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11 Jun 2007 : Column 590

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Question, That the proposed words be there added, put forthwith, pursuant to Standing Order No. 31 (Questions on amendments):—


The House divided: Ayes 274, Noes 229.
Division No. 136]
[8.14 pm



AYES


Ainger, Nick
Ainsworth, rh Mr. Bob
Alexander, rh Mr. Douglas
Allen, Mr. Graham
Anderson, Mr. David
Anderson, Janet
Armstrong, rh Hilary
Atkins, Charlotte
Austin, Mr. Ian
Bailey, Mr. Adrian
Baird, Vera
Balls, Ed
Banks, Gordon
Barlow, Ms Celia
Barron, rh Mr. Kevin
Battle, rh John
Beckett, rh Margaret
Begg, Miss Anne
Bell, Sir Stuart
Benn, rh Hilary
Benton, Mr. Joe
Betts, Mr. Clive
Blackman, Liz
Blackman-Woods, Dr. Roberta
Blears, rh Hazel
Blizzard, Mr. Bob
Borrow, Mr. David S.
Brennan, Kevin
Brown, Lyn
Brown, rh Mr. Nicholas
Brown, Mr. Russell
Bryant, Chris
Buck, Ms Karen
Burden, Richard
Burgon, Colin
Burnham, Andy
Butler, Ms Dawn
Byers, rh Mr. Stephen
Byrne, Mr. Liam
Caborn, rh Mr. Richard
Cairns, David
Campbell, Mr. Alan
Campbell, Mr. Ronnie
Cawsey, Mr. Ian
Chapman, Ben
Clapham, Mr. Michael
Clark, Ms Katy
Clark, Paul
Clarke, rh Mr. Charles
Clarke, rh Mr. Tom
Clelland, Mr. David
Clwyd, rh Ann
Coaker, Mr. Vernon
Coffey, Ann
Cook, Frank
Cooper, Rosie
Cooper, Yvette
Crausby, Mr. David
Creagh, Mary
Cruddas, Jon
Cryer, Mrs. Ann
Cummings, John
Cunningham, Mr. Jim
Cunningham, Tony
David, Mr. Wayne
Davidson, Mr. Ian
Dean, Mrs. Janet
Denham, rh Mr. John
Dhanda, Mr. Parmjit
Dismore, Mr. Andrew
Dobbin, Jim
Dobson, rh Frank
Doran, Mr. Frank
Dowd, Jim
Drew, Mr. David
Eagle, Angela
Eagle, Maria
Efford, Clive
Ellman, Mrs. Louise
Engel, Natascha
Farrelly, Paul
Field, rh Mr. Frank
Fitzpatrick, Jim
Flello, Mr. Robert
Flint, Caroline
Follett, Barbara
Foster, Mr. Michael (Worcester)
Foster, Michael Jabez (Hastings and Rye)
Francis, Dr. Hywel
Gapes, Mike
Gardiner, Barry
George, rh Mr. Bruce
Gerrard, Mr. Neil
Gilroy, Linda
Goggins, Paul
Goodman, Helen
Griffith, Nia
Griffiths, Nigel
Grogan, Mr. John
Gwynne, Andrew
Hall, Mr. Mike
Hall, Patrick
Hamilton, Mr. David
Hamilton, Mr. Fabian
Hanson, rh Mr. David
Harman, rh Ms Harriet
Harris, Mr. Tom
Havard, Mr. Dai
Healey, John
Henderson, Mr. Doug
Hendrick, Mr. Mark
Hepburn, Mr. Stephen
Heppell, Mr. John
Hesford, Stephen
Hewitt, rh Ms Patricia
Heyes, David
Hill, rh Keith
Hillier, Meg
Hodge, rh Margaret
Hood, Mr. Jim
Hoon, rh Mr. Geoffrey
Hope, Phil

