I am grateful to have secured my first Adjournment debate as an MP on an issue that has resonated so deeply with many residents across the Isle of Wight, whether they are directly touched by dementia or not. I put on record my thanks to those across the island who have contacted me and are passionately fighting for their family member or friend during their time of need. It really shows the best of our island, and it makes me even more proud to represent Isle of Wight West in this place.
I also thank the Minister for her engagement to date with me and my constituency neighbour, the hon. Member for Isle of Wight East (Joe Robertson), on the wider issue of patient discharges off the island. I will continue to do all that I can to work across the island and with Government to help find a solution.
I thank my hon. Friend and neighbour for securing this debate, and I strongly support him on this issue. People living with dementia and their families deserve care close to home, and should not have to cross oceans or seas and get trains to get the support that they need. I want to recognise the dedicated workers across Portsmouth North who support those people’s families. In my constituency, cuts to dementia nursing have led to some of my constituents—and my team—visiting the Isle of Wight, where we saw the Parklands Dementia Resource Centre, which is an excellent example of what can be done. Will my hon. Friend expand on Parklands’ work, and join me in urging the Minister to consider more dementia hubs in under-served communities?
I thank my hon. Friend for that timely intervention. Before I get into the deeply troubling accounts that have been brought to me, I pay tribute to Maggie Bennett and her team who run the Parklands Alzheimer’s café. While the café cannot offer overnight accommodation, it offers vital respite for carers. Loved ones can spend a great day at the café, doing activities, chatting over tea and cake and even getting their hair cut. However, for island dementia sufferers, that is where the happy story ends.
The issue of mainland discharges has struck a chord across the island because it goes to the heart of many of the other inequalities my constituents have been expected simply to accept as part island life. We are the only English island where the sole means of transport on and off is entirely privately operated. Coupled with that, we have only a small specialist dementia in-patient ward, and no dedicated long-term NHS dementia provision. There is a very real fear that when someone is at their most vulnerable, where they live will determine how they are treated and whether they are afforded the dignity they deserve: the dignity of being close to family, of continuity in care, and of remaining in the place they call home.
For those unfamiliar with the situation, the recent closure of three care homes on the Isle of Wight, including one in Freshwater in my constituency, has led to 44 residents being displaced, with 10 already placed in care homes on the mainland. The niece of one resident living with dementia contacted my office to say that she is terrified that her uncle will die in his proposed placement in Horsham, 70 miles away,
The hon. Gentleman is giving a typically excellent and passionate speech. No person living with dementia should be removed from their family or support network. Does he agree that as the NHS is restructured, there needs to be a proper focus on outcomes for dementia sufferers right across the country?
I could not agree more; a national dementia strategy is of the utmost importance. As I will go on to say, we currently have a situation where people are being moved away from home or where the care they need just is not available.
Nationally, 87% of care services are now commissioned by councils or the NHS at rates below the true cost of care, and locally contracts are being let at around £24 an hour—only 84% of the Homecare Association’s minimum recommended rate. Within that model, smaller island providers are often subcontracted by larger mainland-based organisations at even lower rates. Despite demand continuing to rise, the island is one of the only authorities inadvertently forcing local care providers to make staff redundant or even consider closure, simply because the funding does not stack up and because price increases are not being passed on to those smaller providers by first-tier commissioning organisations. I strongly urge the Minister to press Isle of Wight council to ensure that any funding uplift reaches the frontline providers that are actually delivering care.
Once again, with no dedicated long-term NHS dementia ward on the island, as soon as those block contracts are full, as they increasingly are, there is simply nowhere else for people to go. At that point, decisions are no longer driven by what is best for the individual, but by whatever capacity happens to be available.
I am grateful to my hon. Friend the Member for Isle of Wight West (Richard Quigley) for raising this very important issue, and I recognise the deeply concerning experiences that he has highlighted of families on the Isle of Wight, including the story of Maggie Bennett and the café that she runs.
