My Lords, I beg to move that this Bill be now read a second time.
The Bill carries the hopes, aspirations and prayers of millions. It is a simple Bill, yet one which can profoundly influence the lives of more than 6 million carers—people who have been shunted out of circulation into the confines of homes, sick bays and impoverished environments. There has been a scandalous, historic disregard of people whose lives revolve around giving themselves to others. Now the Bill, which was introduced in the House of Commons by Hywel Francis and passed all its stages there, aims to change carers from neglected appendages to valued personalities, enjoying full human rights.
There is a roll of honour of politicians who have initiated legislation to help carers, which includes Malcolm Wicks and my noble friends Lord Carter, Lord Pendry and Lady Pitkeathley. Her special qualities are partly explained by her 10 years' experience as chief executive of the Carers National Association—although there is no simple explanation of why she is so very special. There is only one Lady Pitkeathley. The legislation with which they were associated was the Carers (Recognition and Services) Act 1995 and the Carers and Disabled Children Act 2000. Those were valuable steps forward, but it was not until this Bill that we had proposals to help the carer as a whole person, rather than solely as a carer. This is the vital aspect of the Bill.
I wish to express my appreciation of Carers UK which has been exceptionally helpful with its expert knowledge and guidance throughout. But today the main honours go to Hywel Francis and his wife Mair, carers for over 16 years of their son Sam who had Down's Syndrome and who tragically died some seven years ago. Inspired by Sam, they associated themselves with the carers' cause and this fine Bill is the result of that. The hope has been expressed that it should become known as Sam's Bill and, given the all-party support that it has enjoyed, I am sure that all noble Lords would respect that wish and ensure that it soon becomes knows as Sam's Act.
I can think of no better memorial than an Act of Parliament which benefits 10 per cent of our population, some 6 million carers; an Act which enables carers to enjoy equal opportunities, denied to them at present; an Act which guarantees carers comprehensive information about their rights, denied to them at present; and an Act which enables carers fully to develop their lives and individuality, denied to them at present. These would be big gains for people who hitherto have been big losers. With such an Act on the statute book they could pursue their vital caring role while simultaneously exercising their rights and developing their training, employment, education and leisure, instead of merely being adjuncts to the disabled or old person. Of course the needs of the old and disabled person are of tremendous importance but the acknowledgement of that fact can and should go hand in hand with provisions for the carer as a whole person. There is no conflict. In fact, meeting the needs of carers contributes to making them better and happier carers. The two are complementary not contradictory.
I would like briefly to explain the main points about each clause. Clause 1 deals with one of the most basic and troublesome problems facing carers—lack of information. Carers are simply not receiving the help, guidance and assistance that they so desperately need, and the main reason is that they are unaware of what is available or what they are entitled to. That is an astonishing state of affairs. In the Commons debate on the Bill, the MP for Banbury, Tony Baldry, said that 98 per cent of typical carers in a typical local authority area told him that when social services did not have a clear statutory responsibility to assist, no one explained any of their rights to them. No one gave them information about taking a break. No one from social services told them how to look after a relative or friend coming out of hospital. No one offered to explain community care legislation to them. Carers rights were never explained to them. That is why I believe that social services need to be under a statutory obligation to do that.
Further evidence of the problem comes from Imelda Redmond, Chief Executive of Carers UK, who said that,
"there are too many carers struggling without support, cutting back on food to make ends meet, going without breaks—having only one weekend off a year".
People who are denied information about rights are effectively denied those rights. For the many people with the heavy responsibilities of caring for old, frail or disabled people, such a denial is devastating. The need for the Bill stems from the lamentable experience of millions of carers in England and Wales and the personal experience of Hywel and Mair Francis. It is time for action.
Clause 1 sets us on the way and I am confident that this and the other provisions of the Bill will transform this deplorable state of affairs. On the basic issue of information, Clause 1 would amend the Carers (Recognition and Services) Act 1995 and the Carers and Disabled Children Act 2000. It would ensure that when a local authority is assessing a disabled adult or child it would have to inform the carer of their rights to an assessment of their needs. Although guidance indicates that carers should be informed of their rights, the Social Services Inspectorate report states that carers are not routinely offered an assessment. Clause 1 will ensure that they are.
Clause 2 would amend the same two Acts as Clause 1 and ensure that local authorities must amend their assessment procedures so that they incorporated issues of work, training, life-long learning and leisure. Thus we would see a transformation in the way carers are regarded—not before time, they would be seen as individuals rather than ciphers. Instead of simply "helping carers to care" this clause could help to signpost carers to new training courses and guide them back to work—and 80 per cent of carers are of working age. Some 80 per cent of carers would wish to return to work if they could, according to Carers UK. At present, assessments and provisions for carers are provided to enable them to care. The clause helps to change the ethos from assessing carers only on their ability to provide care, to perceiving them as people with full entitlements to a rounded life.
Clause 3, regarding carers' assessments, would also amend the two Acts mentioned previously and ensure that a specific local authority could request the help of any local authority, local education authority, or housing authority, to assist in the planning of carers' services. That would deal with the lack of joined-up policies and would secure co-operation for services to both the disabled person and the carer. It would prevent carers falling between half a dozen stools, thus replacing confusion with co-operation. Fewer things are worse than for a perplexed person to be shuffled from pillar to post by, say, social services and health organisations each not knowing what the others are doing. There is a powerful case for co-operation.
The other Clauses 4, 5 and 6 are standard ones and include the financial provision and short title. Altogether, the Bill, which has enjoyed cross-party support and has laudable aims combined with practical policies, will enrich the statute book and the lives of millions of carers. It has the support of over 300 national and local organisations and their hopes now rest with this House. I am sure they will not be disappointed.
If I may, I should like to add just one further comment. If the House sees fit to pass the Bill, it is vital that it should be fully implemented. We all know that some Acts lie dormant because they are moribund and ignored. As a warning example of what can happen, Tom Clarke, a longstanding friend of disabled people, complained in the House of Commons that an Act that he initiated as long ago as 1986—the Disabled Persons (Services, Consultation and Representation) Act—was only half implemented now. We want none of that nonsense with this measure. We want instant and continuous implementation. It would be incredible that someone doing so devoted a job as caring for a disadvantaged person should be denied the information about benefits or available support. That would be incredible and indefensible. But I trust that this Bill will be a vibrant piece of legislation which will indeed transform the lives of millions of hard pressed carers. I commend the Bill to the House.