Howarth, rh Mr. George
Hoyle, Mr. Lindsay
Humble, Mrs. Joan
Iddon, Dr. Brian
Illsley, Mr. Eric
Irranca-Davies, Huw
James, Mrs. Siân C.
Jenkins, Mr. Brian
Johnson, rh Alan
Johnson, Ms Diana R.
Jones, Helen
Jones, Mr. Kevan
Jones, Mr. Martyn
Kaufman, rh Sir Gerald
Keeble, Ms Sally
Keeley, Barbara
Keen, Alan
Keen, Ann
Kelly, rh Ruth
Kemp, Mr. Fraser
Kennedy, rh Jane
Khan, Mr. Sadiq
Kidney, Mr. David
Knight, Jim
Kumar, Dr. Ashok
Ladyman, Dr. Stephen
Laxton, Mr. Bob
Lazarowicz, Mark
Lepper, David
Levitt, Tom
Lewis, Mr. Ivan
Linton, Martin
Lloyd, Tony
Love, Mr. Andrew
Lucas, Ian
Mackinlay, Andrew
MacShane, rh Mr. Denis
Mahmood, Mr. Khalid
Malik, Mr. Shahid
Mallaber, Judy
Mann, John
Marris, Rob
Marshall, Mr. David
Martlew, Mr. Eric
McAvoy, rh Mr. Thomas
McCabe, Steve
McCafferty, Chris
McCarthy, Kerry
McCarthy-Fry, Sarah
McDonagh, Siobhain
McFadden, Mr. Pat
McFall, rh John
McGovern, Mr. Jim
McGuire, Mrs. Anne
McIsaac, Shona
McKechin, Ann
McKenna, Rosemary
McNulty, Mr. Tony
Meale, Mr. Alan
Merron, Gillian
Michael, rh Alun
Milburn, rh Mr. Alan
Miliband, Edward
Miller, Andrew
Mitchell, Mr. Austin
Moffatt, Laura
Mole, Chris
Moon, Mrs. Madeleine
Morgan, Julie
Morley, rh Mr. Elliot
Mountford, Kali
Mudie, Mr. George
Mullin, Mr. Chris
Murphy, Mr. Denis
Murphy, rh Mr. Paul
Naysmith, Dr. Doug
Norris, Dan
O'Brien, Mr. Mike
O'Hara, Mr. Edward
Olner, Mr. Bill
Osborne, Sandra
Owen, Albert
Palmer, Dr. Nick
Pearson, Ian
Plaskitt, Mr. James
Pope, Mr. Greg
Prentice, Bridget
Prentice, Mr. Gordon
Prosser, Gwyn
Purchase, Mr. Ken
Purnell, James
Raynsford, rh Mr. Nick
Reed, Mr. Andy
Reid, rh John
Riordan, Mrs. Linda
Robertson, John
Robinson, Mr. Geoffrey
Rooney, Mr. Terry
Ruane, Chris
Ruddock, Joan
Russell, Christine
Ryan, Joan
Salter, Martin
Seabeck, Alison
Shaw, Jonathan
Sheridan, Jim
Simon, Mr. Siôn
Skinner, Mr. Dennis
Slaughter, Mr. Andy
Smith, rh Mr. Andrew
Smith, Ms Angela C. (Sheffield, Hillsborough)
Smith, Angela E. (Basildon)
Smith, Geraldine
Smith, rh Jacqui
Snelgrove, Anne
Spellar, rh Mr. John
Starkey, Dr. Phyllis
Stewart, Ian
Straw, rh Mr. Jack
Stuart, Ms Gisela
Sutcliffe, Mr. Gerry
Tami, Mark
Taylor, Ms Dari
Taylor, David
Thomas, Mr. Gareth
Thornberry, Emily
Tipping, Paddy
Touhig, rh Mr. Don
Trickett, Jon
Truswell, Mr. Paul
Turner, Dr. Desmond
Turner, Mr. Neil
Twigg, Derek
Ussher, Kitty
Vaz, rh Keith
Vis, Dr. Rudi
Walley, Joan
Waltho, Lynda
Watson, Mr. Tom
Watts, Mr. Dave
Whitehead, Dr. Alan
Wicks, Malcolm
Williams, rh Mr. Alan

Williams, Mrs. Betty
Wills, Mr. Michael
Winnick, Mr. David
Winterton, rh Ms Rosie
Woolas, Mr. Phil
Wright, Mr. Anthony
Wright, David
Wright, Mr. Iain
Wyatt, Derek
Tellers for the Ayes:

