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Carers

Bill Presented – in the House of Commons at 12:31 pm on 11th June 2009.

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[Relevant documents: The Fourth Report of the Work and Pensions Committee, Session 2007-08, HC 485-I, o n Valuing and Supporting Carers , and the Government's response, First Special Report of the Committee, Session 2008-09, HC 105 .]

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Photo of Phil Hope Phil Hope Minister of State (the East Midlands), Regional Affairs, Minister of State (the East Midlands), Department of Health 12:35 pm, 11th June 2009

I beg to move,

That this House
has considered the matter of carers.

I am pleased to open this debate on carers during national carers week. The way we look after people with care and support needs defines us as a society. Everyone, at some point in their lives, will know and love someone who needs care. Many of us will need care ourselves, for whatever reason. It is an indication of the strength of our society that every day, between 5 million and 6 million people care for their family members. They do an incredible job, often giving up a huge amount to care for someone they love. Carers are not a group separate from the rest of society—they are society.

Through the 10-year carers strategy, which, as some hon. Members will remember, we launched almost exactly a year ago today, the Government want all carers to be universally recognised and valued as being fundamental to strong families and stable communities. That is the unifying vision for the future of our long-term strategy. We want support that is tailored to meet an individual's needs. We want carers to be able to care for the ones whom they love and still enjoy a life of their own. We demand recognition that both carers and the cared for are full and equal citizens.

We have a lot to do before we realise that vision but, one year on, we are on our way. One person who will help us to realise that vision is the chair of the standing commission on carers. I am delighted to announce to the House that Dr. Philippa Russell has been appointed to that role. I want to place on record my thanks to her and all members of the commission for the work that they are doing to develop, implement and monitor the strategic vision, alongside the cross-Government programme board that has been established, and of course the inter-ministerial group, which I chair.

I want to begin by recognising the particular contribution and needs of young carers. We have a special duty to support young carers and to protect them from excessive caring burdens and inappropriate caring roles. As part of our £75-million Think Family programme to support all families at risk, the Department for Children, Schools and Families has set up six extended family pathfinders for young carers. The Department of Health is supporting those pathfinders to test how we can better support families with young carers. We believe that young people who have caring responsibilities for a family member should not be denied the right to enjoy their childhood, and to grow up like every other child.

Yesterday, together with the Under-Secretary of State for Work and Pensions, my hon. Friend Jonathan Shaw, who is the Minister with responsibility for disability, I met carers in Islington and Camden at the official launch of the new website and telephone helpline for carers, Carers Direct, which I will say more about in a moment. One of the concerns that people there raised was the lack of awareness of the needs of carers among the host of different organisations and individuals whom they encounter in the health service and on local councils. I agree with them that it is important that professionals and others who offer support for carers do so while understanding their needs. That is why, over the next two years, Skills for Care and Skills for Health will develop a range of new training programmes and awareness-raising modules about carers for those professionals. We have also commissioned the Royal College of General Practitioners to develop training for GPs, based on the new action guide for primary care, to help GPs better understand carers' needs.

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I

The Minister expects Carers to live on £53.10 per week and they did not even discuss increasing this. Contrast this with how the Minister lives:- Phil Hope's shopping list for his London flat, May 2004 to February 2008 £3,500 bathroom including 750mm vanity cabinet costing £336.20 £2,165 boiler £805.56 17 'misc' items including £1.58 food box £451.73 various household items, including £121.85 on four table lamps £59.99 kitchen equipment £88.71 shelving £95.76 carpet £179 blinds/curtains £176.99 DVD/VCR £174.99 pillows and duvets £195.25 misc kitchens, bathroom items £120 heated blanket £88 convector heater £76 china £107.30 gardening equipment £52.80 cutlery £149.99 radio £95.75 kitchen utensils £125.84 lounge lamp £119.46 replacement barbecue £91.04 decorating materials £61.32 gardening materials £238.53 replace damaged hall flooring £159 replace tableware £194 replace linen £819.01 five items under inc £225 rug, two £14 pedal bins, £32 net curtains £269.64 deposit for sofa £155 shelving £798 two modular bookcases £123.35 kitchen utensils £1,078.56 one two seat sofa (£1,199) one coffee table (£299) £198 replace chairs x 2 and covers £219.28 bathroom, cleaning, kitchen accessories £172.99 bedroom, lounge, accessories £424.98 replacement washer, machine. Hotpoint washer dryer £295 replace armchair. One chair from John Lewis £238.70 various household items £750 television (had claimed £795) £221.74 kitchen equipment £398 bedroom furniture, including chest of drawers £91.62 decorating items £240 replace saucepans £235.60 replace lighting and kitchen equipment £189.62 painting/ decorating/ cleaning items £230 mattress £179 misc electrical goods £249 replace music player £125 replace china £69.50 TV stand £117.90 wall lights £119.99 kitchen item £235.25 kitchen wall and floor tiles £206.32 kitchen equipment £339 replace wardrobe deposit £1,200 replace wardrobe with double wardrobe and sideboard from Sliderobe £240 tiling kitchen floor £229 replace towels and glassware £2,403 Ikea kitchen equipment (part payment) £2,117.53 Ikea kitchen equipment (part payment) Kitchen includes six floor...

Submitted by Ian Sandeman Continue reading (and 1 more annotation)

Photo of Fraser Kemp Fraser Kemp Labour, Houghton and Washington East

Of course we all welcome training for professionals in the field. In common with many other hon. Members, I met some carers in my constituency on Friday. One of the issues that came up was training for carers, not the professionals. One constituent said that she had gone on a training course that had dealt with the particular complex issues affecting her son. She said that she could not express of what huge benefit that was to her in understanding his condition and disability. I know that some research projects are going on, but I ask the Minister to consider training for carers as well as professionals.

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Photo of Phil Hope Phil Hope Minister of State (the East Midlands), Regional Affairs, Minister of State (the East Midlands), Department of Health

My hon. Friend is right to draw attention to that matter. I will say more about it in a moment. I know that he is a real champion for carers in his constituency. We have a training programme, which I shall say more about later, called Caring with Confidence, which is not for professionals; it is for carers, and is delivered by carers, which I think is quite unique. That is extra work that we are doing. He is right to highlight the issue, and we are responding directly to the concerns that he raises on behalf of his constituents.

