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Mr. Owen Paterson (North Shropshire): There seem to be two contrasting aims in new clause 2, as it was elaborated on by the hon. Member for Harrow, West (Mr. Thomas). If there is a disparity between the services provided by local authorities, there may well be justification for a document that analyses that disparity, so that those offering a service that is less good can improve it. However, it is easy to list a load of problems, establish an institutional reform and sweep everything into that dustbin. The hon. Gentleman outlined many problems in some detail and stated that the carers plan would resolve them. That would be our Aladdin's cave.
The problem is that a document that describes the differences between local authorities will be an extremely broad one and thus it will inevitably be bland. That will not help the people who need it. We all hear of traumatic cases--those are the people we should be thinking about. If the carers plan is to be really effective, it will have to consider almost every individual case.
Carers are being treated as a homogenous lump, but every carer is dealing with an individual problem. Many are in families, where, for example, an isolated elderly person has Alzheimer's. They have to cope with the whole range of disabilities--physical and mental--or with different physical surroundings. Some people may be in blocks of flats with wardens; others--as in my constituency--may be in isolated cottages in the countryside. Some people are caring for children. I know of one especially traumatic case involving a quadriplegic child who is completely mentally and physically disabled and will need care for her whole life.
As the hon. Member for Rother Valley (Mr. Barron) pointed out, to help such people effectively, we need an individual plan for every case. That is an ambitious project. It would obviously need a large number of staff and skilled people and large resources. It might be prohibitively expensive.
There might be merit in drawing up carers plans for individual cases, but I am not sure that the hon. Member for Harrow, West has really thought the matter through. There is a contrast between an effective plan that would help those individuals and a broad, bland document that compared disparities between the services delivered by local authorities.
I shall be interested to hear how the Minister intends to resolve the matter. It would be easy to establish a carers plan and say that all the problems outlined by the hon. Member for Harrow, West will go away--but they will not. To be effective, we need to focus much more on the detail, but to do that will be extremely expensive and time-consuming.
Mr. Pendry: Before I respond to the debate, I thank all those who spoke of my incapacity to undertake my proper role of speaking longer than my hon. Friend the Minister, who spoke earlier on my behalf. When he pointed out that I had left my sick bed to be in the Chamber, Members sitting close to me scattered. Only my hon. Friend the Member for Denton and Reddish (Mr. Bennett) was either brave or foolhardy enough to remain within reach.
Any of my hon. Friends who believe that the right hon. Member for Bromley and Chislehurst (Mr. Forth) does not have a big heart and that he does not care about people should read Hansard on Monday. I am grateful for what he said.
My hon. Friend the Member for Harrow, West (Mr. Thomas) introduced the new clause thoughtfully and well. I greatly appreciate the efforts that he put into the new clause and the amendments. I shall deal with the amendments as a group, because they cover the responsibilities of local councils to decide which services they provide to carers and how. It is right to put carers in that position. I understand why hon. Members have tabled amendments. Like all of us, they want carers to receive the services they need--we are all agreed on that. However, as has been pointed out, all the new provisions are either unnecessary or would reduce a local council's ability to make effective decisions based on its own eligibility criteria and on the professional judgment of its assessing staff.
In relation to community care, we must also be very careful not to put carers in a position that is preferable to that of the people for whom they care. We do not want to give the impression of discriminating against service users in favour of carers. We do not want to impose a duty on local councils to provide services to carers--we simply want to empower them to do so. Amendment No. 10 would reinforce what is already clearly understood to be a fundamental principle of good practice in both service users and carers assessments. In the latter case, practitioners are left in no doubt about their responsibilities to hold consultations with carers. Under the Carers (Recognition and Services) Act 1995, the policy and practice guide on the content of a carer's assessment includes such matters as the carer's perception of the situation, the nature of their relationship with the user, the tasks undertaken and the consequent impact on the carer and the tasks with which they would like help.
Amendment No. 13 similarly seeks to remove the local authority's ability to judge whether particular services will help a carer. As I have said, good practice dictates that such a decision will follow discussions with carers, very much taking their views into account. It must also be made within the parameters of the council's eligibility criteria, which will prioritise within the council's resources the support of those with the greatest needs. If the final arbiter of the appropriateness of a service were not the local authority, whose view would matter? If the decision fell to carers, they would once again be in a better position than the service user, and that can be seen only as discriminatory. I therefore ask my hon. Friend the Member for Hendon (Mr. Dismore) not to press his amendment.
Amendment No. 11 would impose a statutory duty on local authorities, rather than create a power to provide services to a carer following an assessment of need. I would not want--I am sure that no hon. Member would--carers to be put in the position where the people for whom they care have no such right. I therefore urge my hon. Friend the Member for Halesowen and Rowley Regis (Mrs. Heal) not to press her amendment.
On amendment No. 14, the Bill enables local councils to offer carers support in order to meet their assessed needs as carers or to maintain their health and well-being. That support or assistance is expressed as
I understand that the purpose of new clause 2 is to ensure that the legislation is properly considered and that councils give thought to the provision of services and also support carers as they carry out their caring role. I understand from my hon. Friend the Minister that the Department of Health would expect such an exercise to be conducted as part of the on-going planning and priority-setting work of social services departments. I am sure that my hon. Friend will wish to say more about that, but for those reasons I ask my hon. Friend the Member for Harrow, West to withdraw the new clause.
