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6 Jun 2007 : Column 80WH—continued
Dr. Francis:
Indeed. As Chairman of the Welsh Affairs Committee I am very conscious of cross-border issues.
There are differences not only between Wales and England but between county boroughs, and I agree that account should be taken of those matters in the two respective reviews, so as to minimise contradictions.
Looking to the future, I hope that we can build on the Acts that I have mentioned and consider ways of ending the remaining discrimination faced by carers. It is still legal to discriminate against someone who is a carer, whereas, as we know, it is illegal to do so on the basis of someone's race or disability. A crucial part of the review of the national carers strategy is to evaluate equality legislation and examine how carers can be brought into the existing framework. A human rights approach is very important. As we have already heard, when Trevor Phillips, the chairman of the new Commission for Equality and Human Rights, recently addressed the all-party carers group, he assured us that he would give proper priority to carers’ rights from the earliest stages of his work.
There is a need also to renew the focus on carers’ access to work, education and training opportunities, as the Bevan Foundation report recommends. It is predicted that 2 million extra workers will be needed in the next 20 years to keep the UK economy buoyant, and that there will not be enough young people to meet that demand. It is also predicted that 3 million more people will become carers during that time. It is therefore self-evident that we must address how carers can gain access to learning and work opportunities—for the sake of both equal opportunity rights and the economy.
Many carers want to return to work. Eighty-five per cent. of the carers taking distance-learning courses on the lottery-funded project run by the National Extension college are of working age—younger than 60—and the majority take courses because they are thinking ahead to a time when they can return to work after their caring responsibilities have ended. For some carers, particularly older ones, education also has social value that should not be underestimated. It gives relief from the isolation created by the caring role, allows for personal development and leisure activity, and for obvious reasons, reduces social exclusion.
Current barriers to education and training are the cost of courses, the lack of alternative care services during the time of study, the inflexibility of the courses on offer and a lack of understanding of carers’ needs by colleges. A big issue is that a carer cannot study for more than 21 hours a week and receive carer’s allowance. At a time when more and more courses can be delivered online, that seems ludicrous. The review of the national carers strategy should include a full review of how the benefits system works, because there are too many rules like that.
May I end on a personal note? My hon. Friend the Minister has been enthusiastic in his support of carers, and he gave me unofficial support in the preparation of the Carers (Equal Opportunities) Act 2004. I hope that he will be the newly appointed carers’ champion and that he will drive forward the carers’ cause across all Government Departments.
John Bercow (in the Chair):
Order. I would like to wish the hon. Member for Aberavon (Dr. Francis) a happy birthday. Before calling the next and last of the
Back-Bench speakers, I would like to make it clear that I shall call the Front-Bench speakers no later than 10.30. I call Mr. David Lepper.
10.20 am
David Lepper (Brighton, Pavilion) (Lab/Co-op): I have already congratulated my hon. Friend the Member for Worsley (Barbara Keeley) on securing this debate. I add my congratulations to those that have already been expressed to my hon. Friend the Member for Aberavon (Dr. Francis) on his sterling work on the legislation that he has taken through Parliament, and on his work on behalf of the all-party group on carers.
I declare a personal interest, in that I am a trustee of a Brighton and Hove-based charity called ARDIS, which was set up some 12 years ago specifically to support people with dementia and their carers. It is the needs of those husbands, wives, fathers, sons, daughters and friends caring for those with Alzheimer’s and other forms of dementia that I would like briefly to speak about in this debate.
The carers who care for people with dementia are often very elderly themselves and in need of support in their own right, let alone in their role as carers. I am thinking, for instance, of some research done in my constituency that revealed a carer aged over 100 caring for his slightly younger wife.
All too often, the support that is available across the country to elderly carers is patchy and piecemeal. In my area, as well as the charity of which I am a trustee, we have a carers’ centre and an active branch of the Alzheimer’s Society. I pay tribute to Neil McArthur, who, for 18 years, was the driving force behind that branch and its extensive work to support dementia sufferers and their carers. Sadly, he died suddenly some two weeks ago. I had the sad duty of attending his funeral yesterday. He inspired many of us locally to try to ensure that support is available for those often elderly people who care for relatives with dementia.
ARDIS can provide a dedicated support worker who is based in our carers’ centre and gives advice and support to carers of people with Alzheimer’s and other forms of dementia, but the support that the charity can give to that post is, unfortunately, time-limited. It is important that older carers should have confidence that, when ARDIS’s financial support unfortunately must come to an end, the Government will have taken account of their particular needs.
As I have said, there are centres of excellence in different parts of the country. We have heard from hon. Members about what exists in their areas and I suspect that those of us who are here today are here partly because much good work is being done in the constituencies that we represent or the areas of which those constituencies are a part. Will the Minister ensure that the Government’s review not only takes into account the needs of young carers, which I mentioned earlier and which others have mentioned, and the needs of those caring for people with dementia, but considers carefully the good practice in many parts of the country and ensures that that can continue with their support? There is no doubt that there has been a sea change since the Labour Government’s introduction of the carers’ strategy a few years ago, but it is important to ensure that the good practice that
already exists in local areas can continue, and that the best of that good practice is replicated across the country so that we can begin to move away from what I regret is still often piecemeal provision of support for people who perform the vital role of caring.