It is really important that GPs understand the additional help that there is for carers, so that when a carer goes to them with health needs, they not only help to meet those requirements but signpost—refer—the carer to other sources of support in their area.

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Photo of Angela Watkinson Angela Watkinson Opposition Whip (Commons)

The Minister referred to extended family pathfinders, and I was waiting for a little more expansion on that theme, but he moved on rather quickly. Will he explain how the scheme will be co-ordinated? Will its co-ordination be the function of health services, social services, education or GPs?

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Photo of Phil Hope Phil Hope Minister of State (the East Midlands), Regional Affairs, Minister of State (the East Midlands), Department of Health

I shall happily write to the hon. Lady to give her those further details. The pathfinders scheme operates through the Department for Children, Schools and Families. Its purpose is to look at the needs of families—as a whole—that are in stress or in areas of disadvantage, which find it difficult to get through life as a family and have complicated caring arrangements and responsibilities, and to understand what works when building a package of support around a family. We want to pilot and test those things in different settings—rural, urban and so on—so that we can understand what families need. However, I shall write to her to detail where they are, how they are funded and so on, so that she understands those points.

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Photo of Anne Main Anne Main Conservative, St Albans

I thank the Minister for giving way on the point about support care packages, because one of my constituents sadly died after a support package was not put in place. Mr. Tonkin starved himself to death in a care home while waiting to return to his family. It took more than five months to begin putting a care package together, but still it never came together, despite the family wishing to support Mr. Tonkin's return to his own home. I therefore caution the Minister, because introducing new structures might sound very good, but we currently have structures—in terms of carers and care packages—that are not working.

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Photo of Phil Hope Phil Hope Minister of State (the East Midlands), Regional Affairs, Minister of State (the East Midlands), Department of Health

The hon. Lady will understand that I cannot comment on a particular case, because I do not know the details. However, I do know that we have to do both: drive up the standards of residential and domiciliary care throughout the country. I am therefore delighted that the Government have given not only ordinary grants to local authorities, but an additional £520 million to help the process of transforming social care and raising the quality of care throughout the country. Responsibility for the quality of care rests with the Care Quality Commission, which conducts inspections of care homes and others who might provide the care to which she refers.

There is also a separate complaints process in place, which the hon. Lady—on behalf of her constituents and, indeed, the family of her constituent—can use, particularly in respect of local authorities, if an individual has not received the care that would be expected. She can use the complaints process to take the matter forward.

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Photo of Anne Main Anne Main Conservative, St Albans

I should not like to leave the Minister with the wrong impression that the care home was at fault; it was the inability to put a care package together, through the Department for Children, Schools and Families, so that the family could have Mr. Tonkin go home. The care home itself treated him very well, apparently. I do not wish to leave the Minister with the impression that it was a poor care home.

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Photo of Phil Hope Phil Hope Minister of State (the East Midlands), Regional Affairs, Minister of State (the East Midlands), Department of Health

I am grateful for that clarification.

I shall move on to respite care, because we know that caring for someone can be hard. Six out of 10 carers say that the biggest thing that we can do to help them is to give them a break. That message was repeated by the carers whom I met at Centre 404 in Islington yesterday. Since we introduced the carers grant in 1999, more than £1 billion has been provided to councils to do just that. The grant is worth £240 million this year and will increase to £256 million next year. It includes £25 million a year for councils to respond immediately to carers who are in a crisis and can no longer care for their loved one. Encouraging the national health service to recognise that support for carers is as much an issue for it as it is for local councils and social care, so we have allocated an additional £150 million to primary care trusts between 2009 and 2011 to work with their local authority partners to provide personalised breaks for carers.

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R

"""""so we have allocated an additional £150 million to primary care trusts between 2009 and 2011 to work with their local authority partners to provide personalised breaks for carers."""" Several carers have been contacting their own PCTs’ ..... 1 . “”””Your request for information has now been considered. However unfortunately we do not hold the information. To date the Trust cannot identify this allocation. Until it has done so, plans for the utilisation of the funding cannot be completed. I apologise that your request cannot be met but if you have any further information needs in the future...

Submitted by Rosemary Continue reading

Photo of Ann Clwyd Ann Clwyd Special Envoy to PM on Human Rights in Iraq

My constituency has a very high percentage of disabled people, because of past industrial disease, and a very high percentage of elderly people. Many carers are being short-changed by an outdated benefits system, which simply does not recognise the enormous contribution that carers make to looking after people who need them to stay at home and give up their jobs in order to assist them. What does my hon. Friend have to say on that point?

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Photo of Phil Hope Phil Hope Minister of State (the East Midlands), Regional Affairs, Minister of State (the East Midlands), Department of Health

I shall come on to allowances and benefits in a few moments, but my right hon. Friend is right to suggest that there is a concern about whether the combination of allowances and benefits works in the best way, because it is a complicated system. Whatever the processes are for reviewing, developing and reforming that process, however, right here and now help is at hand, because individuals can go to the new website that I have described, look at the benefits system and allowances, see what they qualify for and ensure that they get all their entitlements to help them get through the situation.

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R

Saying that right here and now help is available via the new website is misleading.
Advice and information online has been around for a while now.CUK and PRTC already had the information on their websites,had the helplines.
People getting their due entitlement is vital but what he does not seem to grasp is that the benefits are not enough,the amounts an insult.

Submitted by Rosemary

Photo of Derek Wyatt Derek Wyatt Labour, Sittingbourne and Sheppey

I thank the Minister for this morning seeing the Swale carers group, whose members are listening in the Gallery. If we included Skype on that website, we could connect carers and enable them to talk to each other and share their experiences. It is the isolation that they feel most of all. Will that provision be on the site?

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Photo of Phil Hope Phil Hope Minister of State (the East Midlands), Regional Affairs, Minister of State (the East Midlands), Department of Health

I did enjoy meeting, just before the debate, the Swale carers group, whose members are here to—I hope—listen to and take back messages from the House about the support that is available for carers. Carers Direct, the new website, has an interactive facility, and my hon. Friend is right to point out that people feel isolated. I do not know whether many carers blog, but there is a blogging facility on the site. People can literally type in their thoughts, feelings and problems, and watch and listen to other people with similar problems and share information. That facility will break down the barriers for many people who feel isolated in the very important role that they carry out.

