Photo of Alan Haselhurst

Alan Haselhurst (Deputy Speaker)

We now come to the second debate on the Opposition motions. I should announce to the House that Mr. Speaker has selected the amendment in the name of the Prime Minister.

8:26 pm
Photo of Jeremy Hunt

Jeremy Hunt (Shadow Minister (the Disabled), Work & Pensions; South West Surrey, Conservative)

I beg to move,

That this House
recognises the vital contribution that the UK's six million carers make to society;
welcomes recent announcements on carers including the Government review of the National Strategy for Carers, the New Deal for Carers and the Treasury report 'Aiming high for disabled children: better support for families' as steps towards an improvement in recognition and support for carers;
notes that 54 per cent. of carers have given up work and one in five carers feel forced to do so;
recognises the impacts which caring responsibilities have on family incomes, relative poverty and the health of carers themselves;
is deeply concerned that an estimated 175,000 young people are carers of adults with the consequent pressures on them;
calls on the Government to reduce the bureaucracy of social care provision that puts so much pressure on carers;
and asks the Government to bring forward proposals for simplifying the benefit system in order to provide better support for carers and to ensure that the review of the National Strategy for Carers has both short term and long term objectives to enhance support for carers and to respond to the vital role played by carers in society.

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

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

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

Photo of Lembit Öpik

Lembit Öpik (Shadow Secretary of State for Northern Ireland, Northern Ireland Affairs, Shadow Secretary of State for Wales, Welsh Affairs; Montgomeryshire, Liberal Democrat)

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

Photo of Jeremy Hunt

Jeremy Hunt (Shadow Minister (the Disabled), Work & Pensions; South West Surrey, Conservative)

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

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

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

Photo of David Drew

David Drew (Stroud, Labour)

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

Photo of Jeremy Hunt

Jeremy Hunt (Shadow Minister (the Disabled), Work & Pensions; South West Surrey, Conservative)

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

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

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

Photo of Ivan Lewis

Ivan Lewis (Parliamentary Under-Secretary, Department of Health; Bury South, Labour)

Given the hon. Gentleman's remarks, will he withdraw the Conservative party's opposition to electronic data sharing, which is at the heart of our capacity to reduce bureaucracy in public services?

Photo of Jeremy Hunt

Jeremy Hunt (Shadow Minister (the Disabled), Work & Pensions; South West Surrey, Conservative)

Let me put the Under-Secretary right: we have no opposition to electronic data sharing when it happens in a Department for a defined purpose such as simplifying the assessment process.

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Anne McGuire (Parliamentary Under-Secretary (Disabled People), Department for Work and Pensions; Stirling, Labour)

Would the hon. Gentleman and his party object strongly to data sharing between the Department of Health and the Department for Work and Pensions to fulfil the objective that he identified in his comments?

Photo of Jeremy Hunt

Jeremy Hunt (Shadow Minister (the Disabled), Work & Pensions; South West Surrey, Conservative)

If there is a good reason, such as simplifying the complicated assessment processes, we would be happy to consider data sharing. However, we oppose building a national database, such as that required for the identity card scheme. Perhaps the Under-Secretary will tell me how many carers it would help if we scrapped the ID card scheme, which will cost £5.7 billion. We object to that, not to sharing data for a valid purpose.

Does the Under-Secretary of State for Health acknowledge that the system that was designed to help carers and disabled people has become so burdened with bureaucracy that it adds massively to their daily stress? I will now let him off the hook, unless he wants to respond to that question, and move to the Under-Secretary of State for Work and Pensions. She knows that more than half of carers are forced to give up work to undertake their caring role. To what benefits are they entitled?

Carers are entitled to five different benefits: the carer's allowance; the carer's premium in income support; housing benefit; council tax benefit, and the community care grant. I have all the forms that carers have to complete. Can the Under-Secretary guess how many questions we ask people to answer if they want to apply for all five benefits? Does she have any idea? I shall put her out of her agony and tell her that the answer is 769 questions over 170 pages. The state is therefore saying, "We understand and value the role you're performing and we'd like to help you. Kindly complete the attached 769 questions over 170 pages and we'll tell you if you're eligible for help."

It might be justifiable to ask a lot of questions if we needed lots of unique information, but of those 769 questions, only 148—20 per cent.—ask unique questions, with 80 per cent. repeated. No wonder Carers UK says that the application for carer's allowance leaves carers

"confused, angry and with little faith in how the system works, with advisers caught up in complicated advice".

Photo of David Taylor

David Taylor (North West Leicestershire, Labour)

I launched North-West Leicestershire carers week in the Marlene Reid centre, Coalville, this morning and many of the remarks I heard relate to what the hon. Gentleman has said. Would he be surprised at the figure provided to me by a Department for Work and Pensions representative on a stand in the exhibition— that only 500,000 people of the 6 million carers, 3 million of whom are not in work, actually apply for and receive carer's allowance under the current system? I have not had a chance to ratify it, but is it not a surprisingly low figure? Does he agree and can he authenticate that figure?

Photo of Jeremy Hunt

Jeremy Hunt (Shadow Minister (the Disabled), Work & Pensions; South West Surrey, Conservative)

The hon. Gentleman makes an important point. I am not surprised by that figure, as there is a total of £740 million of unclaimed carers' benefits. The result is that many carers fall into poverty. A third are in debt, a third cannot afford to pay some of their utility bills, while another third cannot afford essential repairs to their homes. We need to recognise that, just as there is a direct link between disability and poverty, so there can also be a direct link between caring responsibilities and poverty.

Photo of Michael Weir

Michael Weir (Spokesperson (Energy; Work and Pensions; Trade & Industry); Angus, Scottish National Party)

Does the hon. Gentleman also accept something that I have encountered in dealing with carers in my constituency—that many are of an age at which they do not feel they want to claim benefit? It is rather similar to pensioners and pension credit. An elderly woman said to me, "What's a carer? I have always looked after my disabled daughter". This is another barrier that has to be overcome. It is not just the fact that the money is not claimed: there are reasons for that, just as there are with pension credit.

Photo of Jeremy Hunt

Jeremy Hunt (Shadow Minister (the Disabled), Work & Pensions; South West Surrey, Conservative)

I would agree, but one of the reasons many people do not want to claim it is that the form is so complicated and difficult. Yes, there are barriers in people's thinking—and these are difficult problems to overcome—but there are also practical barriers that we, as a state, can do something about, and the complexity of the form is one of them.

Photo of Bill Wiggin

Bill Wiggin (Shadow Minister (Agriculture & Fisheries), Environment, Food & Rural Affairs; Leominster, Conservative)

In my constituency, there are also many children who care for their disabled parents. Are they expected to fill out those 750-odd questions as well?

Photo of Jeremy Hunt

Jeremy Hunt (Shadow Minister (the Disabled), Work & Pensions; South West Surrey, Conservative)

My hon. Friend makes an important point. If he had attended the debate earlier this year about the life chances of disabled children, he would have heard in my speech that for families with disabled children, the number of questions that have to be answered is not 769, but 1,118. The situation is actually worse for those parents.

What is most worrying about this complexity in the benefit system is how it makes it difficult for carers to work. All these benefits have different rules about the work that can or cannot be done. On carer's allowance, it is possible to earn £87 a week, but any more and the benefit is lost. For income support, anything above £20 is deducted pound for pound. With housing benefit, anything more than £20 is deducted at a rate of 65 per cent., while with council tax benefit it is deducted at the rate of 20 per cent. More than half of carers give up work because of their role, but nearly half would like to work if they could, so why are we penalising them?