Claire Ward and
Mr. Frank Roy
NOES


Afriyie, Adam
Ainsworth, Mr. Peter
Alexander, Danny
Amess, Mr. David
Ancram, rh Mr. Michael
Arbuthnot, rh Mr. James
Atkinson, Mr. Peter
Bacon, Mr. Richard
Baker, Norman
Baldry, Tony
Barker, Gregory
Baron, Mr. John
Barrett, John
Beith, rh Mr. Alan
Bellingham, Mr. Henry
Benyon, Mr. Richard
Beresford, Sir Paul
Binley, Mr. Brian
Blunt, Mr. Crispin
Bone, Mr. Peter
Boswell, Mr. Tim
Brady, Mr. Graham
Brake, Tom
Brazier, Mr. Julian
Breed, Mr. Colin
Brokenshire, James
Brooke, Annette
Browne, Mr. Jeremy
Browning, Angela
Bruce, rh Malcolm
Burns, Mr. Simon
Burrowes, Mr. David
Burstow, Mr. Paul
Burt, Alistair
Burt, Lorely
Butterfill, Sir John
Cable, Dr. Vincent
Cameron, rh Mr. David
Campbell, rh Sir Menzies
Carmichael, Mr. Alistair
Cash, Mr. William
Chope, Mr. Christopher
Clark, Greg
Clifton-Brown, Mr. Geoffrey
Cohen, Harry
Cox, Mr. Geoffrey
Curry, rh Mr. David
Davey, Mr. Edward
Davies, Mr. Dai
Davies, David T.C. (Monmouth)
Davies, Philip
Davis, rh David (Haltemprice and Howden)
Djanogly, Mr. Jonathan
Dorrell, rh Mr. Stephen
Dorries, Mrs. Nadine
Duddridge, James
Duncan, Alan
Duncan Smith, rh Mr. Iain
Dunne, Mr. Philip
Ellwood, Mr. Tobias
Evans, Mr. Nigel
Evennett, Mr. David
Fallon, Mr. Michael
Farron, Tim
Featherstone, Lynne
Field, Mr. Mark
Flynn, Paul
Foster, Mr. Don
Francois, Mr. Mark
Fraser, Mr. Christopher
Gale, Mr. Roger
Garnier, Mr. Edward
Gauke, Mr. David
Gibb, Mr. Nick
Gidley, Sandra
Goldsworthy, Julia
Goodman, Mr. Paul
Goodwill, Mr. Robert
Gove, Michael
Gray, Mr. James
Grayling, Chris
Green, Damian
Greening, Justine
Greenway, Mr. John
Hague, rh Mr. William
Hammond, Mr. Philip
Hammond, Stephen
Hands, Mr. Greg
Harper, Mr. Mark
Harris, Dr. Evan
Harvey, Nick
Hayes, Mr. John
Heath, Mr. David
Heathcoat-Amory, rh Mr. David
Hemming, John
Hendry, Charles
Herbert, Nick
Hoban, Mr. Mark
Hogg, rh Mr. Douglas
Hollobone, Mr. Philip
Holloway, Mr. Adam
Horam, Mr. John
Horwood, Martin
Hosie, Stewart
Howard, rh Mr. Michael
Howarth, David
Howarth, Mr. Gerald
Hughes, Simon
Huhne, Chris
Hunt, Mr. Jeremy
Hunter, Mark
Hurd, Mr. Nick
Jack, rh Mr. Michael
Jackson, Mr. Stewart
Jenkin, Mr. Bernard
Johnson, Mr. Boris
Jones, Mr. David
Kawczynski, Daniel
Keetch, Mr. Paul
Key, Robert
Kirkbride, Miss Julie
Knight, rh Mr. Greg
Kramer, Susan

