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Mr. Burstow: That is the dilemma that the Bill was introduced to solve. If the cared-for person does not give consent to an assessment of their needs, the Bill unlocks the gate so that the carer can be assessed too. We have now slightly shifted downstream the point at which such conflict might arise. Can the Department give strong and clear guidance to local authorities to assist them in dealing with those sensitive issues and relationships?
Mr. Hutton: I shall say something about that issue in a moment, if the hon. Gentleman will bear with me. He is right to trace the history of the measure and the problem that it tried to resolve. However, the matter that he highlights is addressed in another part of the Bill.
The measure will allow services to be provided directly to the carer, notwithstanding the fact that the cared-for person has refused a community care assessment under the National Health Service and Community Care Act 1990. Those services can be provided directly to the carer. We are talking about services that could be described as "either way"--they could be offered to the carer or to the cared-for person. The background to clause 2(3) was an attempt to give local authorities greater flexibility in
That was always the intention of that provision. It was never intended to be some careful device, cooked up by others, to allow local authorities, under their charging policies, to recover more from service users. That was never the purpose. My hon. Friend the Member for Stalybridge and Hyde has always made it clear that that was his view. In a Bill designed to empower and enable carers to receive better support, neither he nor I would support a provision that would knock them back to a situation in which they were unfairly treated or compromised financially. We shall not do that; that is why we tabled the amendment.
On the point that the hon. Member for Sutton and Cheam has just raised about local authorities, new flexibilities under clause 2(3), I tried to spell out in my opening remarks--I am happy to do so again--that we certainly intend to issue guidance, which I remind the House will have statutory effect under section 7 of the Local Authority Social Services Act 1970, on how local authorities may use such flexibilities, so double protection is built in. Amendment No. 39 will make it clear that the consent of both parties is needed, and we have the back-up of the force of section 7 statutory guidance.
Through this amendment, together with amendments that we shall debate in a minute, we have been anxious--my hon. Friend the Member for Stalybridge and Hyde has been so particularly--to ensure that the Bill reflects the perfectly fair and reasonable concerns that have been expressed. We recognised the potential for the sort of circumstances to which hon. Members have referred on Second Reading and in Committee, and believe that amendments Nos. 39 and 33 will lay such concerns to rest. The Bill's original intentions can be reconfirmed and clarified, and we can move on.
It is important to clarify the relationship between carers and the cared-for person. The amendment is necessary to ensure that there is no change in that relationship. Carers care out of duty and love. As drafted, the clause suggests that carers provide "services". We would normally expect such services to be provided under a contractual relationship by an outside body, such as a local authority, the health service or a voluntary organisation. It is slightly problematic to regard the relationship between the carer and the cared-for person as one in which the carer provides services.
The amendment would formalise the relationship, which is essentially based on love and duty. Any of us who have known the relationship--I well recall my mother having to care for her elderly mother for several years--know that carers are not providing direct services but serving out of love and duty.
The term "services" implies that there might be entitlements and that there will be standards and a claim on the carer, which I am sure hon. Members would regard as inappropriate. I therefore ask the House to accept the amendment in order to ensure the maintenance of the status quo in the relationship between the carer and the cared-for person. I believe that the Government will agree that the amendment is in the spirit of the Bill, and I hope that my hon. Friend the Member for Stalybridge and Hyde (Mr. Pendry) is able to accept to it.
Mr. Burstow: I added my name to the amendment for many of the reasons that the hon. Member for Monmouth (Mr. Edwards) has just described. When we are attempting to support family and caring relationships, we should not try to formalise them under service provision. The Bill poses such a danger. The hon. Gentleman is right to have highlighted that by tabling the amendment. I hope that in response to the debate, we shall hear how such a downside could be avoided.
We are about recognising and valuing carers, and ensuring that their needs are assessed at an early opportunity and that they receive the services that they need to be able to fulfil the caring responsibility that they have taken on. To turn the relationship into a contractual one is entirely wrong and we should attempt to avoid the Bill giving that signal. I hope that the hon. Member for Stalybridge and Hyde (Mr. Pendry) can reassure us on that. If the amendment will not achieve our aim, I hope that something will be done at a later stage to give effect to our intention.
I am grateful for this helpful amendment. It serves to highlight the distinction between the support that informal carers provide and the sort of services provided by health and social services and other service providers. Service providers must see carers as partners in the provision of help to the persons needing support and must involve them as partners. However, as the amendment suggests, it would be unhelpful to view the help provided by informal carers in exactly the same light as services provided formally by statutory or voluntary providers.
Most caring is founded on close personal relationships. Sensitive and effective support for the people who choose to be carers involves understanding the unique impact of each carer on his or her caring role, as well as acknowledging the vast contribution that carers make to society as a whole.
Amendments made: No. 29, in page 2, line 42, leave out "(1)" and insert "(2)".
No. 30, in page 2, line 43, leave out "(1A)" and insert "(2A)".
No. 31, in page 2, line 43, leave out "such an assessment" and insert--
'an assessment under subsection (1) or (2)'.
No. 32, in page 3, line 1, after "1", insert--
'or (Assessments: parents of disabled children)'.--[Mr. Hutton.]
'( ) The local authority's decision under subsection (4) is to be made without regard to the means of the carer or of the person cared for.'.
'( ) The decision of the local authority under subsection (4) is to be made taking full account of the means of the carer or person cared for and determined appropriately.'.
Mr. Deputy Speaker: We are discussing amendment No. 33. If it is of any help to the Minister, may I point out that we shall deal with amendment No. 34 after this group? We are now on amendment No. 33.
After discussion with my hon. Friend the Member for Stalybridge and Hyde (Mr. Pendry) and in recognition of the fact that he is losing his voice, he is happy for me to move this amendment which stands in his name and that of my right hon. Friend the Secretary of State for Health.
During the first sitting of the Committee, my hon. Friend referred to a meeting that he and I had with representatives of carers and persons with parental responsibility for disabled children. One of the matters discussed was the concern to ensure that an opportunity is not created for councils to take account of who is best able to pay a charge when deciding whether to provide services as carer services under the Bill or as community care services under the National Health Service and Community Care Act 1990.
It was recognised that such an opportunity could in theory arise because the Bill offers the fullest flexibility to councils in the services that they may offer carers to ensure that the actual needs of individual carers are properly met. To tackle that point, the hon. Member for Sutton and Cheam (Mr. Burstow) tabled his elegant solution to the problem in the second sitting of Committee. His amendment forms the foundation of the amendment that I move today.
I am afraid that amendment No. 48, to which the right hon. Member for Bromley and Chislehurst (Mr. Forth) will speak shortly, has the opposite effect. It is entirely contrary to Government policy on social care. Let me explain to him why. We have already discussed the matter in part in relation to an earlier amendment, when he asked whether resources should be taken into account when needs are assessed or when liability to a charge is assessed.