House of COMMONS
MINUTES OF EVIDENCE
WORK AND PENSIONS COMMITTEE
Wednesday 18 June 2008
MRS ANNE MCGUIRE MP and MR IVAN LEWIS MP
USE OF THE TRANSCRIPT
Taken before the Work and Pensions Committee
on Wednesday 18 June 2008
Mr Terry Rooney, in the Chair
Miss Anne Begg
Mrs Joan Humble
Memoranda submitted by Department for Work and Pensions
Examination of Witnesses
Witnesses: Mrs Anne McGuire, MP, Parliamentary Under Secretary of State (Minister for Disabled People) and Mr Ivan Lewis, MP, Parliamentary Under Secretary of State for Care Services (Minister for Carers), gave evidence.
Q154 Chairman: Good morning everybody. Welcome to the final session of our inquiry on the Government's carers strategy. Welcome to our ministers. It is good to have ministers who know what they are talking about. Perhaps I could kick off. There is a general acknowledgment that there is a lack of information, guidance, and advice for carers. How do you think the carers strategy will deal with that?
Mr Lewis: Do you want us to say a few opening remarks or just go straight to the questions?
Q155 Chairman: If you would like to say a few words, please do.
Mr Lewis: The important thing to say is that this was quite an unusual strategy, in the sense that it started from the point of literally going around the country speaking to hundreds, if not thousands of carers. That is really, really important. It is not based on ministers and civil servants sitting in offices in Westminster and Whitehall drawing up plans for carers; it has been very much based on real-life conversations, discussions, and consultation events with carers up and down the country. Two big themes emerged throughout, wherever we went. One was: "Throughout our caring experience" - and this links, Chairman, to your first question - "we feel as though we have literally had to battle the system throughout. We want a system which is on our side, in every sense - and we want one system, not a collection of public sector agencies - a system which is on our side rather than a system that we are constantly fighting against." Time and time again, that was the message. The second picture issue was: "We have a right to a life of our own alongside our caring responsibilities." If you like, those were the big, overarching themes. We then came up with five outcomes that we believe at the end of a ten-year period it should be reasonable for carers everywhere in the country to expect to be a reality in terms of their experiences. The first is that carers will be respected as expert care partners and have access to the integrated and personalised services they need to support them in their caring role. That is about the status and the value of carers in terms of the way they are treated by professionals, and the fact that every family situation is different and we need increasingly to move towards personalised responses. I have mentioned the outcome of a life of your own alongside your caring role. This is about the right to have a job if you want one. We should remember in this debate that the majority of carers are actually in work and they are juggling caring responsibilities with holding down employment. Of those that are not, many of them would like to work, but the reality is that there is not the flexibility to enable that to happen. The next is that carers will be supported so that they are not forced into financial hardship by their caring role - the whole debate about both allowances and benefits, but also the ability to work and how much you are allowed to earn, et cetera, before you start to lose benefits. Carers will be supported to stay mentally and physically well and be treated with dignity. We know now - and this was something that came across very powerfully - that there is a direct correlation between spending a significant part of your life emotionally and physically looking after somebody in an intense way and the impact on your own health. That impact is on both your physical health and your mental health. We have to do more to be recognizing that carers have specific and distinct health and well-being needs. The final outcome is that children and young people will be protected from inappropriate caring. We need to say on this outcome that it is not the state's job to prevent any child from loving their parent. When their parent is sick or dependent, it is not for us to go in and say, "Thou shalt not love thy parent." That would be entirely inappropriate. However, no child should have their childhood stolen as a result of fulfilling entirely inappropriate emotional and physical responsibilities. One of the most moving things any of us as politicians can do is to sit with groups of young carers and talk about what they go through. There is the difficulty of talking to their mates about this because it is not the kind of thing that teenagers particularly tend to talk about, so it is very important to give them opportunities to talk to other young carers in similar circumstances. Young carers have said to me, "I just want to be a normal teenager" and that kind of message. Finally, whilst we should put resources into supporting young carers' groups, et cetera, we also have a primary responsibility, as I say, to make sure that no child is having their childhood stolen inappropriately and that requires services to behave very differently. For example, we need to look at families, not just at individual units within families. In my other responsibilities, we have made it very clear that adult services, when looking at the needs of an adult who has possible mental health problems or who is disabled or who maybe has a long-term condition, cannot simply look at the adult in isolation and say that the child or young person in that household has nothing to do with them and not liaise with children's services or with the school. That is entirely irresponsible. The messages really are, therefore: a system which is on our side rather than one which we are fighting against, and the right to a life of our own.
Mrs McGuire: The strategy, as Ivan indicated, was developed very much with carers. Quite unusually, Government ministers, including the Prime Minister, were out there in the field listening to what carers had to say to us. The taskforce approach was a very positive one. It gave us some pretty robust challenges. It is a ten-year strategy. It is not one about which anybody could say we were being unrealistic and challenging in the targets. We obviously are not going to deliver everything overnight but there obviously are some issues there that the Committee will want to push us on. We have received a very positive response from carers' organisations, including Philippa Russell, the Chair of the Standing Commission on Carers, who said that this is a fantastic opportunity to build a long-term strategy, which recognizes the positive contribution carers make to the community, while at the same time recognising, as Ivan has said, that carers do have a life of their own. That is something that as a government and as society we need to support and facilitate.
Q156 Chairman: To get back to the question: What are you doing about the information deficit?
Mr Lewis: First of all, there is information at different levels. There has been a debate over a long period of time about the notion of a one-stop shop, for example. I have reached the view that that is an unachievable aim, because having all the information and all the services in one place is unrealistic. People have a right, however, to expect a first stop shop; in other words, if you ring a number, or log on to a website, or visit a series of places in your community, you will end up in the right place in terms of the help you need. We are doing a number of things. First of all, as part of the Putting People First reform programme in adult social care - which began in April and will be a three-year programme, supported by over half a billion pounds - there is an expectation - local authorities have signed up to this - that in every local authority area, working with other agencies, there will be a strategy to create a universal information and advice system in every local community. That is one element of it. The second element is a national telephone helpline and website. The website will go live properly in the summer: it is already up and running but in a very minimalist way. The telephone helpline will be live in the spring of next year. The third example is this notion of an "information prescription". This is currently in the context of development of health reform, but has the potential to be far more than that, where individuals, as a result of their contact, for example, with their GP, would have information collected in a holistic way, on one piece of paper, which enables information about that person to be transferred from professionals rather than being constantly asked, as people get incredibly frustrated, for the same information from different organisations and different professionals. We have a commitment at the local level for local authorities to provide leadership or join up with other agencies to provide access to universal information and advice - and where appropriate advocacy. Also, they will have the national website and helpline, and, in the context of the NHS, working hopefully with social care and other agencies, will have the information prescription.
Mrs McGuire: It is also incumbent on other departments who have been involved in developing the strategy, to look at how within their own niche (in terms of information) they start to roll out the information. For example in DWP, through JobCentre Plus, we are looking at how we highlight the additional services that we are going to provide to those carers who are looking for work. I know that the Government Equalities Office and BERR are looking at ways in which they can highlight the right to flexible working. These are areas where each of the departments who co-own the strategy can make a significant impact in terms of information. Of course it has to be under the umbrella of a strategic approach; it is not about bits and pieces here. That is why it was important that so many government departments were part of the production. In that case they are also part of the implementation.
Q157 Chairman: In relation to both the national telephone information line and the information prescriptions, will there be any advice given on benefits for the sick or disabled person and their carers? Is that part of the service?
Mr Lewis: Yes. Absolutely. Because it is a carers strategy, the tendency is to focus on "It's about carers", but of course carers tell us that the thing which matters the most to them is feeling good about the person they are caring for and feeling empowered through information and advice about where to get the right kind of help and support. There is a culture now in social care, as you know, where if you have means above £21,000 and you go along to your local authority, or if your need (because your elderly mother is lonely or isolated) is apparently low level - and God knows how we have got ourselves into a position where we describe that as low-level - you are told, "You're on your own, there's no help here." The other very important element to this Putting People First reform programme is that the universal information advice is for everybody, irrespective of means. It is not just about your immediate needs but about how to get the support and help you need to fulfil your caring responsibilities. A lot of that is about the condition or the needs of the person you are caring for.
Q158 Chairman: Is the telephone helpline going to be extended to Wales, Scotland and Northern Ireland now?
Mr Lewis: Not at the moment. As I understand it, the situation is that it will not be, in terms of its database of information. Obviously, if people ring up, they are not going to be turned away because of their nationality, but if they are asking detailed questions about what is happening in Scotland or Northern Ireland, and they live in Wales, then at the moment that helpline will not have the capacity to give the information they need. We are in close contact, however with the devolved administrations and it would seem to me that we could reach some sort of accommodation about how we can achieve what you have just suggested. That would be ideal from the point of view of people using services and carers, but, as you know, Chairman, other than benefits, most of these services are devolved, and therefore it is quite a challenge. But we are in regular contact with the individual devolved administrations.
Mrs McGuire: It is fair to say that during the development of the strategy both the Scottish Government and the Welsh Assembly Government were observers as to what was happening. We have not had an opportunity to open up the wider discussions along the lines that you have suggested but there is an issue about the mix of devolved and reserved matters. Obviously, at DWP we have an interest in ensuring that carers in Scotland, Wales, and England - Northern Ireland have a slightly different system - are given the benefit of full information on their entitlements. But whether or not it will be as cohesive as you might wish it to be, I do not think we are in a position to say that yet.