Laing, Mrs. Eleanor
Lait, Mrs. Jacqui
Lamb, Norman
Lancaster, Mr. Mark
Lansley, Mr. Andrew
Laws, Mr. David
Leech, Mr. John
Letwin, rh Mr. Oliver
Liddell-Grainger, Mr. Ian
Lilley, rh Mr. Peter
Llwyd, Mr. Elfyn
Loughton, Tim
Mackay, rh Mr. Andrew
Maclean, rh David
MacNeil, Mr. Angus
Malins, Mr. Humfrey
Maples, Mr. John
Marshall-Andrews, Mr. Robert
McIntosh, Miss Anne
McLoughlin, rh Mr. Patrick
Mercer, Patrick
Miller, Mrs. Maria
Milton, Anne
Mitchell, Mr. Andrew
Moore, Mr. Michael
Moss, Mr. Malcolm
Mulholland, Greg
Murrison, Dr. Andrew
Neill, Robert
Newmark, Mr. Brooks
O'Brien, Mr. Stephen
Oaten, Mr. Mark
Öpik, Lembit
Osborne, Mr. George
Ottaway, Richard
Paice, Mr. James
Paterson, Mr. Owen
Pelling, Mr. Andrew
Penning, Mike
Penrose, John
Price, Adam
Prisk, Mr. Mark
Pugh, Dr. John
Randall, Mr. John
Redwood, rh Mr. John
Reid, Mr. Alan
Rennie, Willie
Rifkind, rh Sir Malcolm
Robathan, Mr. Andrew
Robertson, Angus
Robertson, Hugh
Robertson, Mr. Laurence
Rogerson, Mr. Dan
Rosindell, Andrew
Rowen, Paul
Ruffley, Mr. David
Russell, Bob
Sanders, Mr. Adrian
Scott, Mr. Lee
Selous, Andrew
Shapps, Grant
Shepherd, Mr. Richard
Simmonds, Mark
Simpson, Mr. Keith
Smith, Sir Robert
Soames, Mr. Nicholas
Spelman, Mrs. Caroline
Spicer, Sir Michael
Spink, Bob
Spring, Mr. Richard
Stanley, rh Sir John
Steen, Mr. Anthony
Streeter, Mr. Gary
Stuart, Mr. Graham
Stunell, Andrew
Swayne, Mr. Desmond
Swinson, Jo
Swire, Mr. Hugo
Syms, Mr. Robert
Tapsell, Sir Peter
Taylor, David
Taylor, Mr. Ian
Taylor, Matthew
Taylor, Dr. Richard
Teather, Sarah
Tredinnick, David
Tyrie, Mr. Andrew
Viggers, Peter
Villiers, Mrs. Theresa
Walker, Mr. Charles
Wallace, Mr. Ben
Waterson, Mr. Nigel
Webb, Steve
Weir, Mr. Mike
Widdecombe, rh Miss Ann
Wiggin, Bill
Williams, Hywel
Williams, Mark
Williams, Mr. Roger
Willis, Mr. Phil
Willott, Jenny
Wilshire, Mr. David
Wishart, Pete
Wright, Jeremy
Young, rh Sir George
Younger-Ross, Richard
Tellers for the Noes:

Angela Watkinson and
Michael Fabricant
Question accordingly agreed to.
11 Jun 2007 : Column 594

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Mr. Deputy Speaker forthwith declared the main Question, as amended, to be agreed to.

Resolved ,


11 Jun 2007 : Column 597

Carers

Mr. Deputy Speaker (Sir Alan Haselhurst): We now come to the second debate on the Opposition motions. I should announce to the House that Mr. Speaker has selected the amendment in the name of the Prime Minister.

8.26 pm

Mr. Jeremy Hunt (South-West Surrey) (Con): I beg to move,

Today is the first day of carers week, the week when we as a country celebrate and recognise the extraordinary work of 6 million people who give up huge amounts of their time, energy and effort to look after disabled and older friends and relatives. Here is the problem: the social care budget, for which the Under-Secretary of State for Health, who is in his place, is responsible, is currently £19 billion, but Carers Week has estimated that if the amount of unpaid work done by those 6 million carers were costed, it would come to £57 billion. That means that if they stopped doing that work tomorrow and we wanted to continue with the same levels of care, we would have to quadruple the social care budget, just to stand still.

It is not just a matter of the tax implications. There is a much more fundamental question of the type of society that we wish to be. Those of us on the Conservative Benches think that it is fundamentally right that wherever possible the main caring role is undertaken by family and friends. That is what carers want and what the cared-for person wants. The brutal truth is that because of demographic trends, the huge growth in the numbers of disabled children, and the rapidly ageing society, very soon 6 million carers will not be enough. If we want the number of carers to grow, we must be prepared to answer difficult questions about the role of the state and whether it enables and supports that caring role, or whether, as is all too often the case, it hinders and obstructs that role.

This year’s carers week theme is “My life as a carer”. When I read that, it reminded me of the first carer whom I met when I was a prospective parliamentary candidate. For my sins, I had agreed to be a refuse collector for the day in my prospective constituency. I had spent the morning getting mucky and dirty picking up bottles, cans and newspapers for recycling and
11 Jun 2007 : Column 598
generally thinking that it was remarkable that anyone could want to do that kind of job full time. Then I spoke to the driver of the refuse van that I was with, and he told me that 10 years ago his wife had had an accident in their garden and had become wheelchair-bound and unable to get up, get dressed, wash or cook. Although he had been able to carry on his work, his life outside work had been turned completely upside down. Rather touchingly, he said to me that he would not change her for the world. The question is whether we are doing enough to help and support people who are playing that kind of extraordinary role; Conservative Members believe that we are not.

