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11 Jun 2009 : Column 965

Jeremy Wright: I am sure that the right hon. Lady was as encouraged as I was to hear the Minister talk earlier about the training of those professionals and helping them understand more about the role that carers play. I am sure that she hopes, as I do, that that training will involve an understanding of how to respect the experience and understanding that carers develop about the people they care for, so that what she has just described happens rather less often.

Mrs. McGuire: I thoroughly agree with the hon. Gentleman. I recognise, however, that there is sometimes tension between the right of carers to know things and the individual right of a sick or disabled person not to allow anybody else to know their private medical business. That is difficult to manage, and the group this morning recognised that those are fine distinctions. Somebody said to me that we need to get rid of the grey areas, but I say to the Minister that sometimes the grey areas actually help in managing that delicate balance of rights and responsibilities between carers and the individual sick or disabled person who is being cared for. We need to be careful that we do not over-structure such relationships, because we could end up in a slightly worse situation. However, I agree with what the hon. Gentleman said.

Mr. Stephen O'Brien: The hon. Lady was making an interesting point, just before she answered the intervention by my hon. Friend the Member for Rugby and Kenilworth (Jeremy Wright), about how both the cared-for and the carers are experts in the care required. Given that the Health Bill is about to go into Committee, and that some of the clauses that we will consider deal with direct payments—I rather hope that the hon. Lady will be asked to serve on that Committee—may I ask here whether any of her discussions this morning helped her to see that the extension of direct payments is one way in which those experts in their own care can have better control over the care that they receive? Did she think about how we might consider extending those direct payments?

Mrs. McGuire: In my previous role I helped pilot individual budgets, which build on the direct payments experience, so I am sure the hon. Gentleman will not be surprised to learn that I am keen that that sort of control should be implemented. We can call it a personalisation agenda, or independence, choice and control, but I know that the Government are also keen on it so that individuals can make decisions about their own lives. The hon. Gentleman may not have made the point explicitly, but his intervention implies that he believes that such a step means that people will be recognised as the real experts on managing their own lives, whether they are sick or disabled people, or carers.

I hope that we all recognise that the carers strategy reflects some of the issues that have been brought to the attention of many of us in the past week, and in recent years. They include the inappropriateness of young children being the principal carers in a family. I know from my conversations with the Minister that he is keen to ensure that that is tackled as soon as possible.

Another element that we should never forget is that carers should have a life of their own. It is sometimes easy to put people into little boxes; that ticks other little boxes further down the line. However, carers need the space and capacity to lead their own lives. That can mean working, which involves tricky balancing. I have
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some personal experience, with my sisters, of trying to balance care for my mother, who was dying, with our work commitments. Carers also need time to enjoy themselves and to do things that keep them connected to their own social networks, as opposed to always being part of somebody else’s network. We should not lose sight of that.

I hope that the Minister accepts that the importance of the strategy was reinforced by the publication of figures this week by Carers UK. They show that 86 per cent. of people in this country believe that carers make a valuable contribution to society; indeed, they are only just behind nurses and firefighters. That reflects very well on the way in which that organisation has pushed the issue up the agenda. The figures also show that the overwhelming majority of people believe that benefits are too low, and that 74 per cent. of carers have reached breaking point as a result of pressure—often the pressure of trying to work their way through bureaucracy. Somebody described that to me as like trying to swim through treacle. I shall not elaborate on that: it conjures up an image of what it must be like to try to tend to and support someone, yet find that there is no one-stop shop and no single route to getting help. I welcome the Minister’s comments about trying to make that route easier.

My question for the Minister is, given that the strategy was published last year, how much progress has been made and how is it monitored? Are the milestones, which were carefully laid out in the strategy and worked on with carers, being reached? How will any slippage be addressed?

As the hon. Member for Sutton and Cheam (Mr. Burstow) said, the big elephant in the room is benefits, and the carer’s allowance. As someone who wrestled with the problem for three and a half years as a Minister, I say to my colleague that it will not disappear. We should recognise the origin of carer’s allowance. Lord Morris, as Minister for disabled people at the time, introduced it as a £10 “thank you” to carers—that was how it was interpreted. Those were gentler, different times. However, carer’s allowance has never recovered from being that “thank you” payment in terms of the amount of money that is given. It has always been the lowest benefit and, frankly, it causes great confusion, as the hon. Member for Sutton and Cheam highlighted, and sometimes anger.

The problem of the so-called overlapping benefit rules was raised again this morning, and has been raised with me in my constituency.

Jeremy Wright: I am grateful to the right hon. Lady for giving way again. She said that carer’s allowance was regarded from its inception as some sort of expression of the gratitude of the nation to carers. Is not part of the problem the cliff edge that emerges at retirement for carers who reach retirement age and are no longer entitled to carer’s allowance? It is now regarded as an income replacement measure, so people who retire are not allowed to continue to receive carer’s allowance, and that causes difficulty in trying to replace it with something else, which carers may not be as confident about claiming. Does she have any reflections on that subject?