Moved, That the Bill be now read a second time.—(Lord Ashley of Stoke.)
My Lords, I was delighted to hear my noble friend Lord Ashley commend this important measure to your Lordships' House with all his customary facility and commitment. His speech alone justifies a Second Reading for the Bill.
Like my noble friend, I warmly congratulate my honourable friend Dr Hywel Francis on having piloted his Bill through the House of Commons with such skill and success. Speaking as a serial legislator in this policy area—both as a private Member and a Minister—I hold his achievement in high admiration. By all of my tests of the good MP, he is a parliamentarian of very considerable note.
Hywel has spoken, as has my noble friend, of the unfailing support of Carers UK and particularly of Emily Holzhausen at all stages of the Bill's progress so far. I know how deeply he appreciates also the extent both of all-party support for his Bill and that of Ministers and officials in departments of state all across Whitehall, more especially that of the Department of Health. The story is one of exemplary co-operation between Ministers, parliamentarians, officials and the voluntary sector to make life better for people whose work as carers in the community is reliably estimated to be saving the taxpayer £57 billion a year.
That striking figure is one on which those who always insist on the precise costing of help for carers should reflect. For the cost of the alternative of funding nursing and other institutional care is hugely more than that of giving carers in the community the right support at the right time and in the right place. And if failure to give that support leads to the carer's breakdown, the public funding of alternative care often becomes necessary not only for the person/s she or he is caring for, but also for the carer. That is what can and does result from a total preoccupation with cost and not net cost and knowing the price of everything but the value of nothing.
For me this is a deeply evocative occasion. It recalls the warmth of the all-party support I received, 35 years ago, after publishing my Private Member's Bill that became the Chronically Sick and Disabled Persons Act 1970, which Carers UK described today as,
"landmark legislation of historic impact", and the RNIB as having,
"marked the beginning of a long revolution in the life chances of all disabled people and their carers".
It was not a personal achievement. A wide fellowship of parliamentarians worked with me to enact my Bill—notably Jack Ashley, as he then was, the late and much revered John Astor and my good and ever-resourceful friend Lewis Carter-Jones. The Hywel Francis Bill—"Sam's Bill", as it has been movingly described—is a lineal descendant of that legislation and eminently deserving of swift enactment as now drafted. I stress the word "swift" from long experience of the absolute necessity for supporters of Private Members' Bills to act with constant regard to the very strictly limited parliamentary time available to them.
The Carers (Equal Opportunities) Bill, like the 1970 Act, is about giving carers more choice and the opportunity to lead fuller and more fulfilling lives. It will ensure that assessment of their needs takes that goal wholly into account in relation to leisure, training and work opportunity and a more co-ordinated response from statutory authorities in meeting them. The Bill also recognises the crucial importance of making sure that carers are fully informed and updated on the help to which they are entitled.
Research points time and again to the importance of full and regularly updated information as a gateway to support. The experience of Carers UK, in promoting initiatives like Carers' Rights Day annually, is that carers are very often unaware of their rights and entitlements. There have been improvements in some areas, one recent study showing that carers were more likely to have adequate information if they had become carers in the last two years.
Yet as of now Carers UK alone receives 50,000 calls a year on its CarersLine for advice on benefits and rights. Again, Carers London—its London-based advocacy project—provides advice to over 2,000 carers every year, half of them from black and ethnic minority communities, where clearly the difficulties carers have in accessing information are even more serious than elsewhere.
Here I must declare an interest as Vice-President of the National Information Forum, whose work is now widely and rightly seen as one of the most valuable resources available to disability organisations. I pay warm tribute today to Ann Darnbrough and her colleagues at the forum for the crucially important leadership they perform. They deserve all the support everyone who can help to extend their work can give them.
I believe that the passing of this Bill will lead to carers being much better informed and a disturbing set of facts published by Macmillan Cancer Relief two days ago—which in terms of this debate could not have been more felicitously timed—strongly re-emphasises the importance of its urgent enactment.
The principal facts are that disability benefits went unclaimed by some 83,000 people terminally ill with cancer in the UK: 69,000 in England, 10,000 in Scotland, 3,000 in Wales and 900 in Northern Ireland. Their total loss in benefits was £126.5 million. Moreover, the financial problems of people with terminal cancer are now also being experienced by increasing numbers of people who are living with cancer, but not terminally ill. A cancer patient in Luton quoted by Macmillan says of her experience:
"I found claiming benefit more stressful than having cancer".
That deeply worrying comment should inform our approach to the urgency of the task of making this Bill law.
Clause 1 of the Bill, as my noble friend said, seeks to ensure that local authorities have strategies to improve information to carers about their rights. When a disabled person is being assessed, a local authority will have a duty to tell carers about their rights. That simple procedural change is most welcome, as is much else in this Bill.
I said at the outset that this was a deeply evocative occasion for me and there are two other reasons why. From its inception, I have been closely associated with Crossroads—Caring for Carers—which helps carers to take breaks from caring; and I know how committed the noble Lord, Lord Rix, is in that important policy area. I am a founder patron of Crossroads, an admirable charity, and when I became Minister for Disabled People in 1974 I approved a "pump-priming" grant over a three-year period to facilitate its expansion. This is the charity's 30th anniversary year and, looking back, I can think of no better investment I ever made as a Minister. Its work now extends nationwide and I am sure that all who work or have worked for Crossroads share my pleasure at the prospect of this Bill's early enactment. For its costs too will be a very wise investment.
I am today most vividly reminded also of the late Dame Flora Robson—a carers' champion if ever there was one—who came to see me within a month of my ministerial appointment. She came as chairman of the National Council for the Single Woman and her Dependants, whose pioneering work I know my noble friend Lady Pitkeathley, who worked in the 1970s for Manchester social services, will readily recall. I discussed with Flora the need for a carers' allowance, which happily I was able to legislate for the following year as the first-ever such allowance anywhere in the world.
