implementing the strategy, the Government will continue to work with stakeholders to ensure that everyone working with people with dementia is supported in making ethical decisions.
Lord Harries of Pentregarth: I thank the Minister most warmly for her very positive reply. Would she accept that the vast majority of the 700,000 people suffering from dementia are cared for at home and that therefore carers at home should be treated as genuine care partners, together with the professional team? They should be trusted and given access to information. What would her Government do to promote that?
Baroness Thornton: That was, I thought, one of the most powerful points made in the Nuffield report. In the consultation that Nuffield carried out, many carers expressed concern that they were treated with suspicion by professionals and felt that they needed to earn trust, despite the fact that they were providing most of the daily care. We totally agree that carers should be treated as care partners by professionals. The national dementia strategy makes it clear that family carers are
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Baroness Pitkeathley: Does my noble friend's indication of that extend to helping carers at home to make difficult decisions that are very much in the field of ethics? Those decisions may go from asking themselves, "Can I lock him in while I go to do the shopping?" to deciding whose needs are paramount when residential care is being considered. Will the Government help carers with those kinds of ethical decisions?
Baroness Thornton: The report refers to many of those decisions. The person who is caring for the person with dementia is best placed to take those decisions, but they need support in that. Proper education and training for professionals and carers have been identified as something that we need to address; we need to look at where there are gaps, which indeed there are, and we need to make sure that this is one of our priorities.
Baroness Gardner of Parkes: Does the Minister agree that it is important that people should be able to make decisions in advance? None of us knows who is going to develop dementia; it can occur in anyone. In particular, people should be able to make decisions about their own future while they are still able to do so, or even decisions as to whether they would want to take part in a research project if they develop dementia.
Baroness Thornton: The noble Baroness raises two important points. The first is the need to think ahead and to encourage people to appoint a welfare attorney, if they can, who will support them when the time comes that they no longer have the capacity to do so themselves. Secondly, the ethical issue that the report points to about research is how someone who lacks capacity can take a decision to participate in the dementia research that you might wish to undertake. It is important that those issues are discussed while the person still has capacity and that the decisions are recorded, so that the people who have the care of that person know what their wishes would have been.
Baroness Jay of Paddington: My Lords, I declare an interest as a patron of the Alzheimer's Research Trust. Following the Minister's response to the last question, does she agree that the real issue is to devote more resources to research into dementia as a whole and particularly, as the Nuffield report suggests, into the social research, which covers all the aspects of care and people's experience when they suffer with this disease? In a sense, that is one thing that is sadly lacking in present research resources.
Baroness Thornton: My noble friend makes an important point. We are currently commissioning research into best-interest decisions taken under the Mental Capacity Act. As part of the strategy, my honourable friend the Minister has, as my noble friend will know, established a ministerial group of which the Alzheimer's Society is part, following on from the dementia research summit which pointed to many of those priorities.
Baroness Neuberger: My Lords, does the Minister agree with the Nuffield report that, instead of the risk assessments that are made in care services on a regular basis, we should be looking toward risk-and-benefit assessments, so that people with dementia get some chance to practise everyday activities? In Holland, for example, they do things such as making their own beds, instead of being told that it is unsafe, which is the British practice.
Baroness Thornton: I thought that that was also an important part of the report. The report points to, for example, filling in a pond in a care home, which had given enormous pleasure to people, because of the risk. The noble Baroness is absolutely right. Overall, the Government are taking this report very seriously indeed. It has messages not just for us and how we deal with the dementia strategy but for all professionals and people who are dealing with people with dementia.
Lord Sutherland of Houndwood: My Lords, does the Minister agree that dementia is an illness, not a social malaise, and that the levels of support available for those suffering from dementia should be comparable to those for people being treated for other illnesses under the National Health Service?
Baroness Thornton: Dementia care is not classed as social care. The care needs of a person with dementia include their healthcare, which is of course provided free for anybody with a long-term condition.
The Minister of State, Department of Energy and Climate Change (Lord Hunt of Kings Heath): My Lords, could we hear first from the noble Baroness, Lady Knight, and then from the noble Baroness from the Cross Benches?
Baroness Knight of Collingtree: Would the Minister assure this House that respite care for carers is given a high priority? Carers have to bear a tremendous burden and they cannot do it all the time, every month, every year.
Baroness Thornton: The noble Baroness is absolutely right and that is part of the strategy. One of my neighbours, unfortunately, has Alzheimer's disease; the respite care that her husband receives is vital to his welfare and therefore to her care.
Baroness Greengross: Does the Minister agree with the Nuffield Council that much more needs to be done to include people with dementia in society as equals? What action will her department take to make the services that people use every day, such as shops, restaurants and leisure services, more dementia-friendly?
Baroness Thornton: The noble Baroness raises another important point. The Disability Discrimination Act says that shops and other places where anybody with a disability might go should be friendly for their use. Part of the problem is ignorance about this. We are launching a public awareness campaign about dementia in the new year.
The Minister of State, Department of Energy and Climate Change (Lord Hunt of Kings Heath): My Lords, we published our response to the electricity and gas smart metering consultation today. This sets out the Government's decision that, in regard to homes, real-time displays should be provided with smart meters.
