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11.4 am
Mr. Stephen O'Brien (Eddisbury): I add my congratulations to the hon. Member for Stalybridge and Hyde (Mr. Pendry) on introducing this welcome Bill. I also congratulate him on coming so high in the ballot. I was also on the list, but much lower down than him, so my congratulations are particularly personal.
All my Conservative colleagues join me in welcoming the Bill. Its objectives are wholly commendable and it is consistent with what has been trailed for some time. However, I am disappointed that the Government have not given the Bill sufficient priority and found time for it in their legislative programme, leaving it instead to take up valuable private Member's time. I declare my personal interest: in the light of the Prime Minister's comments on Tuesday to the National Farmers Union, I hope that the Government will consider supporting my Food Labelling Bill, which is due for its Second Reading on 3 March.
The Bill we are considering today extends beyond the family, but its underlying principles are rooted in a sense of family; it is fully consonant with a commitment to the family and the recognition of carers who make provision for their loved ones within the family. I have seen that in my life. My mother and my wife are both nurses who have been concerned with caring for the terminally ill. My
family has lived in a nursing home for the terminally ill that offered respite breaks. Those caring for their relatives could arrange to have them sent to the home under the supervision of my mother for a month while they went on holiday or otherwise caught up with their lives. That was a valuable service. However, it was a private sector service restricted to those who had sufficient means. The welcome aspect of the Bill is that it provides an opportunity for a greater extension of those services and provisions.
The focus must be on resources. The right hon. Member for Coatbridge and Chryston (Mr. Clarke) and the hon. Member for Sutton and Cheam (Mr. Burstow) talked about that in detail. There are two basic issues. The first is the resources at local authority level for those who are already receiving some support. I recently had a case at my surgery involving the devoted and caring parents of a 26-year-old who was severely mentally retarded. They gave him the most amazing care. Their situation had been assessed and they had been awarded 83 days per annum respite care for the previous two years. That was welcome and clearly necessary because both parents were beginning to get on in years.
However, all of a sudden, because of a limitation of resources, the 83 days were reduced by letter to 51 days. That is still not bad, but that is not the point. The parents needs had not changed. They still needed those 83 days to recharge their batteries so that they could provide proper care the rest of the time, which is clearly exhausting. It is also important for carers to know that they have a set amount of time when they will be released from their burden so that they can plan and set targets and goals. The Bill is a welcome move forward in looking carefully at the needs of carers.
Assessments produce certain expectations, and if services are reduced or denied due to a stretching of resources, serious difficulties may arise. If the Bill becomes law, its detailed provisions will have to be worked out with care and consideration. It will be important to make sure that there are adequate resources, so that once an assessment has been made, and provided that the needs have not changed, there are no arbitrary variations in the support that is provided purely because of annual financial considerations.
Another, perhaps more important, aspect of the Bill is the need for resources to provide the services in clause 2, which have been mentioned in previous speeches. Subsection (2) states:
I am interested in how the Bill would operate in terms of resources. The explanatory notes mention training, so perhaps the Minister will say something about that in his
response to the debate. I am also concerned about charging, which is covered by clause 7. Although I understand the framework that is set out, one of the benefits of the Bill will be to encourage carers to feel that their good work has been recognised. However, the charging regime in clause 7 may result in people refusing services because of their inability to pay or their concern about the level of the charges. It is important that the good intentions of the Bill can be translated into action--and that will require resources. It would be useful to examine how the charging provision will operate in practice, so that it does not become a deterrent. I look forward to hearing more about that.
Finally, in respect of the financial provisions in clause 9, I am unclear about what the Government envisage and the extent to which they are working with local authorities to ensure that there are adequate resources. I hope that the Minister will clarify that in his response to the debate.
Mr. John Heppell (Nottingham, East):
I shall not spend long discussing the details of the Bill as it is important to look at the bigger picture. I congratulate my hon. Friend the Member for Stalybridge and Hyde (Mr. Pendry) and many others, including my right hon. Friend the Member for Coatbridge and Chryston (Mr. Clarke), the Under-Secretary of State for Education and Employment, my hon. Friend the Member for Croydon, North (Mr. Wicks), and my hon. Friend the Member for Monmouth (Mr. Edwards) on their work in this field. I could continue mentioning right hon. and hon. Members, but the real congratulations should also go to some of the people who have been campaigning to make carers a big issue.
I see the Bill not as the first step, but as part of a strategy that has suddenly gained pace. I should also congratulate the Minister and the Government on their role, to which I shall turn later in my speech.