Flora was a relentless campaigner for effective legislative protection for carers and she too would be rooting for this Bill if she were here today. So for her—and for all who led the way in the voluntary sector in improving the status and well-being of carers—I wish this humane Bill Godspeed.
My Lords, it is always a pleasure and an honour to follow the noble Lords, Lord Ashley of Stoke and Lord Morris of Manchester. Like them, I most warmly welcome this Bill and I am grateful for the opportunity to speak in this Second Reading debate. I have a long-standing interest in and awareness of the difficulties facing carers of people with a learning disability, both from my personal experiences of having a 52 year-old daughter and a three year-old grandson both with Down's Syndrome—the same as Sam—and as President of the Royal Mencap Society.
Nine years ago, I introduced the Disabled Persons and Carers (Short-term Breaks) Bill into this House. The Bill sought to guarantee that every carer would have their short-term break needs assessed and met. Despite having cross-party support in both Houses, with the noble Lord, Lord Morris—then Alf Morris MP—trying to get it through the other place, the Bill was not taken up by the government of the day, leaving many carers struggling to cope. Over the past decade, there has been continued growth in awareness of the issues facing carers, but there is still a great deal of work to be done. I am therefore very pleased that this Government have decided to support this important Private Member's Bill.
The role of a carer for someone with a severe learning disability is usually full-time and a lifelong commitment. Medical advances and the beginnings of a welcome change in attitudes among healthcare professionals mean that adults with profound learning disabilities are living longer. Family members can therefore be carrying out their caring role well into their seventies and eighties, which is a huge contribution on behalf of society. We must therefore support carers in every way that we can and begin to see them as requiring support both in and outside their caring role.
It is particularly appropriate for us to be considering this Bill today during national Learning Disability Week. This year, Mencap has launched a new campaign, Treat me right!, to highlight the poor treatment that people with a learning disability often receive in their dealings with the NHS. The Treat me right! report shows that carers are often left to pick up the pieces of poor treatment. Many carers are not confident that the most basic needs of their loved one will be attended to in hospital, or even in the GP's surgery, leading to an unnecessary pressure that has knock-on effects for both the carer and the cared-for person. As such, I hope that all your Lordships who are here to support the Bill today will also support the report from the Treat me right! campaign.
Clause 1 will ensure that all carers are informed of their right to a carer's assessment. That is incredibly important. Mencap's Breaking Point campaign, which was launched during last year's Learning Disability Week, found that eight out of 10 families caring for a person with a profound learning disability were at breaking point; six out of 10 of those families had never had a carer's assessment; and five out of 10 had not had their support packages reviewed in the past year. I hope that Clause 1 will begin to address these often heartbreaking situations.
Of course, in order to be of real benefit to carers, assessments must actually meet the needs of the carer. Clause 2 of the Bill is admirable, and I hope that it will be valuable to carers who wish to lead a life outside their caring role. Unfortunately, too often it has been the case that, even with legislation, carers do not get what they need. Obviously, resources play a major part in this, as can an authority's unwillingness to accept the carer's real needs, but it can also be because different authorities are not working together effectively. I hope that Clause 3 will address this last issue, although other authorities are required to give only "due consideration" to calls for assistance from a local authority.
Having heaped praise on the Bill, I have one major concern. As it is worded, no safeguards are in place to ensure that local authorities comply fully not only with the stated words but also with the broader intention of this legislation. It is worth reminding your Lordships that the Bill started out as a call for "equal opportunities for carers". While the Government felt that that was too broad a term to be included in the Bill, it is still very important that carers feel confident that their local services will support them to lead fulfilling lives outside their caring role.
As such, I hope that the Government will commit to ensuring the Bill's proper implementation by encouraging local authorities to meet their duties—perhaps through such overworked mechanisms as performance indicators. As we all know only too well, legislation is only as effective as its implementation, and I look forward to hearing from the Minister how the Government intend to monitor the implementation of this Bill so that my concerns can be assuaged.
I shall conclude now by reiterating my support for this important Bill and by expressing my gratitude to Dr Hywel Francis for bringing it before Parliament and to the Government for supporting it.
My Lords, I am grateful for this opportunity to address your Lordships in this great Chamber for the first time. On first impressions, this House feels like a well oiled machine, churning its cogs and wheels without effort. But the reality, I know, is that this place requires the highest degree of leadership and individual professionalism, which are so characteristic of good management. I want to record my thanks from the outset for the very courteous and efficient reception that I have received here in these early days.
My honour in standing before your Lordships is heartfelt. My early acquaintance with this Parliament began in another place in the 1980s with my first experience of that essentially "British" value of volunteering for a good cause. In my case, the "good cause" was to work in the Liberal Democrat Whips Office. I add hastily for the benefit of my noble friend Lord Roper that I harbour no such ambitions in this place. Even from those early days, it became evident to this eager researcher that your Lordships' House was the place to look for truly informed debates on the issues of the day.
The other reason that I feel honoured is due to no effort of my own; that my sex and ethnicity can, of themselves, render these Benches more reflective of the changing nature of British politics is good. I value that, and I hope to be able to make a contribution from that perspective in time to come.
An opportunity to speak on this Bill is particularly gratifying, and I thank the noble Lord, Lord Ashley, for introducing it in this House. Private Member's Bills, such as this, embody the very best of what is possible when we work together, and I am grateful to the honourable Member for Aberavon in the other place for bringing this forward. The Carers (Equal Opportunities) Bill goes a long way towards defining "equal opportunity" in that it aims to equip individuals to make the most of their personal circumstances and potential for the benefit of the wider community.
Caring is something which has touched all our lives in one way or another. In fact, caring for age-related infirmities is on the rise. As the noble Lord, Lord Drayson, reminded us in his most excellent maiden speech earlier this week, scientific advances are with us to stay. The implications for longevity of the march of science is that caring is a growth business and that it, too, is here to stay.
The Bill will go far in advancing rights for carers, but it is particularly important as it offers new opportunities to bring down the barriers that exist for many Asian and other minority ethnic community carers across England and Wales. The impact of caring is significant for those communities. The 2001 census tells us that 7.9 per cent of the UK population is from a different ethnic background. That includes 4 per cent of our population who describe themselves as Asian—my own background. On those figures, that could mean that one in every 12 or 13 carers is from a minority ethnic group.