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Photo of Paul Burstow Paul Burstow Shadow Chief Whip (Commons)

The Minister talked about NHS funding and £150 million that has been allocated over two years, but will he say more about how carers and others will be able to track how it is spent in order to assure themselves that their primary care trusts allocate it and spend it on carers' needs?

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Photo of Phil Hope Phil Hope Minister of State (the East Midlands), Regional Affairs, Minister of State (the East Midlands), Department of Health

I know that the hon. Gentleman, speaking as a Liberal Democrat, is fully supportive of devolution and of devolving responsibility for resources and decision making to a local level. He will know that the additional £150 million that we have put into PCT budgets, although not ring-fenced, is for the purpose to which he referred. Part of his responsibilities as a local MP, along with those of carers, might be to ensure that the local primary care trust understands the needs of carers, does the job that it should be doing to assess people's needs and ensures that it allocates from its budget the money that the Government have allocated to it to support carers in the area. I hope that he works with local carers to ensure as much—and, indeed, that every Member works with local carers to ensure that local primary care trusts and authorities carry out proper needs assessments and the proper development of programmes and policies to support carers, who do such a fantastic job throughout the country.

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R

Once again the govt distance themselves from responsibility.Why should local carers ensure that PCTs are using the money for the purpose it was given.That is, or should be part of Mr Hopes remit.Or at least ring fence it.You cannot and should not hand over x number of £ and not follow up that it was used correctly.

Submitted by Rosemary

Photo of Andrew Murrison Andrew Murrison Shadow Minister (Defence)

I am grateful to the Minister for giving way; he is being very generous. He mentioned, in addition to health service funding, funding to local authorities. My constituents in Wiltshire will be slightly baffled by that, however, because the county is at the very bottom of the league table for revenue support grant to local authorities. Will he therefore say a little more about how the extra funding has been distributed among local authorities, and the formula that has been used?

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Photo of Phil Hope Phil Hope Minister of State (the East Midlands), Regional Affairs, Minister of State (the East Midlands), Department of Health

I do not have the facts and figures about the hon. Gentleman's particular local authority, but I know that local authorities have had a record 45 per cent. increase in Government funding in real terms over the past 12 years. As a result, local authorities have improved dramatically the quality of a whole range of services in their areas. In addition, the carers grant that I mentioned has been distributed to local authorities. I do not have the figures on how much his local authority has received, but I assure him that it will have had some. I hope that he will put pressure on his local authority, which is almost certainly controlled by members of his own party, to ensure that it gives to local carers the priority that we expect in its assessment and delivery of services, and that it makes the right choices to provide resources to the most vulnerable and caring people in our society.

We want innovation to be at the heart of everything that we do for carers, so, as part of the carers strategy, we are setting up 24 sites to test, demonstrate and evaluate good practice in support for carers. That action will improve outcomes for carers and provide value for money, and the sites will look at health and well-being checks for carers, breaks for carers and how the NHS can better support them.

Yesterday, on the first anniversary of the carers strategy, we launched Carers Direct, which will give people from all backgrounds—young, old and those with disabilities—access to the information and advice that they need. They will be able to support and talk to each other through the website.

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Photo of Fraser Kemp Fraser Kemp Labour, Houghton and Washington East

With the best will in the world, Members of Parliament will have met, and national carers week will have involved meetings with, a minuscule number of carers. Millions of carers out there have a sense of isolation because of the 24/7 nature of the caring that they do. Any investment in technology that will link and bring people together, so that they can get over the sense of isolation, is great. Furthermore, can Members of Parliament have information so that through our local press we can try to make people aware of the issues? Carers often live in isolated conditions.

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I

The money would have been better spent providing free computers and free internet access for Carers, something MPs all get on expenses.

Submitted by Ian Sandeman

Photo of Phil Hope Phil Hope Minister of State (the East Midlands), Regional Affairs, Minister of State (the East Midlands), Department of Health

My hon. Friend is absolutely right. For those people—I shall not stereotype them—who find it less easy to access websites, there is also a telephone helpline. Anyone can ring that and get direct, face-to-face—or mouth-to-mouth—contact, so that they can discuss their needs. [Interruption.] I am not sure that I got the phrasing right there; never mind, Mr. Deputy Speaker—you know what I meant.

The helpline, as well as the website, is important. We need to break down people's isolation. Carers need advice. We know that the system is complicated and that people do not understand the benefits and allowances available to them. They may not know what is available in their areas. If they get on the website or use the helpline, they can find out more and access the support that they need to do their job better and reduce the sense of isolation mentioned by my hon. Friend.

A comprehensive strategy goes far wider than the remit of the Department of Health, so we are working across Government to improve the lives and conditions of carers. Like other constituency MPs, I regularly meet carers and take up their individual concerns in my own constituency. I have had the privilege of meeting lots of carers this week, as part of carers week. One subject that has continually come up is carers benefits. The Government accept that we have to look again at that issue. I remind the House, however, that we have already given a lot of support. Last year, for example, we provided nearly £1.5 billion in carer's allowance to support carers. That, along with the carer's premium and other income-related benefits, forms a vital part of the financial package of support for carers.

For carers who work or want to work, the Department for Work and Pensions has increased the amount that someone can earn while still receiving carer's allowance, from £50 a week in 2001 to £95 a week now—one of the highest earning limits of any benefit. Given the complexities of the benefit system for pensioners, we have also taken steps to simplify the claiming process for pensioners who are carers—they might, for example, qualify for the carer's premium in pension credits.

We need to do more. Even now, as I discuss pension credits, allowances and benefits, I know that people will worry about the complexity. Last December's welfare reform White Paper reaffirmed our commitment to look carefully at carers benefits. We do not want to make the benefits system even more complex; frankly, carers' lives are complicated enough already. That is why the Department wants to make any changes to benefits not only in the context of the social care system, but alongside its wider ambitions for welfare reform, so that the changes lead to a long-lasting and tailored system of support.

For many carers, there is more to life than simply fulfilling their caring responsibilities. If carers want to work, we want to help them do so. We want to step in, not step aside. Let us give—

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R

Straight from the horses mouth so to speak.Mr Hope says carers can access support to enable them to do their JOB better.Does he know any JOB that pays £53.10 for a MINIMUM 35 hours per week.

He 'accepts' the govt should be looking at carer benefits.They have been looking for far too long.It is action that is needed now.

