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6 Jun 2007 : Column 87WH—continued
“boost the vital role played by informal carers by expanding the provision of respite care so more carers can continue to support loved-ones at home and are able to remain in their own home”.
The challenge is highlighted even more starkly by the lack of any effective commitment to respite care in the original national carers strategy, despite its importance being highlighted throughout the document.
The new deal for carers was announced at the same time as the review of the national strategy. Surprisingly, that is not, as its branding would suggest, a welfare-to-work scheme in the same format as the jobcentres’ new deals—perhaps the Minister will explain that choice of phrase. Instead, it is a package of support for carers with three strands: first, £25 million to be spent on providing short-term home-based respite care for carers in crisis or emergency situations in every council; secondly, £3 million towards the establishment of a national helpline for carers; and thirdly, £5 million to support the development of an expert carers programme.
We welcome the Government’s commitment to emergency respite care; we would, given that we proposed it. However, as important as that is, it should be in addition to planned respite care, which has suffered up and down the country——a fact to which, no doubt, hon. and right hon. Members can testify. The reason is a tightening of local authority budgets as an inevitable knock-on effect of NHS deficits. To put the £25 million into context, last week, the Health Service Journal reported that London councils alone are to meet Lord Hunt to discuss extra pressures on social care amounting to £22 million in 2007-08 owing to NHS cost-shunting. It has been reported also that £740 million of caring benefits go unclaimed per year—perhaps my most controversial point is that, as usual, the Chancellor gives with one hand, but takes away with the other.
The £3 million for the national helpline is, somewhat cryptically, “towards” rather than “for” the establishment of a national helpline. I fear that that raises the possibility of another delivery that does not quite materialise, although I hope that that will not be the case. That money finally fulfils the commitment of the national carers strategy to
“an NHS Direct helpline for carer information”.
I hope that the Minister will take the opportunity to explain why it has taken eight years to set that commitment in motion, why he has moved away from NHS Direct as the delivery partner, and when it will be available for carers. I hope that the Minster will detail in his wind-up how, and when, this helpline will fulfil the commitments in the White Paper to provide carers with
“up-to-date information to assist them in their caring role”,
“reliable, detailed information to help them make decisions about their personal support, opportunities for them and the needs of the person for whom they care”,
“information in the widest sense — from legal entitlements, to contact numbers for ‘help’ groups and training, to advice on benefits.”
As with the helpline, all that has been announced is funding towards the development of an expert carers programme, rather than a programme itself. As it is explicitly compared to the expert patients programme, what is the Minister’s opinion on the recent critique of the expert patients programme that was in favour of the whole system informing self-management engagement approach—known as the WISE approach, which is much easier to say.
The final commitment made in the White Paper was to
“encourage councils and PCTs to nominate leads for carers' services”.
The Government have not mentioned that since, and I hope that the Minister will tell us how he intends to move it forward. Speaking to carers, as I do very frequently, I know that one of the key issues that needs to be addressed is the disjunction between the health and social care sectors, which, sadly, the White Paper failed to address. NHS deficits and PCT reorganisations have conspired to exacerbate that situation. We hope that the Government will make proposals soon to address that gap.
One of the groups included in the review will be child carers. Good. The 2001 census identified an estimated 175,000 children and young people in the UK as child carers, although Barnardo’s thinks that the number might be higher, hidden within a culture of secrecy stemming from fears, such as that of social services splitting up the family—a point that I raised in an intervention. Of that 175,000, 18,000 children, aged between five and 15, provided 20 hours of care or more a week—nearly three hours a day—and nearly 9,000 provided at least 50 hours, which amounts to more than seven hours a day.
I hope that, in addressing child carers, the Minister will look to the two key areas from which child carers feel excluded—health and education. Regarding the former, if the children are mature enough to care for a parent, the state should reflect that maturity. Many
child carers are not taken into the confidence of doctors dealing with the disabilities of their parents or other charges. I trust that the Minister will address that. Equally, there needs to be an understanding of the issue in schools; it seems very obvious that to have a member of staff in each school or college fully aware of the needs of child carers, and able to champion them, would be a good idea. Again, that has been suggested today. Of the two alternatives presented by the Liberal Democrats, I believe that we should pursue the champion idea.
I urge the review to deal with the outstanding educational issues.
I hope that the review will not make the mistake of riding roughshod over what child carers want. The temptation may be to impose statist solutions; instead, we should have a range of solutions that give both the child carer, and the person in their care, choice over the best package to fit their circumstances and their life.
I am aware of the time pressures in the debate and I want to hear what the Minister has to say. I hope that he will be prepared to consider the possibility of introducing an adjustment to the remit that Parliament gives the National Institute for Health and Clinical Excellence so that the carer’s interests can also be taken into account in judging the cost-effectiveness and clinical effectiveness of drugs. That would help a lot with some of the issues that we have been facing on Alzheimer’s drugs.