Research by Carers UK has found that there is a common assumption that people within those communities will "look after their own". Evidence from a seminal work by the Social Services Inspectorate in 2000 showed that, as a result, minority communities had far poorer access to support. We also know that people from some groups within these communities are more likely than others to experience poverty—most notably, people of African, Pakistani and Bangladeshi origins.
As the culture of caring for their own is very strong in those communities, we find that caring goes unrecognised in a large number of cases. A recent report on the financial hardship faced by carers found that carers from ethnic minorities were more likely to suffer from poverty than white British or European carers, and that black carers were more likely to have given up work to care than their white counterparts.
First and foremost among barriers to support for carers is a lack of knowledge about their rights as carers. In London, we see multiple barriers to these groups accessing information about their rights. Language, illiteracy and cultural norms for female carers all serve to hold back assistance from social services and other bodies. The fact that the Bill places a new duty on local authorities to inform carers of their rights will go some way towards resolving those barriers. The Bill puts what was always supposed to have been good practice on to a new footing where it is now a requirement.
The hope is that once the obligations on local authorities come into force, they will move to audit their information on the different minority communities in their area. A review of what is provided, how it is provided for non-English speakers and the provision of training for the relevant staff to sensitise them to the different cultural and religious norms could deliver real benefits.
Finally, the Bill marks a win-win situation for all. We know from the figures that providing more support for carers will enable more people to work as carers. We also know that carers with skills beyond those required in caring tasks will contribute to the workforce and enhance society as a whole. So this is a good Bill and I am glad to have made a contribution with so distinguished a line-up of speakers.
In conclusion, the business of this House brings to mind the observations of William Gladstone, in another place, well over a century ago. They are still relevant to this House today, although in different circumstances. On
"Your business is not to govern the country but it is, if you think fit, to call to account those who do govern it".
In that spirit I look forward to joining your Lordships in that task.
My Lords, I am delighted to be able to congratulate the noble Baroness, Lady Falkner, on her excellent maiden speech which I think is a foretaste of her skills and passion. It was a moving address which demonstrates her commitment to the many causes that I know she will espouse. She will be an energetic, knowledgeable and expert Member of this House. She has much experience in campaigning. At one stage, in the area where I live, she gained the highest ethnic minority vote in London for the Liberal Democrats. I look forward very much to hearing many more of her contributions.
Turning to the important Bill which we are considering today, I add my congratulations to Hywel Francis MP and to the noble Lord, Lord Ashley, and my thanks to Carers UK and others for their help on the Bill, which promotes greater consistency and a more integrated approach in helping to enhance the rights of carers and to introduce them into new areas of work and opportunities in life.
For the first time the Bill recognises that carers' information must include not only health, social services and benefits but also housing information and information on education and training opportunities. It will help us to appreciate, perhaps most importantly, the impact of the end of the caring role. For many, especially older people and those caring for them, that will be at the time of the death of the cared for person. Carers have to get over the bereavement that that entails and to rebuild their lives. Most carers of older people are older people themselves, even if they are the children of the cared for person. The peak age for caring is between 45 and 60. Many give up work to care when they are at or close to retirement age.
We take carers very much for granted. The noble Baroness, Lady Pitkeathley, reminds us of that and has done much work in this field, for which we are all grateful. However, what we do not take into account is their isolation and poverty—particularly the impact on their pension rights, especially if they give up final salary schemes—and their ill health, both mental and physical. In giving carers further choices and opportunities, the Bill will help those who are older to battle with the discriminatory attitudes they often face in education and training as well as in the labour market.
We must recognise that if the Bill can help to overcome some of those difficulties it will be of huge benefit to the economy generally, as well as to carers individually, and at no extra cost. Although the Bill is somewhat more relaxed than in its original form when it had very much clearer directions, I accept that it provides opportunities to take forward planning and other measures and strengthen and promote them, provided all those who support the Bill work together, which I am sure they will.
Research by Caring Costs found that 80 per cent of carers would like to return to work. That is an enormous potential boost to our economy. However, for individual carers, a purposeful, practical plan for the next phase of their life will help translate despair for many into hope for the future. Surely, we owe that to carers. That is why I strongly support the Bill.
My Lords, I begin by adding my own congratulations to the noble Baroness, Lady Falkner, on her moving and excellent speech. I am very glad that she can be recruited to the band of usual suspects who can always be relied on to talk on carers' issues. I wonder whether any colleagues on the Liberal Democrat Benches share the thought I had about how pleased Lady Seear, such a doughty campaigner for carers and a great mentor of mine, would have been to hear the noble Baroness, Lady Falkner.
I am delighted to speak today in support of this important Bill and pay warm tribute to the noble Lord, Lord Ashley, for introducing it and to Dr Hywel Francis for the masterly way in which he piloted it through its stages in another place. I want also, as everyone else has done, to thank Carers UK, especially Emily Holzhausen and Dave Clark, although in doing so I must declare an interest as their former employer and now their vice-president.
I want also to pay tribute to the Minister in the other place and the officials in the various government departments who have been so supportive, and to give special acknowledgement to my noble friend Lord Warner, not only for the supportive part I am sure he will play today but for the contribution he made to developing carers' services in the 1990s. As a senior research fellow at the University of Kent he took part in an unprecedented programme of research on carers on behalf of Carers UK (then Carers National Association) considering the implementation of the National Health Service and Community Care Act and carers' and local authorities' experiences of that Act. The two reports he produced, entitled, Just a Fairy Tale?, published in 1994, and Better Tomorrows published in 1995 provided invaluable evidence which really helped the passage of the Carers (Recognition and Services) Act 1995. Both were an authoritative guide to what carers were getting or not getting and were the basis on which we campaigned for the first carers Act.
We are here today in this third Private Members' Bill for carers in what we might perhaps begin to call a series. I have had the privilege of being involved with them all, in rather different ways. For the first, the Malcolm Wicks Bill, I was involved as chief executive of what is now Carers UK and in the role of supporting and advising the parliamentarians and organising the carers' lobby. The then political divide might have been a problem. We had a Labour MP with a Private Members' Bill and a Conservative government. However, it proved not to be so thanks to the good offices of the then Minister, now MEP, John Bowis.