For people living with dementia or complex disabilities, being moved away from their homes and loved ones can be profoundly distressing. Familiar surroundings, routines and relationships are often central to their wellbeing, and it is entirely understandable that families feel anxious when those links are disrupted. The Government are clear that people should be discharged from hospital safely, promptly and with appropriate care and support in place. This is essential not only for patient outcomes but to ensure that hospitals can continue to treat those in greatest need.
Local authorities have a statutory duty under the Care Act 2014 to shape their local care markets, ensuring that there is a sufficient range of high-quality, person-centred services available to meet local needs. Decisions about care placements are made at a local level based on clinical need, the suitability of available services and the individual’s circumstances. Where a person requires specialist or higher-intensity support, it is essential that the placement meets those needs in full.
I did not have time to congratulate the Minister, a fellow Brummie, on her promotion. It is good to see those from Birmingham here in the Chamber.
Question put and agreed to.
House adjourned.
5:32 pm
House adjourned.
“alone, confused and feeling that no one cares.”
Worse still, his family have been told that if they do not accept the placement, they will be liable to pay £500 a day for the hospital bed he will need to occupy.
Other than a few brief periods away, the Isle of Wight is the only home that Phyllis, Adam and Rob Snow’s 87-year-old island-born mother, has ever known. Phyllis now requires round-the-clock care due to a brutal combination of dementia and Parkinson’s, and her family are absolutely terrified by reports of patients like her being relocated to the mainland. With Phyllis already having been stuck on a hospital ward for months, her family are in a lose-lose situation: they either watch her become more vulnerable to infection the longer she spends in hospital, or push for a care home release only for her to be relocated miles away from the only home she has ever known.
It is important to understand how dementia care is currently funded on the Isle of Wight. Much of our provision relies on a limited number of block-booked beds commissioned by the local authority, layered on to an adult social care budget that is already under severe strain.
The closure of three care homes this year has not occurred in a vacuum. In 2022, the island lost six care homes. With one third of our population aged 65 and over, alongside staff turnover rates that are significantly higher than the national average, this is a system already under immense strain. While dementia care on the Isle of Wight is delivered across a mix of NHS, council and private provision, the reality is that the capacity and specialist care has not been enough for some time.
This is not just an island problem; it is a warning of what lies ahead for the country as our population ages. In making that point, I wish to strongly advocate for any measures the Government consider adopting to confront this national challenge being piloted on the Isle of Wight, where the need is greatest and where meaningful change can be delivered most urgently and, most importantly, measured in almost real time. What makes the Isle of Wight a particularly stark case is the added cruelty of our geography: the reality that families must cross the Solent, which some estimates have placed as the most expensive stretch of water in Europe, in order to visit a loved one who is sick and in need of care that simply cannot be provided closer to home.
Eighty-two-year-old Graham Martin, who is living with dementia, is yet another example of the impact of this reality. In mid-April, he was moved to Southampton against the wishes of his family because of his complex needs, separating him from his wife of 63 years, Carol, who is unable to travel to visit him due to her own health and the cost of ferry travel. Being moved away from home, across a stretch of water, is distressing enough; being effectively cut off from loved ones because they cannot afford or physically manage the journey, at the very moment that people need their family most, borders on forced isolation.
As the niece of another patient facing a mainland placement said to me, “Imagine a vulnerable elderly resident in Westminster being sent to a care home on the Isle of Wight. It simply would not happen.” It would not happen because in other parts of the country, the system would not tolerate separating vulnerable people from their families in this way, yet for the Isle of Wight, that basic standard is not applied.
MPs and Ministers all the way up to the Prime Minister have heard me talk relentlessly about how the island is a brilliant place to live, work and learn, and despite my intervention today I still believe that to be the case. But that comes despite the inequality and deprivation we face, which is hidden by neighbouring prosperity. Whether it is schools unable to take a trip across the Solent due to budgetary constraints, young workers having to look for jobs elsewhere due to lack of opportunity, or—as I have spoken about today—an elderly person ripped away from their home because of lack of capacity, the Isle of Wight has been functioning with one arm tied behind its back. The time has come to do something about it.