This is not simply a moral question; it is also, because of the demographic crisis on our doorstep, a practical question. I was trying to think of a way to personalise this issue for the select group of hon. Members in their places this evening. The average age of an MP is actually 50. By the time the average MP becomes 75, there will be an additional 3.2 million 75-year-olds compared with the number of them today. In that period, because of the ageing population, there will be 500,000 fewer children; yet there will be 500,000 more disabled children and all of them will need carers. Six out of 10 men and seven out of 10 women will become carers at some point in their lifetime, but this involves children as well. There are also 175,000 child carers, and that number is growing.

The choice is simple. Do we want family and friends to remain the mainstay of the caring that takes place in our society, or do we want to gamble by doing nothing to reform the bureaucracy of the social care system and the complexity of the benefits system? Do we want to risk those carers giving up and passing that responsibility on to the state, which would be the worst possible outcome for cared-for people?

Photo of Gary Streeter

Gary Streeter (South West Devon, Conservative)

My hon. Friend is making a powerful case and I totally agree with him about streamlining the benefits system; carers certainly call for that. Do they not also call for a bit more help from the state—that is, from all of us—to enable them occasionally to have access to respite care and short breaks? Many of those wonderful people and hard-pressed families are at breaking point. Is not there a lot more that we could do to provide respite care and short breaks? Will my hon. Friend address that point for a few moments?

Photo of Jeremy Hunt

Jeremy Hunt (Shadow Minister (the Disabled), Work & Pensions; South West Surrey, Conservative)

No one has done more than my hon. Friend to campaign for respite care provision. We made significant progress this year, following the Treasury review, when respite care for an additional 40,000 families was announced. He is absolutely right. According to Mencap, eight out of 10 families with disabled children are at breaking point because of the lack of respite care. This is a pressing issue. Dealing with the complexity of the benefit system and the bureaucracy of the social care system is one of the major pressures that these families face, and we could do something about it.

We need to stop talking and start acting. As a shadow Minister, I can offer only the shallow comfort of words. Ministers, however, can offer the real hope of action. We have told them what to do and when they must do it. Six million carers will be watching this week to see whether they are listening.

8:47 pm
Photo of Ivan Lewis

Ivan Lewis (Parliamentary Under-Secretary, Department of Health; Bury South, Labour)

I beg to move, To leave out from "review" to the end of the Question and to add instead thereof:

"of the first ever National Strategy for carers, the New Deal for Carers and the Treasury report "Aiming high for disabled children: better support for families" as steps towards an improvement in recognition and support for carers;
notes that the review of the National Strategy includes a far reaching consultation with carers and others to make recommendations for the short, medium and long-term;
further welcomes the extra £25 million for short-term home-based respite care for carers and the extra £3 million towards establishing a national helpline for carers announced in 2007;
congratulates the Government for introducing in 2007 the new Expert Carers Programme;
further notes that the Pensions Bill currently before Parliament includes a package of reforms to recognise the contribution made by carers and ensure that they can build up better pension records;
further notes that the right to request flexible working introduced by this Government will help carers better balance their work and caring benefits;
and further welcomes the substantial improvements made to the benefits available to low income carers.'.

This issue should unite all sides of the House. National carers week provides us with an important opportunity to pay tribute to the remarkable contribution of carers to their families, friends and our society, and to shine a light on many remarkable and inspirational personal stories, but also to face up to our solemn responsibility to build a system and a society that address the needs of carers, both in fulfilling their caring role and as people who have a right to a life of their own. Observing national carers week is like throwing a pebble into the sea. It will generate a ripple but leave the vast expanse of ocean—the lives of 6 million carers—largely untouched. One week is a catalyst; our challenge is to make a difference 52 weeks a year and 365 days a year to the carers in every community in every part of the country who are coping with unique situations, but also with common problems.

As we face this responsibility, we should not make the mistake of believing that Government or Parliament have all the solutions. We must listen to and learn from individual carers and the organisations who are their voice. I want to pay tribute to national organisations such as Carers UK, Crossroads, the Princess Royal Trust for Carers, Partners in Policymaking, the Children's Society and all the organisations that are part of the Every Disabled Child Matters coalition.

I also want to pay tribute to the hundreds of self-help groups, voluntary organisations and local authorities up and down the country that support carers and enable them to have the best possible quality of life, as well as the individual heroes who exist in every hon. Member's constituency. In my own constituency, Geraldine Green is a remarkable person. As a grandma, she is full-time carer to grandchildren who have autism. As a social entrepreneur, she runs Hurdles, a voluntary organisation offering a range of support services to disabled children and their families. In her spare time—I use the term jokingly—along with a team of volunteers, she has just opened a café with the aim of providing training and work opportunities for young people with learning disabilities so that they can develop the skills and confidence necessary to secure a job of their own. Then there is Jill Pay, whom the Chancellor and I met when we launched the new deal for carers recently. She looks after her daughter Rowan, who has severe learning disabilities, and is supported in doing so by her eldest daughter, Camilla. Geraldine, Jill and Camilla's spirit, tenacity, courage and flair are inspirational, but their frustration and anger at the system must be a wake-up call to us all.

In many ways, that frustration is summed up by a mother I met recently in my constituency. She has a son with autism, and two things that she said stuck out, and could have been articulated by far too many carers: "Why don't the professionals seem to understand that I am the expert on my son?" and "Why do I have to shout before anybody listens?"

As Mr. Hunt said, it is estimated that the country has 6 million carers overall—arguably, about one in every street. Given the likely consequences of changes in our society, that figure will become one in every family. As the hon. Gentleman said, the vast majority of us are likely to become carers. It will no longer be somebody else's concern.

Photo of Jeremy Hunt

Jeremy Hunt (Shadow Minister (the Disabled), Work & Pensions; South West Surrey, Conservative)

The Minister has talked about the number of people who are likely to become carers. Can he explain why his Department is currently refusing to fund the inclusion of a question about caring responsibilities in the 2011 census? Such a question was included in the previous census. Many carer organisations are worried, however, that if his Department is not willing to put up the funds for the same question to be asked in the 2011 census, we will not know how many carers society has.

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Ivan Lewis (Parliamentary Under-Secretary, Department of Health; Bury South, Labour)

As part of the review that we are about to undertake, that is exactly the kind of issue that we need to address. That will be part of the fundamental review of the new carers strategy, which we shall develop and work on in the period ahead.

Photo of Philip Dunne

Philip Dunne (Ludlow, Conservative)

On the subject of the census and listening to the organisations listed by the Minister at the beginning of his remarks, I hope that he will listen to the representations made to his Department today by Shropshire Partners in Care. Its petition, which I delivered with other Shropshire MPs, highlights the problems of process whereby the Government rely on out-of-date 2001 census data to determine the allocation of funding for the elderly, adults with learning difficulties and others in care. Demographic changes, and changes in health, are moving faster than the census data can catch up with them.

Photo of Ivan Lewis

Ivan Lewis (Parliamentary Under-Secretary, Department of Health; Bury South, Labour)

In a moment I shall talk about demographic change, which is why, in the next two decades, the vast majority of people in this country will become carers. Of course I have sympathy with constituents who have strong passionate feelings about their areas, but neither the hon. Gentleman nor the hon. Member for South-West Surrey made one policy or spending commitment during their contributions to the debate. Theirs were all fine warm words, many of which I, as the Minister responsible in the Department of Health, would have no problem with. But they made not one extra spending commitment in relation to the needs of carers.