The Carers (Recognition and Services) Act gave all carers of any age a right to request an assessment of their ability to care when the person they were caring for was about to have a community care assessment, and placed a duty on local authorities to take the results into account when deciding what services to provide for disabled persons.
For the second Bill, the Tom Pendry Bill, I was by then a Member of Your Lordships' House and had the honour of taking that Bill through here as well as being closely involved in the campaign which supported it. The second Bill was different from the first, insofar as by then, 2000, the carers' issue was much more firmly on the political agenda and followed on from the excellent carers' strategy announced by this Prime Minister in early 1999. The Carers and Disabled Children Act 2000 gave carers aged 16 and upwards the right to request an assessment of their ability to care as long as the person they cared for was someone for whom services might be provided, but it also gave local authorities powers to provide carers with their own services. Very importantly, it gave local authorities the power to provide voucher schemes for breaks for carers and to make direct payment to them.
This third Bill is different again. We have had the same media attention, the same negotiations, the same well-organised campaign and the same struggles about what is and what is not possible in a Private Members' Bill, but this time it goes beyond what was aimed for and achieved by the previous Bills or even the carers' strategy. It goes beyond getting carers more recognition of their needs and attempts to achieve for them what a carer in one memorable phrase that I will never forget referred to as "an ordinary life".
That is what carers want above all: the right to do the things which most of us take for granted. They do not want to have these things—time off, a job, leisure opportunities, to go to the leisure centre or just to have a weekend break—at the expense of their caring. Let us be clear: most carers do not want to give up their caring duties; they love the person for whom they are caring, or at least have a very strong sense of obligation to them. However, they want to combine caring and also have a bit of free time, a job which earns money or fulfils them. They want to feel like an equal partner in the delivery of care and not a passive recipient of what someone wants to dole out to them.
The Bill is so important to carers because it establishes the principle of equal opportunities—a concept missing from previous legislation, however welcome that legislation was. This legislation takes carers out of being a "client" or a "user" and almost onto a rights basis. Carers have warmly welcomed this development. That is clearly emphasised by the huge amount of support from over 300 organisations, as my noble friend Lord Ashley reminded noble Lords.
It is very important to capitalise on this good will and to see that the guidance which is issued as a result of the Bill explores further the issue of carers and equal opportunities and looks at how social services can actively promote equal opportunities within all their policies for carers.
I want to say a word about carers and health. The original Bill contained provisions which would have placed a duty on health bodies and local authorities to work together to promote the health and well-being of carers. In Committee, it was agreed that we would lose this clause in favour of another measure. At Third Reading on
"We can better deliver on the promise to ensure that PCTs will have to consult and take into account the health needs of carers through developmental support rather than through directing them through secondary legislation. I assure the House that although we will not proceed with the directions we will pursue alternatives".—[Hansard, Commons, 14/5/04; col. 586.]
It would be helpful if the Minister could report on any progress that has been made on this issue and expand further on what they intend to do to provide developmental support and what those alternatives will be.
The General Household Survey found that 72 per cent of carers who provide over 50 hours of care per week suffer from ill-health; that 50 per cent have been treated for a stress-related disorder since becoming a carer; and that almost half have been treated for a physical injury. While there have been positive developments in local authorities in recognising carers, the NHS still has some way to go. So this is a very important issue.
Also important in the Bill is the duty to consider whether the carer wishes to work, to enter education or life-long learning and, indeed, leisure as part of the assessment. It gives powers to local authorities to require housing, education and other departments to help in the delivery of anything under the two previous carers' Acts. So it links with previous legislation but it goes further than any Bill has gone before. I am convinced that it will make a huge contribution in enabling carers to lead that ordinary life. That is what they want; that is what they deserve; and that is what they have a right to. I commend the Bill to your Lordships.
My Lords, I am very pleased to have the opportunity to speak in support of the Bill, which, most appropriately, has been introduced in this House by the noble Lord, Lord Ashley.
I have read the debates on the Bill in another place, and I too should like to pay particular tribute to the author of the Bill, Dr Hywel Francis, MP for Aberavon, a place for which I have particular regard, and not least because my kinsman, the noble and learned Lord, Lord Howe, was born and brought up there and there too fought his first parliamentary election battle.
The commitment to the disabled and those who care for them that Dr Hywel Francis has shown, both in his own personal life and in Parliament from his maiden speech onward, is more than impressive. The Bill, fully accepted by the Government and now before your Lordships' House, carries that commitment forward. Its important aim is to ensure that appropriate help and wider opportunities are known and available to this vital, yet still far too undervalued, group of carers; and not just on a postcode lottery basis, but universally.
Frankly, I have to admit to being somewhat surprised that such a Bill should have been necessary. When one considers not just the benefit the individual concerned receives from the carer's dedicated and loving support, but also the economic benefit we all receive, as the noble Lord, Lord Morris of Manchester, pointed out, because the state does not have to bear the full cost of residential care—an amazing £57 billion a year I believe—it is even more amazing.
We in this House have recently had a number of debates on the needs and still far from equal opportunities of our country's disabled and disadvantaged citizens. But this Bill, quite rightly, deals with the other vital half of the equation. It does so by placing a duty on local authorities to ensure that some six million carers who look after sick or disabled family members or friends in their homes are fully informed of their rights to an assessment for the kind of help, support and opportunities that could help make their lives more fulfilling.
Sadly, as we have heard from the noble Baroness, Lady Pitkeathley, the important duty placed on the NHS and social services to promote the health and welfare of all carers was lost during the Bill. Like the noble Baroness, I think that we all would want to emphasise that the effect should be carried out. Clearly, by doing our best to ensure healthy carers, apart from preventing suffering to the carer and the cared for, we are also—yet again—saving the financial cost of having to provide full community care.
With the context of what is being proposed, I hope that special attention will be given to speeding up the provision of practical—often relatively inexpensive—carer equipment which, if provided promptly, makes all the difference to a carer's ability to cope. My noble friend Lady Finlay, who is particularly sad not to be here today, especially asked me to stress that the time carers still have to wait for hoists, commodes, door widening and other necessary housing adaptations remains. That is not only totally unacceptable, but worse, it is counter productive. The carer becomes increasingly exhausted and unable to cope. Ultimately, the patient ends up in hospital, leaving the carer feeling guilty that he or she has failed: hardly the intended result.
