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Mrs. Rosemary McKenna (Cumbernauld and Kilsyth): Does my right hon. Friend agree that the problem is the invisibility of such children? For many years, carers as a group were invisible, but child carers continue to be so. Education authorities and schools have a role to play in identifying children who bear such a huge burden.
Mr. Clarke: I agree. My hon. Friend speaks from great experience, as a former president of the Convention of Scottish Local Authorities and provost of Cumbernauld and Kilsyth. I am glad that she has raised the question of education and the role of education authorities.
I welcome the vision enshrined in the Bill. Many of the individual issues raised today will be dealt with in Committee, and an evolutionary approach will take us further still. Whatever questions are put to my hon. Friend the Member for Stalybridge and Hyde and the Carers National Association by those who have campaigned for many years--including Mencap, Lord Rix, and the National Centre for Independent Living, headed by that formidable woman, Jane Campbell--it is important to recognise that they have all welcomed the Bill. You, Mr. Deputy Speaker, would rightly rule me out of order if I referred to Scotland, because the Bill does not cover Scotland, but I am sure that my hon. Friend will acknowledge the views of the Carers National Association for Scotland, especially because his Bill will become a beacon for the rest of the UK and Europe.
The Bill is welcome. It gives a large number of people both rights and responsibilities, but I believe that they will welcome the challenge. People working in the field will always ask for more resources, and they are right to do so. The Government are in a strong position to respond.
Mr. Paul Burstow (Sutton and Cheam):
I echo the concluding comments of the right hon. Member for Coatbridge and Chryston (Mr. Clarke). The Bill deserves to succeed on its own terms, but more importantly because of the people to whose quality of life it will make a substantial difference.
I congratulate the hon. Member for Stalybridge and Hyde (Mr. Pendry) on his initiative in choosing the topic as the basis for his private Member's Bill. On behalf of the Liberal Democrats, I wholeheartedly support the principles that underpin the measure. Although there are specific points of detail that may be the subject of closer consideration in Standing Committee, which I hope the Bill will reach, it marks a step change in the House's attitude to carers. For that, the hon. Gentleman deserves the thanks of a great many people outside the House, not least in my constituency where many carers provide many hours of support for loved ones and others.
At the outset, I shall refer briefly to my own experience in my constituency. When we discuss such matters, we bring to the debate our experience from our constituency surgeries, casework and face-to-face contacts, which we reflect on, evaluate and learn from. In my constituency we have a local carers forum and a local branch of the Carers National Association. We are lucky also to have a carers centre, which underpins all that is being done in Sutton and allows carers' voices properly to be heard by the local authority and other service providers.
I am repeatedly struck by the fact that carers feel undervalued and isolated at home. Last year, I had the opportunity of spending a day with Lilian, a carer in my constituency, who for the past three years has been caring for her husband. He has dementia, one of the cruellest conditions. A person with dementia is there physically, but not in any other practical sense.
I spoke at length to that constituent, who is intensively involved in providing care and support for her husband. What came across most powerfully was her desire to have a life outside that caring role, without feeling guilty. If the Bill enables people like Lilian to get more support for their needs, in addition to support for the person for whom they are caring, their lives will be substantially improved. They will be able to shoulder the burden of care--although they do not see it as a burden--for far longer.
The Bill builds on the existing community care and carers recognition legislative framework. The hon. Member for Stalybridge and Hyde also referred to clauses that amend child legislation. It marks a step change by giving carers a clear right to an assessment even when, as we have heard, the disabled or elderly person who is being cared for chooses not to take up the right, under the community care legislation, to an assessment of his or her care needs.
The hon. Gentleman described the main features of his Bill, so I shall not repeat them as other hon. Members want to contribute to the debate. The Bill makes an important distinction between the rights of the carer and the rights of the person cared for. It extends direct service provision to carers. For the first time, local authorities will have the power to provide services for carers.
The introduction of vouchers may cause concern in other contexts, but in this case would be a powerful tool for giving users control and allowing carers to shape the services provided for them and for those in their care. That is particularly relevant in respect of short-term respite breaks.
With the best will in the world, large organisations such as local authorities cannot always tailor their services to meet individual needs. They cannot always provide a slot for a respite break when it is most needed. Although voucher schemes will have some logistical impact on the ability of local authorities to deliver, they are vital to allow carers and those for whom they care to choose when, where and how respite is taken. That is crucial to the dignity of carers and a recognition of their value.
Another important advance that the Bill would bring about is the extension of the scope of direct payments to carers and to young disabled people of 16 and over. Estimates of the number of heavily involved carers range from 1.75 million to 2 million. Even by the criterion of 20 hours of care a week, 1.7 million carers are potential beneficiaries of the measure. Of those, it is estimated that 1.2 million provide physical and/or personal care for elderly people.
There is no doubt that those figures represent an under-reporting of the true number of people who undertake caring responsibilities. There are far too many hidden carers in this country, especially younger carers, perhaps caring for their parents, who are not picked up in the general home surveys. We need to do more to make sure that we uncover not just the statistics, but the people.
In my borough the statistics reveal that there are 20,000 carers, but far fewer than 10,000 of them are identified as being in receipt of services or as having been assessed. Much more needs to be done to turn the statistics into the names and addresses of people who could benefit from the proposed services. The Bill does a great deal, but it does not address that issue, which is fundamental to developing services for carers.
Clause 1, which provides new rights of access, is welcome. One or two concerns have been raised and need to be dealt with in Standing Committee or in the Minister's response. We hope that there will be scope for amendments to add, for example, parent carers of adult children. It would be interesting to know why they were not included in the scope of the Bill. Another way of addressing that omission, without recourse to primary legislation, would be through new guidance to local authorities under the existing legislation on children.
Clause 2 gives local authorities powers to provide services for carers which are incidental to the care of the disabled or elderly person. Carers need services in their own right. They may need counselling--for example, to provide them with strategies for coping with a person in the early stages of dementia. They need training--perhaps for lifting. Many, though not all, need support groups. Such services require funding. There is anxiety about the precise wording of the clause because it appears that some
of the provision for services that is provided directly to the disabled or elderly person could be given to the carer instead. Clearly, the devil will be in the detail of the regulations. It is vital that giving support to carers does not mean that the disabled or elderly person becomes more dependent on the carer. It is important to maintain a dual focus on the needs of the carer and the person who is cared for. We should not undermine the sense of independence that we wish to give the elderly or disabled person.
The hon. Member for Stalybridge and Hyde referred to intimate services and said that the regulations would define them. We would welcome the opportunity in Committee to explore the potential definitions. The earlier we see draft regulations, the better for hon. Members and for the many organisations that represent disabled people, elderly people and carers. Intimate services are crucial for someone who suffers from dementia. Inadequate services for dealing with incontinence are a key trigger for going into residential care. I would be interested to learn more about what will be included in and excluded from the definition of intimate care. Carers need support to undertake tasks that often lead them to give up their caring role when they may not wish to do that.
Anxiety exists about the charging powers in clauses 4 and 7 and their relationship to clause 2. Clause 2(3) states:
"A service, although provided to the carer . . . may take the form of a service delivered to the person being cared for".
We need further clarification. It would be wrong if local authorities could assess the carer's means and charge the carer for the care package, rather than the current position whereby the local authority assesses the disabled person's means. Some disabled people, because of their means, do not have to pay for services, or they pay a lower rate. The local authority should not be able to use the new power to switch the financial burden to the carer.
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