10.25 am
Sandra Gidley (Romsey) (LD): I congratulate the hon. Member for Worsley (Barbara Keeley) on securing this debate. It has been noticeable this morning that every hon. Member who has spoken has had a real and long-standing commitment to the issue, so perhaps this is not a time for political point-scoring, which would be inappropriate, given the commitment expressed today.
I very much welcome the carers review. I could make the point that it is slightly disappointing that most of the steps forward have been the result of private Member’s legislation, but that would be a little churlish, as private Member’s legislation does not get anywhere without Government support. We must acknowledge that, but I would like the Government to introduce mainstream legislation to tackle some of the problems and issues, and to bring a greater focus to the problem.
Support for carers is a developing problem. At present, there are approximately 6 million carers. It is estimated that, by 2037, the figure will probably increase to some 9 million. Although that seems a long time away, there will be large increases year on year.
The hon. Lady mentioned the income of carers, which is important. Carers do not take on a caring role for the money—money is not always at the forefront of their thinking when they do it. They take on the responsibility because they want to, because of affection and ties—there are many reasons—but it seems wrong that some people are so severely financially disadvantaged when they take on the caring role. A survey by Carers UK showed that 72 per cent. of carers are worse off than when they started caring, 54 per cent. give up work to fulfil the caring role, 33 per cent. are now in debt, and, more worryingly, nearly one third of carers are cutting back on basics such as food and heating simply to try to make ends meet. I sincerely hope that the review will recognise those problems and consider the available income streams.
Hon. Members have pointed out that the system is in a bit of a mess. People have difficulty finding their way around it even to claim benefits to which they are entitled. Some of the age-related anomalies in particular are considered unfair and galling by many carers who feel that they have contributed to society all their life but are not being given help when they most need it.
The support needed is not always financial. It is crucial to develop a respite strategy in the review of future provision. The £25 million announced by the Government for that purpose was welcome, but deals only with the tip of the iceberg. Many times when carers come to see me in my surgery, they raise the problem of respite care. They say, “I could cope, I am happy to cope, but from time to time I just want some time when I can be me.” Whether the respite is a few
regular hours a week or, if the caring responsibilities are weighty, a regular week every so often, they need to be able to recharge their batteries so that they can go back to their caring responsibilities refreshed.
In some parts of the country, there are schemes where respite care works quite well: a regular respite place is available in the same home, the carers get to know the staff in the home and it becomes a home from home. We should examine the economics of providing respite care because we would reap long-term benefits. If people continue as carers for longer, it will save us money in the long run.
Although it has received little political attention, research by the Equal Opportunities Commission carried out before the last election highlighted that, particularly for women, the problem of caring responsibilities was almost as important as child care responsibilities. I will be fair and acknowledge that the Government have done a lot for working women and have helped with child care responsibilities. However, in the age of the extended family, families do not all live in one area any more. The pattern is that they are dispersed, so caring responsibilities and the help available to carers is of increasing importance. Therefore, as we approach the next election, I think that the issue will have a higher profile.
My hon. Friend the Member for Mid-Dorset and North Poole (Annette Brooke) highlighted the problem of young carers and I know that she has a long-standing commitment to the issue. When one meets young carers, it is clear that they receive limited support. My hon. Friend mentioned the case of the teenage girl who said that her support worker was not there when she needed her to be. The simple truth is that young carers need someone to turn to because often schools do not understand the problem. I disagree with my hon. Friend slightly because she said that a lead member is needed in schools; I have concluded that that is not enough. Ticking the box and employing a lead teacher does not solve the basic problem that most teachers have no comprehension of the existence of young carers and the impact of caring on a young person’ s life. When talking to young carers about their problems, they often say things such as, “I am starting to bunk off school because when I have to care for mum, I can’t do my homework properly and I may be late for school. I get in trouble when I go to school and my teacher doesn’t seem to understand.” There is a great need for an increased overall awareness and understanding of young carers and it is vital that their specific needs are taken into account during the review. I hope that the Minister will highlight how the voices of young carers will be included in the review, so that it is not simply well-meaning adults talking about what young carers want.
Another problem is the general level of engagement with services, which is partly caused by people’s lack of awareness and partly by a wariness of the interface with social services. There is a Government will for greater assessment, but that clearly is not filtering through at local level. That is a problem because, although there may be strategies and frameworks in place, if there is no incentive for local authorities or local health authorities to implement them, they are frankly not worth the paper on which they are written.
Carer responsibilities have to become a must-do issue for councils and health professionals. We should perhaps consider introducing quality outcome framework points for GPs, so that they are more proactive in identifying carers. Carer responsibilities perhaps need to be a more important part of social service assessments, so that they fail or lose a star if they do not do consider it. We really need to take this issue seriously.
More should also be done to highlight what a carer is. Thousands of people become carers every year, but research shows that 65 per cent. of them do not recognise themselves as such in the first year of caring. More worryingly, 32 per cent. of people take five years to recognise that they are carers. That also means that a third of carers believe that they have missed out on benefits and pension entitlements and well over half that group think that they have missed out for three years. We are failing those people because, if someone is caring, they do not have time so get to grips with the benefits system.