I turn finally to the expected very positive outcomes of the Bill. I should especially like to commend two specific parts. First, a duty is laid on responsible authorities to co-operate in providing necessary services. That clearly echoes and reinforces other "joined up" government initiatives—seen most recently perhaps in the Children Bill. Secondly, the Bill seeks to improve carers' chances of finding employment. In these days of greater emphasis on, and achievements for, equal opportunities for women and people of different racial backgrounds in employment as well as other areas, the duty on local authorities to ensure that carers are given equality of opportunity in education, training and leisure is particularly welcome. No doubt organisations such as TOPPS can be useful here.
Clearly, flexibility and the need for part-time arrangements in the organisation of training and jobs will be crucial for the majority of carers if that welcome move is to become a reality. Also needed by many carers will be the availability of another person who can cover caring duties while the carer is undertaking training, retraining or is working.
One group of carers whom I hope will benefit hugely from the Bill are young carers. The All-Party Group on Children recently had the opportunity of hearing from a group of children with such responsibilities. They were an impressive group, keeping families together where considerable problems existed—such as a parent disabled, mentally ill or with a drug problem—while also trying to attend school. I must say that their stories did not always reflect well on how their peers treated them, nor indeed on the support and understanding you would have expected them to receive from their teachers.
I will keep your Lordships no longer, but once again I wish the Bill, with its cross-party support, as the noble Lord, Lord Ashley, said, a speedy passage on to the statute book and, more importantly, into practice.
My Lords, it is also my pleasure to rise to support this particularly important Bill, which is another building block towards giving 6 million carers in this country a better deal. Both Malcolm Wicks's Act, the Carers (Recognition and Services) Act 1995, and mine, the Carers and Disabled Children Act 2000, have been built on by Dr Francis in the Bill. All three of us were lucky enough to have done well in the private Members' ballot in the other place and, one would argue, even more fortunate to have received support from across the political divide. From those who have spoken so far, it is clear that that spirit still prevails. I am sure that we all look forward to the granting of Royal Assent to the Bill.
I must confess that I was somewhat disappointed with the BBC "Breakfast" programme a few days ago, which dealt with the problems of carers and those who are cared for without any recognition of the large body of parliamentarians in this and the other House who have shown by the Bill and the two previous Acts genuine concern for carers and their recognition of the important role that they play in society. Nevertheless, we have before us today a Bill that, I hope, the media will recognise and understand and take steps to bring to the notice of the public.
More importantly, it should be brought to the attention of carers themselves, because they have a great lack of knowledge. For it is a fact that many carers do not know about the rights that already exist—the rights that have been fought for in this and the other place on their behalf. With the passing of the Bill, it will be easier for those rights to be understood, as carers will automatically be told of their rights when the person for whom they care is assessed. It gives local authorities new and strong powers to ensure that carers receive that information about their rights. In assessments, it also places a duty on local authorities to provide rights in the areas of leisure time, training and work opportunities. Local authorities can enlist the assistance of housing, education and health departments to support carers. This legislation is a gigantic step forward for carers beyond the two previous Acts, as has already been said. It is as important as they were at the time.
As with Malcolm Wicks's Act, which led the way to both my Act and Dr Francis's Bill, all have shown the appreciation that this House and the other place have for those who do so much, often with little recognition, for those who are in need of care. Despite my Act, if I can call it that—the noble Baroness, Lady Pitkeathley, called it the Tom Pendry Act, so let us continue to call it that from time to time—the situation for carers is not perfect. The Bill before us and, I believe, another Act or two will be needed. We are building bit by bit. The noble Lord, Lord Rix, has already referred to a small gap in the Bill, which may be ironed out—whether at this stage or later remains to be seen.
The important thing for me, and, I am sure, everyone here, is that we are making progress to make this a better place for carers. The Carers and Disabled Children Act was itself an important step forward. It gave local authorities the ability to provide support for carers, giving them an independence that they had not previously enjoyed.
I echo those who have said great things about UK Carers, which has done so much. The noble Baroness, Lady Pitkeathley, has done more than almost anyone else to provide information for those of us who have sponsored such Bills in the past. We should all congratulate them on their efforts over the years. UK carers gave me one example of many that emanated from the power that my Act gave to local authorities. A local authority gave a carer 10 driving lessons so that she could learn to drive. She lived in a rural area with little or no public transport and could not drive. Her husband had had a stroke and could not drive. Now, as a result of her passing her driving test, they can get to the doctor and local amenities and are so much more independent. As I said, that is just one case among many that could be put before the House today.
Carers can use the legislation to enable them to get better breaks to suit them, rather than the local authority determining when they should have a break. However, as we know, many local authorities have not passed on the provision for the rights of carers in my Act. The Bill, when enacted, will ensure that all carers will be made aware of their rights. Unfortunately, as I said, some local authorities did not use the provision. It gave local authorities the power to give direct payments to carers—cash—so that they could arrange their own services. In its research document, Missed Opportunities, Carers UK found that only a few carers had experience of direct payments. Those who received them said that they had been able to find many solutions that they needed.
Essentially, in many ways, the Bill is more important than the two that went before it. It certainly strengthens the two Acts on the statute book. I cannot wait—I am sure that the House cannot either—for the Bill to receive Royal Assent so that carers in this country can benefit from it.
My Lords, we have reached the stage where everything has been said and everyone has said it, so I shall try to be as brief as I can. My first duty is a very pleasant one: to welcome my noble friend to our Benches as a full Member of the House. She said that she had no inspiration to work in the Whips' Office. Wearing my Whip's hat, I can say that she is one colleague who it will take a little time to drag in to do dogsbody work, but we have not given up on her yet.
As the noble Lord, Lord Pendry, mentioned, the Bill builds on best practice. As with many areas of legislation, there has been a snowball effect in that as we deal with one set of problems we realise that there are others, and we have only dealt with them in half measures because we have not opened them up before. With this legislation the snowball has grown and is moving faster. I hope that the legislation will attract better things to it. If it is properly enforced, we will know exactly what is going on.
