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11.57 pm
The Parliamentary Under-Secretary of State for Health (Mr. John Hutton): I congratulate the hon. Member for Eastbourne (Mr. Waterson) on his success in securing time to debate this very important subject. I am particularly grateful for his kind words of welcome at the beginning of his thoughtful and constructive speech.
The Government value the role that carers play. We recognise that they play an important part in the fabric of our society. One in eight adults gives informal
care and one in six homes has a carer. As the hon. Gentleman correctly said, that means that there are nearly 6 million carers in the United Kingdom today
Carers fulfil a vital role in helping relatives or friends and, without their support, many disabled or elderly people would lose the chance to stay in their own homes or with their own families. Caring is something that touches us all. Most of us will have had some experience, either in our own family, or through friends or colleagues, of illness and disability. We therefore know some of the difficult decisions families face and can appreciate the great responsibilities that carers like Margaret Edwards undertake over long periods of time.
On a number of occasions, the hon. Member for Eastbourne referred specifically to the circumstances in which his constituents, Margaret and Paul Edwards, find themselves. It might be helpful if I make one or two remarks about the case to which he has drawn our attention.
East Sussex social services department has agreed a substantial package of support services for Paul and his mother. As the hon. Gentleman said, the services include attendance five days a week at a day service centre, three nights a week of respite care, a Crossroads sitting service and domiciliary care provided in response to requests from Mrs. Edwards. A social worker has been allocated to the family, who I think has--I stand to be corrected by the hon. Gentleman--developed a very good working relationship with the Edwards family.
Equipment has been provided and adaptations have been made to allow Paul to live at home. He has a wheelchair and a specially contoured bed, and ceiling tracks have been provided to lift him in and out of bed. An application by Mrs. Edwards to extend that system to the bathroom, to replace the hoist currently in use, is being considered by the social services department.
The examples that I have given show that the East Sussex social services department has already provided a range of help to Paul and to Margaret, and I am sure that the department will continue to consider sympathetically any additional requests for help from them.
Most people do not plan to be carers. Moreover, many people who provide care regard themselves not as carers but simply as people providing the love and comfort that comes naturally to them. It is a role that arises from mutual bonds of family, duty and affection, sometimes at significant personal cost to carers themselves.
In recognising the contribution of carers, we should not ignore the fact that families and carers can sometimes feel over-burdened, unaided and unsupported in their task. Government and statutory agencies clearly have a responsibility to listen to carers and ensure that the right support is available for them at the right time. That is why, on 10 June 1998, my right hon. Friend the Prime Minister announced that he was asking the then Under-Secretary of State for Health, my hon. Friend the Member for Brent, South (Mr. Boateng) to lead a Government-wide review of measures to help carers as part of a national strategy for carers.
The objective of the national strategy is to bring together a range of initiatives designed to address carers' concerns and to give them support. The strategy's terms of reference include drawing together existing work within government that impacts on carers; taking account
of the emerging findings of the royal commission on long-term care; and assessing whether any key needs have been overlooked.
The hon. Member for Eastbourne has raised the issue of social security benefits and of how the rules and regulations concerning those benefits impact on the lives of carers. I shall specifically address those issues in a moment. First, however, I should like to reassure the hon. Gentleman that we wish to ensure that there is across Government an integrated approach to carers. The strategy is building on work that has already been done in the past 18 months to strengthen links between Departments on carers' issues and is also maintaining a meaningful dialogue with carers' organisations.
I was concerned at parts of the hon. Gentleman's speech, when he seemed to imply that all the problems that carers are now experiencing date from 1 May 1997. They do not. The previous Government had 18 years to deal with some of carers' particularly pressing concerns, and conspicuously failed to do so. On 1 May 1997, the new Government began to start addressing those issues.
The national strategy for carers is built around ensuring that carers' concerns are no longer ignored. Our approach is both inclusive and flexible. The Government are involving in our work on the issue carers' organisations, carers themselves, recipients of care, representatives of the statutory services, various Departments and people from industry and commerce.
On 30 July, my hon. Friend the then Under-Secretary of State chaired a meeting of Ministers from Departments with an interest in meeting carers' needs. That was the first ministerial meeting ever held specifically on carers' needs. Ministers decided that, within the strategy, work will be undertaken on four specific themes: respite--to which the hon. Member for Eastbourne referred; employment issues; community networks; and meeting health needs.
Working groups to examine each of the four themes have now been established and have all met at least once. The groups each include representatives from key stakeholder groups. Additionally, however--to capture the views of an even wider range of people--next week, there will be in London a full-day UK consultative conference at which we shall discuss how the needs of carers might be better met. Those invited include Ministers and other representatives from both this House and the other place; people from both national and local carers' organisations; representatives of local government; industry and commerce; representatives of religious and ethnic minority groups; and--most important of all--individual carers who have written to tell us about the issues that concern them most.
I deal now with social security benefits and the national carers strategy. The strategy will be taking a critical look at all aspects of invalid care allowance and the other benefits that support carers in their valuable role. We will want to see what is currently available, how well the benefits meet the needs of carers and what changes may be appropriate for the future. It is too early to say what the results of that examination will be, but we expect to include any proposals in the strategy's consultation document. I assure the hon. Gentleman that that consultation process will be wide and meaningful.
Nevertheless, social security benefits already make a substantial contribution, whether directly or indirectly, towards informal care. As well as specific provision for carers in their own right through invalid care allowance--which will, incidentally, exceed £830 million in 1998-99, topped up, for those less well off, with income-related benefits--in excess of £24 billion goes towards the income replacement and extra costs needs of long-term sick and disabled people.
Despite that level of spending, there are undoubtedly unmet needs. That is why my right hon. Friend the Secretary of State for Social Security recently announced the latest stages of the process of reforming the welfare state. The Government are determined to help disabled people, and, by extension, those who care for them, especially where the carer and the cared for live in the same home, as is the case with the Edwards family.
We want to help disabled people get back into work. To achieve that, we have announced our intention to modernise incapacity benefit, so that it provides information on what people can do, not what they cannot do, and to help people plan their return to work.
We also intend to introduce a single work-focused gateway. It will help sick and disabled people and their carers consider opportunities for work through personal advisers and a common entry point for all benefits. That will help to improve the service that we give our clients and help them avoid benefit dependency. At the moment, too many claimants experience duplication and confusion. We need to tailor our services to provide a more personalised and professional service and seek to help people become more independent. Obviously, if a carer's duties are particularly onerous, an immediate focus on work would be inappropriate, but we do not intend that people will lose access to their personal adviser.
Also, we are going to provide security for those disabled people who cannot work. We will focus that help on those in the greatest need by introducing the disability income guarantee--a new increase in income support for those severely disabled adults and children with the greatest needs. We expect that some 145,000 adults and 25,000 children will benefit from the disability income guarantee from April 2001. We shall also be reforming the severe disablement allowance so that it provides greater help to those who become disabled early in life, and we shall be extending to children aged three and four the higher rate mobility component of the disability living allowance.
In conclusion, the strategy will be ready for consultation early in 1999. We already know from the research available to us and from the many letters that people send us that carers' main needs are the means to have a break, recognition of the importance of their role, reliable and satisfactory services, relief from social isolation, and information.
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