Conservatives recognise the enormous debt of gratitude that the country owes its carers and the responsibility of those in government towards them. With that in mind, we reconfirm our support for the review of the national carers strategy. I hope that it offers a critique of the delivery of the strategy alongside the challenges for the future. I call on the Government to take note of all that has been presented in the debate today and to provide answers to the questions raised.
10.48 am
The Parliamentary Under-Secretary of State for Health (Mr. Ivan Lewis): It is always a privilege to serve under your chairmanship, Mr. Bercow, which is progressive. I do not know whether that comment will do you any good with your colleagues, but I certainly agree with my hon. Friend the Member for Aberavon (Dr. Francis) in that regard.
I congratulate my hon. Friend the Member for Worsley (Barbara Keeley) on securing this very important and timely Adjournment debate, and I pay tribute to the work that she did in her professional life before entering this place. Since becoming a parliamentarian, she has continued to raise the profile and the status of carers, so that their needs are being considered on an ongoing basis by legislators in this place.
It is of course important that we begin by recognising and respecting the value of the contribution that carers make to our society. We also recognise the wide range of people who fulfil caring roles, whether they be the parent of a disabled child, the husband or wife of a partner—perhaps with Alzheimer’s or dementia, as is increasingly the case—or the son or daughter of an ageing parent.
I pay tribute to the tremendous charities and voluntary organisations in this field. At national level, there are Carers UK, the Princess Royal Trust for Carers, Crossroads and Partners in Policymaking. Those organisations and many others do a tremendous job in ensuring that parliamentarians are kept up to date with the views and real-life experiences of carers. They provide a very strong voice.
The Government’s record on carers is one that we can be proud of, but not complacent or smug about. The 1999 carers strategy has made a significant difference. Alongside that are the annual grants to every local authority, which mean that by next year we will have spent an additional £1 billion on carers. The emergency respite care fund that we have announced as part of the new deal for carers is in addition to the year-on-year money already going into the system to provide respite and other forms of support for carers.
Other measures include the Carers and Disabled Children Act 2000 and the Carers (Equal Opportunities) Act 2004, which my hon. Friend the Member for Aberavon—I wish him a happy birthday—was so instrumental in driving forward, based on his personal experiences of caring. It is always a great privilege to listen to his contributions to such debates. Of course, the future status and role of Ministers in the Government is a matter for the Prime Minister, whoever that might be over the next few weeks. I shall not get into a debate about who will do what jobs—that is a matter for other people—but the point about a champion across Government was well made.
Other measures include the right to request flexible working and enhanced pension credits. A couple of weeks ago, we saw the outcome of the Treasury and Department for Education and Skills review of the needs of disabled children and their families. A long overdue package of respite care was announced, which has been widely welcomed up and down the country as demonstrating the Government’s commitment to addressing the needs of disabled children and their families.
Of course, we need to do a lot more, which is why my right hon. Friend the Chancellor of the Exchequer and I recently announced the new deal for carers, which will consist of a national carers helpline, an emergency respite care fund and an expert carers programme. Equally important is the development of a new national carers strategy, which will be cross-government and, significantly, informed by bottom-up consultation in every part of the country through hundreds of consultation events, at which we will listen to carers and hear from them about what they believe are the fundamental issues that need to be addressed as part of a national carers strategy. The review will be cross-government, but it will not simply involve groups of Ministers and civil servants sitting in rooms in Westminster and Whitehall, making decisions divorced from the real-life experiences and aspirations of carers.
My hon. Friend the Member for Worsley made a number of points, including on the impact on the health of carers of taking on caring responsibilities. I agree that there is a need for further work in that area. QOF—quality and outcomes framework—points are already awarded to GPs to some extent for their identification of carers, but I personally believe that we need to go much further as we negotiate contracts with
GPs, because carers’ main access, with a system of any kind, is often through their GP. That is often the most trusted relationship, so it is very important that GPs take greater responsibility in the future in terms of that gatekeeping role, but that must be in the context of contractual negotiations.
My hon. Friend was right to refer to the impact of caring on carers’ income. Unquestionably, we need to consider holistically the ability to work, benefit entitlements, tax issues and the progress that has been made on credits in relation to the Pensions Bill. We need to consider the consequences for people’s income of fulfilling caring responsibilities.
I agree with my hon. Friend about the relationship with professionals. It is very important that professionals regard carers as partners in the provision of care, but that frequently does not happen. There is a training issue, a cultural issue and, frankly, a management and leadership issue. My hon. Friend also referred to the census. We need to ensure that any decisions about the census are consistent with the commitments that we make as part of the carers strategy.
I can assure my hon. Friend the Member for Aberavon, who as I said has a tremendous track record in this field, that there will be synergy between the work going on in Wales and the review of the national carers strategy. Indeed, the Welsh Assembly will be represented on the oversight group. That synergy will be extremely important.
My hon. Friend made the point strongly, as he did in the legislation that he introduced, about employment, education and training, and leisure. That underpins the need for the cross-Government review to examine all matters of public policy that enable carers to have a life, and not only through the provision of support for their caring responsibilities. We also need to recognise that they are individuals who want to have a life outside those responsibilities. The question is how we can create a system that is far more focused and customised according to the needs of, and realities for, individual carers.