The Bill contains three big clauses. The first relates to carers' right to an assessment, and informs them that they have that right. Information is power. I am fairly sure that the noble Baroness, Lady Pitkeathly, will agree with me on this. The first time that I heard her speak, I made an incorrect assumption and she disagreed with me, but that was a long time ago. All voluntary bodies tend to spend their time telling people what their rights are. Any such organisation will spend hours telling people, "You can do this; you can have that". Ensuring that an official tells individuals that they should have something done for them is a huge step forward. It is definitely best practice.
The Government attempt to embrace such an approach in many respects. The one-stop shop for social security is an idea aimed at conveying information to people; for example, to ensure that they stop underclaiming, that they know what they are doing and that officials know what is going on. That is vital to ensuring that the Government do not waste vast amounts of time in putting unenacted legislation on the books and putting aside budgets that are not used. If ever there were a good start to a Bill, this is it.
Clause 2 aims basically to enable carers to lead a normal life. The fact that someone is a carer does not mean that he or she should resort to the self-sacrifice of a Victorian melodrama. We do not want that; we want carers to be normal individuals with caring responsibilities. Society owes carers a big thank you for taking on those responsibilities; they should be given as much support as possible. The idea of leisure is another great step forward: if carers cannot work because of their responsibilities, they should be allowed to go out a couple of nights a week to pursue a hobby. If a person is not emotionally stressed, drained and driven into the ground, he or she will probably provide better care for longer. The long-term cost implications are favourable to the Government; everything dictates that they are.
Clause 3 relates to co-operation between authorities. What more can we say? How many of us have spent hours belabouring the Government because departments do not talk to each other. The Chinese walls set up by command structures, and so on, have stopped so much legislation, without many good intentions coming to anything. From the point of view of the development of legislation generally, but particularly in this field, if we manage to introduce a model that will force departments to work together and to take account of each other's guidance, it could do a huge amount for the efficient running of government and its change. I would welcome the inclusion of such a provision as a standard clause in a lot of legislation; it would be a very good idea.
I shall try to summarise our attitude to the Bill. It is a good idea; it builds on best practice. It should have happened ages ago—almost a pre-requisite for any social legislation to reach Parliament. I wish it well. I hope that it is enacted quickly and that its good ideas are enacted with all speed.
My Lords, the noble Lord, Lord Ashley, has a long, distinguished history of looking after the needs and aspirations of disabled people; I salute him for it. More recently, he has turned his attention to those selfless people who look after disabled people. I agree with him and others such as the noble Lord, Lord Pendry, who have made the point that carers, too, need our support.
The trouble with being what my children used to call a House of Lords groupie for so many years is that I remember. I remember other noble Lords who were in their day great advocates of the subjects that we debate in this Chamber regularly. On the plus side, I also have the advantage of seeing the gradual progress made by legislation and society on a great range of subjects.
On carers, like the noble Baroness, Lady Pitkeathley, I recall a period before the noble Lord, Lord Ashley, joined us, when the then noble Baroness, Lady Seear, espoused the lamentable treatment—or lack of it—that carers had received over the years. She would strongly approve of this Bill. She, too, had a strong interest in foreign affairs. I am sure that, having heard the admirable maiden speech of the noble Baroness, Lady Falkner of Margravine, Lady Seear clearly has a most able successor. I am sure that we will hear from her both soon and often on her specialist subject. A word of warning, though: it is sometimes a mistake to be tempted to speak too often.
As the noble Baroness pointed out, we have all been involved with carers, many of us in caring. Certainly, I came across many of them in my 10 years as chairman of the Stroke Association. Over that time I was proud to be involved in an annual award to the carer of the year for a stroke sufferer. The noble Baroness, Lady Greengross, talked about elderly carers, but I can tell her that often the people to whom we gave awards were young carers, sometimes of school age.
Although the Bill will do nothing physical for carers, it builds on two previous Acts, the Carers (Recognition and Services) Act 1995 and the Carers and Disabled Children Act 2000. I confess that I was surprised that the eminently sensible Clause 1 of this Bill was not included in previous legislation. Being of a suspicious frame of mind, I assumed, wrongly as it turned out, that the absence of a duty to inform carers of their right to an assessment of their needs was because of the cost to local authorities. This is the first time that I have shared anything, let alone a suspicion, with the Minister's colleague Dr Ladyman.
That suspicion was unfounded. Carers UK, to which I am most grateful for briefing on the Bill, informed me that discussions were held in connection with the previous Bills but that, being Private Members' Bills, any amendment could have rocked the boat so much that they may never have become law. I am also told that local authorities believe that there is virtually no extra cost to them in the Bill. However, I note Clause 5, which allows the Government to give local authorities extra money, should it be necessary.
Carers' responsibilities are obvious to everyone; their rights, on the other hand, are not. It is an unfortunate but undeniable fact of life that not all local authorities advise carers fully, hence the need for this Bill. The fact that private carers are estimated to save social services departments up and down the country £57 billion a year, as mentioned by the noble Lord, Lord Morris, and other noble Lords, should not escape our notice. As noble Lords will appreciate, the political fallout of having to add that enormous sum to council tax would be gigantic.
Not only should an assessment of the needs of disabled people be paralleled by an assessment of the needs of the carer, but the needs of the latter should include, by virtue of Clause 2, whether the carer works or wishes to work, or is or wishes to be in education, training or involved in a leisure activity. Replacement carers may be required for those periods when the regular carer pursues those activities. Without a proper assessment, that need would inevitably go unnoticed. I note the Prime Minister's promise in this connection—made during the Big Conversation on, I believe,
Lastly, I will refer to the need for co-operation between statutory services. There is absolutely no point in doing an assessment just for the sake of ticking a box, which the Government would do well to remember when considering targets. Unless it leads to some positive action where necessary, which it frequently will not, we might just as well tear up the whole Bill. Therefore, I am delighted to see in Clause 3 that other local education authorities, housing authorities and the various health authorities are to be informed when the assessing authority believes it to be necessary.
I have a long-term aim in this connection. Ever since having had the honour to serve in Northern Ireland, I have believed that the best way to organise health and social services is to have them provided by the same organisation. Both the Government by their recent activities, and this Bill in getting the health service and local authorities to co-operate more closely, are creeping towards my personal ideal. For the avoidance of doubt, my ambition is not official Conservative policy, but then this is a Private Member's Bill, so I can and will speak for myself. That said, I am speaking not only for myself when I say from these Benches that we support the Bill and hope that the Government will assure it a speedy passage.
