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Mr. Andrew Dismore (Hendon) (Lab): I well remember the debates on that Bill, and I think that I spoke in support of it—on one of the many Fridays on which I come into the House. I recall that when I was researching for that Bill, I was staggered by the number of children and young people who are engaged in caring responsibilities. It struck me that we had to do a lot more to support that group of people. I am sure that when my hon. Friend comes to describe his Bill, which I wholeheartedly support, he will refer specifically to how to help young people and children who take on such amazingly difficult responsibilities.
Dr. Francis: It so happens that this specific Bill relates to children or young people over the age of 16, but my hon. Friend makes a very important point.
The Carers and Disabled Children Act 2000 opened up a new degree of flexibility for local authorities, which some, like Hertfordshire social services, have used to spend the carers grant. The Act also introduced vouchers for breaks, so that local authorities could have flexibility and direct payments for carers, so that they could buy their own services rather than have them provided for them.
Finally, there was the Community Care (Delayed Discharges etc.) Act 2003, which was improved by the Government, with the support of all parties, and gave carers new recognition at the point of hospital discharge.
What those Acts do not do is see the carer as a whole person. The previous Acts, landmarks though they were, do not recognise that a carer might have or need to have a life outside caring, and that they need to balance such family responsibilities. For example, both Acts talk about
- "assessments of the carer's ability to provide and continue to provide care".
- "help the carer to care".
We do not make it easy for carers to know about their rights, as we have heard. Nor do we view their health and well-being as important. And yet, as a country, we are thoroughly dependent on the support provided by carers. Their input has been estimated at a staggering £57 billion per year—equivalent to the spending on the national health service. In many ways, they are the alternative national health service.
I now want to move on to the detail of the Bill under each clause. The Bill, as we see from the title, focuses on equality of opportunities for carers, and this is achieved mainly under clause 1, which I will take a little time to explain. My aim in including this clause was to set a new principle for carers. We know from all our constituents that carers face multiple barriers in accessing the sorts of things that most people take for granted: work, leisure, learning and training opportunities. These barriers exist because of their caring responsibilities—because they are responsible, by default, for the care of a disabled, frail or chronically ill person. We know that they often cannot leave the house unless they feel that the person for whom they care is safe.
A few of the barriers that carers face in attempting to return to work include: the difficulty of finding alternative care while they attend courses or go to work; the need to make care decisions that directly and negatively affect the carer's ability to work or attend college; and stereotyping by social services, which do not always see carers as needing to have a life outside caring. Assumptions are made all the time that carers should not be working or be on courses, but should be caring for the disabled person.
Mr. Hilton Dawson (Lancaster and Wyre) (Lab): I am sympathetic to what my hon. Friend seeks to do, but I want to tease out a little more the point that it applies to young people only if they are over 16, which he made earlier in response to my hon. Friend the Member for Hendon (Mr. Dismore). A host of issues relate to children of all ages who take on caring roles in relation to parents and siblings. Can my hon. Friend the Member for Aberavon (Dr. Francis) say something about why the Bill does not apply to children under 16? Whether one regards it as in their best interests or not, such children often end up with substantial caring tasks.
Dr. Francis: I anticipated such a question and have been reflecting on the answer. The issues that my hon. Friend raises relate more to the Children Act 1989. Although I would like to have a revolution, what this matter is undergoing is more in the nature of evolution, and my private Member's Bill is tackling a very specific issue relating to adults. However, I endorse his point.
We know from research that the carers who provide substantial amounts of care are the most likely to be working part-time or to be out of work. Many have given up work in order to care. Carers have told me of their particular experiences, and in one case, a simple change to the days on which an older woman attended a day centre meant that her carer lost her job.
How would clause 1 help? As with similar duties in the draft Disability Discrimination Bill, local authorities would have to examine their policies and procedures to
see whether they included barriers to carers' having the kinds of opportunity listed and whether, by changing their practice, they could remove those barriers. Clause 1 would make social services departments think very carefully about how their policies and procedures impacted on carers and their ability to access work and training opportunities. They would have to look at their assessment procedures for carers to ensure that they explored work and training issues, and internal training programmes for staff would have to emphasise the need for carers to have opportunities.Clause 1(1) contains an important principle. We want to move away from seeing a carer as a client to seeing them as a person with a life that they need to combine with caring. Barriers for other groups are fully recognised, and it would be inconceivable to suggest that disabled people, women or people of a different racial origin should not have the right to equality of opportunity. The drafting of the clause draws heavily on several pieces of legislation, including section 14 of the Learning and Skills Act 2000 and the Northern Ireland Act 1998, as well as the draft Disability Discrimination Bill.
I do not believe that there would be significant costs attached to the provision. I have examined the explanatory notes on the draft Disability Discrimination Bill, which contains a much broader clause. Those notes say that most public authorities already carry out such exercises to comply with the Race Relations Act 1976. If similar disability legislation is forthcoming, the costs of the exercises that I have outlined this morning will be negligible, because they will simply be routine.
Local authorities have welcomed clause 1. Commenting on my Bill, the executive responsible for adults and community care in Surrey said that
- "this is an important step forward in getting the full force of the law behind something that Surrey has been developing for several years."
Dr. Francis: My hon. Friend is absolutely correct, and I shall address that point several times during my contribution. The Association of Directors of Social Services and the Local Government Association have been in discussion with me through Carers UK. They believe that costs to them from the Bill would not be an issue because what it would achieve in changing the practice and culture surrounding carers, and in improving standards, would be much more significant.
If we take the approach of making services more flexible for carers who want to go into education or remain in work, we will do ourselves a favour economically, as my hon. Friend the Member for Ilford, North (Linda Perham) said. British Gas has written to me in support of the Bill, and has told me that it introduced positive employment policies for carers some years ago. It knows from carers in its work force just how difficult it can be to juggle work and care when
there is not flexibility of services. One of its employees, Tony Camp-Bell, who works in Southampton, has said that one of the main reasons why he can remain in work is British Gas's flexibility, which has allowed him to adapt his working hours to fit in with his caring responsibilities. However, not all carers benefit from such enlightened employment policies, and they all need the assurance that their employment needs will be taken into account by social services when making decisions about support.I understand that there are some concerns over clause 2. My main aim in including it is to ensure that there is a robust planning mechanism behind the provision of information for carers. I see it as important for local authorities to look at information provision for carers strategically and to work with health bodies to deliver that information. Such a mechanism could be an important conduit for information about benefit rights and forms of support that exist outside statutory provision.
Clause 2 is drafted to fit with the language used in the Local Government Act 2000. However, I understand that there are some concerns over the clause, which I am willing to discuss if my Bill is fortunate enough to proceed to Committee stage. Nevertheless, I remain keen for health bodies, in particular, to plan for and help in the delivery of useful information to carers. We would never let a nurse administer medication without knowing how to do that or how to deal with serious side effects. Why, then, do we let carers struggle on without such vital information?
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