Q159 Chairman: I have to say I am slightly disappointed by that. From all the evidence we have had and from what you have said about your constituents across the country, one of the key issues for carers is access to employment. It is a UK service, and yet we are going to have this narrow helpline just for England, and perhaps for England and Wales, because of devolved health issues. I hope we can speed up whatever discussions are happening with the devolved assemblies.
Mrs McGuire: That is something you would want to address with the devolved administrations. But, as you are aware, Mr Chairman, most of the social care levers are in the hands of the administrations in Wales and in Scotland. Certainly we will be looking to see that we can have some sort of coherent approach. In both Scotland and in Wales, the DWP and JobCentre Plus work very, very closely with the devolved administrations, but it is how we recognize the integrity of the devolved settlements whilst at the same time ensuring that where there is a reserved overlay we can work together to the benefit of carers or, indeed, for any of our particular customers in the devolved administration areas.
Q160 Chairman: The Committee, as you know, visited Australia, and we were very impressed with their Commonwealth Carer Respite Centres. We have also seen a Carers' Centre here in the UK. They do seem to do a brilliant job of pulling everything together. Is there any intention of developing that sort of thing more widely?
Mr Lewis: We obviously have a number of Carers' Centres in this country. The Princess Royal Trust for Carers has done an excellent job. We know that in many local communities, a combination of the voluntary sector and local authorities have developed Carers' Centres. The reality is that carers do value and welcome having somewhere they can go, where they can be themselves, where they can have space, and where they can talk about whatever they want to talk about. It might be about themselves, it might be about their caring situation, it might be about some of the anxieties and stresses involved in being a carer. One recently opened in my own borough. I went to open it during Carers Week last week. We should not forget what we have done to facilitate those Carers' Centres. There is a danger, when you talk about a new strategy, of forgetting all that you have done in the past eight or nine years. We have put unprecedented levels of money into them, through the annual Carers' Grant to every single local authority. A lot of local authorities, I am glad to say, have entered into partnerships with the voluntary sector and have developed Carers' Centres. Carers' Centres have evolved from that, as well as from the tremendous work that the Princess Royal Trust for Carers has done, often in partnership with local authorities, but not exclusively. The Department of Health has a budget called section 64, which it spends with the voluntary sector, and I am doing a fundamental review of that at the moment. It is about £20 million a year. If you look at the way it has been spent over the years, it has not necessarily been spent in pursuing very clear strategic objectives, it has just been spent - some of it in a traditional way, with voluntary organisations we have always done business with, but based on an application model where if you know how to fill in the form you may get the grant. Even though your project may not be as great as others, which are innovative and exciting, they do not have the skills to fill the form in. One of the things we have singled out in the strategy is in terms of that review of section 64. We are very seriously considering making projects offering emotional support to carers (that is, Carers' Centres) as one of the priorities for that grant aid in the future. We have not made a definite decision on it but we are looking at that the moment.
Q161 Chairman: We went to the Princess Royal Trust for Carers at Harrogate. It is absolutely brilliant.
Mr Lewis: It is probably one of the best in the country.
Q162 Chairman: It is not a drop-in centre; it provides tremendous hands-on support. You will see in the report some heart-rending stories from the child carers. They do not want, if you like, the namby-pamby, "Come in here and have a cup of coffee," and an arm around the shoulder, but real, practical advice.
Mr Lewis: The one in Bury is going to be as good as the one in Harrogate, I promise.
Q163 Chairman: But it is in Lancashire. It cannot be!
Mrs McGuire: In Sunderland they have a very similar approach. They work in partnership with a range of organisations. I was up there recently. As a carers' organisation working with JobCentre Plus, they see employment support as being crucial to the support they offer their members or those who just want to come in. I heard some fantastic tales of people who initially came in for that element of "soft support" but then had opportunities opened up to them, particularly in the employment field. Again, that was done very much in partnership with the local JobCentre Plus, and, indeed, I think we have used an example from Sunderland in the strategy.
Mr Lewis: It is a good illustration of listening. The woman who runs the Harrogate Centre is a very impressive person indeed. She was at a roundtable meeting with the Princess Royal and a number of other people, and she gave me some very hard data on what the centre did and what mattered to carers, based on their contact with carers. The interesting thing, Chairman, is that top of the list when asking carers what mattered was emotional support. Up until that point, I have to say, emotional support had not featured that heavily in the strategy we were developing. Her presentation and her hard, if you like, intelligence, did influence the fact that the strategy does have quite a significant strand on emotional support. Anne is absolutely right, before carers will move on to talk about "a life of our own alongside caring" - whether it be employment, social and leisure networks, childcare, whatever - having that space to open up is absolutely crucial and all the evidence supports that.
Chairman: This is not in any way a special plea, but the one of the issues highlighted by both Carers' Centres, but it was very stark at Harrogate, was that they get funding from three PCTs, the county council, the usual Lottery bid. There are about seven different streams of funding, 80 per cent of which expires before the end of the year. There is hope of getting it renewed, but it is that core funding that allows the basic operation, and everything else should be a bonus. We need to move on.
Q164 Mrs Humble: Anne, I would like to ask you some questions about carer's allowance and the amount of carer's allowance. You say in the review that you are "reviewing the structure of the benefits available to carers in the context of wider benefit reform and the fundamental review of the care and support them". What does that mean? We have had people saying to us that the carer's allowance is not fit for purpose. If it's because the carer's allowance is not fit for purpose?
Mrs McGuire: We have to be very clear in looking at the carer's allowance. We do need to look at it in the wider context of welfare reform. Both Ivan and I, as well as other colleagues, are very well aware of the criticisms of carer's allowance, but the one thing that came out of the discussions that we had, particularly myself, with those who were involved in the consultation is that is not quite as easy to fix (if I could put it in that shorthand term) as you would think. I know there was demand for an immediate increase up to the level of jobseeker's allowance and that is why we think it is important to look at it in the wider context of welfare reform. As colleagues are aware there is an ongoing process in terms of our welfare reform and we would like to fit it into that wider strategy. I do not underestimate the concern that there is out there about carer's allowance, but I think that it is the best way to go. Interestingly, most of the carers' organisations have recognised, while they are disappointed about that element of this strategy, that you cannot change carer's allowance overnight. There are so many implications. Once you start to deal with one benefit, the knock-on effect both for individuals and for the benefit system as a whole can be quite profound.
Q165 Mrs Humble: Can you give us any indication of what sort of areas you are looking at?
Mrs McGuire: We want to look at how it fits in with other working age benefits, for example. The social care reforms have been led by the Department of Health and there may be implications there depending on what comes out of that consultation. The immediate response, the knee-jerk response, is, "We just need to do something quickly with the carer's allowance" but in fact it takes far greater thought than the six-month development of strategy afforded us to do. In the Department of Work and Pensions we are very clear that we want to see the carer's allowance being part of that wider reform of our welfare system. Interestingly, carer's allowance, although it obviously has a very high profile, will have a different priority with different groups of carers. It is not always carer's allowance that is the priority, for example, with those who want to balance work and caring, or for those who want to see no disregard or no earnings' limit on any work that they undertake. There are different priorities for different groups of carers. That is why, to be frank with you, it would have been really difficult to come up with a solution that would have satisfied all of those different constituencies within the caring community, within the timeframe of the development of the strategy.
Q166 Mrs Humble: One of the issues that has been raised with us as a possibility for changing carer's allowance is to have a two-tier allowance: an income replacement benefit and then an additional costs of benefits. Are you going to consider that as part of your review?
Mrs McGuire: Your question highlights the complexities of some of the solutions. How would a two-tier system work? How would you assess the extra costs for some carers? How would that fit in with some of the changes that are coming in for social care support? How would that fit in, for example, with some of the changes coming with individualised budgets for disabled people? It is about looking at the whole picture but I am obviously interested in your comment on a two-tier approach. We want to get a benefit that is straightforward, simple, and, if you meet the criteria, easy to administer. It is how we recognize the changing role of carers, and sometimes see the changing role of an individual carer. For example, the carer of a disabled child, who will perhaps be full-time before the child goes to school, may want to engage in part-time work when that child goes to school. It does not mean that they are no longer a carer for that individual disabled child; it is just how we have a system of support that is flexible enough to meet those changing demands. It will not always be through carer's allowance. At some point in the individual's life it will perhaps be the extra support that we are committed to giving through JobCentre Plus - which is an element of the strategy as well - and it may well be that the appropriate support at that time is some of the things that Ivan's Department have the responsibility for. I know there is a focus on carer's allowance, but it is only part of the big picture.
Q167 Mrs Humble: You mentioned a minute ago, the cost to carers. We have received a lot of evidence on that, with some people saying that there are substantial additional costs to the carers themselves. The Department in its submissions said that very little research has been done in this area. Of course, it is difficult to differentiate between the cost to the carers and the costs that arise because of the person they are caring for. Additional heating costs in a home might fall to the carer, but they fall to the carer because the individual who they are caring for needs warmth in the home.
Mrs McGuire: Yes.
Q168 Mrs Humble: There is also the cost of food. Carers also talk about the cost to them for transport and other issues. When the Committee went to Australia - I missed that trip! - my colleagues said it was a very informative visit and they learned a lot from what the Australians are doing. One example of good practice was negotiating concession cards for carers in relation to travel, parking, leisure, and other things. Are you going to be doing more research on the costs that arise to carers as distinct from the cared-for person?
