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1 July 2010 : Column 316WHcontinued
People in my constituency are being denied respite care opportunities, where previously they were offered them. I am worried that that might be regarded as an
easy cut for local authorities to make and that it might be an invisible cut, because, for example, one family would not know that another family had also had their request for care turned down. The criteria can be confusing and families can find that although in the past it has been possible for a family member to go into care, that is no longer so.
In taking up such matters with the local authority, I have found that some of the reasons given are economic, but it also says that it does not have the proper equipment. An increasing number of people who need to be cared for need hoists, for instance. An increasing number of carers are therefore coping at home with quite complicated issues, and when the person whom they care for goes away, equipment such as hoists, which is needed, is no longer available in an easily accessible form through the local authority.
Clearly, we must ensure that respite care does not become a Cinderella service, because it is often the only way in which people keep going. If it is not provided, the obvious alternative is that carers will stop doing the job and we will have to find full-time care for the person who was being cared for. Obviously, that is to everyone's detriment, and the situation may end up being not so happy. Whether provided by the council or charitable organisations-help comes from many different funding streams, including third sector organisations and so on-we must ensure that funding for care in the community does not diminish.
The incoming Government must take a national care strategy by the horns, because we all know that in the next 20 or 30 years the number of older people will increase, people will live longer and the number of those who need various forms of care will increase. If we do not have a national care strategy in place quickly, cuts will be made, homes will be closed and all sorts of care services will be withdrawn. We will build up a dangerous backlog of problems that will have to be sorted out. We must get that national care strategy moving quickly, because it will have enormous implications for funding. It must be a long-term proposal; it cannot be adopted tomorrow. I beg the Government to take up the excellent work that has been done on that to date.
Finally, I want to speak about research into conditions such as dementia and Alzheimer's disease. We all know how distressing a physical illness may be, but at least the sufferer can carry on a dialogue with loved ones and negotiate, discuss and decide the best thing to do. Sadly, diseases such as dementia and Alzheimer's are often the Cinderella of medical research services. But the long-term impact on families of the distress caused by someone who does not recognise them and makes all sorts of accusations may be difficult, added to which sufferers may be kept alive for a long time and remain physically well. Sadly, I have seen cases of early onset dementia, which is distressing because the sufferer often needs 24-hour supervision. We must prioritise the research that may not attract big funders. Some research subjects are fashionable, but for others, such as dementia, it is much more difficult to attract funding, often because they are not pinpointable as specific diseases. There are many generalised and different forms of dementia, and we need support and backing for research.
Thank you, Mr Benton, for giving me the opportunity to speak. I hope that the Minister will be able to answer some of my questions.
Tony Baldry (Banbury) (Con): I am grateful to you, Mr Benton, for giving me the opportunity to contribute to the debate. With Baroness Pitkeathley in another place, I co-chair the all-party group on carers. We succeeded the hon. Member for Aberavon (Dr Francis), who during the last Parliament carried out that task alone and so brilliantly that it took two of us to succeed him. I pay tribute to his work-I am sure that he will continue to be a contributing member of the group-and many of those who have contributed to the debate have joined the all-party group because we want to be a strong collective voice in the House for carers.
The Minister is in a privileged position because the hon. Gentleman, the Minister and I were made parliamentary champions for carers during carers week earlier this year. It is rare to move from being a parliamentary champion to being a ministerial champion for carers within a few days. We will see how my hon. Friend delivers in his new and challenging task on behalf of carers. It is rare in Whitehall for a Minister to walk into a Department understanding part of the brief that he has been asked to cover.
Mr Iain Wright: That is dangerous.
Tony Baldry: The hon. Gentleman may say that, but I think that it provides a phenomenal opportunity for my hon. Friend to stride out and seize the agenda. I will try to keep my comments short. During carers week, I made a long speech which, for hon. Members and others who are new to Hansard and who may wish to read it, is on my website at tonybaldry.co.uk/campaigns/carers. We are all in the new technological world, and I do not want anyone to believe that only the new intake is up to date with the internet. Some of us who have been around for a bit can keep up with the new global technology.
I want to make various points to my hon. Friend the Minister. I am glad that we frequently have debates on carers, largely as a consequence of carers week and the previous Prime Minister's intervention. Last year, we had a topical debate, and I am glad that we are having a full afternoon's debate in Westminster Hall. One of the first issues is identifying carers. Many carers do not recognise themselves as carers, so they are not recognised in the system as carers. It would help them enormously if social services and the health service recognised and encouraged people to recognise themselves as carers. We would then have a much more accurate picture of the number of carers in the community.
GPs may have thought-I defer to my hon. Friend the Member for Totnes (Dr Wollaston) on this-that it would not be beneficial to identify carers because they could do little for them. The ability to recommend respite care for carers may have prompted GPs to ask themselves, "Is this person a carer; is there something I can do to help them and to support them through respite care?"