Mr. Hutton: I shall try to be brief. I certainly lend my support to my hon. Friend the Member for Stalybridge and Hyde (Mr. Pendry) in his unwillingness to accept the group of amendments and the new clause, and I endorse all the arguments and his reasons for doing so.
Like my hon. Friend, the Government are committed to striking the right balance. We want to empower carers--of course we do. That is precisely the thrust behind the national carers strategy and, in fact, the main thrust of my hon. Friend's Bill. Several references have been made, including by my hon. Friend the Member for Harrow, West (Mr. Thomas), to the practical ways in which the Government are expressing their support for that commitment. They include the special carers grants that total £140 million, which will be made available over the
It is important that we strike the right balance, as my hon. Friends have said. While empowering carers, we must be careful to ensure that there is no diminution of the rights of those who receive support from carers. We cannot allow the needs of those who are cared for to be recognised any less or their statutory rights to appear in any way less favourable than those of carers. We must have consistency and fair treatment between carers and those being cared for. For the reasons that my hon. Friend the Member for Stalybridge and Hyde has expressed, amendment No. 11 would make it harder for us to maintain such a level playing field.
The Government are committed to promoting the independence of disabled people. We have set up the Disability Rights Commission, for example, and are hoping under the Bill to extend the direct payments scheme. The best way of supporting carers is often to support the service user as flexibly as possible. I know that my hon. Friend the Member for Stalybridge and Hyde has been only too mindful of the need to strike a balance between the interests of service users and of carers.
The Government want councils to have the flexibility to support carers in ways that best meet their needs without compromising the rights of service users. We therefore welcome the approach of my hon. Friend in giving local authorities a duty to assess on request, but a power to provide services that they deem appropriate under their eligibility criteria. Such important eligibility criteria for carer services do not exist at the moment, but we will ensure--I am sure that the House will want us to do so--that policy and practice guidance on the Bill, when it is enacted, will support councils in developing them.
Other work to support that important process is in fact already under way. An equitable approach to meeting the needs of service users and carers is a key plank of the Government's policy. Over the coming months, as my hon. Friend the Member for Harrow, West said, policy and practice guidance on a new initiative to ensure consistency in social services eligibility criteria will go out for consultation among local authorities and others. When the comments received have been duly considered, guidance will go to councils on how best to ensure greater consistency and transparency in implementing future eligibility criteria. I say to my hon. Friends the Members for Harrow, West and for Rother Valley (Mr. Barron), who has an interest in the matter, that such guidance will have statutory effect under the Local Authority Social Services Act 1970.
If the Bill receives Royal Assent, the Department of Health, as my hon. Friend the Member for Stalybridge and Hyde has pointed out, will make good use of the opportunity to revise and strengthen the guidance for practitioners who conduct carer assessments. As my hon. Friend rightly said, the full participation of carers will form a crucial part of that guidance. So, for the reasons that he has made clear, amendment No. 10 is not necessary. We shall also seek to address the fact that there has never been a simple, carer-friendly guide on carers rights, which we shall put right, too.
On new clause 2, I find myself in the rather odd position of agreeing with the right hon. Member for Bromley and Chislehurst (Mr. Forth). We shall have to keep that between the two of us. We need to be careful not to add unnecessarily to local authority planning obligations. In fact, I think the opposite; we should be looking to simplify the planning requirements that we place on local authorities.
As my hon. Friend the Member for Rother Valley rightly pointed out, we should be encouraging greater co-operation between health authorities and local authorities. If we approach the issue of carer services from the perspective that I am afraid underlines the new clause, responsibility will fall entirely on local authorities. I understand why my hon. Friend the Member for Harrow, West has phrased the new clause in such a way, because the Bill is about local authorities, but to place the planning responsibility for improving carer services solely on councils would be to misunderstand the nature and purpose of this entire area of social policy. We must ensure that we encourage greater partnership between health and local authorities in improving the way in which all local authority services for carers are delivered.
My hon. Friend, who obviously takes a very close interest in such issues, will want to know that there is much work under way to improve the planning process in the area. He will be aware, although he did not refer to it in his speech, that we are trying to encourage health and local authorities to develop new joint implementation plans locally in a number of key areas which will benefit and interest carers, including learning disability, mental health and services for older people. In all such areas, a significant amount of work is under way. My hon. Friend also rightly referred to the way in which we are intending to ensure that we raise the quality and level of social services performance through, for example, the development of our new performance assessment framework, which will be of particular benefit to carers.
My hon. Friend the Member for Stalybridge and Hyde was right to say that, if the Bill receives Royal Assent, the Government intend that planning for carer services should become part of the mainstream of planning and priority setting in social services. Local authorities are, of course, already preparing plans under section 46 of the National Health Service and Community Care Act 1990. Those plans are an important source of information for non-statutory bodies and, of course, the public--I know that my hon. Friend the Member for Harrow, West is interested in empowering members of the public--on how an authority intends to implement its community care responsibilities. Local authorities are required by the 1990 Act to consult widely on those plans. Statutory directions that emphasise the need for authorities to consult all those involved in community care, including representatives of independent-sector providers, other agencies, such as health and housing authorities, and representatives of both user and carer groups, have been issued.