Mrs McGuire: If I could speak on behalf of both Ivan and myself, it is a living document in that respect. Obviously we will continue to look at the various demands, to look at the research. I appreciate that we can go to other countries, look at systems there and say that what they do there is fantastic, but sometimes we have to look at it in the round as well. There may be other elements of the Australian system - and I have never been to Australia, so I do not know what the specific system offers up - that may not be quite so good. It is about how you import elements from another country's social system into our own country, but we are prepared to look at whatever we can to make the life of carers better. Your initial comment about the interaction between carers' needs and the needs of the individual they care for is important to this whole discussion as well. That is why, in parallel with the carers strategy, we also have the independent living strategy and the right to independence, choice, and control for disabled people. There are different elements to the changes that are happening out there.
Q169 Tom Levitt: I am delighted to hear Anne say that she wants the benefit system to be straightforward and simple, so we had better explore that a little bit more and look at the underlying entitlements. At the moment, there can only be one carer's allowance claim linked to one claim for DLA or for attendance allowance. We have been told that that is unfair for carers who look after more than one disabled person and also for disabled people who need more than one carer to be looking after them. Do you have any plans to reform the rule on making one carer's allowance claim to one DLA or attendance allowance claim?
Mrs McGuire: I recognize the criticism. I do not wish to take refuge in legality and technicalities here, but the carer's allowance is legally, technically, and in all senses, an income replacement allowance. Therefore, the basic rules of our social security system, which have been accepted for many years, are that you cannot pay more than one income replacement allowance benefit at a time. I appreciate the frustration that that may cause. If you are looking after two people, if you have the responsibility for the care of two people, it may seem illogical that you cannot get two allowances, but essentially the allowance is there to compensate for income that you have either foregone or income to which you cannot get access. If we had to change it for a carer's allowance, then we certainly would need to look at the impact of that decision across the whole of the social security system. The changes that people would like to see in the carer's allowance that have been flagged up would have profound implications across the board in terms of our social security system. Carer's allowance is not the only allowance, where this happens; there are other areas where income replacement benefits are paid and only one benefit can be paid at a time. Obviously, as I said in my opening remarks, we are looking at an ongoing welfare reform development and these will be issues that we potentially will have to look at. It may well be that the solution is not to pay two carer's allowance but to look at how we support carers who have different and perhaps more complex and heavier caring needs than other people. It is how you develop your thinking on it.
Q170 Tom Levitt: It may be that that is an argument in favour of the two-tier allowance that was mentioned earlier.
Mrs McGuire: I am hoping to take away all sorts of ideas from this session this morning as to how we can develop these things.
Q171 Tom Levitt: Could I ask you about qualifying periods for carer's allowance. If it is linked to attendance allowance, there is a six-month qualifying period; if it is linked to DNA, there is a three-month qualifying period. Of the DLA claims that are turned down, over half are then overturned on appeal, but the qualifying period would only start from when the DLA starts and not from when the initial DLA claim was made and incorrectly turned down. Clearly on qualifying periods, there is a confusion. What plans do you have to address the qualifying periods issue to try to make it more consistent and clear?
Mrs McGuire: With the greatest of respect, could I correct you on the appeal turnover rate. In actual fact it is slightly less than 50 per cent. It varies between 47 per cent and just under 50 per cent - we have made a real effort to try to get decisions right - and it is 47 per cent of those which go to appeal. If my memory serves me right - and I will correct this figure if my memory is not right on it - it is probably around about two per cent of our total application load that goes to appeal, so the figures are not quite as horrific. We obviously want to get the appeal rate down, to get those decisions right in the first place, but they are not quite as horrific as perhaps you have indicated. I suppose your question goes back to how we gate-keep carer's allowance. Carer's allowance is currently predicated on DLA and attendance allowance entitlement for the person you are caring for. Obviously, because of the way those allowances are structured, which means that we do need to identify whether it is a long-term disability or a health condition, it is very difficult, I think, under the current structure to look at ways in which we can kick in with a carer's allowance before there has been a decision on whether or not disability living allowance or attendance allowance is going to be paid. Technically, there is not a waiting time on carer's allowance. The waiting time (if I could use that term) is on assessing eligibility for attendance allowance and disability living allowance. Again, Mr Chairman - and I do not wish to keep saying this, so perhaps this is the last time - the questions have indicated just how interesting and difficult or challenging some of the reforms to carer's allowance would be, because all the questions obviously have highlighted serious implications for how we support carers through the benefits system.
Q172 Tom Levitt: The Department have said that you are committed to establishing a certification scheme for carers who care for more than 20 hours a week. Would you look, perhaps, to extend that to a second type of certificate for those who care for over 35 hours a week to determine eligibility for carer's allowance. When do you think you'll be introducing the certificate?
Mrs McGuire: The 20 hours a week is for the national insurance credit, for the entitlement to pensions, and in that area we are obviously working very closely with the Department of Health. In relation to the certification on 25 hours a week, we already determine, through our application form for carer's allowance, whether or not someone is giving 35 hours a week care. To be frank with you, I am not sure what added value we would get with a certification process. I may be wrong in that, but at the moment I cannot see what else it would bring in terms of supporting carers.
Q173 Tom Levitt: Perhaps that comes back to the previous question on entitlement, to the gate-keeping benefit. The gate-keeping benefit comes first, and if there is already a certificate to say that 35 hours per week of care is being given then the carer's allowance would be automatic, presumably.
Mrs McGuire: I would need to think about it to be honest with you.
Q174 Tom Levitt: Could I now move on to overlapping benefits. One piece of evidence, we had reads as follows: "The older person playing the carer's allowance, knowing they will not get it, in order to get a letter saying they are entitled but cannot be paid, therefore they can claim additions in mean tested benefits." I believe you are doing some work on improving the quality of such letters but what else are you doing to address the complexities of the overlapping benefits?
Mrs McGuire: I appreciate that sometimes our letters can appear to be opaque.
Mr Lewis: And wind people up.
Mrs McGuire: I do not need any heckling from the Department of Health here! In my three years as a minister it has been one of my challenges to get us to a position where we put out letters that, first of all, do not cause panic because perhaps the message is unclear or is disguised in language that ordinary people do not recognize, and try to explain as simply as possible the outcome of a very complex benefits decision. I know this may come as news to the Chairman, who has made this a bit of a campaign issue as well, but we have made improvements to our benefits letter. We work very closely with partner organisations such as the Princess Royal Trust for Carers, RNIB, Mencap, et cetera. In our benefits letter, we try to identify an individual's legal entitlement - and that has to be legally stated - and at the same time put out all sorts of other bits of information as to where they can go to get advice from other organisations, et cetera. I still think, frankly, that we have some way to go on this, but it is one of the areas that our Pension Service and Disability and Carers' Service are looking at. On the issue of trying to make it a simpler process for the individual, we are working in certain areas across the country under our CASPER initiative - which is not a friendly ghost, but looking at how, particularly with older people, we can give them a decision on the carer's allowance, their underlying entitlement, pretty quickly, almost when we do the assessment in their home. We are obviously looking at how we evaluate that, and we are looking at using a visiting service in a far more positive way to do that. When you explain it to people, they can understand why we want to keep that underlying entitlement, because it is the passport to other benefits. Of course, it also activates the carer's allowance within pension credit, et cetera. It is an important entitlement to hold on to, therefore, but I appreciate that when you say to somebody, "You are entitled to something but you're not going to get it," it can cause some confusion. We are working to try to improve that message, particularly working with organisations that have front-facing involvement with individuals.
Q175 Tom Levitt: I think it is also true that carer's allowance can cause some other benefits to be lost. For example, the severe disability premium is lost from the pension guarantee credit when the carer receives carer's allowance. Coming back to recognising the costs of caring as well, there is a huge resentment amongst older people that, because carer's allowance is an income replacement benefit, there is, in effect, no recognition of the costs of caring as far as an older carer is concerned because it is totally subsumed into the state pension. They are not entitled to the carer's allowance if their state pension entitlement is higher than the carer's allowance entitlement.
Mrs McGuire: Yes, if they are not entitled to pension credit.
Q176 Tom Levitt: Is there any plan to compensate older carers, of whom there are going to be increasing numbers, looking after their own parents even, to compensate them for the cost of caring? Because there are costs of caring.
Mrs McGuire: I hate to refer back to an answer I gave earlier, but the legal basis for both the state pension and carer's allowance is an income replacement benefit.
Q177 Tom Levitt: Perhaps we are talking about a premium. This is going back to the two-tier element. I accept that argument.
Mrs McGuire: Obviously, these are issues that we are going to have to look at, evaluate and assess, and then judge whether or not that is where we want to put significant resources. Mr Chairman, there is a lot of pressure to do more for the poorest carers, who have no other access to any income, to support those carers who have multiple caring responsibilities who have no opportunity for work. All of these elements need to be part of this wider discussion that we will have to have about how we reform our support for carers. Indeed, as I indicated earlier, when you go into a group of carers, depending on what their individual issues and priorities, you will get a different answer. For many older carers, it will be the overlapping benefit rule; for younger carers, it will be access to/good support for moving into employment and how they access training, for example, while they have caring responsibilities. That is why the additional investment for carers that we are putting in through JobCentre Plus, for replacement care so that an individual can undertake training, is vital for those folk. They are not easy issues to resolve. The ideas that are coming up from this session, I am sure, we will take away with us and certainly seriously consider.
