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I also pay tribute to the organisations that support carers, particularly Carers UK, the Princess Royal Trust for Carers, the countless local support groups and the online carers’ chat rooms and information sources, which
are increasingly important for mutual support—a point made by the hon. Member for Houghton and Washington, East (Mr. Kemp) a moment ago. I pay tribute also to all those involved in organising carers week. That is now in its 14th year, which is testament to its effectiveness in highlighting carers’ concerns and needs.
According to Carers UK, there are about 6 million carers in the UK and more than three in five people will become carers at some time in our lives. I was interested that the Minister said yesterday in the departmental press release that there were only 5 million carers, as opposed to the 6 million identified in the 2001 census. Have the Government done a recalculation? If so, will the Minister put into the Library evidence of how many carers there are? Perhaps he will catch your eye later, Mr. Deputy Speaker, to cover that point.
Too often, carers bear the brunt of inadequate provision of care and support. They are among those who are suffering the most because there has been prevarication on reform, not least on the part of the Government. Help the Aged and others have called for carers to be supported as an integral part of the care and support system. I am sure that other hon. Members will speak in more detail about the Select Committee report. It is one of the indicative issues of this debate that a Department of Health Minister and his shadow should be leading the discussion on a Department for Work and Pensions report—a report that certainly has ramifications for the Department for Communities and Local Government, Her Majesty’s Revenue and Customs and the Cabinet Office, among other Departments. It is important to note that the health and well-being of carers rightly dominate the concerns and focus of carers and those for whom they care.
The report can be condensed into two main areas. The first is soft support for carers—inclusion in Government policy across the board, information services and so on. The second is discussion of carers’ wages and benefits and the issues faced by carers who are in employment. That raises pertinent questions of the Minister about where we are up to on the carers strategy. We want not a list of pledges, but a list of what has been done to date. One specific issue is whether primary care trusts are actually using the money provided for emergency-only respite care for the purpose for which it was intended. Will the Minister clarify that point, which relates to what the hon. Member for Sutton and Cheam (Mr. Burstow) said a moment ago?
The Government are very good at dragging their feet on such pledges. Yesterday, the Minister announced a hotline for carers in Islington. Carers had called for that and welcomed it, but it was first promised in the 1999 carers strategy, on almost the same day as I first entered the House following a by-election. The hotline was reannounced in the updated strategy and was supposed to have been in place early this year. The House will be aware that the Government have been similarly slow in setting up the national flu helpline—a key part of their pandemic flu plan. What confidence can anyone have in a Government who take 10 years to set up a phone line?
Last year, the Prime Minister and the previous Secretary of State for Health trailed a carers’ wage in the press before the publication of the strategy. Will the Minister confirm that that, in the end, was just more spin? It only ever referred to an extension of direct payments to spending on carers—and not even that has happened.
Obviously, the biggest step forward for carers will be reform in the long-term care system. The Government’s financial squeeze has led to rising eligibility criteria at the local level, and too often carers bridge the gap. So I ask the Minister again: in carers week, of all weeks, and before spring technically ends in a few days’ time on 21 June, where is the Green Paper that the Government have categorically promised and guaranteed?
For 11 years, the Government have ignored a particular issue. Tony Blair told the 1997 Labour party conference that he did not want his children to grow up in a country where people had to sell their houses to fund their long-term care. Since then, we have had the Wanless report from the King’s Fund, in 2006. We also had a “zero-based review”, announced by the right hon. Member for Birmingham, Hodge Hill (Mr. Byrne) in response to the Wanless report in 2006, but there is no evidence of any serious work having been done on it.
The hon. Member for Bury, South (Mr. Lewis) said in the House that he thought that the comprehensive spending review 2008 would deliver a solution. The CSR announced a Green Paper, to be preceded by a consultation on the future of care and support. A Green Paper is, by definition, a consultation too. That Green Paper was due in early 2009, March 2009, spring 2009, and June 2009. Can the Minister confirm that the timetable in the departmental plan is now—surprise, surprise—summer 2009: that is, by September?
Next week, we will be taking the Health Bill through its Committee stage. I was pleased that Lord Darzi, under pressure from his peers, amended the Bill to add carers as a group who must be consulted on the NHS constitution. I was astounded by that omission and the neglect on the part of the Government. The Bill currently defines carers as
“persons who, as relatives or friends, care for other persons to whom NHS services are being provided”.
That seems a somewhat draconian contraction by the Government of the definition of a carer already inscribed in the Health and Social Care Act 2008, which has the broader definition of
“people who care for service users as relatives or friends”,
with no other qualification. Why are the Government seeking to reduce the statistics on carers?
Jeremy Wright (Rugby and Kenilworth) (Con): In support of my hon. Friend’s case, does he think that part of the problem is the dissonance between what the Government say about the importance of carers and the fact that carers’ interests tend to slip so regularly off the Government’s priority agenda?
Mr. O’Brien: I am grateful to my hon. Friend, who chairs, admirably and with great credit from both sides of the House, the all-party group on dementia, which has a major read-across to all the concerns of carers. He is right. It is no good to lay out so many expectations across the board, particularly for people in hard-working and sensitive areas such as caring, only for them to be dashed when the rhetoric does not convert into action. One of the greatest challenges that we face as politicians is to hold the Government to account on the expectations that they have raised.