Photo of Jeremy Hunt

Jeremy Hunt (Shadow Minister (the Disabled), Work & Pensions; South West Surrey, Conservative)

In that case, will the Minister give a policy commitment about reducing the bureaucracy of social service provision?

Photo of Ivan Lewis

Ivan Lewis (Parliamentary Under-Secretary, Department of Health; Bury South, Labour)

As part of the review of the needs of carers, we will listen— [Interruption.] The hon. Gentleman referred to the review being all talk. To be clear, he therefore wants a process in which senior civil servants and Ministers sit in offices in Westminster and Whitehall and impose a new strategy on carers, rather than engaging with people in the real world who experience services daily, and ensuring that there is a bottom-up strategy in which carers identify the priorities and what they expect from the state.

Photo of Sally Keeble

Sally Keeble (Northampton North, Labour)

Will my hon. Friend confirm that a key Government recommendation was that local councils should appoint lead people to liaise with carers and co-ordinate the services that they need? That should overcome a lot of the difficulties that, as Mr. Hunt suggests, many people experience.

Photo of Ivan Lewis

Ivan Lewis (Parliamentary Under-Secretary, Department of Health; Bury South, Labour)

I entirely agree, but localism—in which the Conservative party also believes—means that we do not impose any one model on care services run by local authorities or primary care trusts. The outcome of the review of the needs of disabled children and their families illustrated the importance of the lead professional who helps families to navigate the system, which is at the heart of the provision of modern personalised public services. Those are the changes that we need to see, in the context of reform of social care and of public services more generally.

Photo of Jeremy Wright

Jeremy Wright (Rugby and Kenilworth, Conservative)

I am sure that all carers would like to be helped to find their way through the problems that becoming a carer throws up, but would not the adviser's job be much easier if the benefits system, in particular, were much less complex? The Government could do something about that.

Photo of Ivan Lewis

Ivan Lewis (Parliamentary Under-Secretary, Department of Health; Bury South, Labour)

Let me say gently that this is the Government who introduced a national carers strategy in the first place, in 1999. This is the Government who introduced the annual carers grant that goes to every local authority, and this is the Government who gave carers the right to request flexible working. We will take no lectures from Opposition Members. There may still be issues to be addressed, but that is precisely why we are now going to engage in the most extensive consultation ever, with carers in every community in the country, to ensure that we can make the necessary changes.

Photo of Hywel Francis

Hywel Francis (Aberavon, Labour)

As chair of the all-party parliamentary carers group, I want to record my thanks to the official Opposition for initiating the debate and giving us an opportunity to showcase the tremendous advances achieved by this Labour Government over the last decade. Will my hon. Friend reiterate his warm response to what I said last week in congratulating the Labour-led Welsh Assembly Government on establishing, in that Government, a carers champion—an example that we should follow here in England?

Photo of Ivan Lewis

Ivan Lewis (Parliamentary Under-Secretary, Department of Health; Bury South, Labour)

If there is a vacancy for such a role in this Government, I think that my hon. Friend would be an excellent candidate—although it is not for me to hand out ministerial appointments, especially at this stage in the political cycle. On the basis of his personal experiences of caring, he has been a tremendous champion and advocate of change in our society, to transform the experiences of carers in Wales and throughout the United Kingdom. Over time, the Carers (Equal Opportunities) Act 2004, which he promoted, will make a massive difference to the opportunities available to carers. He should be very proud of the difference that he has made.

I must make some progress, as Back Benchers will want to make their own contributions. I was talking about the changes taking place in our society, to which we have a duty to respond. The demographic realities are that people are living longer, which will continue, and that disabled people want not just longer lives but full lives. There have been medical advances too. Another fact, which is often missed, is that people are demanding—not being forced—to remain in their own homes rather than going into institutions. The implication of that for the role of carers is profound, and will become even more profound.

We must also recognise that carers are people first, with their own needs, aspirations and fears. They need help with caring, but—I do not think that the hon. Member for South-West Surrey mentioned this once—they want a life as well, and public policy should reflect that.

I have already referred to the tremendous progress made in recent years. I am not suggesting that the Conservative Government did nothing, but we were presented with a pretty blank piece of paper in terms of the commitment that Government were willing to make to carers historically. We introduced the 1999 strategy—the Prime Minister's strategy—we awarded an annual carers grant to every local authority, and we produced the Carers and Disabled Children Act 2000. I referred earlier to the Carers (Equal Opportunities) Act and the right to request flexible working.

Pension credit legislation is going through Parliament, and a tremendous package of support—which is overdue—was announced several weeks ago, involving a partnership between the Treasury, the Department for Education and Skills and my Department. That will significantly enhance the support available to disabled children and their families in every community. There will be many more short breaks and much more respite care, along with lead professionals, and a focus on a transition that is often difficult—the cliff edge between being a child or a young person and becoming an adult.

We are now about to make a reality of our announcement of a couple of months ago of a new deal for carers. The national telephone helpline will mean that carers have easy, ready access to information focused on their needs. Carers tell us that they want to be able to make a call or to log on to the web and to know that they will end up in the right place and have their needs met.

Photo of Rosie Winterton

Rosie Winterton (Minister of State (Health Services), Department of Health; Doncaster Central, Labour)

Signposted.

Photo of Ivan Lewis

Ivan Lewis (Parliamentary Under-Secretary, Department of Health; Bury South, Labour)

Carers want to be signposted in an appropriate way, as my right hon. Friend says.

We are developing the expert carers programme, so that carers in every community have the training and support to develop the skills and confidence not only to be able to look after the person they are caring for, but to engage on a far more equal footing with professionals. There is also the emergency respite care fund. Carers themselves have told us that one of the greatest difficulties they face is a sudden caring breakdown, a sudden difficulty with the person they are looking after and a sudden need for emergency support. We will make further announcements later this week about the consultation. Over time, we want to bring about a system that is on their side, and which gives carers a life of their own. Issues have to be addressed.

I was interested by the curious contribution of the hon. Member for South-West Surrey on the question of information sharing, because he said that information could be shared, but only within a Department. But the first thing that carers say to us is, "We want a holistic, cross-Government approach. Each one of us is a person, not a series of compartments as represented by Government or local delivery mechanisms." To suggest that the Conservative party is happy for electronic data to be shared, but only if it is within a Department, misses the point and fails to listen to what carers tell us about their priorities.

I turn to the question of social care, which is massively important to the quality of carers' lives. We need a new consensus for a new settlement. We must recognise that society is changing so rapidly that we need a new balance between the state and the responsibilities of families and individuals. That settlement must be fair but it must also be sustainable. We must be clear that resources will always be finite. The question is: what, on a long-term basis, is both just and sustainable in terms of funding a social care system that is fit for purpose to meet the challenges of demographic change?

In the context of changing the social care system, we also need to transfer a lot of power and control from organisations to those who use services and to their families through individual budgets, direct payments, person-centred planning and self-directed support. We need to move away from a system in which professionals determine the life chances of individuals, and transfer a maximum amount of power and control to those who use services, and to their families.