Mr Lewis: I think we should also remember the review of the care and support system as well as the focus on benefits, because essentially at the heart of that is trying to recast the respective responsibilities of the state, the family, and the individual in a very, very rapidly changing society from a demographic and expectation point of view. Part of that is looking at the benefits system alongside the social care system, where your eligibility/your access, is on a completely different basis, in a completely incoherent way arguably. One of the potential solutions is to look at this more holistically, from a system-wide point of view, rather than simply looking at it in the narrow confines of individual benefits. If you look at that debate about the respective responsibilities of state funding an individual, a part of the debate that is not often referred to it is whether we should be considering over time a significant redirection of resource from public authorities of one kind or another (whether it be social services or health) to the family/the individual? I do not think we have begun to think about the potential implications of that. We need to look at this in the context of benefit reform, but it is very, very important that we try also to look at it as a system-wide issue.
Q178 Chairman: It is 20 hours a week caring to qualify for the NI credit pension, and 35 hours for the carer's allowance. Do we accept that is an anomaly?
Mrs McGuire: I accept it as a difference.
Q179 Miss Begg: In your opening remarks you talked about how important it is for carers to have a life of their own. One of the ways they can have their own life is to work, study, or volunteer. I have a few questions around the incentives to do that. You will be pleased to know that, unlike the previous questions, these are potential solutions that will not cost the Government lots and lots of money. The first one is that you cannot qualify for carer's allowance if you are studying for more than 21 hours. Will you review that, because that would allow carers, certainly at the time of their caring, to be preparing themselves for going into work when possibly the caring role lessens or, indeed, comes to an end.
Mrs McGuire: We are obviously looking at all of these issues in the context of our welfare reform. I do not mean to be tedious on this, but that genuinely is what we are doing. We are also currently working with the Department of Innovation, Universities and Skills, DWP, and JobCentre Plus to look at ways in which we can improve access to learning and support for those who want to move into the job market eventually and who are currently constrained by caring responsibilities. Of course, in the strategy we have highlighted the fact that we will give more focus through JobCentre Plus and through care replacement, for example, for those who want to move into training. It is an issue that is obviously in the forefront of our minds. We do need to recognise that if we are saying to people that they need to keep themselves connected with the job market then we need to look at ways in which we can facilitate that and ensure that our benefits system is not acting as a counterweight to that.
Q180 Miss Begg: For young carers, that is very, very important. The pattern for a lot of young carers is that once they leave school they do not get the chance to get into employment or further education because they have no income because of the 21-hour rule.
Mrs McGuire: I recognise that you have an interest in devolutionary issues as well. We work very closely in Scotland and in Wales, through JobCentre Plus, on looking at how we will open up opportunities, so that element of the strategy is very much a GB-wide strategy.
Q181 Miss Begg: Perhaps at the other end of the age range, the demographic changes you have just mentioned are having quite a serious impact on carers' own health. That is why in Carers Week it was being emphasised by Carers UK that very often the health needs of the carer are ignored. Part of the psychological improvement of carers' health is to get back into work, and we have talked about that. Notwithstanding the fact that the Government has increased the earnings' limit for carer's allowance quite considerably, what is to stop the Government putting it up to £150? It is not going to cost them any more money. It is going to encourage more carers to go into work because it becomes more worthwhile. Is that something else to be considered, that the threshold goes up to £150?
Mrs McGuire: It is not just an issue of finance but there are knock-on costs if you increase the earnings' limit. It is not a no-cost solution, because there are knock-on effects for other parts of the benefits system. I certainly have spent a significant amount of time both in discussion with officials and, indeed, in discussion with colleagues. David Clelland, for example, led quite an interesting campaign in the North East on introducing a taper. Again it can appear to be an easy solution to quite a well-defined problem, but in actual fact it does add again significant complexity to carer's allowance. It would mean reporting in every week if somebody earning some extra overtime, with all the complications of them making adjustments. We want to get the right support for carers without doing some of the tinkering which will add complexity both to the benefits system and to the life of the individual carer. That is why we want to have time to look at how we do this in the context of some of the other changes that potentially will be coming in our working age benefits system. But it is not a no-cost option. I am sure I can give you the table of costs, but it is not just about costs. I know sometimes government can be accused of not doing things because they cost too much. Sometimes that is the case, and I hope, if that is the case, I would put my hands up and say, "That's the problem," because obviously there are priorities that we do have to consider. It is not just about costs on this occasion; it is about complexity.
Q182 Miss Begg: It would be interesting to see that because I take your point that if you are going to introduce a taper then that is more complex. It is certainly something that carers say to us, that at the cliff-edge of £95 you get nothing. On our visit to Harrogate, carers were saying that they were juggling their jobs to make sure they were always below the £95 limit, because they would lose a great deal just by doing a bit of overtime. Even when the minimum wage went up, it affected their ability to work. There is obviously a feeling of injustice in the respect that there is that cliff edge which you generally do not get in most other parts of the benefits system.
Mrs McGuire: There are just under 500,000 people claiming carer's allowance, give or take. There are over four million carers who work. I appreciate and do not underestimate the constraints that the earnings' limit may impose on those people who are claiming carer's allowance, but for some of the four million carers who are out there working it is how best to get additional support through the social care system; how we work together across health, local government, transport and all these other areas (the Department for Universities, Innovation and Skills, et cetera); and how we work together to support them in balancing their working role and their caring role. So it is an issue, I appreciate that, for those who are claming carer's allowance, but there are lots of carers who do not claim carer's allowance.
Q183 Miss Begg: This might concern carer's allowance, but, on the other hand, if they are allowed to earn £150 then they are more likely to go into work. I think it is about giving them incentive to work as well. If they are in work and they are reimbursed their costs for travel and lunch, that counts as income. Even half the reimbursed cost of a replacement carer is all treated as earnings under the benefits system. This obviously comes back to the cost of caring: even when they are getting a sum of money to cover that, it is still treated as income. Are you going to look at that?
Mrs McGuire: There are certain costs that we take off before we impose an earnings' limit. Certainly I am always prepared to look at whether or not we can adjust those costs to meet the needs of carers. This is an opportunity for us to go back and look at the costs that we can deduct before the earnings' limit. Although we say an earnings' limit of £95, it is an earnings' limit of £95 once certain costs are taken off, including the costs for replacement care if that is needed. Obviously I am certainly willing to look at that again, as we look at the developing strategy and at how best we can financially support those carers who perhaps are totally dependent on the carer's allowance plus some limited earnings.
Q184 Miss Begg: You can understand the feeling of injustice if carer's allowance is an income replacement and yet the paid-out costs are treated as income. In any other walk of life, if it costs you to travel somewhere and you get that money back it is not normally treated as income.
Mrs McGuire: I am certainly prepared to look at that in the context of our wider reform.
Q185 Greg Mulholland: My questions really follow on from the questions on overlapping benefits, but I would like to focus particularly on pension entitlements, if I may. We have already heard the issues of financial hardship, complexity, overlapping benefits, but, as you are well aware, one of the real areas of concern - indeed real anger - is that there is a sense that, despite the fact that society and the Government say that they very much value the work that carers do and recognise its importance, nevertheless people get to the stage where they feel undervalued. Pensioners, who have gone through their lives and had that life transformed through having to care and losing income, then find themselves in a situation where they are in financial hardship. We are well aware that there are things in place that are designed to change this, and I would like to ask you first of all about the new carer's credit, which is clearly a very important part of this. At the moment the plan is to base the entitlement on the benefit being claimed by the person being cared for rather than on the carer's own situation. Carers UK estimate that that will mean that 40,000 people caring 20 hours a week or more will not get the credit for the basic state pension and 60,000 will not accrue entitlement to the second state pension. It seems as if this is going to help people, but quite a lot of people are still going to miss out and will still be in hardship. Why are you not instead looking at making entitlement based on the carer's own circumstances rather than the person they are caring for?
Mrs McGuire: I am not quite sure if I catch the drift of your question. A person who is a carer by definition is caring for someone.
Q186 Greg Mulholland: But the entitlement is based on whether the person they are caring for receives ---
Mrs McGuire: Twenty hours care.
Q187 Greg Mulholland: --- Attendance Allowance or the higher or middle rates of the Disability Living Allowance. Obviously if the person they are caring for is not, and yet they are still caring 20 hours or more a week they will not qualify, so people are going to miss out.
Mrs McGuire: If they are delivering care 20 hours a week, and I am prepared to come back to you, Chairman, if I have not quite got this correct, if they are being certified as caring for 20 hours a week the person they are caring for does not necessarily need to have Disability Living Allowance or Attendance Allowance because the benchmark there is 35 hours a week.
Q188 Greg Mulholland: That is not what the current plans are. My second question ---
Mrs McGuire: If I have made an error there I will certainly clarify that, Chairman.
Q189 Greg Mulholland: My second question is related to that, which is following the announcement by the Pensions Minister about the Government's commitment to a certification scheme, does that actually mean that we are seriously working towards perhaps all certified carers receiving entitlements to the new Carer's Credit because clearly that would stop these people missing out?