Lembit Öpik (Montgomeryshire) (LD): Does the hon. Gentleman accept that the Motor Neurone Disease Association would agree with his view that we as a society have not done enough to recognise carers? Is he aware that the cost to the state of caring for people suffering from motor neurone disease is £241 million per year, and that it would be a great deal more if we did not have the enormous voluntary contribution that he is discussing? It is about time that we recognised that and gave those carers the rights that I imagine he would agree with.

Mr. Hunt: The hon. Gentleman makes a good point. I am happy to praise the Motor Neurone Disease Association because he said earlier that if I did so he would buy me a pint in the bar later. In fact, I am genuinely happy to praise its work, because carers for people with motor neurone disease demonstrate one of the critical factors about carers, which is that their caring role often lasts for 24 hours, creating enormous stress and pressure. That is why it is incredibly important to do everything to support that role.

Before I talk about the things that are going wrong, it is also important to talk about the things that have gone right. There have been a lot of changes over the past 15 years that have helped the role of carers. The Carers (Recognition and Services) Act 1995 set up carers’ assessments. In 1999, we had the first ever national carers strategy. The Carers and Disabled Children Act 2000 extended the right of direct payments to families with disabled children. The Carers (Equal Opportunities) Act 2004 gave local councils an obligation to promote carers’ assessments to those entitled to them. Last year, as I am sure that the Minister will tell us, we had the Work and Families Act 2006, which extended the right of flexible working to carers. We have had some modest improvements in respite care. The Pensions Bill, which is before Parliament at the moment, will strengthen the rights of carers in terms of entitlement to state pensions.

However, eight years on from the national carers strategy we are still in a situation whereby three quarters of carers say that they are worse off as a result of their caring role, 79 per cent. of carers say that their health has been affected by their caring role, and one in five carers say that they have had to reduce the amount of food they buy because of the financial pressures created by their caring. I am afraid that the Government’s response has been disappointing. They have promised yet another review—a review of the strategy involving, we are promised, the widest ever consultation with carers. In the end, however, this is the
11 Jun 2007 : Column 599
politics of “talk, talk”. The danger of that is not only that it does nothing in itself but that it obscures the fundamental problem—the Government’s thinking that the only solution to these problems is financial, which means that carers are made to wait in a queue alongside everyone else who is calling on public resources and get restricted to the occasional scraps. We need a much more radical and imaginative approach. In particular, we need to slay the myth that the only way to improve the lives of the UK’s 6 million carers is to increase spending on the system, when often it is the system itself that is failing.

Mr. David Drew (Stroud) (Lab/Co-op): There was a consensus following the Sutherland report, and it is disappointing that that was broken by the Government on financial grounds. There should be free nursing and social care, but people should have to pay for their accommodation once they get above a certain income threshold. If we had moved in that direction, we might have solved the problem.

Mr. Hunt: The hon. Gentleman is right. There is a huge challenge ahead in terms of how we finance social care provision, and it is particularly acute given the changing demographics. I hope that he will agree with what I am about to say about changing the system to ensure that much greater resources are directed to carers.

Two Under-Secretaries from two Departments are present, so let me deal with them one at a time. I shall start with the Department of Health. Let us consider the example that I gave of the refuse collector from Farnham. When his wife became disabled, he would have had to grapple with three levels of bureaucracy in the social service system. The first is the carer’s needs assessment. For that, he would have to provide 140 different pieces of information spread over 40 pages and three different forms. Secondly, his wife would have to undergo possibly five different assessments. She would have to: go through a contact centre to ascertain whether she was eligible; do a fair access to community services assessment followed by a community care assessment, and she might have to undergo a specialist assessment for physiotherapy or occupational therapy. She then might have to do a further assessment, which is named—somewhat ironically—the “single assessment process”. If we examine the questions that both must answer, two thirds of the questions that he has to answer are already asked of her.

Councils throughout the country would like to reduce the bureaucracy of the assessment process but legislation requires much of the assessing, thus making reduction difficult. The third layer of bureaucracy is perhaps the worst because it is hidden. It is the bureaucracy that providers of social care must tolerate. It comprises: reports to get star ratings from the Commission for Social Care Inspection; 26 performance assessment frameworks, including key thresholds; delivery and improvement standards reports for the Audit Commission; best value performance indicator reports; comprehensive performance assessment reports, and, for the Department of Health, the referrals, assessments and packages of care reports. All that bureaucracy comes at a huge price of £2 billion. That money is used in the assessment and commissioning process, not in delivering the services that carers and disabled people need.


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