Mrs. McGuire: Carer’s allowance is an income replacement benefit, as is the state pension. We think of the state pension as being somehow different from a
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benefit, but technically that is what it is. Both are income replacement benefits, and that is where the difficulty arises with overlapping benefit. However, I hope that the hon. Gentleman gives the Government credit for trying to mitigate some of the cliff-edge effects of reaching state pension age. Before the Government were elected, carers fell off a benefit “cliff” when they reached state retirement age and carer’s benefit stopped immediately. The Government ensured that a carer’s premium was incorporated in pension credit, which means that the individual’s total income is not reduced.

However, that does not address the fundamental problem. How does one explain to parents who have looked after their disabled child from the hour the child was born, and received carer’s allowance through most of that child’s life, that when they reach 60 their caring responsibilities are no longer recognised? The Government have wrestled with the problem and I hope that, as part of the roll-out of our welfare programme, we can consider how to improve on the current situation. I hope that we can find a way round the overlapping rule. Perhaps it means designating carer’s allowance as something other than an income replacement benefit. However, we must all recognise that that comes with a significant cost, and there is no point in politicians who do not currently have to make those decisions calling for that to happen without examining the costs of delivering it. It does not come cheap, but I hope that the Government will continue to keep it under consideration.

We recognise that caring responsibilities will touch us all at some point in our lives, either as carers or as those receiving care. Yesterday at the reception, two carers, Janice Clark and Valerie Rossiter, gave their personal testimony. Both made powerful statements about their lives and how they had been affected by caring responsibilities. Valerie’s experiences were particularly moving. She explained her situation so graphically that it is difficult for me to interpret it for the House today. She has been married for 42 years, yet now her husband does not know who she is. He is in the advanced stages of Parkinson’s disease. She said, “This is the man I loved, and now he doesn’t know who I am.” That is the emotional toll that caring takes on an individual. She was philosophical about some of the battles that she had to fight. She said that although her husband is suffering, although she sometimes has to swim through the bureaucratic treacle, and although she will continue to look after him for the rest of his life, what keeps her going is wanting her experiences to be an example to ensure that other carers do not need to confront some of the difficulties that she has had to face.

I want to pay tribute to the Government’s response over the years to the problems that affect carers. However, we all recognise that the battle has not yet been won. We still need to continue building on the solid foundation that we have created. We still need to recognise that carers are the glue that keeps many families together, and by so doing keeps communities together. I hope that in his response the Minister will continue to pledge his support on the issues that affect the lives of 5 million or 6 million carers. In some ways, the numbers do not matter: we just know that a lot of people out there are taking responsibility, and that one day we too may have to accept that responsibility in our own families.

Several hon. Members rose

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Mr. Deputy Speaker: Order. I am now going to call the Liberal Democrat spokesman, but I should just explain that under the rules governing topical debates, he has six minutes, plus an added minute for any intervention that he chooses to take.

1.30 pm

Greg Mulholland (Leeds, North-West) (LD): Thank you, Mr. Deputy Speaker. I will certainly keep my comments within that time.

I welcome this hugely important debate, in this hugely important week. I echo the comments of other hon. Members in paying tribute to the amazing contribution to society that carers make up and down the country, in enabling loved ones to continue living their lives in a loving environment and with dignity, which we would all warmly support. I also pay tribute to Carers UK, which does a wonderful job as the voice for carers in ensuring that all of us and people throughout the country are aware of carers, their needs and the role that they play.

It is interesting that this year’s carers week, under the heading of “Carers: the UK’s secret service”, focused on the health of carers. It is also interesting that we are having a health debate about carers; I was speaking in a work and pensions debate on carers only a few weeks ago. The cross-departmental responsibilities involved create challenges, and we do not always get joined-up thinking. Some of the figures from the health perspective of caring are particularly interesting. Figures from a Carers UK survey show that more than half of all carers have suffered from a stress-related illness, that more than half have suffered from a physical illness as a result of caring and that 95 per cent. disguise illness because they want to continue with their caring responsibilities. Those are stark figures. It is therefore right that we should concentrate on the health aspects of caring, as well as on the financial implications.

I would like to ask the Minister some questions about the £150 million that has been earmarked for primary care trusts to spend on respite for carers. First, can he supply us with a breakdown of how much of that money has gone to each primary care trust? How has the Department made PCTs aware of their responsibilities and of what the money is intended for? Most importantly, however—this is what carers want to know—how many carers have benefited from that money? Bluntly, how many carers have received a break? The information that I have received from Carers UK suggests that possibly not many have, which I am afraid means that the money is not getting through. I would ask the Minister to consider that point carefully and give a response.

A year on from the launch of the carers strategy—an initiative that was welcomed—the Minister has to say how much has changed for carers. Clearly some initiatives are happening, including some that should already have been happening. However, he must accept that if one speaks to carers, as I know many hon. Members have, one will hear from them that very little has changed, and that is not enough. Crucially, the fundamentals have not changed. The fundamentals relate to how we regard carers in this country. The simple reality is that, through the historic development of the carer’s allowance, we have asked, “What benefits should we
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give carers?” However, we should turn that question on its head. We should instead ask, “How as a society can we adequately recognise carers and what they do, and recompense them for the contribution that they make to society?”