I pay tribute to the Under-Secretary of State for Work and Pensions, my hon. Friend Mrs. McGuire, who has worked alongside me on that agenda in making tremendous progress for disabled people in our society. She has not only served as the Minister with responsibility for disabled people but has been the champion of disabled people across Government, and she has continued to make the point that every Department must fulfil its responsibility.

I now move on to the national health service. It seems that we have to do more in terms of access to general practitioners. They are often the gatekeepers. for carers, they are the trusted professionals. We need to ensure that in future GPs give far greater priority to identifying carers and ensuring that they are referred to the right service and to the place where they will have their needs met.

As the hon. Member for South-West Surrey said, we must also acknowledge that the health of carers often deteriorates as a consequence of fulfilling caring responsibilities. That has implications for the NHS. Carers, more than most, require a truly integrated approach at local level between local government, the local national health service and the voluntary sector. We need services in local communities to be much more joined up. We need to move from a notion of partnership to one of integration, and to recognise that the prize that we now seek is not simply a synergy between the NHS and social care. In order to protect the health and well-being of carers, the NHS, all the services local government commissions and provides, and the voluntary sector need to harness their resources efficiently and in a joined-up way.

Employment is another issue. Some carers might want to combine their caring responsibilities with having a job, and others who have been out of the labour market for a long period might want to have the chance to re-enter it. We must look into what support we might give them. Education and training are important factors.

It is right that the system draws a distinction between adult services and children's services, but we need to ensure that that does not lead to young carers being failed. There is a danger of that happening. We know from evidence and research—and from some powerful and sad recent stories—that there are many hidden cases of children and young people fulfilling caring responsibilities for a parent. A child or young person should not do that alone without having a lot of support. That affects their education, and their chance to do the things that children and young people ought to do. Society and Government need to take a fresh look at the support that we offer young carers, not only through our Department but in the education system.

The hon. Member for South-West Surrey asked about the benefit system. I agree that we need to examine benefits, taxation and pensions in an integrated way. The key issue here is the financial impact of caring on the carer and their family. In no circumstances should a carer have to live in poverty as a consequence of having made the choice to care.

In an Adjournment debate last week, my hon. Friend Dr. Francis, who has now left the Chamber, raised the issues of leisure, friendships and social relationships. Many carers tell us that they suffer isolation and loneliness. Therefore, it is crucial to ensure that carers have access to leisure opportunities—to a social life, to friendships and to informal networks.

The reform of public services is not only about addressing leadership, management, targets and organisational changes. We must not forget that pressure from those who use services and who fight and campaign for them is also important. That is why having a voice, information and advocacy are crucial. We must ensure not only that we change public services by reforming systems, but that we transfer a lot more power and opportunity to influence public services at the local level to those who use them, and to their families.

The support we give to carers will define the character of our country as we face up to future challenges. We must care for them and be compassionate, and we must empower and support them so that they can maximise the quality of life of the loved one or friend whom they are caring for. Carers are usually better placed than the state to offer appropriate care, but they need the state to be on their side. They need a state that is active and enshrines rights in law, that provides accessible and quality information, advocacy and support, that personalises public services so that respect and dignity are at their heart, and that ensures that choosing to care does not mean giving up one's own life.

As a result of demographic change, medical advances and changing expectations, the needs of carers will become more, not less, important in the future. Caring will ask new questions of every family and community, of the state and the voluntary sector, of the husband and the wife, and of the son and the daughter. This Government will provide leadership and ensure that carers are at the heart of a new contract with the people, so that the system is on their side and they can have a life of their own. To make that aspiration a reality is the prize, and it must become a shared mission.

9:09 pm
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Sandra Gidley (Shadow Minister, Health; Romsey, Liberal Democrat)

I welcome the chance to debate these issues today, at the beginning of carers week. Although there has been a little bit of acrimony, it is fairly obvious from the speeches of the Minister and of Mr. Hunt that there is a genuine will to do something, so I do not intend to make many party political points this evening.

At the beginning of carers week, we are obviously celebrating the contribution that carers make to society. The Carers UK website published today the results of a survey that it carried out on behalf of 3,500 carers, who are probably fairly representative of the 6 million out there. The results highlighted the negative impact that the role of carer can have on a carer's relationship with their partner. Some 66 per cent. said that their relationship had suffered, and 60 per cent. said that they had little quality time. Interestingly, when they did have such time, 21 per cent. used it to catch up on sleep, so it is clear that other things suffer, too. Importantly, nearly two thirds—63 per cent.—felt a loss of identity.

For many people, caring is a long-term commitment, so it is worrying to note that three quarters of carers have not had a regular break from caring in the previous 12 months, and that 38 per cent. have not had a single day off in the last 12 months. I will be kind and concede that the Government have put £25 million toward respite care, which was mentioned in an earlier intervention. That is of course very welcome, but it is targeted at emergency respite care only. We have to look at ways of freeing up money to make sure that people have regular access to respite. As constituency MPs, we have all probably had people coming to see us saying, "I could cope if only I knew that I was going to get regular time off at some point in the future." Services are so stretched that even if time off is booked—of course, booking time off has an impact on people's lives because they cannot therefore be spontaneous; they have to sort out their social lives weeks, if not months, ahead—it is often cancelled at the last moment or changed because an emergency has arisen involving someone with a greater need. Carers realise that there are people with greater needs, but it is difficult if we cannot honour even small commitments.

In a trial on the Isle of Wight, carers received regular respite every few months. Respite care was always with the same nursing home, so the staff got to know the individual concerned and the carer got to know the people in whose care their loved one was being entrusted. The system seemed to work very well. If people feel that they are being treated as human beings and can have a regular break, they can carry on caring for longer. Some work needs to be done on the economics—perhaps as part of the strategy—because we do not really know the answers at the moment. That system seems like a good thing, but perhaps some pilots are called for properly to assess the long-term benefit.

The survey to which I referred also looked at carers' financial situation. The Minister rightly made the point that nobody should be financially worse off because they have caring responsibilities, but the reality is that 67 per cent. said that they were, and 28 per cent. said that they felt unable to support the family properly. One in five carers is forced to give up work, but many of them are missing out on the benefits, pensions and practical support that is available. Here, there is something of a double whammy. As has been pointed out, caring is a full-time occupation. Many people who suddenly acquire these responsibilities do not also have the time or energy to access the very complex benefits system and to work out what they are entitled to. As has also been pointed out, even if they did have the time, the system is complex, inconsistent and bureaucratic.

According to estimates, carers actually save the economy £57 billion each year, but carer's allowance is still very low at £48.65 a week. Rates of unclaimed benefit also remain high. Although, in theory, part of the problem is being tackled, in practice, carers are not getting the little to which they are entitled. I agree that there must be a wholesale review of the carers benefit system, including the provision that is available to retired carers. That is another anomaly that must be reviewed, and I am sure that during the review, it will be brought to the Minister's attention time and again.

The anomaly for young carers is that they cannot claim benefits if they take part in education for 21 hours a week or more. By young carers, I mean young adults who may wish to take part in some education. The anomaly is a disincentive to young carers, because they do not have the resources to carry on furthering their education or training, and if they do not take the opportunity when most of their peers do so, they could be locked into a lifetime of social exclusion.

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Annette Brooke (Children & the Family, Cross-Portfolio and Non-Portfolio Responsibilities; Mid Dorset and North Poole, Liberal Democrat)

Is my hon. Friend concerned about what might happen to young carers when the school leaving age is raised to 18, and about whether the Government will give that every consideration in the review?