I want briefly to touch on the subject of young carers. It was, to say the least, slightly concerning that although
the Health Committee discussed young carers in its report, the Government’s written response completely omitted to mention them. The Minister must have realised the Government’s embarrassment about that, because he briefly alluded to young carers in his opening remarks. I hope that that embarrassment will now be covered by the Government making a specific acknowledgement that they need to address the issue of young carers in a written document whereby they can be held to account. They may therefore need to issue an addendum to their response.
The 2001 census found that there were approximately 175,000 young carers in the UK, although that figure is believed to be higher by those who work in the field and see things for themselves. The average age of young carers is an absolutely shocking 12 years old. One in three regularly misses school, and one in four has no external support whatever. That has led to tragedies such as that of Deanne Asamoah. When will the Government take action? Following the Minister’s acknowledgement that the needs of young carers must be addressed, given their absence from the Government’s response, we need to move from words to a good set of actions that can be implemented and will support young carers.
It is right for the House to be debating issues facing carers. They are, as those involved in carers week have put it, a “secret service”, so it is right that this House should do all it can to bring them out of the shadows, and that the Government should do all they can to support them. Conservative Members thank carers for the sacrifices that they make in order to improve the lives of others and their loved ones, and recognise that helping carers is one of the best ways to help those they are caring for. Most importantly, we join third party organisations in calling on the Government to publish the Green Paper on care and support without any further delay. Only in the debate about reform can carers begin to hope for a system that does not let them down. If, as seems increasingly likely, the Government cannot get beyond the stasis of a divided and leaderless party, for the sake of carers and all those in our society who need help, the Minister should urge the Prime Minister to call a general election.
1.4 pm
Mr. Paul Burstow (Sutton and Cheam) (LD): I am grateful for the opportunity to contribute to the debate, Mr. Deputy Speaker, and I know that there are hon. Members in all parts of the House who are hoping to catch your eye. I come to the debate to represent several of my constituents who are carers or who work for caring organisations.
In responding to my earlier intervention, the Minister referred to the need for MPs to play a part in ensuring that the NHS spends the £150 million that has been allocated over the next two years wisely and well in order properly to meet the needs of carers. I can assure him that in my area not only am I well in touch with carers, but carers make sure that I am in touch with their concerns. We have a very effective carers’ centre run by the Princess Royal Trust for Carers, which has now been there for more than 20 years. It was opened in the 1980s, as probably one of the first of its kind to be
established, and it is highly regarded by all the carers who have been through its doors over all those years.
My reason for speaking is to convey to the Minister and Members in the House several comments that were made to me by carers at an event that I attended yesterday as part of carers week. I invited them to put their comments in writing. They particularly feature carers’ concerns about the inadequacy of the benefits regime that relates to the carer’s allowance and so on. There is a strong sense that this issue is well overdue for attention. It has been the subject of plenty of reports from Government, yet they are still not addressing it. Ken Fish, a carer in my constituency, asked:
“Why should Carer’s Allowance be stopped when the carer receives old age pension at 60 for women and 65 for men, when carers are entitled to Carer’s Allowance for caring for more than 35 hours per week and when the same carers have paid National Insurance Contributions or have had credits paid for them when they are continuing to care as both they and their cared for get older, frailer and less mobile?”
That is at the heart of many of the representations that I am sure will be received by hon. Members on both sides of the House. Margaret Burrows said:
“Older people that are carers need more help and support to continue in their caring role. No age restrictions for receiving Carer’s Allowance. I feel unappreciated by society for being a carer, in particular for those carers caring for someone with mental health problems.”
Another carer I met at the coffee morning, Pat Rogerson, said that she received a letter from the Department for Work and Pensions saying that she was entitled to the carer’s allowance, but when she read on a little further she found that the next paragraph said that she could not get the carer’s allowance because she was getting a pension. She asks why a letter like that is sent, and why she is not being paid the carer’s allowance. June Baine, Rhona Banford, Jill Winder and Christine Holmes also want that question answered.
Although the Minister was helpful in explaining the complexities of the current system, he did not go on to say either of two things: that the Government honestly do not believe that this is a financial priority and feel that it cannot be afforded at this time—that would be the straightforward thing for him to say—or that there is a timetable by which the level of the carer’s allowance will be raised and its eligibility extended, so that pensioners, who often shoulder some of the greatest burdens of carers, will get proper recognition in the payments that they receive.
Jeremy Wright: Does the hon. Gentleman agree that we cannot afford not to do something about this issue? If carers decided—I am sure that very few of them would wish to do so—that they could no longer shoulder such burdens, and the state was asked instead to do the work that they do unpaid, we would end up with a very much greater liability on the taxpayer.
Mr. Burstow:
It is estimated that our 6 million carers are worth £87 billion in the burden that they shift from our public services—both social care and the health service. Taking on that responsibility affects their physical and financial health in the long term. We know from the statistics that were published during last year’s national carers week that many carers find that by the time they have finished their caring role, their earnings potential
has been diminished and their savings have been run down, and they feel let down as a consequence.