Much greater awareness of the issue is needed and a higher proportion of carers need to receive assessments. To help with that, the Government need to deliver on their pledge to fund a national advice and information service to help carers. Where do carers go at the moment for help? I shall finish by praising some of the wonderful local carers’ support groups. Individual groups have been mentioned, but local groups exist all around the country and provide considerable help and support for people who are caring for someone. The benefit of those groups must not be underestimated and when I recently visited one, I was recommended a book called “The Selfish Pigs Guide to Caring”. I do not know whether hon. Members have read it, but it highlights brilliantly that carers are not Mother Teresa. The difficulty is that a carer will want to help their loved one, who may have been their partner for years, but they may feel resentful about doing so. It would be nice if people did not have to turn to such books and if help was more readily available. If we can work together to achieve that, we will have come a long way.
10.36 am
Mr. Stephen O'Brien (Eddisbury) (Con): I congratulate the hon. Member for Worsley (Barbara Keeley) on securing this important debate, which has provided a fitting preparation for all of us for carers week, which is next week. I shall be participating in many events both in my constituency and elsewhere in the country. Since becoming an MP, the hon. Lady has been a champion for carers and has brought insight to the issue from her previous work for the Princess Royal Trust for Carers. I pay tribute to the hon. Member for Aberavon (Dr. Francis) for his authoritative and moving speech and wish him many happy returns of the day.
I put on record my wholehearted support for the 6 million carers in this country; they do amazing work in often difficult circumstances. In that context, on a personal level, I am proud to be married to a hospice nurse and to be the son of a nurse who ran a small respite and end-of-life care home for a decade in the 1980s, when I witnessed admirable first-class care at first hand. Individual unpaid carers give care of no less quality and importance.
The national carers strategy was welcomed by all parties and was launched in 1999 with three main strands: information, support and care. Under information, the Government promised a new charter on what people could expect from long-term care services. That would involve setting new standards, improving the consistency of charging for services, good health information, an NHS Direct helpline for carer information and Government information on the internet. On support, the Government wanted carers to be involved in planning and providing services and for local caring organisations to be consulted. They also thought that comment cards, advice surgeries and carers weeks would all be good ways to involve carers. The national carers strategy said that there would be a carer’s right to have their own health needs met, which was mentioned earlier, and new powers for local authorities to provide services to carers, as well as those being cared for. It also said that the first focus of the new powers should be on helping carers take a break and that there should be a new special grant to help them do so. On top of the £750 million for prevention and rehabilitation, £140 million would be provided over the next three years to help carers take a break and used in a targeted way. Financial support for working carers would be kept under review.
On 22 February this year, the Minister and the Chancellor announced a review of the national carers strategy, which fulfilled a promise made in the White Paper, “Our Health, Our Care, Our Say”. Typically, no timetable has been announced and I hope that the Minister will rectify that omission this morning. Conservatives welcome the review— although we hope that it is not an attempt to kick the issue into the long grass. I do not believe that it is, but such views would be overcome by the Minister announcing a timetable today.
In the Conservative statement of aims and values, “Built to Last”, my right hon. Friend the Leader of the Opposition outlined our party’s commitment to carers’ rights and restated our commitment to respite care for carers, and we welcome warmly the Government following our lead on that. In addition, our “Built to Last” document established that the
“test of a strong and just society is how it looks after the least advantaged — but this duty is not reserved for the state alone. It is a shared responsibility”.
As part of that, our party is committed also to an increase in general well-being and sustainability to enable
“people to strike a better balance between work and life through flexible working”—
a point made powerfully earlier on by the hon. Member for Worsley—
“with government setting an example by making the British public sector a world leader in flexible working.”
That was precisely the point on Jobcentre Plus raised in an intervention.
“Our Health, Our Care, Our Say” gave the following commitment:
“The updated strategy will reflect developments in carers’ rights, direct payment regulations, carers’ assessment and carers’ grants. We will work with stakeholders to consult, develop and issue a revised cross government strategy that promotes the health and well-being of carers, including the particular needs of younger carers, and includes the use of universal services.”
Any serious review of the national carers strategy must contain a qualitative assessment of the impact of the 1999 carers strategy, in addition to establishing ways to support carers. It must also make more concrete commitments than were present in the original carers strategy, with a timetable for delivery associated with each one. I urge the Minister to confirm what that review will contain and, in particular, how it will take forward support for carers and when it will be published.
The new deal for carers was outlined in the health White Paper, “Our Health, Our Care, Our Say”. Tellingly, that document reports that the
“your health, your care, your say listening exercise revealed considerable public support for carers. Better support for carers came third in the 'people's options' at the national Citizens' Summit”.
It is worth noting that the 2005 Labour manifesto made two references only to carers’ issues, which were both, of course, extensions of other main policy areas—pensions, which was mentioned earlier, and the ongoing consultation on a putative right for carers to request flexible working arrangements from their employers.
The Conservative manifesto at the last election pledged to
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