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Sandra Gidley (Shadow Minister, Health; Romsey, Liberal Democrat)

My hon. Friend makes a very good point. She has a long commitment to the subject of young carers, and I hope that her point will be addressed by the Minister when she winds up, because it is valid.

The issue is about joined-up government. There are Ministers present from two different Departments, but it has already been pointed out that the Department for Education and Skills has a role to play, and I suggest that the Department for Communities and Local Government has a role, too.

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Mark Williams (Shadow Minister, Welsh Affairs; Ceredigion, Liberal Democrat)

One of my hon. Friends talked about young adults and the challenges facing them as carers. Is my hon. Friend aware of primary school children who have been undertaking caring roles? Children as young as eight years old—at arguably the most formative time in their education—are taking on caring roles out of necessity. Does she agree that we must urgently consider models to support those children?

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Sandra Gidley (Shadow Minister, Health; Romsey, Liberal Democrat)

My hon. Friend makes an excellent point, and I shall return briefly to that subject later in my comments.

Older carers often have to change jobs. The survey that I mentioned said that 57 per cent. felt less able to focus on a career, and respondents also quoted reduced promotion prospects and the fact that they were unable to take up training opportunities. Some 40 per cent. found it difficult to get back on the job ladder when returning to work. When asked how their working life could be made easier, one fifth felt that they needed greater support from their boss, and 18 per cent. more understanding from colleagues. Again, access to carers advice came up during that part of the survey.

There is a need to ensure that the way in which companies structure their training programmes does not discriminate against carers. Often, companies' work practices are assessed for gender, and parental provision is also taken care of. It is also important to note that 80 per cent. of carers are of working age, and 3 million already combine work and care. Advice needs to be made available to them so that they can perhaps change their career slightly, or learn how to suggest alternative working practices to their employers. Of those people who were not working because of their caring responsibilities, one third said that they would return if the right alternative care and flexible support were available.

The peak age for caring is 45 to 64 years old, and the cost of replacing the expertise of a worker of that age is immense. Flexible working is one way forward, and I recognise the Government's efforts in that direction, but many companies still enshrine the old ways of working, and I do not think that quite enough has been done to encourage companies regarding the way forward.

At a recent meeting with BT, I learned that 75 per cent. of its work force were flexible workers. The company decided that it would be resented if flexible working was available only to parents or carers, so the same provision was offered to everybody. As a result, BT has identified average productivity gains of 21 per cent., cost savings, increased customer satisfaction, increased creativity and energy and—no surprise—a decrease in sick leave. To introduce a green theme to the debate, BT calculated that it had saved 12 million litres of fuel. Flexible working is good for people and good for the environment so I hope more will be done to encourage other companies to follow those who have successfully adopted those practices.

My hon. Friend Annette Brooke mentioned young carers; there are 175,000 in the UK, 13,000 of whom care for more than 50 hours a week. In 1999, the national carers strategy made a number of proposals to improve recognition and support for young carers, but unfortunately only 18 per cent. of young carers actually receive an assessment of their needs. I am sure Ministers agree that the problem urgently needs to be addressed. Sometimes, there is a family decision not to seek support, so more work needs to be done with families to reassure them that if social services are aware of the problems they will not take the children away and break up the family, as that may be a concern. Sometimes, however, lack of support is simply indicative of a failing system.

There is often poor awareness in schools. Teachers may tell a child off for not doing their homework or for being late, when the situation may have been prompted by the child's caring responsibilities. Such an approach does not encourage school attendance.

Last week, in the debate in Westminster Hall, my hon. Friend the Member for Mid-Dorset and North Poole recommended a whole-family approach—a point echoed by the Minister in his speech. My hon. Friend welcomed more joined-up thinking between adult and children's services, because they are all part of support for the family. The system may fall down because a parent who needs support during the night may not meet the criteria for adult social services, yet in practice there is a huge impact on the child who may have to get up every night to undertake caring responsibilities.

The Government have greatly progressed the agenda. Mention was made earlier of the carers hotline. I rang the hotline because I thought it was such a good idea—as the Minister said, people want access to advice when they actually need it—so I was a little surprised to hear a recorded message:

"This hotline is only available Wednesday and Thursday between the hours of 10 to 12 or 2 to 4."

At other times, people are merely sent a package of information.

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Ivan Lewis (Parliamentary Under-Secretary, Department of Health; Bury South, Labour)

May I point out to the hon. Lady that the helpline does not exist yet? I do not know which helpline she is referring to, but it is not the one we are talking about establishing.

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Sandra Gidley (Shadow Minister, Health; Romsey, Liberal Democrat)

In that case, the situation is even worse because I used a link from a Government website. I had assumed that the helpline had not been established so I was delighted to find what I thought was the official website. Perhaps the Minister who winds up the debate will tell us when the hotline is to be established and what service we will be getting for the £3 million that has been allocated, but clearly not yet spent.

As a society we have to start getting our heads around the problems and challenges. Caring is an emerging electoral issue. An ageing population means that 3 million extra carers will be needed by 2037, in addition to the 6 million at present. In many ways, the issue is hidden because carers do not have time to lobby.

Finally, I again plug the book, "The Selfish Pig's Guide to Caring", by Hugh Marriott, which shows clearly that carers do not express their feelings because they risk appearing uncaring. We need to encourage honesty in the debate. In a survey, when people were asked which words best expressed the experience of being a carer, 74 per cent. said "stressful" and 71 per cent. said "demanding". More heartening, 31 per cent. found caring rewarding and 20 per cent. found it fulfilling.

In many ways I hope there will be no vote tonight. We need to change the habits of a lifetime and reach cross-party consensus to change those percentages and move the agenda forward.

9:25 pm
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Sally Keeble (Northampton North, Labour)

I will be brief, because I recognise that other people want to contribute to the debate. I welcome the debate and the remarks made by Mr. Hunt. Bureaucracy always needs to be simplified. However, to make that an end in itself is limiting. It is also true to say that the issue is partly about the nature of the society in which we live, the kind of society we want and the importance of supporting people so that they can look after their families in their own homes, which is obviously right. People will always look after their families, relatives and neighbours in quite remarkable circumstances. For generations, people—an awful lot of them women—have looked after their family members at great sacrifice to themselves. Part of the challenge faced by the Government is how to make sure that people are able to act as carers with dignity and support and without running themselves ragged in the process.

The Government have done a great deal in this respect and two areas have not been highlighted enough. First, there is the carers supplement to pension credit. That is enormously important because it deals with the anomaly that Sandra Gidley pointed out in relation to people who, post-retirement, are suddenly deemed not to be carers any more and with the difficultly implicit in the carers benefit system, which is that carers are recompensed for lost wages. The carers supplement to pension credit has been under-recognised. I also suspect that the pressure in relation to pension credit and means-testing has discouraged retired people who are carers from recognising that this important element of support exists.

Secondly, there is the provision in the Pensions Bill for carer credits and for widening the scheme so that it is not linked just to certain restricted benefits. That will enable quite a number of people in my constituency, where there is a high level of participation in work, to feel a bit more confident about giving up full-time employment to take on caring responsibilities, without fearing that that will leave them without a pension in retirement. Those two points are important and are perhaps not sufficiently recognised.