Submitted by Rosemary

Photo of Alan Haselhurst Alan Haselhurst Deputy Speaker and Chairman of Ways and Means

Order. I am afraid that the Minister has used up his time allocation. He has been generous in allowing interventions, but time has been added for that.

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Photo of Stephen O'Brien Stephen O'Brien Shadow Minister (Health) 12:53 pm, 11th June 2009

It is good to have this opportunity to debate the issues affecting carers across the United Kingdom. I pay tribute to all those who care for relatives and friends. It is a taxing and often thankless task, and it is right that the House should pay tribute to them. Well over 200 right hon. and hon. Members on both sides of the House have signed early-day motions 1519 and 1355 in support of carers week. That stands as our debt of gratitude.

I also pay tribute to the organisations that support carers, particularly Carers UK, the Princess Royal Trust for Carers, the countless local support groups and the online carers' chat rooms and information sources, which are increasingly important for mutual support—a point made by Mr. Kemp a moment ago. I pay tribute also to all those involved in organising carers week. That it is now in its 14th year is testament to its effectiveness in highlighting carers' concerns and needs.

According to Carers UK, there are about 6 million carers in the UK and more than three in five people will become carers at some time in our lives. I was interested that the Minister said yesterday in the departmental press release that there were only 5 million carers, as opposed to the 6 million identified in the 2001 census. Have the Government done a recalculation? If so, will the Minister put into the Library evidence of how many carers there are? Perhaps he will catch your eye later, Mr. Deputy Speaker, to cover that point.

Too often, carers bear the brunt of inadequate provision of care and support. They are among those who are suffering the most because there has been prevarication on reform, not least on the part of the Government. Help the Aged and others have called for carers to be supported as an integral part of the care and support system. I am sure that other hon. Members will speak in more detail about the Select Committee report. It is one of the indicative issues of this debate that a Department of Health Minister and his shadow should be leading the discussion on a Department for Work and Pensions report—a report that certainly has ramifications for the Department for Communities and Local Government, Her Majesty's Revenue and Customs and the Cabinet Office, among other Departments. It is important to note that the health and well-being of carers rightly dominate the concerns and focus of carers and those for whom they care.

The report can be condensed into two main areas. The first is soft support for carers—inclusion in Government policy across the board, information services and so on. The second is discussion of carers' wages and benefits and the issues faced by carers who are in employment. That raises pertinent questions of the Minister about where we are up to on the carers strategy. We want not a list of pledges, but a list of what has been done to date. One specific issue is whether primary care trusts are actually using the money provided for emergency-only respite care for the purpose for which it was intended. Will the Minister clarify that point, which relates to what Mr. Burstow said a moment ago?

The Government are very good at dragging their feet on such pledges. Yesterday, the Minister announced a hotline for carers in Islington. Carers had called for that and welcomed it, but it was first promised in the 1999 carers strategy, on almost the same day as I first entered the House following a by-election. The hotline was reannounced in the updated strategy and was supposed to have been in place early this year. The House will be aware that the Government have been similarly slow in setting up the national flu helpline—a key part of their pandemic flu plan. What confidence can anyone have in a Government who take 10 years to set up a phone line?

Last year, the Prime Minister and the previous Secretary of State for Health trailed a carers' wage in the press before the publication of the strategy. Will the Minister confirm that that, in the end, was just more spin? It only ever referred to an extension of direct payments to spending on carers—and not even that has happened. Obviously, the biggest step forward for carers will be reform in the long-term care system. The Government's financial squeeze has led to rising eligibility criteria at the local level, and too often carers bridge the gap. So I ask the Minister again: in carers week, of all weeks, and before spring technically ends in a few days' time on 21 June, where is the Green Paper that the Government have categorically promised and guaranteed?

For 11 years, the Government have ignored a particular issue. Tony Blair told the 1997 Labour party conference that he did not want his children to grow up in a country where people had to sell their houses to fund their long-term care. Since then, we have had the Wanless report from the King's Fund, in 2006. We also had a "zero-based review", announced by Mr. Byrne in response to the Wanless report in 2006, but there is no evidence of any serious work having been done on it.

Mr. Lewis said in the House that he thought that the comprehensive spending review 2008 would deliver a solution. The CSR announced a Green Paper, to be preceded by a consultation on the future of care and support. A Green Paper is, by definition, a consultation too. That Green Paper was due in early 2009, March 2009, spring 2009, and June 2009. Can the Minister confirm that the timetable in the departmental plan is now—surprise, surprise—summer 2009: that is, by September?

Next week, we will be taking the Health Bill through its Committee stage. I was pleased that Lord Darzi, under pressure from his peers, amended the Bill to add carers as a group who must be consulted on the NHS constitution. I was astounded by that omission and the neglect on the part of the Government. The Bill currently defines carers as

"persons who, as relatives or friends, care for other persons to whom NHS services are being provided".

That seems a somewhat draconian contraction by the Government of the definition of a carer already inscribed in the Health and Social Care Act 2008, which has the broader definition of

"people who care for service users as relatives or friends", with no other qualification. Why are the Government seeking to reduce the statistics on carers?

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Photo of Jeremy Wright Jeremy Wright Opposition Whip (Commons)

In support of my hon. Friend's case, does he think that part of the problem is the dissonance between what the Government say about the importance of carers and the fact that carers' interests tend to slip so regularly off the Government's priority agenda?

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Photo of Stephen O'Brien Stephen O'Brien Shadow Minister (Health)

I am grateful to my hon. Friend, who chairs, admirably and with great credit from both sides of the House, the all-party group on dementia, which has a major read-across to all the concerns of carers. He is right. It is no good to lay out so many expectations across the board, particularly for people in hard-working and sensitive areas such as caring, only for them to be dashed when the rhetoric does not convert into action. One of the greatest challenges that we face as politicians is to hold the Government to account on the expectations that they have raised.

I want briefly to touch on the subject of young carers. It was, to say the least, slightly concerning that although the Health Committee discussed young carers in its report, the Government's written response completely omitted to mention them. The Minister must have realised the Government's embarrassment about that, because he briefly alluded to young carers in his opening remarks. I hope that that embarrassment will now be covered by the Government making a specific acknowledgement that they need to address the issue of young carers in a written document whereby they can be held to account. They may therefore need to issue an addendum to their response.