It is good to have a national strategy that outlines many aspirations, which will be shared by everyone in this House and beyond it, but setting ambitions for 2018 makes them seem an awfully long time away. The message that I have heard from carers who are caring today is that they cannot wait for those ambitions to be realised by 2018, or for the carer’s allowance to be raised at some point in the future. Can the Minister therefore guarantee that the Government will shortly set out a timetable for the very necessary reform of the carer’s allowance?
I wonder also whether the Minister could say a little more about the time scale for the roll-out of the national strategy. It is not entirely clear what the milestones are and how carers on the ground can satisfy themselves about the strategy and hold people to account locally for delivering it. At the event that I attended yesterday, Lorraine Brown said that better services for carers of young people and for the cared-for, such as younger people with dementia, were particularly important. All too often, dementia services for people who become senile at an early age are inadequate. They are often put with older people suffering from dementia, in a setting entirely inappropriate for them. More needs to be done to cater for that group, and that is certainly a concern that Lorraine Brown has.
Jackie Ure wanted to make the point yesterday that carers have a sense of struggle and of navigating their way through a complex system. All too often there is no one there to guide them, hold their hand and support them until they turn up at the door of the carers centre in Sutton, where that support is provided. That situation is replicated up and down the country, with people waiting for an assessment, battling to get the right care plan implemented and then ensuring that the financial assessments do not financially cripple the individual concerned. All those matters make caring a burden that it should not be. It is a burden that people willingly take on, and we should not be making it worse through the systems that we construct around people.
I have not spoken at great length today, but I wanted to represent my constituents who willingly shoulder that burden for children, loved ones, husbands, wives and others. I hope that the Minister will be able to give us some reassurance about what will happen in respect of the carer’s allowance, and some sense that he understands that it is not good enough for him to say to MPs simply that we have to hold our local PCTs to account. He has a responsibility to ensure that PCTs put their money where their mouth is and deliver for carers.
1.11 pm
Mrs. Anne McGuire (Stirling) (Lab): Like other Members, I welcome this debate, particularly as it is happening during carers week. I wish to put on record my thanks to the Prime Minister, who met the all-party carers group a few weeks ago. As someone who this year has been designated the parliamentary champion for carers, I was delighted to join that meeting. The Prime Minister over the past two years, and his predecessor, have given carers great support and started to put carers issues higher up the political agenda. All political parties now recognise them as an important focus for social policy.
I was delighted to be invited by a consortium of 10 organisations to be this year’s parliamentary champion, and to host yesterday’s reception in the Commons. I am delighted that so many MPs attended that reception to hear for themselves, in an informal way, some of the issues that have an impact on carers’ lives. We should pay tribute to the many organisations up and down the country that have participated in this week’s events. As I understand it from the consortium that Carers UK pulled together, more than 1,000 partner organisations are celebrating the contribution that carers make to our society and taking the opportunity to highlight the issues and continue the pressure on Government, and indeed on all political parties, to ensure that we do not lose momentum in improving the lives of carers.
In my constituency the Princess Royal Trust for Carers held its own event yesterday, which was linked with its annual general meeting. I had hoped to attend, but obviously yesterday’s parliamentary business made that impossible. I pay particular tribute to the Stirling Princess Royal Trust for Carers for the work that it does, particularly in supporting young carers. Many of us recognise that all sorts of fairly young children take on responsibilities way above their age level, which they should not be asked to do. I do not want us to say to children, “Of course you can’t participate in the care of a parent or sibling,” but we must ensure that those children’s needs and rights are not neglected as they absorb caring responsibilities that they should not have to take on. The trust in Stirling certainly does a lot of good work in that area.
Over the past 10 years, as I said, carers’ issues have come up the political agenda, and we should pay tribute to this Government. In 1999, the first ever carers strategy was developed. Although it was 10 years ago, we should not lose sight of that. It was the first time that any Government had actually recognised that serious needs were being neglected. As the Minister said, the new strategy published last year built on that first strategy but recognised that times had moved on, and carers’ interests and issues are perhaps better articulated now than they were in 1999. Indeed, the pressure groups on carers issues have built on that first recognition in 1999.
I met representatives of the Swale carers group this morning, as did the Minister. I know that my hon. Friend the Member for Sittingbourne and Sheppey (Derek Wyatt) was very keen to encourage his local carers group to engage not just with the Minister but with me. One thing that came out of that discussion, and which is embedded in the new carers strategy, was the fact that carers need to be respected as expert care partners. Often they are marginalised by health professionals, not because the health professionals are bad people but because they do not see the carers who are with a sick or disabled person day in and day out. Somehow when it comes to big decisions that need to be made, they feel marginalised.
One woman told me this morning that when she moved from one PCT area to another, there was a different attitude to her involvement. In the first area she was very much part of the team, but when she moved house to another PCT area she found that she was totally excluded. Confidentiality clauses were somehow brought into the discussion, and she was not allowed to be a full participant.
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