Mrs McGuire: There are obviously still ongoing discussions between ourselves and organisations. We are looking at hopefully laying the regulations on the 20 hours later on this year. Carers UK have flagged up some issues there and we would want to pursue that with them. Our intention is to maximise the coverage in terms of individual carers accumulating the credits for their pension, and that will benefit women disproportionately because they provide a significant amount of care, although increasingly men are providing care. We are obviously looking at laying those regulations later on in the year.
Q190 Greg Mulholland: You agree that it would be sensible, so that these people do not miss out, to have a system where all certified carers would be entitled to this extra financial help?
Mrs McGuire: We are looking at maximising the coverage to ensure that people build up a pension in their own right. Obviously if there are issues that have been raised with us, we will look at that.
Q191 Greg Mulholland: I think I will take that as a yes. Moving on to the Personal Account, which is another important part of this, you will be aware that there are a lot of concerns that these, whilst clearly a good idea, are not flexible enough in the case of carers, particularly with interrupted working patterns. The other concern raised by Carers UK is that often people will have saved something before having to go into caring, but at the moment there are real concerns that will not assist those who have only got a small level of savings. What plans have you in terms of ensuring that the Pay and Save, which the Government has said it is committed to, will apply to carers so that the Personal Account can help carers in this situation avoiding financial hardship?
Mrs McGuire: We actually think that Personal Accounts will benefit savers because of their portability. Most carers move in and out of a job at different points in their lives and we do think the portability element of Personal Accounts will help that. There are other ways in which people can save for their future retirement but, as I say, we think that Personal Accounts are a significant improvement in the coverage that carers will have in terms of provision for their retirement because of the portability. These are issues that Carers UK, who we meet with on a regular basis, will continue to raise with us. At the moment, we think that Personal Accounts certainly will benefit carers.
Q192 Greg Mulholland: Okay. Final question: clearly the new Carer's Credit is a big, positive step forward but you will be aware that, as is often the case when change of this nature is made, there are people who are saying, "What about us when we will not qualify", people in this case who are already at that stage or will be at state pension age, there is a sense that they are going to miss out. Again, Tom has already touched on the situation for existing pensioner former carers, have you any good news for them at all or are they going to be the people who miss out from 2010?
Mrs McGuire: This is a question that can be raised whenever you make a change, whenever you have an age threshold, somebody may feel that they are on the wrong side of the decision. What I would say to you is that we have made significant improvements in the way in which we support older carers. Indeed, up to 2002 if you were over 65 you were not even entitled to the underlying entitlement for Carer's Allowance. We stopped that and we built the additional support into Pension Credit which currently pays just over £27 in addition to pensions if there is a Pension Credit in place. I do not want to go through some of the other things that this Government has done for older people, but when you look at things like the Minimum Income Guarantee, et cetera, we have tried to focus a significant amount of our resources on older people and also factor into that any additional support that we can give them for their caring responsibilities, and that is why that additional caring element is built into Pension Credit. Previously, prior to 2002 that just was not there, it was a state pension and no recognition at all that there were any caring responsibilities within that individual's life.
Q193 Greg Mulholland: So perhaps some of the ideas that we mentioned about the premium could be ones that could be looked at?
Mrs McGuire: I am here to listen and to learn, Chairman, as well as to hopefully defend a strategy.
Q194 Mrs Humble: Can I move on to discuss the wider issues that you mentioned earlier, Ivan, on support services because we cannot just look at benefits, and indeed employment opportunities for carers, without looking at the support systems that should be there for the ones they are caring for. We have had evidence from people saying that as carers they would like to go into work but they cannot because there is not sufficient social care support available for the person they are looking after. How do you see your role in that, Ivan, from the Department of Health's point of view?
Mr Lewis: I was enjoying listening to Anne and learning from her most of the time! It is absolutely crucial, is it not, that the whole quality of life for the carer and the family unit is often tied up with, first of all, the Chairman's opening question about access to decent information, advice and, where appropriate, advocacy, and the quality, the flexibility and the responsiveness of the support, and that is very variable as you know, Joan, in terms of your championing of social care over many years. We have a number of issues that we are trying to address. We have got the Transformation Programme, three years, and we have got the longer term fundamental Review of Care and Support. In terms of the short-term, the elements of that which are important and will make a difference are a shift to prevention and early intervention from a system that increasingly has only intervened when people become very dependent and very frail. We have already touched on universal information and advice. Personal budgets for the vast majority of adults, so rather than just piloting individual budgets a shift towards that becoming the mainstream where you have a much greater level of control and choice over where you get your support or, indeed, identifying what your support needs actually are. We should not forget this is a big part of Putting People First as well, carers being treated as expert care partners. We also want, of course, a much closer relationship between social care and the National Health Service and, where appropriate, the voluntary sector in every local community. To some extent, that is reflected in the Putting People First Transformation Agenda, but equally it is important that it is reflected in Lord Darzi's Next Stage Report into the future of the National Health Service which is due relatively soon. All of that coming together, if we think about it, should make a big difference. There is the review of eligibility criteria that I have asked CSCI to undertake where we have this situation of, if you like, the content of national banding which is then applied locally, and we all know the inconsistencies both within local authorities for access to services and between local authorities, which frequently do not make any sense. We know about the cliff edges of £21,000 or more, "Sorry, here's a list of agencies, there is nothing we can do to help you". Equally, there is the example I gave earlier where if you go along to the Social Services Department and say, "My mum is no longer going out, she doesn't seem to be getting any visitors. She's becoming lonely and isolated, I am really worried about her", and the local authority person will say, "Sorry, that's low level need, there's nothing we can do to help you". Local authorities will tell you that this is all about resources and I think this is complete nonsense. Whilst we do need to recognise the demographic pressures that we are all facing require us to step up to the mark in terms of our ageing society, the fact that disabled people now have full lives and want to live independently, the fact that people's aspirations in terms of their care and support are very different from only five, ten, 20 years ago, the reality is that first of all we are not making best use of resources because of the silos between the different agencies that are all functioning in the system. Equally, we have somehow lost the notion that this is not just about highly intensive professional interventions. Part of supporting people to have a decent quality of life is community support, it is social networks, volunteers, befriending, the voluntary sector itself. Social care has become this highly intensive service that is focused on a very small number of people. I believe that is an unintended consequence, to some extent, of the community care legislation of the early 1990s where essentially we assess, assess, assess again, if you are lucky, and then having assessed people we do not do very much for them. I am one of these people, having worked in social care for quite a long time before I came into this place, who believes that there has been a whole series of unintended consequences that have led to a system that is not flexible, it is not personalised, it is not responding to individual needs. We also know that too often individuals find organisations functioning in silos, families and households are treated in silos with children's services, adult services, rather than looking at people in a holistic way. We also know that, of course, the whole victory for the carers' movement was the notion that they have distinct needs which are separate from those of the person they are caring for and carers are entitled to assessment in terms of their distinct needs as well as an assessment of the person they are caring for and the consequences of that. I think it is fair to say with the fundamental Transformation Programme of social care over the next three years, with the review of eligibility criteria, with the big debate we are now having at last in the country about what kind of care and support system that we expect we have a right to have and are prepared to fund, and a growing understanding that we do have to have a much greater level of integration between health, local government, the voluntary sector, some of the responsibilities that Anne has in terms of benefits and employment advice and housing, if we can get towards a notion of the system coming together to focus on the needs of the individual or the family rather than expecting individuals and families to fit into this complex myriad of organisations and bureaucracies, and I personally think that personal budgets are arguably one of the most powerful ways to break down those silos by bringing together different funding streams into one place and giving the people themselves maximum control and power, we now have a reform agenda that is very compelling. The proof of the pudding, to use a good northern expression which probably unites Yorkshire people and Lancashire people, is in the eating and it will be whether carers and people who use services at the end of three, four years, and hopefully beginning over the next year, start to see and experience a very different response from the system than they have experienced in recent times.
Q195 Mrs Humble: I am going to make a comment and not ask you to say anything because then I have got another question. First of all, we have had a lot of evidence that carers are not being assessed in the way that they should be assessed, so a clear message has to go out to local authorities to make sure that carers do receive their assessment. Secondly, whilst I support the new and innovative way of delivering social care, and applaud the use of community resources, volunteers and sitting services as well as professional staff, one of the problems that carers have told us about that system is that it can be unreliable because in the old days the individual went to a daycentre for five days a week and at least the carer knew they were in the daycentre for five days a week and then they could build their lives around that, but they cannot do that now. With flexibility can come unreliability, so we need to make sure a new flexible, innovative system recognising the needs of the cared-for and giving them a better quality of life is also sufficiently reliable for the carer to be able to trust it because, again, parents who have children with a disability find they can go into work because the child is in school for certain set hours, but when the child is 16/18 all of a sudden they find that disabled child is at home and they do not have the guaranteed social care support. We do need to look at that. I was interested in what you said, Ivan, about the roll-out of personalised budgets. Do you have a timescale for that?
Mr Lewis: I do. If I can also touch on the point you have made, because I think it is really important.
Q196 Mrs Humble: I knew you would not let me get away with saying something without commenting.
