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Mrs. Heal: My hon. Friend the Member for Hendon (Mr. Dismore) has already touched on some of the points that I wanted to make about my amendment No. 8. With the support and encouragement of the Government, local authorities are reaching out to carers and involving them in more than just consultation, which in many ways they have been involved in for years. Carers have played their part gallantly and, in addition to their caring responsibilities, have given their time, expertise and suggestions to local authorities. They have done that willingly, because they have felt that their contribution was important and valued. They hoped for an improvement in services not just for themselves, but for the person for whom they were caring. The well-being of the cared-for person is always paramount for carers.
Slowly but surely, carers are gaining a voice and saying that they, too, have needs and should be listened to. Consulting and involving people is not sufficient. We have already talked about partnership and empowerment. I endorse those concepts. If they are to be meaningful to the millions of carers in this country, my amendment should be accepted, because only then will they feel valued.
This is not about what carers want. It is about their agreement and involvement. We should make it clear to carers and to the local authority that conducts the assessment that it must be done in an atmosphere that involves the agreement of the person to whom the services will be supplied.
Mr. Paterson: I am worried that the amendment that the hon. Member for Hendon (Mr. Dismore) tabled would make the Bill too prescriptive. I understand why the hon. Gentleman wants to include a time limit to ensure that the bureaucratic process does not take too long. However, as I said when we considered a previous group of amendments and, as my hon. Friend the Member for Meriden (Mrs. Spelman) pointed out, much depends on medical assessments.
Some cases in my constituency involve highly specialised medical assessments by consultants who are often in different parts of the country. Regrettably, those high falutin people take time to make their assessments. Although I sympathise with the desire of the hon. Member
for Hendon to set a deadline to ensure that decisions are made, the bureaucratic process should not take over to such an extent that medical information is not available.I have more sympathy for amendment No. 8, which the hon. Member for Halesowen and Rowley Regis (Mrs. Heal) tabled. Each case is different; that applies not only to each carer but to each person who is cared for. We cannot be prescriptive and issue a diktat from the centre to cover every case. I like the hon. Lady's wording:
- shall agree with the carer.
I like the wording of amendment No. 8, but not that of amendment No. 2, which is too prescriptive and might lead to a lack of essential medical information.
Mr. Burstow: I, too, support amendment No. 8, which the hon. Member for Halesowen and Rowley Regis (Mrs. Heal) tabled. In earlier debates, we considered the need to strike a balance between the carer and the disabled person. We also need to strike a balance between the strong power of the local authority as the assessor of the need and the person whose need it assesses. The amendment provides a useful opportunity to explore that a little further.
The balance is also relevant to the disabled person whose care needs are assessed and for whom a care plan is drawn up. Transparency and clear statements in the care plan are required so that plans can be challenged and the authorities that set them made accountable. A requirement for the process to have the carer's agreement is therefore sensible. However, perhaps the wording of amendment No. 8 will not achieve that, and I look forward to the response of the hon. Member for Stalybridge and Hyde (Mr. Pendry) and of the Minister. The spirit and intention of the amendment is worthy. Perhaps another form of words could be found to effect the amendment later in the Bill's passage.
Mr. Pendry: I congratulate my hon. Friends the Members for Hendon (Mr. Dismore) and for Halesowen and Rowley Regis (Mrs. Heal) on the way in which they spoke about the amendments. They are caring amendments and I understand the spirit that lies behind them. I appreciate that my hon. Friends have tabled them because they support the Bill.
Amendment No. 2 would ensure that the benefits of carers assessment are secured as quickly as possible. We all support that. However, hon. Members have constituents who care for people who have refused an assessment. The amendment might not work in their best interests. The amendment would require authorities to be satisfied that a carer cares for a person for whom they provide or arrange the provision of services and to carry out an assessment "within 42 days" of the carer's ability to provide and to continue to provide.
I am sure that most hon. Members would acknowledge the need for local councils to ensure a speedy assessment and provision of services to support the carer. However, I support local discretion to ensure the highest quality
outcome through the quality of the evidence on which decisions are made. I therefore ask my hon. Friend the Member for Hendon to withdraw the amendment.On amendments Nos. 4 and 5, clause 1 gives informal carers of 16 and older who provide or intend to provide a substantial amount of care, the right on request to an assessment by the local council of their ability to provide and continue to provide care. Clause 1(2) allows a council to
- take into account, so far as it considers it to be material,
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Clearly, when the information already held is up to date, it is in the best interests of both carer and council to allow the council discretion to take account of an assessment conducted under the 1995 Act. One reason is that flexibility is likely to speed up the delivery of services to carers; another is that it would be both bureaucratic and costly for councils to be required to undertake unnecessary additional assessments. The amendments would place a duty on councils to take into account the last assessment under section 1(1) of the 1995 Act, even if a carer's circumstances had changed since that assessment. That cannot be in the best interests of either carer or council.
I thank my hon. Friend the Member for Halesowen and Rowley Regis (Mrs. Heal) for tabling an amendment that would ensure that assessments were conducted in a way that encouraged the participation of carers. However, for two reasons, I ask my hon. Friend not to press the amendment to a Division. First, current guidance on good practice in the assessment of service users and carers is already clear: it states that participation in the assessment process is key. Secondly, my hon. Friend the Minister has assured me that the regulations that will be drafted to accompany the Bill will give local authorities a duty to ensure that such issues are discussed.
My hon. Friend the Member for Halesowen and Rowley Regis can rest assured that carers' involvement in their assessment is integral to the fabric of the Bill. Support for people who choose to be carers requires an understanding of how individual carers' roles affect them, and that can be ascertained only through a fully participatory assessment process. I hope that on that basis, too, my hon. Friend will not press her amendment to a Division.
Mr. Hutton: It is clear to all of us--I know my hon. Friend the Member for Stalybridge and Hyde (Mr. Pendry) agrees--that it is imperative for assessments to be made as quickly as possible. As always, the question is whether we want to create a statutory limit, and my hon. Friend has advanced some powerful arguments as to why that may not be the best option.
By means of several initiatives, we are trying to ensure that local authorities carry out assessments quickly. We have already done two things. My hon. Friend the Member for Harrow, West (Mr. Thomas) mentioned the performance assessment framework. As part of our drive to improve the performance of social services departments, we have established key indicators to determine whether authorities are providing services effectively and efficiently. There are 35 indicators, but there will soon be 50.
A number of the indicators relate to how effectively authorities are delivering services to carers. One relates specifically to how quickly carers receive help. The performance assessment framework, and the performance of authorities judged against it, will inform the use of the best-value powers taken by the Government under the Local Government Act 1999. We will not tolerate poor performance; we will not tolerate circumstances in which carers' needs are not assessed quickly and efficiently. If we tolerated those things, we would sanction not just poor practice but ineffective service. There is no doubt that support for carers will be better as a result of consultation and involvement with users, and will be better if it is provided as quickly as possible. My hon. Friend the Member for Stalybridge and Hyde was right to draw the attention of my hon. Friend the Member for Halesowen and Rowley Regis (Mrs. Heal) to commitments we gave in Committee that we will ensure that guidance and practice notes issued in the context of this legislation will emphasise the importance of good practice, including involving and consulting carers in the assessments. I make that commitment again today, and the guidance will have statutory effect under section 7 of the Local Authority Social Services Act 1970.
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