Lord Teverson: How can I do anything but congratulate the Government on their excellent decision? It is a very important way in which individuals can take control of their energy usage and supply. How will the Government make sure that the cost of these meters, which will now be rolled out across the nation over the next 10 years, is not completely charged over that time to consumers, given the considerable saving that energy companies will make in the absence of reading meters and many other functions?
Lord Hunt of Kings Heath: My Lords, I am grateful to the noble Lord for his welcome for the decision. The cost will fall to the energy companies. We would expect some of that then to follow through in prices to customers. We project that the net gain for customers will be about £28 per household from 2020. We wish to ensure that there is a competitive market with proper regulation so that customers are given a fair deal.
Baroness Wilcox: My Lords, the Government's announcement is timed very well. The noble Lord, Lord Teverson, must be very pleased today that the Government read his Question a week ago and came up with the Answer for him just in time. However, it is disappointing. Again, here we go: hesitation, hesitation and another delay. Does the Minister agree that families sorely need control over their escalating fuel bills and sticking to the same old slow timetable for rollout by 2020 will leave the United Kingdom and consumers lagging behind again?
Lord Hunt of Kings Heath: My Lords, we are not lagging behind. This is the first country to decide to have smart meters for all domestic households. The timing is entirely consistent with what we discussed when the Energy Act went through last year. The reason for doing it over this period is to do with cost. If we went for a quicker timetable, it would cost much more money, which would have an impact on consumers. It is a reflection that the party opposite just cannot do its economic sums.
Lord Hunt of Kings Heath: My Lords, they are small screens, rather like a small laptop, which will show the energy use-gas and electricity-at the moment that you look at them. They will also give the price that you are paying and will give the consumer much more control over their energy. They will encourage consumers towards energy efficiency. Also, because of the technology, the process of switching tariffs will become much easier.
Lord Stoddart of Swindon: My Lords, the noble Lord, Lord Teverson, remarked that the new meters would be used by companies to read meters remotely. He also mentioned other purposes. Indeed, from reading the press lately, some of the other purposes would involve monitoring use and having the ability to switch off appliances. That would be an intolerable intrusion into people's privacy in their homes. It would also be very dangerous.
Lord Hunt of Kings Heath: My Lords, as regards the information that is made available to the energy companies, it is very important that there is a proper process in relation to data protection. There have to be protocols about what information should be made available and for what purpose. However, the fact is that two-way flows of information between consumers and energy companies will lead to the development of a smart grid. That is essential as we go forward. It will allow us to have an efficient energy system, but we will be very careful in regard to the point raised by the noble Lord.
Lord Jenkin of Roding: My Lords, the Minister indicated that it would be for the energy suppliers to oversee the installation of the smart meters. Is he aware that the sector skills council which represents the energy industries has sought funding for the training of the many thousands of technicians who will be needed to install these meters, but that this has been
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Lord Hunt of Kings Heath: My Lords, I was not aware of the issue; I am very happy to look into it. It certainly shows that there will be a huge scale of investment in smart meters in the next few years, which will lead to the creation of many jobs. We want to make sure that those operatives have the necessary skills. But I am very happy to look into that matter.
Lord Redesdale: My Lords, the Minister noted that the energy companies will be supplying the meters to their customers. Is that not a very inefficient method considering that many companies will be dealing with perhaps one house in each street? Would it not be much better to do it on a street-by-street or regional basis? Is this not a failure on the part of Ofgem?
Lord Hunt of Kings Heath: My Lords, I am always happy to pass on criticism to Ofgem where it is fair, but it is not fair to blame Ofgem in this case. This is a right decision. The companies have a relationship with customers at the moment. Every year, half a million meters are taken out and new ones are installed in new-build, so the companies have great experience and a relationship with the consumer. Of course, there is an argument for doing it on an area-by-area basis, but energy companies do that at the moment, so we think that our approach is the best one.
To ask Her Majesty's Government, in the light of the Commonwealth Heads of Government Meeting in Trinidad from 27 to 29 November, how they are building a constructive relationship between the United Kingdom and Caribbean Commonwealth countries.
The Minister of State, Foreign and Commonwealth Office (Baroness Kinnock of Holyhead): My Lords, last week, Her Majesty the Queen made a state visit to Bermuda, the Bahamas and to Trinidad and Tobago. Her Majesty attended the Commonwealth summit in Trinidad and Tobago. In Port of Spain, at the summit, my right honourable friend the Prime Minister met the Caribbean Heads of Government and emphasised strongly the value of the UK's relationship with the Caribbean region and its people. Before attending the summit, I visited Jamaica and met Ministers and others.
Baroness Scott of Needham Market: Is the noble Baroness aware of the very widespread perception in Caribbean countries that the UK Government have much less commitment to the Commonwealth Caribbean than they previously had? Is she aware, for example, of the widespread anger among Jamaican parliamentarians
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Baroness Kinnock of Holyhead: I thank the noble Baroness. I am aware and, indeed, acknowledge that some disquiet has been felt by the Caribbean Governments in particular. We are making every effort to address that. I have been engaging with the diaspora in the UK. I have had a round table with representatives of the Caribbean community and a UK-wide event with the diaspora. I have plans in hand to deal with issues such as trade and industry, the relationship with DfID and, I hope, with the border authority as well, so I am making a serious effort to address some of the concerns that have been raised.
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