Mr Lewis: Over many years I have let you comment without ever responding! There are two other things that are happening this year that are really important. The people you are referring to are the people who will be affected by these developments. One is the refresh of Valuing People, which is about people with learning disabilities, and also the fact that very soon we are going to be launching the first ever national Dementia Strategy because for people caring for people with dementia there are real concerns about the quality of the respite, the day care, because if you not happy with the quality you are not going to use it, so it is not going to be much use to you. Also, in terms of people with learning disabilities, the move away from traditional daycentres is fine providing people put in place proper replacements. One of the areas where we have not made anywhere near enough progress, and it is back to joining up, is on employment opportunities for people with learning disabilities which Anne and I are working very, very closely on now. You said the feedback from people is that it is not working, but the reason it is not working is because we have not even started creating this new system, in my view. We have got a whole series of unintended consequences which has led to a "no help here" culture and a social care system which for too many people is not good enough, absolutely not good enough. I believe that the reform programme we have put in place now has the potential, if it is implemented properly, to make a massive difference alongside Valuing People, the Dementia Strategy and the reforms to the NHS. On the question of personal budgets, Putting People First is clear that by the end of three years in local authority areas throughout England we expect the vast majority of adults in terms of those eligible for public funding to be in receipt of personal budgets. There are two other issues we need to raise in this context. One is, what do we mean by it, and I want to be very clear about this. For some people it means direct payment, you get your own money, you employ your own staff and run your own operation. By the way, despite the cynicism, increasing numbers of people are making that choice when they are given the choice. However, that is not right for everybody, so there are two other ways you can use a personal budget. One is you get the money and pay a traditional care provider to provide you with a service, you shop around, you choose, you get help to do that but you make the choice about where you want your care and support to come from. The third is that you say, "I want maximum ability to articulate my own needs. I want maximum control but I want you to settle the bills because I do not want the hassle of the bureaucratic cost". The final thing I would say about all that is it is not just about choosing from the existing menu. The whole point of giving people personal budgets is to change the provider side. It is to change the menu, not to choose from traditional conventional services. If we are going to create a flexible system, it is not just about giving people power and control, it is also making sure that the provider side, the supply side, is completely different and people can use that money in an innovative and imaginative way. The other massive issue is our capacity, and I think we would be honest about this based on the evaluation we have received but also based on discussions that have been taking place with secretaries and others. Our ambition is that we maximise the number of funding streams over time that go into personal budgets. You need to look at an individual from a holistic point of view. Public agencies need to come together and decide with the person what their needs are, how much the State is willing to make available to have those needs met and put all of that money, irrespective of which department it begins its journey from, the stream of funding, into one budget focused around the needs of the individual. That is our ultimate ambition. We are still a long, long way away from achieving that at the moment. In the autumn we will publish the results of the evaluation. Between our two Departments there is already a commitment to begin to do some more accelerated work on how we can get some of these funding streams together. The Secretary of State for Health, the Prime Minister and Lord Darzi have all very encouragingly spoken about the potential to put health funding, where appropriate, into personal budgets, for example for people with long-term conditions, so put health funding alongside social care funding, which is another way of breaking down the Berlin Wall. I think this is at the cutting edge of public service reform, this is at the frontier of public service reform. I will be very honest, the reason why in Putting People First, with Anne's support, I went for the notion that by the end of three years we want the vast majority, if not everybody other than those admitted for emergency service, is because unless you are radical on this agenda and unless you are radical in government what happens is we will have five years of pilots, ten years of reflection and then another five years of implementation and delivery. It is a very deliberate radical programme of change. Of course, the Department of Health's job now, having set that vision and having reached that agreement, and, by the way, it was a deal with local government, it was not imposed on usual top-down public service reform, we have now also agreed to work together on supporting delivery and implementation of that Putting People First agenda in every community. The Department's job now on this agenda, as far as I am concerned, is to provide the maximum possible help, support, spreading best practice, learning how you go about implementing this new system because, make no mistake about it, if you move to a system which is predicated far more on personal budgets and individuals, this is not tinkering at the edges, this is a massive system-wide reform. You will have to do everything differently. In terms of a public service reform agenda, you also have to win the hearts and minds of the people at the frontline. You have to win the hearts and minds of the staff, because it is a very different way you are asking them to work, but also you have to win the hearts and minds of people using the system and family members, so you remove the anxiety and insecurity about, "This will mean a lot more stress and anxiety because you are asking me to run my own business effectively" and make it clear there are lots of ways you can exercise power and control. I have met very few people in my life who, given a choice, do not want to have maximum control over their own destiny. The final point I want to make is the difference that professionals make and the State makes to the quality of people's lives is important, but the difference that carers and families make to people's quality of life is usually far more profound and more significant than any intervention from a statutory agency. We have frequently forgotten that when we have designed particularly a social care system, but you could look at public services across the board.
Q197 Chairman: Just on these personalised budgets, does that not almost demand that DLA comes into that pot in terms of money but we need to re-look at what DLA is actually about?
Mrs McGuire: DLA is almost the original individual budget because it is assessed on an individual's needs in terms of extra costs, et cetera, and disposal of that money is very much up to the individual. People use it in all sorts of different ways, as is the case with Attendance Allowance. Obviously in looking at social care reform there are some who would say you also need to look at these other additional cost benefits. It will be interesting to see what comes out of the current consultation which is being led by the Department of Health but in which the DWP are very closely involved.
Q198 Mrs Humble: It also links into the Disabled Facilities Grants because the DLA pays for social care needs and if those social care needs in the home have been met through adaptation ---
Mr Lewis: And transport.
Q199 Mrs Humble: Then you need to look at what ----
Mrs McGuire: I do not want to deviate too far from carers here but this links into another crucial strategy, which is our Life Chances report, which is a 20 year strategy identified in 2005 and some of the elements that Ivan has discussed on individual budgets are part of implementing that strategy as well. The move came from disabled people themselves. All of these elements, carers, disabled people, the rights of an individual disabled person to decide whether or not they want to go to an adult training centre or perhaps try a job ten hours a week, are all integrated and part of a bigger movement in terms of how we reform our public services, how we value disabled people and the contribution they make, how we value the contribution that carers make to our society and how we recognise amongst that disparate group those very specific individual needs. What we are trying to do in terms of our benefit system, our social care system, is to finesse an enormous operation to meet the needs of individuals and if we get it right there is a real trick in it.
Mr Lewis: I agree entirely with what Anne has said. What a lot of people have missed is the fundamental review, debate, leading to a Green Paper on care and support is not just about social care and this is really, really important. This is about bringing together the debate about social care and the independent living agenda and trying to come up with a system-wide solution which makes sense. The other point I would make is at the first consultation we had in Manchester on Monday a disabled rights activist said very simply this: "I would be more than happy to have my DLA put into a personal budget alongside other funding streams, but the deal is that we don't have this business where I'm told by professionals 'here's a very narrow way that money can be spent'." As far as I am concerned, that is the whole underpinning value of a personal budget, it must be maximum flexibility. Providing we protect public money appropriately against abuse and providing the use of that money is contributing towards people's health, wellbeing and independence then it is not for us to put all sorts of limits on how that money can be spent. I am quite optimistic that the disability rights movement, as long as they come with us on this journey, will not see personal budgets as a threat but as a really big opportunity, but of course they have a right to expect reassurance from us in terms of what that will mean for their ability to exercise maximum control.
Q200 Miss Begg: I come back to employment and training away from the benefits aspect of it. My first question is about the Employment and Support Allowance and the effect it will have on carers because obviously there are going to be carers who will be claiming the ESA. What are going to be the obligations on them in terms of meeting work-focused interviews, work-focused activity? Will parents take up that new opportunity if the alternate care is not in place? How do we ensure that Jobcentre Plus staff are aware of the individual needs of carers and be able to respond appropriately?
Mrs McGuire: First of all, anyone in receipt of Employment and Support Allowance who does not receive the additional support element will be the subject of the conditionality, if I can put it that way, about the work-focused interview. However, and John Penrose sat with us through many hours of debate ---
Q201 John Penrose: It was marvellous.
Mrs McGuire: An absolutely fantastic experience for us all. We were very clear then, and we have embedded it in regulations, that there will be a facility to defer the conditionality on work-focused interviews and carers, if my memory serves me right, was an issue that was raised during those discussions and it will be in regulation that Jobcentre Plus advisers will have the facility to recognise at a particular point in an individual's life that their caring responsibilities will make it impossible for them to become involved in work-focused activity in whatever manifestation that needs to be. You are also right to point out that we need to make sure that our Jobcentre Plus advisers are not only knowledgeable about the regulations but are sensitive to the individual needs.
Q202 Miss Begg: Can I ask how you are going to do that because it has certainly come up in our evidence that while if you go into Jobcentre Plus there might be personal advisers with experience of disability, personal advisers with experience of lone parents, there is no-one at the moment in individual offices who has experience of carers and the complexity of the caring needs. Will it be that there will be one or two people in each office who will deal with the carers as they come through the door, if you can identify them as carers, and that is part of the problem as well, carers do not always self-identify, or are you looking to train up all Jobcentre Plus staff as personal advisers having detailed knowledge of the needs of carers?