When capacity on the island runs out—and without the necessary action, it inevitably will—people are not just delayed but displaced. What should be an absolute last resort for the most vulnerable people is fast becoming a routine response, with elderly people being sent miles from their home simply because the system cannot cope. That is neither sustainable nor dignified, and it cannot be allowed to continue. I ask the Minister to take action for the benefit of my Isle of Wight residents.
However, I do recognise that local capacity pressures, particularly in geographically isolated areas such as the Isle of Wight, can mean that suitable placements are not always immediately available. My hon. Friend spoke about the impact of care home closures in his constituency and shared Phyllis’s story. While temporary placements further away are necessary to ensure that a person is discharged safely and without delay, those situations clearly have a huge impact on families.
On the Isle of Wight, local partners are working to improve access to more seamless pathways across health and social care so that people can move more easily between services and receive the support that they need. This includes strengthening co-ordination and expanding care in the community so that wherever possible people can be supported at home or close to home. As my hon. Friend said, because of the island’s size and physical isolation, that also requires close working with mainland partners to ensure that residents can access the full range of care that they need, including specialist provision where it is not available locally.
We will continue to explore and build on opportunities to deliver services for the benefit of the Isle of Wight community so that care can be delivered at the right place at the right time. We expect local systems to plan for demand and work with providers to strengthen capacity, including for people with dementia and complex conditions.
As we heard from my hon. Friend, it is vital that when a difficult decision is made to close a care home, the process is handled as sensitively as possible. Local authorities should have procedures in place to minimise disruption, with time allowed to support a safe transfer that supports the wellbeing of individuals, families and carers. Providers should ensure that proper arrangements are in place to support the transition of residents to their new position. Our expectation is that every effort should be made to provide care as close to home as possible and to take account of family connections and personal preferences wherever practicable. It is also essential that individuals and their families are involved in decisions about discharge and ongoing care. The guidance is clear that planning should begin early and that patients and carers should be supported to make fully informed decisions where appropriate.
We know that people who are discharged in a timely way with the right care and support in place experience better recovery and health outcomes. That is why we expect local systems to work together to ensure discharge processes are as effective as possible, particularly for people with dementia and other complex needs. The Government are therefore working with the NHS and local authorities to strengthen the local health and care system so that it can better meet those challenges.
Through the better care fund, more than £9 billion is being used to support integrated working between the NHS and local authorities, enabling more joined-up services and improving the planning of care outside of hospital. We will also reform the better care fund to support more effective joint planning and delivery between health and social care. That will be focused on improving how services are co-ordinated and supporting care that helps people regain their independence, reduces unnecessary hospital stays and enables people to receive care closer to home.
We also recognise the importance of improving care and support for people living with dementia. According to NHS data, NHS Hampshire and Isle of Wight integrated care board recorded that as of March more than 18,000 people had a diagnosed form of dementia. The Government want a society where individuals with dementia and frailty receive high-quality, compassionate care from diagnosis through to the end of life. That is why we will deliver the first ever modern service framework for frailty and dementia to deliver rapid and significant improvements in the quality of care and productivity. That will be informed by phase one of Baroness Casey’s independent commission into adult social care, which is under way and expected later this year.
We are committed to feeding into the NHS and local government planning cycles in September and aim to publish the full framework by the end the year, as recommended by Baroness Casey. We intend to engage with a range of partners over the coming months and will ensure that the voices of people with lived experience are at the centre of our work to develop the modern service framework.
I thank my hon. Friend for bringing his constituents’ voice to the House. I reiterate that we recognise the very real concerns raised by families on the Isle of Wight, particularly when people with dementia or complex needs have been moved away from their homes and communities. While there will be circumstances where temporary placements further from home are necessary, care should be provided as close to home as possible in a way that respects the individual’s needs, preferences and connections to their family and community.