I want to comment on two areas of caring. Last Friday, in preparation for carers week, I spent time with some carers. Two of them were caring for spouses who were in ill health and a number of issues were raised about what happens when people's health fluctuates and the carer finds themselves falling in and out of recognised care. The other group of people who seem to have had little recognition and who do heroic work are grandparents who take on the care of their grandchildren. I spent some time with Tanya Kettleborough. She and her husband took on two granddaughters after the girls' mother horrendously abused and then abandoned them. Those two girls had the emotional difficulties of being abused and abandoned, and one of the girls was also left with profound physical disabilities because of the level and nature of the abuse.

To an extent, the hon. Member for South-West Surrey was right: there is an issue about how much money carers get. In order to give her grandchildren a secure home, the grandmother had got a residence order, so she had forgone the opportunity of getting foster care payments, which would have given her an income of about £600 a week given the scale of the disabilities of one of the children. Instead, she got payments of about £370 for two weeks. She thus gave up about half her possible income, yet she said that she would do that again because it was what she wanted to do for her grandchildren. The care that she gives is astonishing. I had met the little girl before and I am sure that she has made much more progress in a couple of years with her grandmother than she would have done in residential care, which would have been the alternative.

While the grandmother said that this was not about the money and that she would do the same thing again, then came the buts. She wanted a new buggy for Shannon, the little child, because the child had outgrown her existing buggy and all the thrashing about had weakened it, meaning that it was no longer safe. In addition, the buggy did not have proper straps for the little girl, so the grandmother had to get some on eBay. As we all know, there are long waits for wheelchairs and buggies for disabled children. I think that the lack of buggy was down to one of the health providers.

Padded walls were needed for the bedroom because the little girl would bang her head on the wall. Someone first said that they would pad all the wall and then that they would pad just around the bed. While that would be just about manageable, it had not been done. There was also no chair for the little girl, so she had to sit in her buggy indoors. While a chair had been loaned by social services, it was inappropriate and not big enough. A ramp was also needed to get the child out of the house in the buggy. That was down to the housing authority, although an occupational therapist was required to carry out an assessment and procure the ramp. The grandmother's real problems were not money, her age—she was in her early-50s and had to give up work completely, although she had worked for her entire adult life, which obviously damaged her pension rights—her job security, or the fact that she was up all night with a little girl who could not sleep, but that she could not get the things that she needed, that there were waiting lists and that she did not know when the occupational therapist would come.

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Nadine Dorries (Mid Bedfordshire, Conservative)

Does the hon. Lady agree that the story that she is articulately relaying is repeated by carers to Members in constituencies throughout the country over and over again? The problem for each family is usually not obtaining one particular piece of equipment, whether that is a bath hoist, proper padding for a bed, incontinence sheets, or the right chair, but that they cannot get three or four things. The problem continues over the years. How long will it take to get this right?

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Sally Keeble (Northampton North, Labour)

I think that the example that I am citing is especially poignant because of the nature of the family involved. The system must be able to adapt to the needs of many carers, especially those who are pitched into it, and to recognise that many small support systems are needed to make such care placements possible. It is important that local authority leaders in managing care are appointed and work effectively. Targets such as those on waiting times for operations should be extended to the time allowed for the provision of aids and adaptations. It is completely impossible to care at home for someone who has outgrown their wheelchair, or if aids and adaptations are provided only after a person's physical condition has deteriorated to the extent that they can no longer be used. For example, I have a friend who received his hoists only after his condition had virtually reached the point at which he could not use them. There is an urgent need to recognise and address that situation. I put it to the hon. Member for South-West Surrey that those needs are every bit as pressing as, if not more pressing than, the need to deal with some of paperwork involving benefit claims.

Although the hon. Member for Romsey and others have raised this point, I wish to emphasise the situation for young carers. The website of the excellent young carers initiative shows that in the 2001 census, it was estimated that there were 5,016 carers aged five to seven providing one to nine hours of care a week, and that 943 of those carers provided 50 hours or more of care a week. Those astonishing statistics obviously have implications for every agency. I should also point out that a number of those children are bullied, and there is a real need for schools to consider the emotional support that those children need in order to cope with their difficult situation.

I simply echo the comments made by other hon. Members about the outstanding support that carers provide; in many ways they are the unsung heroes and heroines of the care world. In her response, I hope that the Under-Secretary of State for Work and Pensions, my hon. Friend Mrs. McGuire, will set out exactly how the Government will meet the challenges of upgrading support for carers.

9:35 pm
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Jeremy Wright (Rugby and Kenilworth, Conservative)

It is a pleasure to follow Ms Keeble, because I want to concentrate on people at the opposite end of the age spectrum to those whom she was talking about when she left off her remarks. I shall talk a little about older carers. As we have heard, there are about 6 million carers in the UK, and about a quarter of them are over 65. It is a staggering statistic that 8,000 of them are over 90; I find that remarkable.

Older carers face particular problems, some of which are obvious, and others of which are less obvious. Among the more obvious problems that they face, particularly if they are caring for someone with a physical disability, is the difficulty of managing the physical lifting as they become older. Secondly, older carers may have difficulties with fatigue, which begins to set in more easily, and becomes more difficult to recover from. Thirdly, other hon. Members have mentioned medical conditions, which often afflict the carers themselves; that problem is exacerbated among older carers. Less obvious are the financial problems, although they too have been mentioned, not least by the hon. Member for Northampton, North.

On the finances of older carers, there is no doubt that the carer's allowance is, understandably, regarded as an income replacement measure, but when a person retires, they may lose that income, because it is offset against pension payments. An extra difficulty is that some carers have been forced to retire or stop working earlier than they otherwise would have done, so their pension payments are reduced and their pension income is therefore smaller. As others have said, it is still too complicated for people to get what is available. The carer's addition to the pension credit is not claimed by 63,000 carers who are entitled to it. That figure is too large. Older carers are the very people who are put off by the vast amount of paperwork, referred to by my hon. Friend Mr. Hunt, that must be completed if they are to obtain that income.

Older carers are also put off by the need to ask for help—a point that Mr. Weir made. It is important to remember that when we are dealing with the over-65s, we are dealing with a proud generation. They do not enjoy asking for help. They have the admirable but completely counter-productive attitude that it is up to them, not the state, to look after their loved ones, so they do not claim help—both with regard to respite and with regard to financial assistance—when they should. The difficulty that the Government, and indeed any Government, face is that they must identify carers who do not identify themselves as being in need of help, and must none the less provide that help to them.

In providing that help, carers' relationship with the agencies that ought to be in partnership with them to help provide care is crucial. It is important, particularly for older carers, that their relationship with social services departments is good, productive and a genuine partnership, but too often that is not the case, as the Under-Secretary of State for Health, Mr. Lewis, has said. A good relationship with the social services department means that an older carer is more likely to ask for help when it is needed. A bad relationship means that it is less likely that that help can be asked for, and that may be because many older carers fear that if they go to social services and ask for help, they will be judged incapable of looking after their loved one, who will be taken into residential care against their wishes and the wishes of the carer. That must be addressed. The Minister himself said that far too often carers believe they have to shout loudly to obtain the services that their loved ones need. He is entirely right, and it is perhaps the most significant problem that many carers face and which they often identify. It is particularly acute among older carers. Far too often, the services that are available to carers and the people for whom they care are arranged for the convenience of the provider, not for the convenience and use of the person who utilises them. Surely, the assumption should be that it is the carer, who knows the individual best, who knows best, not that it is the state that knows best.