Mrs McGuire: I think it is fair criticism that perhaps carers were not seen as a particular priority for Jobcentre Plus. For those who were not on any kind of benefit they were not seen as having a qualifying benefit, et cetera, and all of those issues were around. We have recognised that gap in our provision. Certainly on more than one occasion the criticism that you have raised with me today has been raised with me directly that a carer would go into a Jobcentre and nobody would know how to deal with them. We are looking very seriously at how we do that. Part of it will be about improving the training for our Jobcentre Plus advisers and we are also committed to putting a carer expert into every Jobcentre Plus district in the same way as we have already a childcare expert in every Jobcentre Plus district. We are looking at how we give carers better access to information and how we also encourage employers to look at whether or not their job vacancies would be amenable to some sort of flexibility in terms of caring responsibilities. Our Jobcentre Plus advisers and those who liaise directly with employers are looking at flagging that up to employers that they might want to look at whether or not the person they are looking for to fill a vacancy could be a carer whose hours might need to be manipulated or adjusted to fit in with their caring responsibilities. There is a greater awareness that we have to get our act right in terms of supporting carers.
Q203 Miss Begg: On that one, will your advisers be advising carers on the right to workplace flexible working? I know from speaking to a group called, I think, Parents for the Second Time, grandparents looking after their grandchildren, very often because parents are drug addicts, they seem to be, working in my own constituency. The chap I was talking to had no knowledge that he had the right to request flexible working, in this case caring for a child but, indeed, caring for someone. Now some of that information will be for people who are presently in work because obviously people going into work have to wait six months until they request that. How can carers access that knowledge because it is certainly not out there in the general community and I do not think it is even out there in the caring community that they have that right? Interestingly, when we went to Australia, that was one thing we were doing better than they were in Australia, they were looking at what we had with some envy. We have got it but nobody knows about it.
Mrs McGuire: Yes, and BERR and the Government's Equality Office have taken that element of criticism on board and are looking at how they mount a significant publicity campaign highlighting the issue of flexible working and details of that roll-out are being finalised. I expect it to move into full play around about the autumn of this year. Information is crucial for carers to make the decisions that they want to do, information in terms of how they manage their caring responsibilities and work and the fact that many carers do that and we need to build on that experience, and how, as you quite rightly indicated, if you are in work and have caring responsibilities, some of which might come up pretty quickly, then you have the right to request that flexibility. Indeed, many employers do recognise the importance of holding on to good employees by allowing flexibility and I think in the strategy we have highlighted a couple of employers, one a large and the other a fairly small employer, who have built in flexibility because they recognise the value of holding on to a good worker, and it is more cost-effective. What we need to do, Chairman, is make sure that our Jobcentre Plus advisers and operation is more sensitive to the needs of carers than perhaps they have been in the past.
Q204 Miss Begg: I think I have just nicked John Penrose's question so I will move on.
Mrs McGuire: It is a bit like the Two Ronnies where I have answered a question before it has been asked, is that right? My apologies.
Q205 Miss Begg: Can I get back to the Jobcentre Plus staff and the recognition that the person in front of them is actually a carer. We are hearing that with GPs a person comes in, the GP deals with their health problems but never asks the question, "Are you caring for someone else?" Are you going to have that kind of question somewhere earlier on in every interview - and I mean every interview - the Jobcentre Plus staff do? They will ask about childcare but they will not necessarily ask the question, "Have you got other carer responsibilities?" and obviously the advice they give will be dependent on that knowledge.
Mrs McGuire: This is where I indicated in my earlier answer that it is about improving the training for our Jobcentre Plus advisers to allow them to ask those trigger questions which will encourage them to develop an individual package of support for a person who has carer responsibilities in the same way as it is almost taken for granted now that you would do for somebody who has childcare responsibilities. Also to look at the options there might be in the wider community with voluntary organisations, local authorities, PCTs, which might be brought in to support that individual carer as they move into employment. I think that is particularly why I am really excited by the fact that we are putting our carer expert in every Jobcentre Plus building on the very, very positive effect that the childcare expert in Jobcentre Plus has had in encouraging, for example, lone parents with childcare responsibilities back into employment.
Q206 Miss Begg: The review pledges up to £38 million to support carers to better combine paid employment with their caring role. Is that a new spending commitment, is it new money, and, even if it is not new money - if it is new money or not new money - what is that money going to be spent on?
Mrs McGuire: It is new money for carers. It is a designated pot for carers up to £38 million.
Q207 Miss Begg: May I ask the devolution question, will the Barnett consequential go to ---
Mrs McGuire: No, no, it is new money for carers from within our current existing resources. There is a Barnett consequential, it is not new money being brought in to DWP, it is over our spending review period and we have effectively said that of our current budget we will spend up to £38 million supporting carers. Hopefully in my earlier answers I have given some indication of where we are going to spend that money in terms of training, et cetera. The other point, and I know that in your earlier questions you talked about access to training, is to provide replacement care for carers who want to access training. That is a new and quite exciting development because perhaps we have always looked at it in terms of children but if you are an adult carer who wants to get back into some sort of employment, your skills are needing upgrading et cetera, how do you fit that in with your caring responsibilities? Well, we are prepared to work with you and, if necessary, provide that replacement care or access to the replacement care.
Q208 Miss Begg: Which leads me on neatly to my next question which reflects back to the earlier question I asked about access to education and training. There is quite a lot of evidence which suggests that the carers are disadvantaged in the way that education and training is delivered, it is very rigid and does not have the flexibility, even with the extra help, to relieve people's caring responsibility, it is still very difficult for them necessarily to get where they have to be to do what they have to do within the care. Are you working with the Department for Education and Skills to come up with a different delivery mechanism? Is that something you are looking at?
Mrs McGuire: We are looking at how we increase the flexibility of all these elements. The increasing use of e.learning I think will benefit many carers who perhaps do not necessarily want to go outside their own environment, for whatever reason, or alternatively can access e.learning at a time which suits them, perhaps later on in the evening or early in the morning, in some ways building in a slightly different way from some of the early pioneering work and, indeed, the current work of the Open University where people could control when they did their learning. I am not saying go to television programmes at four o'clock in the morning which, if I remember correctly, used to be the Open University before video recorders, but looking at that flexibility that is why our partnership with the Department for Innovation, Universities and Skills is crucial to that support, not just for carers but for other people who will find a more flexible approach to learning is far more appropriate for their circumstances.
Q209 Miss Begg: Going back to the benefit, Carer's Allowance is not recognised, if someone is on Carer's Allowance they do not necessarily get financial assistance, if they are on Income Support they would, and I do not know if you are able to look at that, that is obviously acting as a barrier to people who are on Carer's Allowance rather than on Income Support, they cannot take up the education which may be there because they cannot get the finances because there is no help.
Mrs McGuire: I think that links back to my earlier comment to your question on the 20 hours rule as well. We need to look at how we dismantle some of the barriers. If we want to encourage people into training and education, to build up skills, to move into the employment market, then we need to look at how some of those elements of our rules perhaps disadvantage people in that respect.
Q210 John Penrose: I want to ask you some questions about how you get people to work, I want to talk about how we keep them in work or, alternatively, how we allow them to stay in work if they acquire caring responsibilities and they already have employment. You have already touched on flexible working so perhaps we can finish that topic off first. Quite a lot of the evidence we are getting is showing that there is quite widespread ignorance about the right to request flexible working. What do you think needs to be done, firstly, to make sure that everybody knows they have got this right, and when to exercise it and how to exercise it?
Mrs McGuire: I think we need to review the effects of our communication on all of these issues about people's right to demand, in this case, flexible working. That is why I think it is important that BERR, along with the Government's Equality Unit, are looking at how they get that message out. Obviously we can do a certain amount of that through Jobcentre Plus but essentially most of our interaction will be with people who are not in employment. There will be an element, obviously, of people who are looking to change employment and looking at our 650,000 vacancies which are on our IT system. What we have to get is a message across to individuals but also to employers as well. Certainly I have found over the last three years that the engagement with employers on employing disabled people is beginning to gather momentum and there is beginning to be a greater understanding that if you want the best person for the job you need to look at the widest possible pool of talent. If you want to keep a good person in a job, who potentially for a short period of time may have caring responsibilities, it is not just about their right to request flexible working, it is about saying to the employer, "Actually there is a good business case for you to encourage flexible working in those circumstances".
Q211 John Penrose: I am absolutely with you, but that has proven a very slow and difficult road in many other areas, disability rights you just mentioned, and clearly this is a difficult argument to get to be perceived by employers and employees alike, particularly some groups of employees, an awful lot of carers do not realise they are carers to start off with anyway.
Mrs McGuire: That is right.
Q212 John Penrose: I take the principle you are enunciating and I am sure I would agree with it, but what specific actions are you able to take to drive the message home because more words from here are fine ---
Mrs McGuire: Fine words butter no parsnips. It is not just about warm words. The specialist in this in terms of Government department is undoubtedly BERR and they are taking very seriously the review of our communications strategy linked, of course, into the Equalities Office who have a keen interest in this but that strategy - the details are not finalised yet - is about how we communicate and who communicates with whom. I think in many respects the best people to speak to employers are not Government departments but other employers.
Q213 John Penrose: When is that due to be published?
Mrs McGuire: Later on this year. I anticipate it to be around about the autumn.
Q214 John Penrose: Are you able to say whether or not it is going to include anything about the 26 week rule because there are an awful lot of problems with lack of flexible working that can happen in the first six months of employment or in the first six months of acquiring caring responsibility when you are already in a job. If you do not have the right to request flexible working at that point you could have lost your job by the end of six months.
Mrs McGuire: I am sure these are matters which BERR will take into consideration.
