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Mr. Heppell: Is not that why it is so important that the carers national strategy introduces a requirement for local authorities to survey carers to find out exactly what they want? If we ask them what their needs are, rather than try to second-guess them, there is a good chance that we will meet those needs.
Mr. McCabe: I totally agree that we should ask people what they want rather than try to second-guess their needs. However, we also need a culture and framework in which we respond by doing what they ask, rather than being
locked into the mindset that services must be organised and provided in a certain way and people must be told what services they can have. That is the current mindset, and direct payments could change it, but we must get away from the over-professionalised notion of how services should be delivered.
Returning to the example of home helps, it is ironic that in creating more professionalised services, we have made them less available to people. Many need services at the weekend and late in the evening, but it is almost impossible for most local authorities to provide home care at those times without exorbitant costs. That results in the absurd situation of people being told when they must go to bed and what day of the week and what time they can have a bath. That is a direct consequence of the way in which we organise services because we employ people who prefer to work nine to five, and those are not necessarily the hours when people are most in need of the services.
Mr. Gareth R. Thomas (Harrow, West):
On the over-professionalisation of services, will my hon. Friend take this opportunity to praise the Carers National Association and, more importantly, centres such as the Harrow carers centre in my constituency, which have lobbied social services and other statutory authorities that provide care for the flexible services about which he is talking?
Mr. McCabe:
Yes. A number of organisations have done wonderful work. As I said at the outset, I am not attacking local authorities or condemning social workers, but we have inadvertently organised services so that they are of least benefit to the people who are most in need of them.
Mr. Dismore:
I am concerned that we do not set professional services against non-professional services. Is not the real issue the need to build a proper partnership between statutory agencies such as health authorities and local authorities, the voluntary sector and individuals to make sure that we have a properly co-ordinated service that plugs all the gaps and takes account of the criticisms that my hon. Friend has been making?
Mr. McCabe:
I repeat, I am not knocking professionals or condemning local authorities and social workers. I merely suggest that we have created a structure, a mindset, a framework that over-professionalises certain aspects of the work and certain tasks. The way to address that is both to listen to carers and their organisations and to create the partnerships that will ensure that flexible care and support are provided at the times people need them.
Acting as a brake on the success of current direct payments is the fact that they can create difficulties for the recipient, because that individual becomes, in effect, an employer and faces all the red tape and bureaucratic inconvenience that that implies. When considering the implementation of the Bill, will the Minister look at ways in which we can relieve some of the pressure on individuals who have direct payments, so that they do not become locked into interminable employer obligations? Although they might have ulterior motives, some local authorities have argued that one reason that direct payment is used to a lesser extent than we might have hoped is that people find
quite daunting the number of potential risks to which they become exposed in the role of employer. Is there any way to ease that problem?
Earlier, we heard about a scheme in Harrow; there is a similar scheme in my constituency, where there is not-for-profit home help agency. People contract with it to obtain the services they want at the time they want them, but the legal and employment framework is handled by the agency. It strikes me that such a system might offer an answer: it organises and controls services and, by localising them, makes them more intimate and more responsive to individual needs; it also relieves the individual of some of the unnecessary burdens and pressures that go with being an employer. We should consider such schemes. Otherwise, in trying to empower individuals, we might hamper them with unnecessary burdens that stifle them and prevent us achieving our goal.
Mrs. Heal:
Does my hon. Friend agree that it is important to take note of some of the complexities of direct payments, even though such problems may be different in respect of payments made to carers rather than to those cared for? I have no doubt that those hon. Members who are fortunate enough to serve on the Committee will address those problems. I am sure my hon. Friend agrees that the Bill offers carers a wide spectrum of choices, which will enable escape from the strictures of limited choice. The combination of direct payments, vouchers and local authority provision will offer a range of possible services that carers and the people for whom they care want.
Mr. McCabe:
I agree, which is why the Bill is so wonderful. It will unlock people's potential and enable them to escape from the terrible environment into which we have inadvertently put them: that of being nothing more than the recipients of services. The Bill will give people the chance to open up their lives and gain greater control over them. That is what the Bill is all about.
Mr. Philip Hammond (Runnymede and Weybridge):
I congratulate the hon. Member for Stalybridge and Hyde (Mr. Pendry) on his choice of subject for his private Member's Bill. He spoke of winning friends, and I assure him that he will have won many through his contribution today.
I congratulate other hon. Members who have spoken. Many have displayed a depth of experience and knowledge that has made the debate interesting and worth while. I am pleased to see the Minister of State, Home Office, the right hon. Member for Brent, South (Mr. Boateng) on the Treasury Bench for the winding-up speeches, as he has been a major contributor to the Government's strategy for dealing with carers.
The Government rightly recognise the position and role of carers in our society. Many hon. Members referred to the large number of carers--almost 6 million by most estimates, although inevitably the figure will always remain an estimate. The essential feature of those carers is that their care is voluntary. They do it out of love and a sense of duty and obligation. In that way they contribute to our society some £30 billion worth of care.
We as a society have not only a moral obligation to support carers in what they do, but an economic imperative. The care that is provided informally in our society underwrites our national health service and underpins our social care system. The great silent army delivers care that would simply be unaffordable if it had to be provided through the formal system.
It is right and proper that the Bill focuses on the needs of voluntary carers, and in doing so underpins family and community values. We support and encourage that trend.
The starting point in the discussion about care and carers must be that care is rooted in the family, with the state and the statutory bodies providing support and encouragement for that care--not the other way round, starting from the assumption that the state has an obligation to provide all the care needs of every individual. The hon. Member for Birmingham, Hall Green (Mr. McCabe) developed that point admirably in his speech.
The Government have outlined a national strategy for carers, with which we are broadly in agreement. The right hon. Member for Coatbridge and Chryston (Mr. Clarke) described the development of policy towards carers as evolutionary. That was an inspired use of language.
I shall try to put the Bill in the context of the evolution of Government policy across Governments of both parties towards the needs and recognition of carers, and show that the Bill is part of a continuum. It is not a sudden departure or a step change, but, as the hon. Member for Stalybridge and Hyde said, it builds on what has gone before.
In their national strategy for carers, the Government have repackaged the various strands of Government policy that deal with carers. In the mood of a Friday debate, perhaps I can say that they have rather better packaged those separate strands to present a coherent whole. However, the Bill is essentially a continuation of what has gone before. That is emphasised by the fact that my right hon. Friends the Members for South-West Surrey (Mrs. Bottomley) and for Charnwood (Mr. Dorrell) are co-sponsors of the Bill.
The Government's national strategy for carers makes a welcome statement about recognising and supporting carers, and identifying the needs of carers as distinct from the needs of those cared for. Balance is essential. We must find a way to support carers without eroding the essentially voluntary nature of what they do, which is rooted in obligations of love and duty. Those are important, if unfashionable sentiments.
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