We are about to move to GP commissioning for services. I will try to ensure on my patch that I identify which partner in every GP practice in my constituency has the lead responsibility for carers. One objective of organisations such as the Princess Royal Trust for Carers and Carers UK is for them and us collectively to encourage
GPs to engage with carers and to recognise and note those GP practices that are particularly helpful in supporting carers. With the best will in the world, the picture is patchy. Some practices work hard to support carers, but others, which may not be insensitive, have not taken such support fully on board in their list of priorities.
We must all recognise that the number of carers will inevitably increase with an ageing population. There is something else, which I fully appreciated only recently during carers week. At a reception in the Jubilee Room, I listened and talked to a number of carers who were looking after relatives with Parkinson's disease. My mother was a theatre sister during the blitz in Coventry, and people either survived or died. People from earlier generations went into hospital for one acute incident from which they either recovered or died. Generally, the Greco-Roman medicine of western Europe works on the basis that people are given drugs or medicine and they get better.
The truth, however, is that an increasing number of people in our society have to care for people whom they love very much, but who are progressively getting worse and know that they will never get better. There are people who have Parkinson's disease, dementia or Alzheimer's disease, and in addition to the financial and other challenges that carers face, the psychological drain of knowing that, however much someone is loved and cared for, they simply are not going to get better but will progressively get worse must be enormous.
The number of people who have to care for people with age-related dementia and Alzheimer's is increasing. When I was first elected nearly 30 years ago, each Christmas I would go round every nursing home in my constituency. Most of the residents were frail widows in their 70s who were perfectly spritely and intellectually sound. I have now given up going around nursing homes on my patch at Christmas, because almost everyone is suffering from some form of age-related dementia and they have absolutely no idea who I am at all. There is that standard joke where an MP goes in and says to a resident, "Do you know who I am?", and they say, "No dear, but if you go and ask matron she may be able to help you."
The pressure on staff is enormous, and if someone is old and frail, their chances of getting into a residential care home are increasingly less, so people have to be looked after at home by carers. Furthermore, the number of people who have early, pre-senile dementia and are waiting for places to get into a nursing home is increasing, and those people have to be looked after by carers. Therefore, the number of carers in our communities will increase substantially over time, and we must ensure that any carers strategy takes account of that.
We must ensure that new policy initiatives, such as GP commissioning, help carers and do not work against them. There are also other initiatives. For example, local authorities are, quite rightly, being enjoined to ensure that they get value for money in all services, including carer services.
In Oxfordshire, as in the constituencies of other hon. Members I am sure, carer services are going to be tendered. However, in Oxfordshire, we already have three good carers centres that are manned-or womaned-by volunteers. There is the Princess Royal Trust for Carers
and other carers centres that have grown up over a period of time. The North and West Carers Centre in Banbury won the Queen's award for unsung volunteers. Those people are not going to go away; they are committed to supporting carers.
However, there is a risk of an inevitable momentum, and that the county council social services department might feel that it has an obligation under some EU or Government directive to put services out to tender. It might feel obliged to contract out carers services to some completely different provider in some other part of the country. That does not seem to go with the grain of what I understand when I hear colleagues from all sides of the coalition talk about the big society. If the big society-as opposed to the big state-means something, it means building on the work of those volunteers and on the community spirit within one's own community. It means building on civic pride and local roots, not undermining those things. I hope that ministerial colleagues in the Department of Health and other Departments will understand that although we should ensure that every Department gets value for money, that should not undermine the volunteers who have the competencies that are needed.
That brings me on to how we train carers, and I make this point simply so that my hon. Friend the Minister can respond to it should he wish. There has been some concern about the Department's contract with Caring with Confidence, which is an organisation that has trained carers at carers centres. The Department has felt it appropriate to cancel that contract, possibly because it felt that sufficient carers were not being trained. However, there is an issue about how one ensures that carers and people who, often late in life, find themselves as carers can acquire the skills and competencies that will help them.
I make my final point so that we can have some clarity on this issue, either now or at some stage in the future when the carers strategy is published. Hon. Members from all parties have drawn attention to the carer's allowance. At present, the only assistance that a working carer receives is the carer's allowance, but those who are retired-many carers are above retirement age-get no further recognition in the system because Treasury rules state that people cannot claim two benefits. That is not new; it is a long-standing rule. If someone draws a state retirement pension, they can draw only that and cannot get anything more for being a carer.
During the previous Parliament, a couple of Select Committee reports were published on this subject, and that work should not be lost. The new Government must respond to those reports, and either make it clear that they cannot afford any further financial support for carers, or give some indication that they may be willing to consider recalibrating the benefit and financial system in support of carers.
In 2008, the Work and Pensions Committee recommended an overhaul of the benefits system. A report entitled, "Valuing and supporting carers", which was the fourth report of the 2007-08 Session, recommended a new two-tier support system with a carer support allowance paid at the same rate as jobseeker's allowance and a caring cost payment that would be available to all carers in intensive caring roles, similar to child benefit and set at between £25 and £50. That element would be available to some carers who were unable to claim the
first element, including those carers in receipt of a state pension. The Committee also recommended that the Department for Work and Pensions commission an urgent examination into introducing a taper to the carer's allowance earnings limit and lifting the 21-hour study rule.