Q215 John Penrose: The cynics on my right say that means no then! We will look forward to the report being published in the autumn with great interest and I hope we will have a look at it when it is. Other points that we have made to us are potential solutions to this problem of retention in employment for carers. Some people have come up with the idea of Statutory Care Pay modelled on Statutory Sick Pay. In the discussions we have had so far everyone is understanding the motivation behind the suggestion, there are quite a lot of criticisms of Statutory Sick Pay in that it keeps people away from the employment market for a very long time before they start to engage and clearly people will be worried about replicating those concerns, but there are some good principles behind it. Do you have a view on the Statutory Care Pay or some cousin of it which you think might be a potential solution?
Mrs McGuire: My own instant reaction to your comment would be that it would be incredibly expensive and perhaps it would create significant additional burdens for employers. I think actually that I would prefer us to focus on the issues such as flexibility in terms of the job market because, as I say, I think we have indicated in our strategy that where employers are willing to embrace flexibility for their employees in care positions, there is actually more benefit to both the employer and the employee.
Q216 John Penrose: That is a better solution in my view.
Mrs McGuire: I actually think it is a solution which is about individuals. When you get down to issues such as Statutory Care Pay you are beginning to impose an additional bureaucracy which may not deliver. I do not necessarily feel it will deliver, maybe Ivan has a different view on this.
Mr Lewis: No.
Mrs McGuire: This may be the point where we might agree to disagree, I am not sure.
Mr Lewis: No, not in the slightest. I was going to say that I think the Dame Carol Black Report, which was done recently on the relationship between health and wellbeing and the workplace which was for both our Departments, offers us a real opportunity as well because that is about early intervention. It is about recognising that there are so many organisations I guess in the public and private sector who do not perform anywhere near as well as they could because they do not care enough or realise enough that the health and wellbeing of each individual employee makes a massive difference to the success of their organisation as well as the fact that that can lead to individuals, as you say, becoming trapped on benefit on a long-term basis and leaving the labour market. I think the Dame Carol Black review provides us with a real opportunity to look at carers in the workplace in a preventative and early intervention way. So, as well as the campaign we are committed to in terms of employers raising awareness in terms of the virtues of employing carers, the benefits of offering your employees flexible working, not in a grudging way but in a positive way, we are committed to a campaign because of what you said, John, about a lack of awareness of individuals themselves, alongside those two things if you can also recognise and bring together the health and wellbeing, mental and physical agenda, with the workplace, with the world at work, I think that is going to be a long-term basis solution.
Q217 John Penrose: The final question is on another set of ideas we had suggested to us and I would be interested in getting your reactions which is the notion of care vouchers. It has been pitched to us that they are a top-up rather than a replacement, so I was intrigued to listen to Ivan's comments earlier on about personalised budgets because care vouchers as they have been proposed to us would not replace existing State delivered, in the broadest sense, home care funding but they would top it up as well in a more flexible way. What are your views on either the proposal as it is currently being pushed around but also whether or not some cousin of it, again, would be an acceptable alternative?
Mrs McGuire: I am just worried about all these cousins that are being introduced all over the place! Obviously the issue of care vouchers has been raised in various discussions. I am not particularly persuaded that they would best meet the needs of carers. For some carers obviously they would be very attractive. I think for other carers there would be a significant benefit to them in managing their care support. Interestingly, I do not think any of the proponents of it yet have costed exactly what it would be. I would suggest that it would be very expensive for the return that carers would get from it.
Mr Lewis: I agree with that. My only observation is in a sense if you consider the personal budget model and the potential, there becomes no need for vouchers essentially.
Q218 John Penrose: Because you would be moving the entire system on to something closer to a voucher system?
Mr Lewis: Absolutely. The problem with the personal budget agenda is it is at quite an early stage and also there are a lot of misunderstandings about what we mean by it, I think. It is essentially about allowing a person to express and articulate in their own way, not confined by a tick box exercise, what their needs are. The person planning with, where appropriate, professional members how those needs are going to be met, identifying the amount of money that person is entitled to receive from the State in various forms, and then allowing the person maximum control with differential levels of assistance depending on people's capacity, depending on their motivation to organise, to choose, to control that care and support is very, very exciting.
Q219 John Penrose: It sounds like the care voucher people would probably declare victory and retire because it would move the entire system closer to what they wanted in the first place.
Mr Lewis: That is what I really believe. There are a lot of barriers, there are a lot of treaty issues and the evaluation evidence will show that we have had a lot of success with this, that people do talk about a much more satisfactory service but arguably also not necessarily a lot more expensive because if people have more control they actually spend money wisely. If you give people the benefit of the doubt there will always be a small number of people who do not but the vast majority of people do. The difficult issues, frankly, are bringing it together, getting all Government departments to understand what this is, to sign up to it, buy into it and to recognise this needs to be a Government plc policy, not just the Department of Health and the Department of Work and Pensions' policy because it is about completely reorganising the relationship between the State and the citizen. It is a massive redistribution of power, frankly, from the State to the citizen without leaving the citizen alone. This is really important. The State still needs to be there on people's side helping people to exercise this control but it is an entirely different relationship. If I may be allowed to say one other thing on personal budgets. I also think this Committee struggles and grapples with the number of families in every community who are described as dysfunctional, who are described as challenging. My view is that the personal budget is a massive solution towards tackling those number of families. My view is they should be ruthless in identifying who those families are. We should designate a responsible and accountable professional to be responsible for those families. We should give that lead professional a budget which can be spent linked to a rights and responsibility contract with every single one of those families on a sustainable basis. That accountable responsible professional given a delegated budget, not these other numerous different public sector organisations trying to fish around and help or change the lives of these same families. For me over time that would probably be the most effective way of trying to break down into generational deprivation. I am going way beyond my brief in raising this issue but I think probably personal budgets in the hands of lead professionals, right and responsibility contracts, ruthlessly identifying which families we are talking about would be a major way of tackling child poverty and breaking into generational deprivation, stopping kids drifting into the criminal justice system, supporting good parenting. It has the potential to transform. It is a very different model of personal budget than the one we are talking about here.
Mrs McGuire: Just on the care vouchers principle, what I do not want to lose, although the focus of attention has been on carers, is the significant contribution that is already made to the care receiver. In some ways you could argue that Disability Living Allowance and Attendance Allowance are similar to a care voucher system. They already put significant financial resources into the hands of the individuals, around about £8.8 billion, and if you add to that some of the other services that are in place to the care receiver you are talking about another £12-13 billion. In terms of the voucher system, on one side there is currently a significant investment in terms of meeting care needs to the tune of some £20 billion plus per year in the system. As I say, I know it is a campaign issue. Although my colleague has said that he has gone way beyond his remit, I actually think that some of the issues he has raised link very much to some of the core issues around caring responsibilities that carers have. The important impact that caring can have in the wider community is very relevant and if he has gone beyond his remit then so have I.
Q220 Miss Begg: I realise time is getting on but just some questions on equality and discrimination. I suppose the main one is that I think there is a going to be an announcement about the Single Equality Act next week. Should it be extended to include carers?
Mrs McGuire: Chairman, colleagues, I have always found it best in these circumstances when a piece of legislation is about to be announced to suggest that we all wait for the official announcement of the legislation. I do not mean to be difficult in this but I am sure, Anne, you would not expect me to further comment. We have obviously had a consultation on our equalities legislation and the determination of that will come in the very near future.
Q221 Miss Begg: That will obviously determine the next question. When do you expect a decision in the Coleman case because that obviously would become irrelevant if carers are to be covered by the discrimination legislation.
Mrs McGuire: Obviously the Coleman case is of interest to us and I am sure colleagues have followed its progress. At the moment it would be purely speculative for me to say whether it will or will not happen because we have not had the final judgment yet.
Q222 Miss Begg: Have you any idea when that judgment is due?
Mrs McGuire: It depends which day of the week it is, to be honest. It could be any time from now through to whenever. We have to wait. Obviously depending on the judgment we may have to consider what action we have to take but, at the moment, although there is obviously an Advocate General's opinion, that is not the judgment of the ECJ.
Q223 Miss Begg: Hopefully one you might be able to answer then is should there be extra public sector equality duties with regard to carers? I understand that Section 75 of the Northern Ireland Act 1998 already does that, there is a precedent there. Is that something the Government is looking into? How can you ensure that the rights of carers in relation to employment, training, education and leisure are fully implemented?
Mrs McGuire: The results of the consultation are due out in the very near future. Part of the consultation did encourage people to comment on our approach to carers and I fear we are just going to have to await the results of the consultation. I am sorry to appear difficult at this end of the discussion but I do not think it would be for me at this moment to prejudge what is going to come out in the consultation response by the Government.
Q224 Miss Begg: I cannot work out from your face whether there is a potential smile there or a frown!
Mrs McGuire: Anne, you have known me long enough to know you will never be able to work out anything from my face.
Miss Begg: I will hope there is good news next week.
Q225 Chairman: Just in closing, this session has been absolutely fascinating and the passion and commitment that you two as witnesses have shown has come across, but for me the key thing is we have four million carers in work most of whom have had good experiences but there are some bad experiences. I think the half million who are on Carer's Allowance are probably the reverse, for most of them it is not a good experience and for some it is. It is how we move this agenda forward recognising that these are actually people who are involved. What we have talked about today are an awful lot of technicalities but if we can move those technicalities into actually being with people then maybe everybody gets a better deal. Thank you very much. Your commitment is obvious. We are really grateful for today.
Mrs McGuire: Thank you very much.