The hon. Member for Sutton and Cheam (Mr. Burstow) and my hon. Friend the Member for Monmouth spoke from personal experience. I consider myself fortunate in that I have never had long-term responsibility for caring for someone. We can attend forums and talk to constituents, but we can never understand what it is to be a carer unless we have experience of caring.
My right hon. Friend the Member for Coatbridge and Chryston always used to tell people, "At some stage in your life, it is likely that you will suffer some disability and find out what it is like to be disabled." It is also likely that at some point in their lives, most people will be a carer. Recent studies show that, in a typical lifespan, six out of 10 people are likely to undertake heavy caring duties and that the chances of becoming a carer increase with age. Even those whose attitude is, "I'm looking after No. 1" should remember that at some time in the future they may need the provisions that we are making today.
The common-sense argument for the proposed changes in the Bill and the overall strategy are overwhelming. It is obvious that we need to do something to help carers. I have heard many debates about who should be responsible for community care and whether social services should take more of the burden off the national health service. In reality,
the majority of community care is undertaken not by the national health service or social services, but by ordinary carers who are devoted to members of their families. Those carers save the Government some £34 billion. That is an awfully big resource, and a resource that we cannot afford to ignore. If we do, carers will burn out and cease to be able to act as carers. They may become ill themselves, which means that the burden--not just in relation to the person being cared for but in relation to the carer--falls on the state. We end up providing a higher level of service because we could not provide the necessary support in the first place. I welcome this Bill because it provides that support.
I said that I had no personal experience of being a carer, but I do have one small experience about which I wish to tell the House, as it left a lasting impression. My wife used to work for social services in a residential home for people with disabilities. The home took the residents for a weekend trip, and wanted volunteers to assist. My wife kindly volunteered me for a weekend at Butlins in Skegness. People might agree that there may be grounds for divorce in that, but it turned out that Skegness--although it is always fairly bracing--was quite sunny. We had a pleasant weekend, and the company was excellent. I had a good time, and it was fulfilling and rewarding.
I was a second-class carer, as the residential workers carried out any unpleasant tasks. My tasks were menial, but what stays in my mind was how exhausted I was at the end of the night and at the end of the weekend. That made me think--what if I had been caring not for a weekend, but for a week, a month, a year or a lifetime? That is the reality for many carers. We must make sure that we provide support for those lifetimes.
In some respects, the Bill is just a step forward. My hon. Friend the Member for Croydon, North proposed the Carers (Recognition and Services) Act 1995 under the previous Tory Administration, and that was a step forward, but it did not deliver in all respects. The proposals were not taken up, and carers recognised that. I was pleased to see the fresh impetus that was given to the matter by the incoming Government.
It was no surprise that one of the first groups that the Prime Minister invited to No. 10 Downing street was carers, and it was significant for them to receive that level of support from someone so senior. There was an immediate recognition by the Government that something needed to be done quickly. As a result, the Deputy Prime Minister launched the national strategy for carers in February last year, and the proposals in the Bill are in the strategy document. I am pleased that my hon. Friend the Member for Stalybridge and Hyde decided that we must implement the proposals: it is a question not just of fine words but of producing concrete proposals on which people can work.
I want to congratulate those in local government and the health service, who have been putting the local plans together. We heard from my right hon. Friend the Member for Coatbridge and Chryston that £750 million had been put aside to help develop people's independence, and that £375 million has been put aside for children's initiatives. The initiatives under the national strategy are significant, with £20 million going in this year, £50 million next year and £70 million the year after that.
Local organisations have asked me what is to happen after the three years. We know that money is there now, but I was asked to lobby for the money to remain and, if
possible, to be increased in the future. I can tell my hon. Friend the Minister that I am lobbying now: I want that money to remain and to increase after the three years. We need to ensure that the necessary resources exist.
I want to congratulate local organisations working within the national strategy who have spent money locally. We often talk about partnership--it is a buzzword--but I see real partnership in the work in Nottinghamshire between local authorities, health authorities and voluntary organisations which are putting together plans to ensure that people can have respite care. They are producing practical plans that aid people, and the Bill will help to make that more possible.
"The services referred to are any services which . . . may take the form of physical help or other forms of support."
As my hon. Friend the Member for Poole (Mr. Syms) said, one of the most significant aspects of caring involves lifting and turning the patient. The professionalism and ability of carers to turn patients and help them to avoid bedsores is often regarded as a test of the effectiveness of the care provided. A commitment to training is absolutely crucial, and may be a more effective use of resources. Training is important not only for lifting, but for the regime of turning patients if they are bedridden or seated for long periods of time.
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