One of the biggest social and economic challenges facing the next government will be the rising costs of caring for people living with dementia.
Dementia is a general term for a group of related symptoms, rather than a single disease, and too many cases go undiagnosed. But the statistics are brutal.
Last year, the ONS classified dementia as the UK’s single biggest killer. Over time, as many as one in three people born here will be diagnosed with dementia, and one in two will know someone living with the condition. As it stands, there are already nearly a million people in the UK with a diagnosis of dementia. This figure will only increase as the population ages.
Research undertaken by CF (Carnall Farrar Ltd) and published this month by the Alzheimer’s Society found that the annual cost of dementia to the UK economy is already around £42 billion. This is forecast to rise to £90 billion (in today’s prices) by 2040.
Despite this, public awareness of dementia is still generally low. Many people are reluctant to seek an early diagnosis, despite the benefits of doing so. The costs are also largely borne by individuals and by their families and friends in the form of unpaid care.
These hidden costs may reduce the direct burden on the taxpayer, but they are just as real. The CF research found that a third of unpaid carers spent more than 100 hours per week looking after a dementia patient. Even ignoring the costs to them, that will be contributing to labour shortages.
The good news is that great work is already being done in this area, notably by the Alzheimer’s Society and by Dementia UK. The UK Dementia Research Institute is also doing world-leading work on dementia and other neurodegenerative conditions, investigating the causes, developing preventative interventions, and harnessing the power of AI.
But dementia research still receives less funding than many other conditions. Relatively little money is spent on preventative care and early diagnoses, such as memory assessments. This is an obvious area where a little more public investment would have huge long-term benefits, including future savings on more expensive care.
Another priority is to minimise dementia-related hospital admissions and to improve the care of people living with dementia in hospital. This is the focus of the Geller Commission (of which I am a member), an independent review of clinical pathways which is currently taking evidence.
Hospital patients with dementia are mostly being treated for other conditions. Nonetheless, dementia can make treatment more complicated, hospitalisation can accelerate conditions associated with dementia, and dementia itself can extend patients time in hospital. At a time when waiting lists are long, the opportunity costs of NHS beds are also particularly high.
We need to consider other measures too. Some have suggested setting a higher national minimum wage specifically for work in social care, but singling out a particular sector could easily backfire. Without increased funding it would simply drive many care homes out of business. It would be better to raise the status of care work, for example through the additional qualifications in mental health nursing and dementia studies now offered by the University of West London.
Others have suggested limiting the type of businesses that can run care homes, making it harder for ‘profiteering’ private equity firms in particular to enter the market. But this would simply reduce the supply of places. It would be better here to invest more in quality assurance and supervision, while actually encouraging competition.
It is also important to maintain a flexible policy on international migration. One of the biggest drivers of the recent jump in migration to the UK has been an increase in the number of people coming from countries like India and Nigeria to work in health and social care. The politics of immigration can be ugly, but in this case the wider benefits should be obvious to all.
Some interventions would not cost a lot of money. For example, a public information campaign would help to tackle the unfounded stigmas around an early diagnosis of dementia, such as the fear of automatically losing your driving licence.
Whichever levers need to be pulled, the soaring costs of dementia care demand urgent action.
Julian Jessop is an independent economist and a member of the Geller Commission
