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Mr. Burstow: I have listened carefully to what the Minister says about the Government's work on child carers. Does he, as a Minister in the Department of Health, have the policy lead on young carers or is it the responsibility of the Minister for Children in the Department for Education and Skills? If that responsibility lies with him, will he undertake to talk to his colleague in the DFES about its drafting of child protection legislation to ensure that that addresses some of the concerns raised?
Dr. Ladyman: My right hon. Friend the Minister for Children has the lead in respect of the delivery of social services and education services for children. I have responsibility for children's health. The needs of young carers fall into both our portfolios, which is why we work closely together. We meet several times a week and constantly discuss the cross-departmental issues in respect of children. Although a bit of the issue falls into both our portfolios, the hon. Gentleman can be assured that we are tackling the problem in a joined-up way. I shall certainly ensure that my right hon. Friend is aware of his comments. I know that she is aware of the needs of young carers.
The hon. Member for Tiverton and Honiton made some important points. She said that had her child's care needs been properly met, the burden on her as a carer would have been much reduced. That is true. I take that as a given and we should get that message out to the field. However, it must not be assumed—I know that she
did not do this, although her words could have been read in such a way—that the only way to meet the needs of a carer is by addressing the needs of the cared-for person.
Mrs. Browning: The Minister is right. I did not intend to say that that is the only way to meet the needs of the carer. I was merely flagging up the fact that underlying the needs of carers are the needs of the cared-for person. If their needs are not properly met, the person who often carries the burden for that is the carer.
Dr. Ladyman: The hon. Lady is right. I heard her speech, and there have been few times when she has spoken in the House, especially on these issues, that I have not wondered why she is not on the Labour Benches rather than the Conservative Benches—no greater compliment can I pay her. She was right to encourage professionals to use their imagination and to think out of the box. We need to get that over to them.
My right hon. Friend the Member for Coatbridge and Chryston (Mr. Clarke), who apologised to me for being unable to return to the Chamber for the closing speeches, made several important points. While he was making them, I had a quick look in "Dod's" at his background and noticed that he has an interest in astrology. When he started asking me lots of questions about what the future holds, I was tempted to intervene to ask him to tell me. He was right to identify the need to address various issues such as how the legislation will work, what it will do and how much it will cost. I shall return to that.
My right hon. Friend also asked some specific questions about the impact of direct payments and the Government's attitude to them. I believe that direct payments can fundamentally overhaul the way in which we deliver all social care services, both to those who are cared for and to their carers. I have met people who have severe physical disabilities, those who have severe learning disabilities and others with moderate support needs who tell me that receiving direct payments instead of direct care has transformed their lives. We need to translate that to carers.
Carers have the option of receiving a direct payment. That takes us back to the point about training people who advise carers. It is a duty on councils to make a direct payment. It is their duty not just to offer a direct payment but, under legislation, to make a direct payment, and doing so should be councils' first choice. People are supposed to opt out of a direct payment scheme not opt into it, but very few local authorities seem fully to have taken that message on board and are therefore not making the option clear to people who use care services.
Mr. Edwards: My hon. Friend mentions the need to train people who advise carers. Does he therefore agree that it would be important to include as standard in all training and education programmes for social workers, doctors, nurses, occupational health workers and health visitors an element about the needs of carers, and information on the legislation, policy and duties on local authorities? What input can my hon. Friend have into those training programmes to try to bring that about?
Dr. Ladyman: We can do a number of things. For example, there is the Social Care Institute for
Excellence, whose job it is to identify best practice and to ensure that it is disseminated throughout the sector. We can work with that body. In a moment, I will talk about a number of specific issues that we have taken up concerning the roll-out of direct payments. We have established the direct payments development fund and built a number of other services around the scheme to try to get the message over and to help roll out the scheme.In addition, we are in the middle of a series of national conferences, at which the Department of Health is explaining to people from local authorities and the voluntary sector their duties and best practice in making direct payments. I have recorded a speech for those conferences in which I express my support for direct payments. It is being played at all the conferences around the country, and I will be appearing live at the one in London—so they have that to look forward to. I have no doubt that the touts will already be out selling tickets. Therefore, our commitment as a Government to getting the message over cannot be doubted. We have set up a national direct payment steering group comprising representatives from across Government, local government and voluntary organisations, including Carers UK, to monitor, comment on, and have an input into national policy development, particularly the progress of the development fund. The take-up of direct payments in each local council is a key performance indicator this year, and has already proved to be a powerful incentive to local councils to think about direct payments more imaginatively. The performance indicator shows that in England in 2002–03—I apologise to my hon. Friends and all Welsh colleagues in the House, as I do not have the figures for Wales—an average of 23 people per 100,000 received direct payments. There was, however, considerable variation across councils, suggesting that many of them could make significant improvements. In 2002, there was a 400 per cent. increase on the previous year's take-up. Although we started from a low base, progress in driving forward the use and take-up of direct payments is improving all the time.
The hon. Member for Banbury (Tony Baldry) spoke about implementation, as did several other hon. Members. I was fascinated to hear the results of his survey, and I would be grateful if he gave me a written summary. A key tool for the Government in ensuring the implementation of both our existing policies and the Bill, if it is enacted, is the inspection and performance assessment frameworks. The hon. Gentleman mentioned, as did several other hon. Members, carer's allowance and funding for carers. He said that carer's allowance stops when someone starts to claim retirement pension. The explanation, of course, is that carer's allowance is a benefit to replace lost income. Someone who is caring is not working. Consequently, they lose income, so carer's allowance is provided. The state pension is also a benefit to replace lost income when someone retires. An enduring rule of the benefit system for several decades under Governments of all political persuasions is that people cannot receive two benefits for the same purpose. Hence, when someone
takes up a state pension on retirement they lose their carer's allowance. The carer's allowance, however, is not the only support that we provide for carers.
Mr. Berry: My hon. Friend will appreciate that we have all heard that argument on countless occasions. We understand the logic, but it is simply based on the historical circumstances in which the carer's allowance was established. The issue is whether or not carers over 65 should get increased support for their caring activities, not least because if they did not undertake them it would be far more expensive for the Government to fund them.
Dr. Ladyman: My hon. Friend has made those points before, and I am aware of his feelings on the issue. However, carer's allowance is not intended to cover the costs of caring, which ought to be met by other means and benefits. If the costs of providing care for an individual are not being met, one needs to look holistically at the package of costs for both the cared-for person and the carer to make sure that there is not a net cost to the carer.
Mr. Berry: Would my hon. Friend therefore tell the House precisely what resources are available to the over-65s, and does he believe that they are adequate in any way for the task in hand?
Dr. Ladyman: It would depend on the level of care that was needed if someone was over 65, but an obvious resource is attendance allowance, which can be paid at both lower and higher rates, depending on whether the older person requires care at night.
In addition, older people with care needs are also entitled to a carers assessment and they are entitled, if they want to, to ask for those care needs to be provided for by a direct payment rather than as direct care. There are several different methods for ensuring that household income is maintained in that process. However, I encourage my hon. Friend to take up those issues with a Minister from the Department for Work and Pensions and leave us poor old Health Ministers alone.
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