Today’s report prepared by research teams from the LSE & Institute of Psychiatry reveals the sad reality of dementia and its likely long-term impact on us all. There are currently 700,000 people with dementia in the UK. It is projected that by 2025, there will be over a million people with the disease, of whom two thirds will be women. The present financial cost of dementia to the UK is over £17 billion a year. The researchers’ investigations revealed that caring for one person with late-onset dementia costs society an average of £25,472 per year. And it is not just financial burdens that should be of concern. Demented patients can have a profound adverse effect upon the family unit.
Dementia is increasing in prevalence as a consequence of our ageing population. Other important contributory factors to this increase are high blood pressure, raised cholesterol and a lack of exercise. There is no cure for dementia, and those with the condition will need increasing care as the disease progresses. I have worked in a dementia unit and hence understand the difficulties of the levels of care needed. Unfortunately, psychogeriatrics is not a glamourous specialty, and consequently does not attract the necessary funding of research and care. As Professor Martin Knapp, of the London School of Economics, one of the report’s authors, said: “Dementia is one of the main causes of disability later in life ahead of cancer, cardiovascular disease and stroke, yet funding for dementia research is significantly lower than these other conditions.”
It is not only dementia that is on the increase. More than 1.5 million Britons now have Type II Diabetes 1. This is thought to be a direct consequence of poor choices in diet and diminishing levels of exercise. The cost of diabetes to the NHS by 2025 has been estimated at 25% of the entire healthcare budget.
Finally, I would like to mention a condition that infuriates doctors. It is one that leads to approximately one million missed GP consultations per year in this country3. I believe that the condition is caused by the NHS and the way in which it is structured. I am referring to the ‘DNA tendency’ (DNA = ‘Did Not Attend’). On most days, I have patients not attending scheduled appointments. This attitude reflects a growing problem of people not respecting the system. Clearly, because people do not directly pay for the service, they do not treat it with the necessary respect.
The “Three Ds” I have referred to will eventually cause the break-up of the NHS as we know it. Unless the British healthcare system changes, from being the responsibility of the state to being the responsibility of individuals and communities, it is doomed. Like dementia, the incidence of Type II Diabetes can be reduced by changes in lifestyle2. If an individual exercises more, does not smoke and is not overweight, he is less likely to develop both conditions. The same philosophy should apply to DNAs. These missed appointments will only diminish in number when patients are held more responsible for their cost.
Emphasising personal responsibility for health and the care of your own family has to be the way forward for health and social care in this country. Where there are genuine cases of need the state should step in. In my professional experience, however, most people are capable of looking after themselves. Indeed, when a patient accepts the challenges of diabetes and dementia, I have found only better outcomes in terms of morbidity. My advice is to give people more responsibility for their lives and we might see an improvement in their health.