The hon. Member for Mid-Dorset and North Poole (Annette Brooke) and my hon. Friend the Member for Aberavon asked about the future of the carers grant. Comprehensive spending review negotiations are ongoing with the Treasury. It would be premature to make any commitment, but I believe that reflected as a consequence of this CSR will be the Government’s continued commitment to funding that is distinct and specifically available to carers.
The hon. Member for Mid-Dorset and North Poole, like other hon. Members, rightly referred to the needs of young carers. We are only just beginning to face the realities of that issue in society. Young carers do a tremendous job, but we know that it has a massive impact on their education and on their relationships with peers, and indeed on every aspect of their life. It can be incredibly emotionally draining—a fact that some very sad cases have brought to light in recent times.
We must consider the responsibilities that we have across the system. I am thinking of education, health and youth provision and how we identify and appropriately support young carers. The hon. Member for Mid-Dorset and North Poole was right to talk about the need for much greater synergy between services specifically for children and families and services for adults. It is irrelevant to the young carer and the person whom they are caring for where the service fits; they want a joined-up service.
My hon. Friend the Member for Brighton, Pavilion (David Lepper) raised the extremely important issue of the demographic realities in society, to which my hon. Friend the Member for North-West Leicestershire (David Taylor) also referred. People are living longer and longer, but in doing so have more and more difficult and challenging conditions, such as dementia and Alzheimer’s. In those circumstances, there is a growing challenge for society and carers. I suspect that we need specialist responses for people caring in those circumstances. We certainly need centres of excellence. There are a couple of those in my constituency: the Pinfold Lane day centre and Heathlands nursing home, where people with Alzheimer’s and their carers get the service that they would expect.
The hon. Member for Romsey (Sandra Gidley) raised a number of important issues in what was, I grant, a very apolitical and appropriate contribution; most of these issues unite people in the country and on both sides of the House. She rightly talked about the centrality of listening to the voice of all carers, but particularly young carers, as we develop the new national strategy. We have to listen to the voice of carers on their daily realities, priorities and concerns.
The hon. Member for Eddisbury (Mr. O’Brien) asked a number of questions. On the time scale, we intend to publish the new national policy for carers in January 2008. We hope to have the telephone helpline and the expert carers programme up and running by the summer of 2008. We will make the funding specifically for emergency respite care available to local authorities in October 2007. The hon. Gentleman was right: of course, as part of developing a new strategy, we must consider the impact of the existing strategy and the new legislation that has been introduced over the past few years.
The needs of carers have never had a higher status than they have now. That is entirely right. For too long, carers’ distinct needs were not recognised in health care, social care or, indeed, public policy generally. The distinct and specific needs of carers now have a much greater priority, but we must remember, as my hon. Friend the Member for Aberavon said, that these issues are about almost every element of public policy. Therefore at both national level and local level we need a genuinely joined-up approach. We need to recognise that the state has major responsibilities in this field, but equally we can achieve what we need to achieve only by working and engaging with the voluntary sector and community-based organisations and by listening to the voice of carers as we develop the response.
Museums
11 am
Mrs. Sharon Hodgson (Gateshead, East and Washington, West) (Lab): I am pleased to have secured the debate and to be able to speak about the Government’s policy on museums. I am also pleased to serve under your enlightened chairmanship, Mr. Bercow.
The Government’s policy on museums and their broader support for the cultural sector over the past 10 years have been a resounding success, particularly for the youngest in our society: more grants have been given, museums have modernised and attendance has accelerated. Our great national museums have reaped the rewards of the Government’s brave decision to introduce free admission, which has seen literally millions more Britons experience the wealth of shared experience, knowledge and heritage that those museums possess.
I know from work in my constituency that our regional museums have also undergone a transformation thanks to the renaissance in the regions programme and funding from the Heritage Lottery Fund. Without the Government’s financial support and cultural vision, such programmes would never have been put together. However, the real successes could never have been achieved without the tireless work and steadfast commitment of the Museums, Libraries and Archives Council.
It is testimony to the leaps and bounds that have been made over the past decade that there is almost universal agreement about the pivotal role played by culture throughout society. As the Prime Minister has stated, culture plays a creative, economic and even diplomatic role in making Britain what it is today. Indeed, he went on to say that a return to boom-and-bust funding of the cultural sector would risk turning back the clock on the tremendous achievements that have been made so far, and I could not agree more. It is vital that we do not sit back and watch the paint dry, and I hope that a deal can be secured after the next spending round to ensure that that does not happen.
As hon. Members are well aware, I am extremely proud to represent Gateshead and Washington and, in doing so, the wider north-east. It gives me particular pleasure to say that the north-east continues to provide a strong example of how increased museum funding can be best used to make a real difference in the community. Renaissance North East is part of the wider renaissance in the regions programme that is transforming our museums and which has proved to be one the most beneficial projects ever run by the Department for Culture, Media and Sport.
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