The 2001 census found that there were approximately 175,000 young carers in the UK, although that figure is believed to be higher by those who work in the field and see things for themselves. The average age of young carers is an absolutely shocking 12 years old. One in three regularly misses school, and one in four has no external support whatever. That has led to tragedies such as that of Deanne Asamoah. When will the Government take action? Following the Minister's acknowledgement that the needs of young carers must be addressed, given their absence from the Government's response, we need to move from words to a good set of actions that can be implemented and will support young carers.

It is right for the House to be debating issues facing carers. They are, as those involved in carers week have put it, a "secret service", so it is right that this House should do all it can to bring them out of the shadows, and that the Government should do all they can to support them. Conservative Members thank carers for the sacrifices that they make in order to improve the lives of others and their loved ones, and recognise that helping carers is one of the best ways to help those they are caring for. Most importantly, we join with third party organisations in calling on the Government to publish the Green Paper on care and support without any further delay. Only in the debate about reform can carers begin to hope for a system that does not let them down. If, as seems increasingly likely, the Government cannot get beyond the stasis of a divided and leaderless party, for the sake of carers and all those in our society who need help, the Minister should urge the Prime Minister to call a general election.

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Photo of Paul Burstow Paul Burstow Shadow Chief Whip (Commons) 1:04 pm, 11th June 2009

I am grateful for the opportunity to contribute to the debate, Mr. Deputy Speaker, and I know that there are hon. Members in all parts of the House who are hoping to catch your eye. I come to the debate to represent several of my constituents who are carers or who work for caring organisations.

In responding to my earlier intervention, the Minister referred to the need for MPs to play a part in ensuring that the NHS spends the £150 million that has been allocated over the next two years wisely and well in order properly to meet the needs of carers. I can assure him that in my area not only am I well in touch with carers, but carers make sure that I am in touch with their concerns. We have a very effective carers' centre run by the Princess Royal Trust for Carers, which has now been there for more than 20 years. It was opened in the 1980s, as probably one of the first of its kind to be established, and it is highly regarded by all the carers who have been through its doors over all those years.

My reason for speaking is to convey to the Minister and Members in the House several comments that were made to me by carers at an event that I attended yesterday as part of carers week. I invited them to put their comments in writing. They particularly feature carers' concerns about the inadequacy of the benefits regime that relates to the carer's allowance and so on. There is a strong sense that this issue is well overdue for attention. It has been the subject of plenty of reports from Government, yet they are still not addressing it. Ken Fish, a carer in my constituency, asked:

"Why should Carer's Allowance be stopped when the carer receives old age pension at 60 for women and 65 for men, when carers are entitled to Carer's Allowance for caring for more than 35 hours per week and when the same carers have paid National Insurance Contributions or have had credits paid for them when they are continuing to care as both they and their cared for get older, frailer and less mobile?"

That is at the heart of many of the representations that I am sure will be received by hon. Members on both sides of the House. Margaret Burrows said:

"Older people that are carers need more help and support to continue in their caring role. No age restrictions for receiving Carer's Allowance. I feel unappreciated by society for being a carer, in particular for those carers caring for someone with mental health problems."

Another carer I met at the coffee morning, Pat Rogerson, said that she received a letter from the Department for Work and Pensions saying that she was entitled to the carer's allowance, but when she read on a little further she found that the next paragraph said that she could not get the carer's allowance because she was getting a pension. She asks why a letter like that is sent, and why she is not being paid the carer's allowance. June Baine, Rhona Banford, Jill Winder and Christine Holmes also want that question answered.

Although the Minister was helpful in explaining the complexities of the current system, he did not go on to say either of two things: that the Government honestly do not believe that this is a financial priority and feel that it cannot be afforded at this time—that would be the straightforward thing for him to say—or that there is a timetable by which the level of the carer's allowance will be raised and its eligibility extended, so that pensioners, who often shoulder some of the greatest burdens of carers, will get proper recognition in the payments that they receive.

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R

Well said Mr Burstow

Submitted by Rosemary

Photo of Jeremy Wright Jeremy Wright Opposition Whip (Commons)

Does the hon. Gentleman agree that we cannot afford not to do something about this issue? If carers decided—I am sure that very few of them would wish to do so—that they could no longer shoulder such burdens, and the state was asked instead to do the work that they do unpaid, we would end up with a very much greater liability on the taxpayer.

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Photo of Paul Burstow Paul Burstow Shadow Chief Whip (Commons)

It is estimated that our 6 million carers are worth £87 billion in the burden that they shift from our public services—both social care and the health service. Taking on that responsibility affects their physical and financial health in the long term. We know from the statistics that were published during last year's national carers week that many carers find that by the time they have finished their caring role, their earnings potential has been diminished and their savings have been run down, and they feel let down as a consequence.

It is good to have a national strategy that outlines many aspirations, which will be shared by everyone in this House and beyond it, but setting ambitions for 2018 makes them seem an awfully long time away. The message that I have heard from carers who are caring today is that they cannot wait for those ambitions to be realised by 2018, or for the carer's allowance to be raised at some point in the future. Can the Minister therefore guarantee that the Government will shortly set out a timetable for the very necessary reform of the carer's allowance?

I wonder also whether the Minister could say a little more about the time scale for the roll-out of the national strategy. It is not entirely clear what the milestones are and how carers on the ground can satisfy themselves about the strategy and hold people to account locally for delivering it. At the event that I attended yesterday, Lorraine Brown said that better services for carers of young people and for the cared-for, such as younger people with dementia, were particularly important. All too often, dementia services for people who become senile at an early age are inadequate. They are often put with older people suffering from dementia, in a setting entirely inappropriate for them. More needs to be done to cater for that group, and that is certainly a concern that Lorraine Brown has.

Jackie Ure wanted to make the point yesterday that carers have a sense of struggle and of navigating their way through a complex system. All too often there is no one there to guide them, hold their hand and support them until they turn up at the door of the carers centre in Sutton, where that support is provided. That situation is replicated up and down the country, with people waiting for an assessment, battling to get the right care plan implemented and then ensuring that the financial assessments do not financially cripple the individual concerned. All those matters make caring a burden that it should not be. It is a burden that people willingly take on, and we should not be making it worse through the systems that we construct around people.

I have not spoken at great length today, but I wanted to represent my constituents who willingly shoulder that burden for children, loved ones, husbands, wives and others. I hope that the Minister will be able to give us some reassurance about what will happen in respect of the carer's allowance, and some sense that he understands that it is not good enough for him to say to MPs simply that we have to hold our local PCTs to account. He has a responsibility to ensure that PCTs put their money where their mouth is and deliver for carers.