Most people, as we all agree in this debate, would prefer their care to be delivered at home, in an environment with which they are comfortable and familiar. If that is to be achieved, we must all assist carers to deliver that care. Again, as we all agree, in future there will be many, many older carers, partly because of longer lifetimes, but partly because of other demographic changes. Indeed, it is far from inconceivable that someone looking after an aged parent is well past retirement age, so there is a whole new dimension to older carers' needs and responsibilities that we must address.

I agree entirely that supporting carers is not just the right and decent thing to do but is economically prudent. If people providing care on a voluntary basis do not continue to do so, it is simply unsustainable for the taxpayer to pick up the entire burden. I hope very much that the Government and, indeed, any Government will continue to give older carers particular consideration in making their judgments.

9:42 pm
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Greg Clark (Shadow Minister (Charities, Voluntary Bodies and Social Enterprise), Communities and Local Government; Tunbridge Wells, Conservative)

It is a pleasure to follow the powerful and reasoned contribution of my hon. Friend Jeremy Wright.

I should like to make one point, which is inspired by regular visits to the House over the past two years by the members of the west Kent branch of the Alzheimer's Society. A powerful point that emerges from talking to them is that the society is there to help the carers of suffers of that terrible disease as much as those who have the disease. That points to a wider lesson: when the drugs and treatment that can alleviate the effects of diseases are considered by the National Institute for Health and Clinical Excellence, the guidelines that it is obliged to follow focus narrowly on the effect on the patient, the health service and personal services, but the effects on carers are left out completely. I do not blame NICE for that—that is the nature of the standing orders from the Secretary of State under which it operates—but it is possible, particularly when considering Alzheimer's disease, that when NICE clinically evaluates a new generation of drugs and concludes that a certain drug is not sufficiently effective to be prescribed, if the effect on carers were allowed to be taken into account, a different result would come about. The Alzheimer's Society estimates that the new generation of drugs can save an hour a day of carers' time. That may not seem to be terribly much, but as the drugs cost £2.50 a day, even if carers were paid the minimum wage, the drugs would pay for themselves twice over if NICE were allowed to take into account the effect on carers.

I hope that when the Under-Secretary of State for Work and Pensions, Mrs. McGuire, replies she will comment on whether the Government are prepared to relax and change the conditions under which NICE operates to allow it to take into account the effects on carers. That is not necessarily a recipe for increasing expenditure but for a prioritisation of Government expenditure to reflect the true effect on people with diseases and those who look after them.

9:44 pm
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Tim Loughton (Shadow Minister (Children), Health; East Worthing and Shoreham, Conservative)

The debate has been short, but concise and of high quality. It is a shame that more of the hon. Members who were present earlier for the Iraq debate were not in the Chamber to listen to the excellent representations that have been made. We are debating not an instant, but an ongoing experience for many millions of our constituents.

Ms Keeble made a good point when she reinforced the consensus against bureaucracy and flagged up the caring responsibilities of many grandparents. My hon. Friend Jeremy Wright made a powerful demographic point about the ageing population. Representing a constituency such as Worthing, I know about old carers, many of them well into their seventies, if not more, looking after even older charges. My hon. Friend Greg Clark made a pertinent point about the particular challenges facing Alzheimer's sufferers. As somebody who has a large Alzheimer's Society branch in my constituency, I applaud the excellent support that it provides to carers. We have people in their mid-thirties now with Alzheimer's—not only are instances of the disease increasing, but it is affecting younger people.

I will not repeat the comments that have been made about the number of carers—6 million, or one in 10 adults—or the cost to the state that is being saved. Some 20 per cent. of young carers look after parents or family members with a mental health problem. We are discussing not just physical disabilities. I shall focus my comments on young carers, because we have so far talked mostly about older carers. I welcome the legislation that has been introduced over recent years, and some of the Government's strategy, but still too many young carers tell us that they are not getting the help and support that they need—an awful lot of warm words, but not enough firm action.

Surely our responsibility as parliamentarians and the responsibility of the Government should be to do everything we can to remove the obstacles to caring and to make the job of carers much easier because they do the nation an enormous service. We need to make their access and entitlement to information much easier so that they do not have to spend so much of their time hunting for it. We must make the paperwork simpler and shorter. My hon. Friend Mr. Hunt cited horrendous figures to illustrate the complexities of the benefits system.

We must increase the availability of respite care and offer flexible respite care that can also be provided in the homes of the people being cared for. It is not just a question of sending somebody to a residential home. A little break can give a big boost to carers who have onerous responsibilities day in, day out. Above all, we must recognise and value the contributions of carers and provide flexibility. Caring is not a constant—the condition of a person who has a disability can go up and down so we need long-term and sustainable strategies. That is why, at the last election, we had in our manifesto certain commitments that would recognise the vital role played by informal carers.

I said that I would concentrate on the role of the 175,000 young carers—2 per cent. of children overall, including 18,000 children under the age of 15. That was starkly brought home last month when the Princess Royal Trust for Carers raised the case of Deanne Asamoah, the 13-year-old who died from a morphine overdose after caring for her terminally ill mother for four years, and the pressures of caring that brought her to that tragic end to her own life. Some 250,000 children in the United Kingdom live with a parent who engages in some form of substance misuse, and they often end up as carers as well.

The "Hidden Lives" report produced last year by Barnado's shows that some young carers can go for years without requesting help. They are often excluded from medical discussions. One of the things that young carers mentioned to us is that when they are effectively providing nursing support to a family member, the doctor will exclude them from discussions, yet they are vital to providing that care and undertaking big responsibilities such as administering the drugs that may be prescribed. They suffer at school, and their social life and their health suffer. That is why I am glad that so many hon. Members mentioned the effect on carers themselves, not just the mechanics of caring for people with disabilities.

I echo the tributes that have been paid to organisations such as Barnado's, the Princess Royal Trust for Carers, the Children's Society's young carers initiative, NCH and Crossroads, and particularly to Jenny Frank, the programme manager at the Children's Society, who every year organises the young carers festival, which I have attended for most of the seven years that it has been held in Southampton, together with Annette Brooke. Some years ago, at their own behest, they organised a parliamentary question time and invited MPs to go down there to answer questions. They invited us to go down again to report on the progress that has been made. I always feel slightly guilty at the lack of progress for young carers in too many cases, despite the warm words of many of us.

That festival, Madam Deputy Speaker—I know that you have your own interest in it—is a truly remarkable event. I defy anybody who goes there not to be overwhelmed by the enormous dedication of and sacrifices made by young people, many of whom are very young indeed. On 18 April this year, many of them came to Portcullis House, where I chaired a session with them in which they could, face to face with parliamentarians, give their checklist of the things that they wanted to happen to make their job easier. Let me quote some of the comments from that event and from previous young carers festivals. The things that they wanted to say to social services included:

"I want someone to teach me to cook proper meals for my mum when she's ill, not scrap meals."

"I want someone to be there when needed and when things get out of hand."

"To answer and return phone calls, and actually be on time and friendly and talk to me not just my parents."

"If they're not going to help they should say so straightaway."

Things that they wanted to say to their teachers included:

"We cannot always manage our time to do homework and often it is necessary to miss school and so we fall behind, but it is NOT our fault."

"We might be tired because we've been busy at home."

"We might need time to have FUN!"

I could repeat such comments from all the other events that we have attended.