Like so many Select Committee reports in the last Parliament, that report got lost in a review-I do not wish to criticise; it is just a fact, a process. The then Government said that they were introducing the carers strategy and would take the report on board and think about it, but I cannot recall anything coming out at the other end on what they thought about the Committee's recommendations.
Last year, the Public Accounts Committee published a report on "Supporting Carers to Care", which criticised the confusing and complex processes and poor communication involved in the support that carers received from the Department for Work and Pensions, including benefits and employment support-that point was made tellingly in a good contribution by my hon. Friend the Member for Blackpool North and Cleveleys (Paul Maynard). The Committee found that one fifth of carers who received benefits struggled with the application process, which is not surprising if no one helps them to fill in the forms. It found that the complexity of the system discouraged applications, and that Jobcentre Plus advisers were not given enough incentive to help carers to find part-time work. I am not sure that we ever had a response from the last Government to the Public Accounts Committee's report.
It would be helpful if, early in the life of the present Government, we had an indication of how Ministers collectively see the opportunities for supporting carers financially. Of course, everyone recognises that that is set against a background of very difficult financial constraints and circumstances. That is a given. It should not be necessary, every time that one makes a speech now, to explain that we are the country with the largest amount of debt in the world, due to circumstances. However, it would be helpful, with a view to taking forward policy on carers, if we had an understanding of how the Government see the ability to give carers further support. I am referring to support that is valuable not only in financial terms, but because it makes carers feel that they are being recognised by the wider community for the work that they do and the role that they play.
My hon. Friend the Member for Totnes rightly raised the issue of young carers and my hon. Friend the Member for Blackpool North and Cleveleys raised the issue of young carers being bullied. I am always at a loss to understand why, in the 21st century, schools, the education system and all the people involved are not capable of being more supportive of young carers. That goes back to the point about identifying carers. Young carers deserve to be identified just as much as any other carer. One would hope that the education system and schools were capable of recognising young carers, that social services, GPs and others would try to ensure that schools knew who the young carers were and that schools would give young carers support. Often, they deserve double the support for the tasks that they are undertaking.
Many hon. Members, at different times in their lives as constituency MPs, come across families that include young carers and find out that the stress is incredible because they are often asked to take on adult responsibilities. Another difficulty is that the parent for whom they have
taken on responsibility is sometimes able to look after themselves and be a parent, and sometimes is unable to look after themselves and is being cared for. For a child, having to cope with a parent who sometimes acts as a parent and an adult and sometimes is not capable of looking after themselves must be incredibly difficult, because they never know when they go home whether their mother will be poorly, drunk or whatever and whether they will be the carer or the child.
Schools and the system therefore need to give young carers particular support. I do not understand why every year when carers week comes round, we continue, a bit like groundhog day, to have the same debate about young carers. This area does not require huge amounts of extra money; it just requires the system and the community-society-to work out how we give younger carers greater support.
It is clear from the debate and I can tell the Minister that it is clear simply from the number of hon. Members who have joined the all-party carers group-I am sure that many more Members of both Houses have not yet got around to joining it but are equally interested-that there is considerable interest in and support for carers in Parliament. Those Members will be anxious and keen, in the course of the Parliament, to see what further work we can do in support of carers. Particularly for Government Members, if what my right hon. Friends in the coalition Government are saying about the big society and about engaging the community is to have any meaning at all, a very good test of that will be how we deliver enhanced and better lives for those who are caring in our society.
Barbara Keeley (Worsley and Eccles South) (Lab): It is a pleasure to serve under your chairmanship, Mr Benton, and to speak in this important debate on carers. I thank the Minister for his comments on my new role. He may know that carers issues were of importance to me before I came to this place. I have always made it a priority to champion carers and carers organisations. It is very important that a number of hon. Members who have spoken today feel the same way and might take on that role, too. If we believe that carers have been a silent army, it is up to us, as Members of the House, to be a voice for them in relation to Government. Many hon. Members here today will be able to do that, and I hope that they do.
I pay particular tribute to the work of the all-party carers group, which has always been a very strong voice in the House. The chair, the hon. Member for Banbury (Tony Baldry), has just spoken. The group is ably supported by Carers UK. I pay tribute to the work of the Princess Royal Trust for Carers, Crossroads Care, Age Concern and the many other organisations that provide vital advice and support to carers. I also pay tribute to the standing commission on carers-whose chair, Philippa Russell, is with us today-because it provides a voice for carers.
In relation to supporting carers to have a life outside caring, I think that the key issues are respite care and breaks, supporting carers financially and supporting young carers and the people for whom they care, so that those young people do not have to take on the heavy burden of caring that many of them do. In the debate, we have already touched on most of those issues.
The Labour Government's vision for carers as detailed in the updated national carers strategy identified the following outcomes. It stated that
"carers will be respected as expert care partners and will have access to the integrated and personalised services they need to support them in their caring role; carers will be able to have a life of their own alongside their caring role"-
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