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Photo of Anne McGuire Anne McGuire Labour, Stirling 1:11 pm, 11th June 2009

Like other Members, I welcome this debate, particularly as it is happening during carers week. I wish to put on record my thanks to the Prime Minister, who met the all-party carers group a few weeks ago. As someone who this year has been designated the parliamentary champion for carers, I was delighted to join that meeting. The Prime Minister over the past two years, and his predecessor, have given carers great support and started to put carers issues higher up the political agenda. All political parties now recognise them as an important focus for social policy.

I was delighted to be invited by a consortium of 10 organisations to be this year's parliamentary champion, and to host yesterday's reception in the Commons. I am delighted that so many MPs attended that reception to hear for themselves, in an informal way, some of the issues that have an impact on carers' lives. We should pay tribute to the many organisations up and down the country that have participated in this week's events. As I understand it from the consortium that Carers UK pulled together, more than 1,000 partner organisations are celebrating the contribution that carers make to our society and taking the opportunity to highlight the issues and continue the pressure on Government, and indeed on all political parties, to ensure that we do not lose momentum in improving the lives of carers.

In my constituency the Princess Royal Trust for Carers held its own event yesterday, which was linked with its annual general meeting. I had hoped to attend, but obviously yesterday's parliamentary business made that impossible. I pay particular tribute to the Stirling Princess Royal Trust for Carers for the work that it does, particularly in supporting young carers. Many of us recognise that all sorts of fairly young children take on responsibilities way above their age level, which they should not be asked to do. I do not want us to say to children, "Of course you can't participate in the care of a parent or sibling," but we must ensure that those children's needs and rights are not neglected as they absorb caring responsibilities that they should not have to take on. The trust in Stirling certainly does a lot of good work in that area.

Over the past 10 years, as I said, carers issues have come up the political agenda, and we should pay tribute to this Government. In 1999, the first ever carers strategy was developed. Although it was 10 years ago, we should not lose sight of that. It was the first time that any Government had actually recognised that serious needs were being neglected. As the Minister said, the new strategy published last year built on that first strategy but recognised that times had moved on, and carers' interests and issues are perhaps better articulated now than they were in 1999. Indeed, the pressure groups on carers issues have built on that first recognition in 1999.

I met representatives of the Swale carers group this morning, as did the Minister. I know that my hon. Friend Derek Wyatt was very keen to encourage his local carers group to engage not just with the Minister but with me. One thing that came out of that discussion, and which is embedded in the new carers strategy, was the fact that carers need to be respected as expert care partners. Often they are marginalised by health professionals, not because the health professionals are bad people but because they do not see the carers who are with a sick or disabled person day in and day out. Somehow when it comes to big decisions that need to be made, they feel marginalised.

One woman told me this morning that when she moved from one PCT area to another, there was a different attitude to her involvement. In the first area she was very much part of the team, but when she moved house to another PCT area she found that she was totally excluded. Confidentiality clauses were somehow brought into the discussion, and she was not allowed to be a full participant.

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Photo of Jeremy Wright Jeremy Wright Opposition Whip (Commons)

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

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Photo of Anne McGuire Anne McGuire Labour, Stirling

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

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Photo of Stephen O'Brien Stephen O'Brien Shadow Minister (Health)

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

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Photo of Anne McGuire Anne McGuire Labour, Stirling

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

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

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

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

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

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

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

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Photo of Jeremy Wright Jeremy Wright Opposition Whip (Commons)

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

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Photo of Anne McGuire Anne McGuire Labour, Stirling

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

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

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

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

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Several hon. Members:

rose —

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Photo of Alan Haselhurst Alan Haselhurst Deputy Speaker and Chairman of Ways and Means

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

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Photo of Greg Mulholland Greg Mulholland Shadow Minister (Health) 1:30 pm, 11th June 2009

Thank you, Mr. Deputy Speaker. I will certainly keep my comments within that time.

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

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

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

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

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

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

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

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Photo of Paul Burstow Paul Burstow Shadow Chief Whip (Commons)

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

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Photo of Greg Mulholland Greg Mulholland Shadow Minister (Health)

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

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

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

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Photo of Angela Watkinson Angela Watkinson Opposition Whip (Commons) 1:38 pm, 11th June 2009

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

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

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

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

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

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

Schools are as supportive as possible of pupils in those circumstances, but we must find ways to ensure that those children do not fall below their educational potential. There is a direct link here to the next debate, as young carers may self-exclude from entry into the professions, not from a lack of ability but from a lack of personal aspiration and ambition and from a sense of duty to caring. There is a challenge here for schools and social services to work together to prevent this from happening, particularly in families with no history of further or higher education.

I am particularly involved with autism in my constituency, and the spotlight has been on autism recently. Those of us who took part in the "Walk in our Shoes" day had the opportunity to see at first hand how autism in one child affects the life of the entire family. The daily routine is arranged around the needs of the autistic child, and I was surprised to learn of the associated additional costs involved, including the frequent replacement of damaged items in the home and unusually large quantities of laundry, for example.

Parents of children on the low-performing end of the autistic disorder spectrum have a continuing long-term caring role. Their children are unable to reach the usual periodic milestones in development that gradually reduce the parental supervision and caring role. Special schools play a hugely supportive role, providing not only education for their pupils but a period of respite during the day, which is often the only opportunity for parents to sleep. Some children with autism are very bad sleepers; I have heard parents say that their child can go without sleep for a week. If there are other children in such a family, the mother often stays awake all night trying to keep the autistic child quiet and occupied so that the rest of the family are not disturbed. The children might have to go to school in the morning; the father might have to go to work.

I pay tribute to the three superb special schools in my constituency—Dycorts, Ravensbourne and Corbets Tey—for the quality of the education that they provide and for the endless patience and respect that they show to their pupils in teasing out every last ounce of potential for development. The end of statutory education is often dreaded by parents, as the days are long and difficult to fill. The wonderful ROSE—realistic opportunities for supported employment—project at Havering college of further and higher education is a boon to students with learning difficulties and their parent carers. The supported employment project started in a very modest way, with a small number of job tutors and students, but it has grown more than anyone dared to hope. It has gone from strength to strength.