Many young carers get into problems at school through no fault of their own. The cycle of truancy that can result can often be as follows. A child takes on a caring role and gets behind with work. They are late for school because they are looking after younger brothers and sisters, or they miss days when their family member is unwell. They are afraid of giving the real reasons, so they make up unconvincing excuses. They get detentions after school but cannot attend them because they have to get home. That leads to more trouble and worsening relationships with teachers, and it starts to become easier to stay at home where they feel valued. They miss out on their education, on their social life, and on their good health, which often means that they miss out on the career prospects that go with them.

What is needed for young carers is not rocket science. They tell us that they need continuity of funding for young carers' projects so that they do not start and then stop because the money has run out. They need good projects such as the Brighton young carers outreach project. They need respite to be available and to be able to have a social life. They need to be able to get together with other young carers. They need to know where to go for help and to be able to get it without struggling. They need to be included in health decisions about their charges. Above all, they need understanding and flexibility at school, with a nominated teacher who appreciates the problems that go with caring. We need to look after the health, career and development of our young carers, not just the people they look after, and the same goes for adults. The state should be on their side and at their side, not in their way. We owe these people a debt of gratitude, and we owe it to them to make their job easier.

9:53 pm
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Anne McGuire (Parliamentary Under-Secretary (Disabled People), Department for Work and Pensions; Stirling, Labour)

Like Tim Loughton, I too, Madam Deputy Speaker, would like to recognise your own contribution to the support of carers over many years. I am sure that Mr. Speaker will not mind my saying that it is entirely appropriate that you are chairing tonight's debate.

I welcome the opportunity to highlight the commitment of carers who, as Members on both sides of the House have said, put a degree of commitment and energy into their task that would put many of us to shame. Today's launch of carers week makes it entirely appropriate that we are discussing these issues.

I echo what the Under-Secretary of State for Health, my hon. Friend Mr. Lewis, said when he opened the debate. The Government are justifiably proud of their record in extending support and opportunities to carers over the past 10 years, including the first national carers strategy in 1999. I believe that Governments should be judged not on their Green Papers and strategies but on their achievements. As my hon. Friend the Under-Secretary of State for Health said, the Government not only produced a national strategy for carers shortly after taking office, but have introduced a raft of initiatives since then.

At the heart of that strategy was the recognition that carers also deserve care and support. That did not previously exist. I thank Mr. Hunt, who led for the Opposition, for acknowledging some of the Government's achievements. Tangible policy changes have occurred. We introduced the carer's grant to support councils to provide breaks and services for carers in England. By 2008, that grant will have delivered £1 billion worth of additional support. We introduced new legislation to improve carers' rights and a new right to carer's assessment. Indeed, in 2004, Parliament extended the nature and scope of carer's assessment through the Carers (Equal Opportunities) Act, which, as my hon. Friend the Under-Secretary said, was a private Member's Bill.

However, as the motion states, many carers do not currently work. The Government want carers to be able to work when their caring commitment allows them to do so. We all recognise that employment brings not only financial advantages but social contact, on which many carers miss out if they care full time. That is why, in April this year, the Government extended the right to request flexible working to the majority of carers of disabled adults. Again, that was not even contemplated previously.

I hope that hon. Members recognise that we have demonstrated our commitment to helping carers balance their caring responsibilities with their need and desire to work and engage in social activity.

Let me pick up on a couple of points that hon. Members made. Sandra Gidley highlighted the importance of flexible working practices and I was delighted to hear the example—I think it was of British Telecom—that she gave. She said that the company had introduced flexibility not only for specific categories of workers but across the piece. That will undoubtedly assist carers. I gently suggest to her that she needs to look again at the website from which she got the telephone number she mentioned because we cannot trace a Government helpline that is open only between the hours of 10 and 4 on two days a week. We suspect that it may be one of the many helplines that voluntary organisations have set up. If she gives us the telephone number, we will double-check that.

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Ivan Lewis (Parliamentary Under-Secretary, Department of Health; Bury South, Labour)

Don't ring us, we'll ring you.

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Anne McGuire (Parliamentary Under-Secretary (Disabled People), Department for Work and Pensions; Stirling, Labour)

Something like that.

I was especially delighted that my hon. Friend Ms Keeble highlighted the importance of the carer's element in pension credit. She rightly said that it is a bit of an unsung, positive response by the Government to income maintenance for those at state retirement age when they lose out on their carer's allowance.

Let me point out to Jeremy Wright that one problem that we addressed with regard to older carers was lifting the age embargo that existed throughout the Conservative Government's tenure and which meant that people at state retirement age were no longer entitled even to apply for carer's allowance. We lifted that embargo and said that age was no disadvantage to applying for carer's allowance, and when it could not be paid because of the double entitlement rule, we introduced the carer's premium, which my hon. Friend the Under-Secretary highlighted.

I appreciate that I may not have much longer to stand at the Dispatch Box, since I see Mr. McLoughlin from the Opposition Whips Office in his place. I regret that the debate has been so short, but I hope we have demonstrated that we are committed to recognising the efforts of carers and building on their support. I look forward to further discussions with colleagues across the House to see how we can make matters even better.

Question put, That the original words stand part of the Question:—

The House divided: Ayes 198, Noes 291.

Division number 137

See full list of votes (From The Public Whip)

Question accordingly negatived.

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

Main Question, as amended, put and agreed to.

Resolved,

That this House recognises the vital contribution that the UK's six million carers make to society; welcomes recent announcements on carers including the Government review of the first ever National Strategy for carers, the New Deal for Carers and the Treasury report "Aiming high for disabled children: better support for families" as steps towards an improvement in recognition and support for carers; notes that the review of the National Strategy includes a far reaching consultation with carers and others to make recommendations for the short, medium and long-term; further welcomes the extra £25 million for short-term home-based respite care for carers and the extra £3 million towards establishing a national helpline for carers announced in 2007; congratulates the Government for introducing in 2007 the new Expert Carers Programme; further notes that the Pensions Bill currently before Parliament includes a package of reforms to recognise the contribution made by carers and ensure that they can build up better pension records; further notes that the right to request flexible working introduced by this Government will help carers better balance their work and caring benefits; and further welcomes the substantial improvements made to the benefits available to low income carers.

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Sylvia Heal (Deputy Speaker)

Order. Will Members who are leaving the Chamber please do so as quickly and quietly as possible? Will those who are remaining please reduce the level of conversation?

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Sylvia Heal (Deputy Speaker)

Order. I wish to hear the hon. Gentleman's point of order.

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Nicholas Soames (Mid Sussex, Conservative)

Today, I tabled a parliamentary question to the Secretary of State for Foreign and Commonwealth Affairs. Since a Foreign Office Minister is present, I wondered if I might raise the matter with you, Madam Deputy Speaker. The question was:

"To ask the Secretary of State...how many Russian diplomats have been asked to leave London for activities incompatible with their diplomatic status in the last 12 months."

The answer is:

"I will reply to the hon. Member shortly."

It seems to me that that cannot be an accurate or proper reply to give to a Member of Parliament—that the Foreign Office does not know how many Russian diplomats have been asked to leave because of activities incompatible with their diplomatic status. As a general point, will you say that the Chair expects that properly tabled questions deserve and require proper answers?

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Sylvia Heal (Deputy Speaker)

The occupant of the Chair has many responsibilities, but Ministers' replies are entirely Ministers' responsibility. I think the hon. Gentleman's point of order will have been heard and noted.