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Mr. Heppell: We should bear in mind that we are not starting from base zero. The idea that local authorities do

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not provide any of those services at present is nonsense. I recently received a letter from the Carers Federation, Nottingham and Nottinghamshire, which praised the local authority for the initiatives that had already been taken. We should not assume that we are starting from nothing and that only the carer's grant will improve the services that we are considering. Many people enjoy residential respite services, breaks at home and day-care services. We are considering expanding those services, not starting afresh.

Mr. Deputy Speaker (Sir Alan Haselhurst): Order. The hon. Gentleman is making another speech. Interventions must be short.

Mr. Dismore: I am grateful to my hon. Friend for his intervention. The Opposition tend to focus on the money that central Government provide and neglect what is happening locally through social security budgets, through other agencies and through the voluntary sector.

My hon. Friend is right to say that it is worth restating not only what happens locally, but nationally. Paragraph 24 of the national carers strategy sets out the resources that the Government are starting to provide. It states:


That is the overall picture. The document continues:


    "On top of that, we are making available a new special grant--ringfenced funding--to local authorities for the enhancement of services to allow carers to take a break from caring. The grant will total £140 million for England over the next three years--£20 million in 1999/00, £50 million in 2000/01, £70 million in 2001/2002."

The hon. Member for Runnymede and Weybridge (Mr. Hammond) referred to the final figure.

I am sure that carers and those they care for, who are also electors, will realise that by 2001-02 we are likely to be approaching or on the other side of a general election. The hon. Member for Runnymede and Weybridge referred to the Government's actions after 2001-02. I assume that he believes that the Conservative party will not win a general election, and is asking for our forward plans after the comprehensive spending review in the summer. The hon. Gentleman made no commitment about the money that the Opposition would be likely to devote to caring.

Mr. Heppell: In the second year of the carer's grant, 95 per cent. of the grant will be spent on breaks, as opposed to 75 per cent. in the first year. That is another example of expansion within existing financial provision.

Mr. Dismore: I am grateful to my hon. Friend. He mentioned the money that is available, and I hope that that will not be the end of the story. As people become more aware of the challenges and problems that carers experience, there may be an expansion of provision in the voluntary sector, and people who are not paid will provide short breaks through, for example, evening sitting services. In addition to the money, which is vital, there will be added value as the debate progresses and improvements in voluntary services.

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Before I took a series of interventions, I referred to the needs that carers identified in response to the survey that my local authority conducted. We have dealt comprehensively with short breaks, but the survey identified the need for more help with transport. Unreliable transport is a problem for carers, who need to be able to plan their day. If they do not know at what time transport to the day centre will turn up, it is difficult for them to undertake any activities that they had in mind as part of the break. A range of transport services is more likely to meet the diverse needs of carers.

As my hon. Friend the Member for Halesowen and Rowley Regis mentioned earlier, carers need help with practical matters such as shopping, cleaning and gardening. I hope that such activities will be identified as part of the assessment to which clause 1 refers. They need a holiday and a break from the caring environment, even if that is a brief trip to the constituency of my hon. Friend the Member for Scarborough and Whitby. May I promote my birthplace, Bridlington, which is a far better seaside resort than Scarborough for a day out or a week's holiday? It could provide carers with a welcome break from the caring environment.

Carers need training not only in lifting--although obviously it is important that they do not injure themselves when moving people with disabilities--and rather personal tasks such as incontinence management, but in dealing with stress, which sometimes gets a bad name in the House and among the wider public. In my previous life as a lawyer, I often had to advise clients who were suffering from stress on how to pursue claims. I found generally that people tend to pooh-pooh stress; they think that it is part of everyday life. Of course it is: making a speech in the House can be very stressful for many of us.

Mr. Forth: No, no.

Mr. Dismore: I am sure that making a speech is not stressful for the right hon. Gentleman; he is an experienced parliamentarian.

Mr. Forth: I love it.

Mr. Dismore: The right hon. Gentleman loves making speeches, but it can be stressful for many of our colleagues. Making a speech is a one-off--we can prepare and we know it is coming--but carers face different problems. They may have to experience stress day in, day out, or the relative they are looking after may cause them a lot of stress.

Mr. Quinn: As a mere engineer, I offer my hon. Friend an engineer's definition of stress--it is the load on an area. Is not the Bill about easing and spreading the load so that stress is dispersed?

Mr. Dismore: My hon. Friend makes an interesting analogy. The Bill is about spreading the load, which is why training is important. I am pleased that that features in the national strategy for carers, which says on page 60:


The document deals with all sorts of matters on which people need training. I would not be wasting the House's time by describing them, but I want to make a little

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progress and return to the point I was making about stress. Participants in a course called "Looking After Your Stress", who valued the contacts and friendships that they had made, reported decreasing stress levels. If stress management can be taught to carers, it will make their lives a lot easier and a lot better and enable them to continue caring for a lot longer.

Carers need greater flexibility and choice in how services are delivered and the Bill goes a long way to providing that through the arrangements for vouchers or direct payment. I am particularly struck by the fact that people like to be in control of their own lives wherever possible--I had not thought about that issue until I started to research carers for the debate--and can often provide far better services that are tailored to their needs if they have the money to do so. Inevitably, there is an off-the-peg element if services are provided by a statutory agency--people get what is on offer whether it fits or not.

I know that local authorities--mine is one of them--are doing their best to tailor off-the-peg services to carers' needs, but there is inevitably a degree of coping with a services straitjacket. If we can empower carers to buy their own services as and when they need them--through either vouchers or direct payment--that will be an extremely welcome development. Indeed, carers may get more for their money in the absence of all the overheads that go with providing a statutory service.

Carers need a listening ear and someone to talk to; that is part of trying to deal with stress. I was pleased to be invited to open a good neighbours service on the Grahame Park estate in my constituency-- neighbours try to help others out. On many big housing estates such as Grahame Park there is great isolation. The nature of housing estates tends to make people lock themselves into their homes at night rather than engaging with their neighbours. That isolation is part of the problem for carers. Developing befriending and good neighbour services is a way of trying to break down that isolation.

The strategy also refers to the need for better information and advice--which I have already dealt with--financial advice and carer-friendly employment practices. I do not want to run the risk of straying out of order by talking about all the wonderful family friendly employment policies that the Government are introducing, but we should recognise that the needs go beyond simply looking after children. The family includes elderly relatives, who may have difficulty looking after themselves, and relatives with disabilities. The family is more than just parents and children. I hope that as our family friendly employment policies develop, they will take carers' needs into consideration.

We need more help and advice from GPs. Part of the problem with the GP service in my area is that primary care provision is overstretched and GPs do not have the time that they need to talk to carers about some of the issues that we have discussed. If GPs had a little more time to talk to carers, they might find that their work load reduced, because if carers have more information about the condition of the person they are caring for, they may be able to provide basic care instead of having to call on the GP or the health service. It is in the interests of GPs to try to spend a little more time with carers and discuss their needs.


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