We have heard the figure of £87 billion that is saved for the national health service by the contribution of our 6 million carers. However, I wonder what the cost to the NHS would be of not properly supporting carers. The figures for how many carers are suffering from illnesses as a direct result of their caring responsibilities suggest that the cost would be huge. That is something that we must look into. Many carers are older people who care for loved ones, and we know that their numbers will increase simply because of demographics.

We have also heard about younger carers, who are covered in the report by the Select Committee on Work and Pensions, of which I am a member. As has been acknowledged, young people who are carers cannot do the things that other young people do, such as sport. Therefore, they cannot keep themselves as healthy as other young people if they are not given proper respite. There is also an impact on their earning potential, their chances of going to university and the other things that come under the work and pensions banner.

However, the crux of the matter, as several hon. Members have said, is that we simply do not have a system that adequately reflects the contribution made by carers. The level of the carer’s allowance remains a source of shame and embarrassment to this country. I echo the calls made by the right hon. Member for Stirling (Mrs. McGuire) and my hon. Friend the Member for Sutton and Cheam (Mr. Burstow)—we need a timetable. This Government are running out of time; they have a matter of months. Surely the Minister, who I know cares deeply about the issue, wants to bring forward a proper timetable for the reform of those benefits.

Mr. Burstow: My hon. Friend is rightly pressing the Minister to provide a timetable for the reform of the allowance, but does he agree that we also need a timetable for the publication of the Green Paper?

Greg Mulholland: Absolutely. I thank my hon. Friend for that intervention, which I should like to use to ask the Minister to indicate the extent to which carers’ needs will be considered in the Green Paper, because that is so crucial to the wider issue.

We must have a timetable, but I reiterate what I said in the debate a few weeks ago. We cannot accept the reform of benefits for carers under the umbrella of benefit simplification. That will mean waiting too long. Carers cannot wait for a wider review of the benefits system. That work will be important, but carers need to be considered separately and sooner, because as the hon. Member for Rugby and Kenilworth (Jeremy Wright) said, the cost implications of not doing anything are huge.

It is a pleasure to speak in this debate and to point out the huge contribution that carers make. However, may I leave the Minister with this thought: can he give us an indication of when, before this Government leave office, he will put that timetable in place?

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1.38 pm

Angela Watkinson (Upminster) (Con): This important debate is taking place in carers week. Indeed, I shall be attending carers day in my constituency tomorrow, as I am sure many colleagues will be in theirs too. It is right that Parliament should draw full attention to the important contribution that carers make to the quality of the lives of their family members with a chronic illness or disability.

Carers make an impressive collective saving of £87 billion a year to the public purse. Indeed, it is doubtful whether our public services would have the capacity to intervene for the number of people being cared for if their families were no longer able to cope. An estimated 6 million people are caring currently, and we must not take them for granted. It is important that we acknowledge that that huge saving to the taxpayer, which is higher than the total NHS budget in 2006-07, often comes at great cost to individual carers, in terms of limited access to education and training opportunities, availability for work, which seriously limits their earning potential, and social contact outside the home.

All too often, carers experience impaired health, which results from the daily demands that caring places on them. Carers are not noted for complaining about their lot in life. Old and young carers alike put the needs of their loved ones before themselves, and they do it cheerfully, but on a very tight budget. I welcome the Minister’s comments about a benefit review, which I hope will happen soon.

The situation for carers is quite complex, because they are allowed to earn only £95 a week if they wish to have access to the carer’s allowance. They are also limited in their ability to make themselves available for employment, given the logistics of their daily lives. The number of hours that they can leave home every day may be limited, and they need to balance that responsibility with the needs of the person for whom they are caring. So we are not only talking about a financial equation; there are other practical problems relating to the earning capacity of carers.

I welcome the Minister’s comment about family pathfinders. That was news to me, and I was pleased to hear it. I want to say a little about young carers. I have been surprised to find out how many young people are caring for a parent who is disabled or who has a chronic illness. The London borough of Havering, of which Upminster forms a part, presents young citizens awards every year for a range of special achievements including sport, education and volunteering. Young carers are always represented.

The routines and daily lives of young carers are very different from those of their peers. Many children need to be chased in the morning to get dressed, eat their breakfast and remember their PE kit and their homework, but these children do all that for themselves as well as caring for their parent. They help to wash and dress them, then perhaps write a shopping list for the food for family meals that they need to collect on the way home from school. Lunch time for those young carers is not taken up by clubs or sports or playing with their friends. It is an opportunity to go home and check on their mother. After school, they collect the shopping, go home and help to prepare the evening meal. These responsibilities, although carried out willingly and cheerfully, can be emotionally and physically exhausting for a child.

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