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An overview of the impact of dementia that focuses on underdeveloped countries across the globe, and migrant and minority ethnic communities within the developed world. Increased longevity increases the risk of dementia and brings new challenges in terms of cultural perspectives and cultural obligations in the care of elders. The chapter examines these challenges in detail and their consequences in planning for support and care.

This article summarises what the Department of Health's (2005) Delivering Race Equality (DRE) agenda in mental health services set out to achieve and the background to this. The article then provides commentary on the Central and North West London NHS Foundation Trust's experiences while acting as one of the 18 focused implementation sites (FIS) created as part of the Department of Health's five‐year Delivering Race Equality Action Plan and highlights the recommendations that developed out of this work and have national application.

One of the major developments of the post‐War years has been the rise of consumer protection ‘watchdog’ committees galore, a flood of legislation and completely changed enforcement methods by existing local authority officers who to all and intents have become a completely new service. Voluntary agencies, national and local, based on the local High Street, have appointed themselves the watchdogs of the retail trade; legislation and central departments, the larger scene. The new service has proved of inestimable value in the changed conditions; it continues to develop. When shopping was a personal transaction, with the housewife making her purchases from the shopkeeper or his staff on the opposite side of the counter; when each was well known to the other and the relationship had usually lasted for many years, often from one generation to the next, things were very different, complaints few, unsatisfactory items instantly replaced, usually without question. This continuing state of equanimity was destroyed by the retail revolution and new methods of advertising and marketing. Now, the numbers of complaints dealt with by consumer protection and environmental health departments of local authorities are truly enormous. We have become a nation of “complainers,” although in all conscience, we have much to complain about. Complaints cover the widest possible range of products and services, of which food and drink form an integral component. The complaints to enforcement authorities include many said to be unjustified, but from the reports of legal proceedings under relevant enactments, it is obvious that the bulk of them now originate from consumer complaints. Not all complainants, however, relish the thought of the case going before the courts. Less is heard publicly of complaints to the numerous voluntary bodies. Enforcement authorities see complaints in terms of infringements of the law, although their role as honest broker, securing recompense to the aggreived customer, has become important; a few departments being able to claim that they secured reimbursements and replacements of value totalling upwards of amounts which annually run into six figures. The broker role is also that adopted by voluntary bodies but with much less success since they lack the supporting authority of legal sanction.