Editorial: England must improve its dementia services

GP has run a series of articles over the past four months following the 'zero tolerance' pledge made by ministers in June over the use of antipsychotics in dementia patients.

Dementia experts warned that GPs were under pressure to prescribe the drugs because of a lack of specialist units to refer dementia patients.

In July, we published a warning by the Medical Defence Union that GPs could be struck off for prescribing antipsychotics to a dementia patient who then went on to suffer a stroke as a result. In August a GP investigation found that the number of prescriptions by GPs for antipsychotic drugs could rise by 9.6 per cent over two years.

Today GP can reveal that one in four PCTs has closed or reduced dementia services in the past three years and less than half have early detection services in place.

Dr Chris Manning, founder of charity PriMHE and a member of the RCGP mental health group, accuses PCTs of finding it acceptable to cut dementia services in a way that they would not dream of for cancer.

Some PCTs do say that, although they do not provide any specific dementia services, care is provided as part of services for older people with mental health problems.

But the Alzheimer's Society describes even this as unacceptable, while calling the figures unearthed by GP as 'extremely distressing'.

There are indications that the DoH is at least aware of the problem and may even tackle it in the first national dementia strategy, expected next month. It may even herald primary care-based dementia care co-ordinators and better-resourced memory clinics in every PCT.

Frankly, it is no more than the GPs who risk being struck off for prescribing these drugs, and their patients, deserve.

GP is reminded of a quote attributed to Gandhi: 'A nation's greatness is measured by how it treats its weakest members.'

So how should we rank England's greatness on the basis of its treatment of people with dementia?

Must do better - and soon.

More opinion online
Read more opinion from the GP editorial team in the editor's blog at www.healthcarerepublic.com/blogs. This is what the team had to say this week.

"The government has inadvertently created a sort of cafe culture by forcing smokers to sit outside in all weathers. So, if they really want Britain's streets lined with chic, well-behaved, sensible drinkers, maybe all they have to do is ban alcohol indoors."

"Delivering a punch line, taking medicines, investing in a bank - all need to be done at the right time. Too early and you miss the point, too late and your efforts fall flat. Changing when a patient takes a drug could be as important as changing what they take."

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