Instead of a life of boredom at home on benefits, the young people with learning difficulties—many of them are young people with autism—are able to have paid employment with support that is gradually withdrawn until they are able to travel and spend their working day independently. They have proved themselves to be reliable, cheerful and anxious to please their employers. Moreover, their parents benefit from the daily respite. When the ROSE project started, its organisers went out to local employers in my constituency to try to persuade them to provide placements for students with learning difficulties. Over time, the students have been so successful that the employers approach the project to ask whether it has students available.

People with Down's syndrome now have a good life expectancy because of improved health care, but independent living is not always possible for them, and the caring role of parents can often extend into the parents' old age. Caring parents have real worries about their physical ability to continue to care and, worse, about the future of their children when they are gone. How will they adapt to changed living circumstances and cope with bereavement?

Alzheimer's sufferers present particular problems when the condition comes on late in life, as it often does. Their carers are usually their spouses, who are themselves elderly and may not be in the best of health and fitness. There is added stress when the sufferer no longer recognises the carer. Even though they might have spent decades living together in a loving relationship, they often end their days in very different, stressful circumstances.

Older people are probably the least likely to seek help, particularly the very elderly people who do not like to make a fuss. They do not like to bother the doctor as they feel they must be terribly busy looking after other people. This means that situations often reach crisis point before help is sought. That can result in the person with Alzheimer's being taken into professional care and the very elderly spouse making daily visits but not being recognised. That is a very sad situation.

I have in my constituency the wonderful Havering Association of Disabilities, which is an umbrella organisation for carers and people with a wide range of disabilities, run by the inspirational Mary Capon. It provides an effective support network, including a befriending service that is invaluable for disabled people living on their own. The befrienders form a real relationship with people. They visit them at home and also take them out, which often provides the only opportunity that those people have to leave the house.

The organisation also provides a good range of social activities, and opportunities for training in information technology and in preparing a CV, in preparation for seeking employment. Without even asking Mary Capon, I say to the Minister that I know that she would love the Havering Association of Disabilities to be involved with the family pathfinders project, whatever form it takes.

I know that all hon. Members are very much aware of the huge contribution made by carers in enabling their loved ones to remain in their own homes in familiar surroundings, and in reducing the size of the health and social services budgets by putting their owns needs in second place. But we always need to ensure that carers' continuing efforts are appreciated. We all know individual carers and discuss their circumstances with them regularly, but the acknowledgement and appreciation need to range wider, so that no carer feels isolated or overlooked, and so that all possible practical and financial help is made available to improve the quality of carers' lives.

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Photo of Jeremy Wright Jeremy Wright Opposition Whip (Commons) 1:49 pm, 11th June 2009

It is a great pleasure to follow my hon. Friend Angela Watkinson and I substantially agree with many of her points. Indeed, I agree with a great deal of what all contributors to the debate have said—including the Minister, who opened it and whom I am delighted to see still in his place. He knows better than most that this policy area requires consistency of approach, which is difficult to achieve when we have a different Minister every few months. It is a pleasure to see him still in his post.

I shall make just a few points in order to allow the Minister time to respond to the debate. My first is about the number of carers, although I am in agreement with my hon. Friend that, in a sense, it does not much matter whether there are 5 million or 6 million. My point is that the argument should be, at least in part, about how many of those who are carers identify themselves as such. Many do not: they see themselves as doing right by their families, looking after family members in the way that they believe it is incumbent on them to do—without wishing, as she said, to make a fuss or to draw attention to what they do, and without seeking recognition or reward for it.

Carers are often very modest people, with every reason not to be so. The recognition that we rightly give to them—and it should not be just annually in debates like this; I agree with those who say that we should recognise them more frequently, more regularly and more consistently—comes not because they ask for it, but because they richly deserve it. We need to persuade those carers to identify themselves as such before we can offer them the sort of assistance the Minister set out and to which others have referred. The offers of help and support, the information exercises and so forth are linked with the opportunity that we should take to recognise carers and encourage those who do not yet recognise themselves as such to do so in order to access all those streams of support.

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Photo of Angela Watkinson Angela Watkinson Opposition Whip (Commons)

I agree that carers do not often fit readily into a definable box. Mrs. McGuire may recall that I visited her in her previous ministerial role. I came to see her with a young lady from my constituency who was trying to balance work and benefits with her mother, who did not regard herself as a carer because the daughter was ostensibly living independently. However, the mother spent most of her life dashing back and forth from her own home to her daughter's home to give her the support that she could not manage without.

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Photo of Jeremy Wright Jeremy Wright Opposition Whip (Commons)

I entirely agree, and I think that the lady my hon. Friend describes is one of those whom we should try harder to reach and offer the sort of support that we all want carers to receive.

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Photo of Paul Burstow Paul Burstow Shadow Chief Whip (Commons)

According to the last census, there were about 19,000 carers in my constituency, but we have identified only about 4,000 or 5,000 in the borough. Does the hon. Gentleman agree that one group of professionals most likely to come across carers—either because of a carer's ill health or the ill health of the person for whom they are caring—is general practitioners? GPs need to get training in order better to identify carers and then act as the facilitators in passing the information on to others.

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Photo of Jeremy Wright Jeremy Wright Opposition Whip (Commons)

I entirely agree; the hon. Gentleman is absolutely right. That is why, as I said, I was encouraged by what the Minister told us about opportunities to train those who are professionals to understand how to help those who are not professionals but who are still making a substantial contribution to the care of people we are most concerned to look after.

It seems to me that this is more than a matter of gratitude or just saying thank you to carers—however much we rightly do so in the debate—because we need to offer them real and practical support. As the Minister rightly said, we must try to ensure that carers have the maximum opportunity to combine their caring responsibilities not only with a fulfilling social life but, just as importantly, with a fulfilling career. That should enable them to get back into work, succeed on their own terms and still maintain their caring responsibilities. Once again, it is important for carers to identify themselves to receive the recognition they deserve; in circumstances of better and greater recognition, it should be easier for them to go to their employers and ask for the flexible working they need. It should be easier for that to happen if employers automatically understand what carers do and how important it is for them to continue with it.

It is also important to ensure that health and social services professionals—the people mentioned by Mr. Burstow—can recognise the importance of a carer's responsibilities and a carer's understanding of the individual for whom care is being provided. Too many carers—we all talk to them—are frustrated because they are treated as people who do not understand what is going on, when in fact the opposite is the case and the carer is the one who spends the most time with the person for whom care is being provided. He or she knows that person best, and their opinion of that person—what they need and what they will best respond to—should be fully taken into account.

