I beg to move,
That this House, noting that there are an estimated 5·5 million people from the age of seven to 70 years caring for disabled and elderly relatives at home, often for many years, pays the warmest possible tribute to those carers; and, further noting the research which shows that carers themselves suffer disproportionately from mental and physical illness, social isolation and poverty, calls upon the Government to take urgent action to improve their position, especially in view of the undoubted savings to public funds which flow from their commitment, and in particular to ensure that, in line with its stated policies on care in the community: (i) adequate respite care, both at home and in short-stay facilities, be assured by a considerable improvement in the level of support given to statutory and voluntary agencies, (ii) a flexible system of cash and other appropriate support services, such as home helps and home nursing, be available at times when the carer needs them and (iii) the invalid care allowance is made available to married women carers as recommended by the Select Committee.
Community care policies have been advocated now for a decade on the basis that it is much better for those who need support because of physical or mental infirmity to be cared for outside large institutions. It is now becoming increasingly recognised, however, that that policy has merely shifted the burden of care from the trained and supportive to the untrained and isolated in the form of the family. What started off as a policy of keeping dependent people out of institutions has backfired to the point where it has created more mentally and physicaly ill people—this time those who are supposed to be the carers.
At present, carers save the state over £5,000 million. That would be the cost to the state if it had to provide alternative institutional care. One would think that the state would aim to put back some of that money to support them in their invaluable role. Instead, the Government have been offloading responsibility on to their shoulders without even a sideways look at how they should be helping.
At present 5·5 million men and women are caring for an elderly or disabled friend or relative who could not live safely or comfortably without their help. They include about 1·25 million people who are caring for someone who is severely or extremely severely handicapped. I understand that as many as 100,000 of them have been caring for more than 10 years, and that thousands have been caring for as many as 30 years or more. Those figures give the lie to the myth that we are no longer a caring nation.
Today, far more people than ever before are making a major contribution to the physical and mental health of a family member, but they can maintain that role only if they have support. The Opposition have tabled this motion because of the absence of that support in far too many cases.
About two out of three carers are in poor physical or mental health at any one time. Recent surveys have shown that nearly half are at serious risk of mental illness. Nearly seven in 10 suffer physical injury as a result of their caring duties, because there is a great deal of single-handed lifting involved, unlike in hospitals where nurses are ordered to lift only in pairs or using the appropriate hoists. The position is made worse for carers when a back injury cannot be rested or a hernia repaired because there is no one to take over their caring duties while they are in hospital.
Carers suffer emotional and psychological stress from social isolation, when other family members flatly refuse to help, or when statutory services simply fail to materialise in support. The complete submersion of one's own needs and preferences in those of another and feeling wholly out of control of one's life are major causes of depression in carers. They suffer financial penalty because disability and frailty nearly always lead to reduced income and increased outgoings. The Government should not be so mealy-mouthed about that by altering the word "poverty", which we use, to "disadvantage" in their amendment. Carers suffer "poverty"—and we use that word advisedly.
Many entitlements to benefit are lost as soon as a disabled person moves in with a family member. An elderly disabled parent can no longer claim supplementary pension and will lose heating and diet allowances. Most important, carers' problems are often multiple, not of one type alone. Physical injuries, psychological stress, and financial hardship are often compounded. In addition, many carers have duties towards not only one single disabled, or extremely disabled, person, but to two, or even three. I could give many examples, but I shall cite one.
A woman of 50, whom I know, cares for her husband who is 20 years older than she is and is suffering from dementia. Her parents, who are in their 90s, and her mother's sister live with them. Both her mother and her mother's sister are physically frail, and her mother is also blind. She receives assistance only from a district nurse who comes once a week to give her mother a blanket bath. Such cases are typical. There is nothing exceptional about them.
All the evidence shows that the more handicapped and dependent a relative is, the less support a carer will receive from formal and informal agencies. That makes the cumulative burden all the harder to bear. The more disabled a relative, the fewer the people who are prepared to give the necessary assistance. It is because volunteers and neighbours are of little help when a disability becomes advanced, which is when help is needed, that statutory support is urgently required.
Above all, the debate centres on the unrecognised needs of women. More than one in eight women is a carer, and four out of five carers are women. Their position is much worse than that of their male counterparts because they are much more likely to have to give up their jobs. They have less money, experience more stress, and are less likely to receive support services. To add insult to injury, married and cohabiting women are denied invalid care allowance, which is the sole benefit paid to people who are prevented from undertaking full-time work because they are carers.
The problem will not go away. As the numbers of elderly people increase—that section of the population will grow fastest towards the end of the century—an increasing number of people will need assistance if they are to continue to lead independent, fulfilled lives. Our intention today is to make it clear that carers cannot and must not be expected to bear the full weight of the Government's community care policies unseen, unpaid and undervalued. That is the central theme of the debate.
I take this opportunity to pay the warmest tribute to the Association of Carers for its dedicated and tireless campaign to bring this vital issue to the attention of the nation.
At present, the position of carers is worsening. The Social Security Bill will leave carers entitled to long-term supplementary benefit worse off by £6·90 a week. In addition, they will have to pay the first 20 per cent. of their rates from that reduced income. The Government have refused to move on the European Advocate General's recommendation on the Drake case, made a week ago. They have talked of the money being spent on services instead of on invalid care allowance. The truth is that the allowance is not being paid and the services are not being provided. The Government failed to support the carers' clause in its original form in the private Member's Bill introduced by my hon. Friend the Member for Monklands, West (Mr. Clarke). Therefore, they have denied carers the right to be assessed for their ability to care or to continue caring, and that is extremely important to carers.
Even the Government's helping-the-community-tocare programme—I pass over its tiny £10·5 million budget—has been a wasted opportunity for carers, because almost none of the funding has been directed towards increasing statutory services to carers as a right.
Our motion calls on the Government to provide some real, substantial increase in support for carers in ways which they want. First, carers—who have often given up full-time work to undertake their caring role—want an income independent of those whom they look after. Following the clear prompting—I know that this is a recommendation—of the European Court, we in the Labour party believe that the Government have an undeniable duty to pay invalid care allowance to married and cohabitating women. I have received legal and counsel's opinion that if, in June, the European Court decide that the Government are discriminating against women, and if they do not pay invalid care allowance to every eligible woman, regardless of whether she has claimed it, backdated to December 1984, they will be acting unlawfully.