I take the point made by Mrs. McGuire that it is important to reconcile that viewpoint with the occasional desire of the person being cared for to take a different view to that of their carer on any subject. In the majority of cases, however, what the person cared for will want is for their carer's view to be taken fully into account. Rarely is it in fact taken into account as fully as we would wish by the professionals involved in their care.

I wish to refer to two specific groups. The first was mentioned by my hon. Friend the Member for Upminster and, indeed, by Greg Mulholland, who both rightly highlighted the interests of young carers. It is right to pay particular attention to their needs, but equally we should not forget those at the other end of the age range. Older carers have particular needs and particular requirements. They are the ones whose health suffers disproportionately as a result of their caring responsibilities. We know that something like a quarter of the 5 million or 6 million carers are of retirement age. That is a very significant number of people, and I believe that there are about 8,000 carers over the age of 90! How those people manage, I simply do not know, but we must be aware of their particular needs and requirements when we consider how best to help carers.

The second group is, as my hon. Friend said, an overlapping group—those who care for people who have dementia. The Minister would be disappointed if I failed to mention dementia at some point in my remarks. It is important to recognise the particular requirements on those who care not just for people with dementia but for all who have a mental illness or disability as opposed to a physical one. I am not saying for a moment that it is easier to care for someone with a physical disability, but it is different, and there are different requirements on carers looking after someone with a mental difficulty.

As my hon. Friend pointed out, one of the main differences is that the carer starts to lose something of the person they knew as the illness or condition progresses. More often than not, the person being cared for requires more and more from the carer, just as the carer is losing more and more of the one for whom they are caring. That is an extremely distressing situation to be in for anyone with a caring responsibility. We need to take account not just of the physical health needs, but of the mental health needs of those who are carers, and ensure that the risks they run—in exposure to depression and other conditions—are adequately catered for.

I have a couple of final points about the specific and practical action that we can take. The first, which the Minister mentioned, is respite care. It is right to provide for the availability of such care. No one can do a caring job 24 hours a day, seven days a week—they simply could not cope; people need a break sometimes. A break will help them to do a better job for the rest of the time; that is well understood by everyone. It is also worth acknowledging that simple provision of respite care will not do the job, because we also need to provide for quality respite care. If we do not, it will not be a real break at all. We have all spoken to carers who tell us, "I put the person I care for into full-time care. I had a week's holiday, but it was the worst week in my life, because I spent the entire time worrying about whether my loved one was being properly looked after." That is not respite care. We need to ensure that the respite care we provide is of sufficient quality to provide that reassurance, and that information about its quality is provided to carers so that they enjoy the break that we can offer them.

My last point is about simplicity. When it comes to the benefit system, we will all have difficult decisions to make about how much can be afforded, but it is beyond question that when people look at a website or call a phone line to understand what is available, the information given must be easily digestible. Whether the advice is there or not, the actual provision of benefits needs to be simpler. That is why we have to talk about the cliff edge or the distinction between retirement and non-retirement so that there is some continuity and simplicity in the benefits that those who provide care can receive.

We shall never be able to make the lives of those who care easy—that is beyond all of us—but we do have a responsibility to make those lives slightly less difficult, and I think that both this and the next Government should focus their attention on that.

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Photo of Phil Hope Phil Hope Minister of State (the East Midlands), Regional Affairs, Minister of State (the East Midlands), Department of Health 2:00 pm, 11th June 2009

With the leave of the House, Mr. Deputy Speaker, I shall respond to the debate.

I thank all hon. Members for their valuable contributions. I particularly thank my right hon. Friend Mrs. McGuire and Jeremy Wright for their clear and moving speeches. I am pleased that carers week gave us the opportunity to engage in this debate, and also to give other hon. Members and organisations an opportunity to engage in debates throughout the country. I thank all the organisations that work to support and represent carers, not just national organisations, but the organisations in Members' constituencies of which we have heard today, which do such fantastic work all over the country.

Angela Watkinson reminded us of the role played not just by carers but by volunteers and befrienders. The fact that 20 million people offer their services voluntarily to the community is, along with the number of carers, a sign that we have a strong society with its values in the right place.

Let me try to clarify the question of numbers. I understand that the 5 million figure given yesterday relates to the number of carers in England, while the 6 million figure given by Carers UK relates to the whole United Kingdom. However, as we were told by Mr. Burstow, the figures may be even higher, because not all carers identify themselves as such.

Hon. Members pointed out that GPs provide an important gateway to the necessary resources, and drew attention to the need for support for both young and older carers. They also mentioned dementia. The hon. Member for Rugby and Kenilworth, who chairs the all-party group on dementia, spoke of the importance of responding to the individual needs of different people in different ways and tailoring support. Caring can sometimes be very distressing and demanding.

Let me say a few things that I did not have an opportunity to say in my opening speech. Hon. Members referred to carers who want both to care and to go on working. We want to help them to do that. Jobcentre Plus is recruiting specialist care partnership managers, who will be responsible for improving information on carers support for both staff and customers. We want to try to remove some of the barriers faced by carers who wish to return to paid employment. We want to stand up and represent their employment interests in a variety of partnerships. The aim of Employers for Carers, an organisation launched earlier this year, is to identify and promote the business benefits of supporting carers at work. Many employed people also have caring responsibilities, and Employers for Carers offers practical support for the development and benchmarking of good practice.

I do not have time to respond to all the points that have been raised, but I will say to Mr. O'Brien, who listed a number of demands and complaints, that I did not hear from him a single commitment or pledge of support for any particular policy. I feel that he struck a discordant note in choosing to create a party-political divide by calling for an election. That was silly. He made a sad, slightly whingeing and unhelpful contribution to an important debate which should have united the House. Similarly, Greg Mulholland asked questions but offered no information about the Liberal Democrats' proposals—

One and a half hours having elapsed since the commencement of proceedings, the motion lapsed (Standing Order No. 24A) .

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Photo of Alan Haselhurst Alan Haselhurst Deputy Speaker and Chairman of Ways and Means

Order. I am sorry that the Minister has had to suffer a double whammy, but we must now proceed to the next debate.

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So many words are said by so many about carers and in particular young...

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