My Lords, I am delighted to have the opportunity to add my voice to that of my noble friend Lord Ashley of Stoke and other noble Lords in support of this Bill. The Carers (Equal Opportunities) Bill is a further testament to the cross-party recognition of the crucial role played by carers. I too congratulate the noble Baroness, Lady Falkner, on her thoughtful maiden speech. I look forward to hearing many more contributions from her in this House.
I pay tribute also to the role of Dr Hywel Francis in the other place in bringing this Bill forward, and to the work of UK Carers and other carers' organisations in bringing the Bill to this stage of preparation. Carers continue to be a priority in this Government's agenda and have remained so since 1999, when carers' contributions and concerns were first formally recognised in the National Strategy for Carers. I am pleased to be able to say that not just as a Minister but as, I suppose, one of my noble friend Lady Pitkeathley's group of the usual suspects on carers' issues. I am grateful for her kind remarks and the trip down memory lane that she gave me.
The carers' strategy is unique; it was developed across government with carers and the organisations that represent them. It has led the way on partnership working, and we continue to work with the voluntary sector and other major stakeholders in developing policies to support carers. The work undertaken by my colleague Stephen Ladyman during the Bill's progress through the other place has more than demonstrated the Government's continuing commitment to supporting carers. Their contribution to enabling people to stay in their own homes and remain independent, not only for as long as they wish, but to enjoy that time, is rightly acknowledged in the Bill. However, support for carers must revolve around ensuring that they are also able to make choices as individuals. It is important to ensure that those who wish to care are able to do so with the support they need. It is equally important to make it possible that those who care can combine normal, everyday activities such as work and leisure with caring. We know that caring for others can come at a price in terms of the health and wellbeing of carers, as well as prospects for employment and self-esteem.
It is critical that we, as a Government, listen and learn from carers' experiences. They provide a reality check for all of us on how our policies are working. Carers are key partners in care—partners with a wealth of knowledge and experience that produces better policies, better legislation and better services. This partnership has been reflected in the Bill. People and organisations from all walks of life support the Bill, but most importantly carers and the organisations that represent them recognise that it has the potential to make a real difference to their lives.
As a Government, we are confident that the Bill has emerged from the other place in a form that fulfils the fundamental requirements for any new legislation. It fits within the framework of the modernisation of public services, and it complements existing laws. Most importantly, it delivers real and concrete changes for carers without disproportionate burdens on local councils. It makes it clear to councils what they are required to do. Clause 1 introduces new provisions to the existing carers' legislation requiring councils to inform carers that they may be entitled to an assessment. That will ensure that carers are getting information about their rights, as a number of noble Lords have said, in a more consistent way and at an appropriate time.
Clause 2 creates a specific duty that councils, when carrying out assessments under the existing legislation, must consider the wishes of a carer to work or undertake education, training or leisure activities. That will ensure that the assessment is undertaken in a style that appreciates and explores the needs of carers so that they are able to participate in life beyond their caring duties. By amending existing legislation, no authority should have difficulty understanding what they must do. In terms of carers' assessments, that means taking carers' lives outside caring into full account. This clause will ensure that councils consider and support carers in accessing opportunities to engage in work, education, training and leisure alongside those who are not carers.
Clause 3 makes provision for consideration of carers in the planning process, as well as providing a specific duty to consider assistance in relation to individual carers. The experience of councils with the Children Act led the supporters of the Bill to believe that this clause was important, and we thoroughly agree with them. It will promote joint working by requiring bodies, including councils and the NHS, to give due consideration to requests for help from a local authority in relation to planning and the provision of services that might assist individual carers to care and to continue to care.
We consider it vital that local councils are able to engage at a planning level with their partners in health and social care. That means that, at a strategic level, social services will have a lever to influence the priorities of their partners in health and the other council departments. The emphasis on cross-authority co-operation will be reinforced by the supporting carers theme for round 6 of the beacon council scheme, ensuring that the best councils have the opportunity to share their ideas and show how innovative services for carers can be through working across boundaries.
We have, however, added an additional duty in respect of co-operation. The Government feel that it is important for councils to be able to plan at an individual level. This is not designed to place onerous burdens on other parts of local government or on health bodies, but it gives social services an opportunity to put their case about the benefits offered in individual circumstances. As many noble Lords will know, this case is frequently a compelling one, but can sometimes be seen as a low priority.
The noble Lord, Lord Rix, asked about monitoring implementation. Sustaining carer support will be ensured through the existing system for monitoring councils' performance, the Commission for Social Care Inspection delivery and improvement statement. In March, the Department of Health published a new measure to assess the value and impact on the carer of the support provided at a local level. This indicator will measure the outcome of assessments for carers and will make it clear to councils what their key priorities are. It will also ensure that we know where carers are being well-served and where they are not.
My noble friend Lady Pitkeathley raised the issue of the alternative to a direction to the NHS. Taking into account the needs of carers and other stakeholder groups should be intrinsic to any planning process that the NHS undertakes. It should not be a bolt-on driven by directions. Effecting real change is best done through making the NHS performance management system work for us in this area. That is why we are considering how best to do that with our partners in the NHS. Put simply, it should be for the local NHS to demonstrate to their strategic health authorities that they are effectively taking account of the needs of carers in their planning processes. If strategic health authorities are not satisfied that that is the case or if the Department of Health has specific examples of how the process is not working, we will intervene. I can reassure my noble friend about that.
The noble Lord, Lord Skelmersdale, asked about the Prime Minister's suggestion that he wants to consider as a priority extending the right to request flexible working to people caring for sick or elderly relatives. I am glad that the noble Lord is participating in the Government's Big Conversation. Although we are keeping to the commitment, we will not make any changes to the Employment Act 2002 until 2006, because we have made a commitment on that issue. However, we will continue to work out and listen to ideas that come forward. To that end, my colleague Stephen Ladyman has been involved in two round-table meetings hosted by the voluntary sector during Carers' Week on to discuss with carers and employers ways to make it easier for carers to juggle their caring role, while trying to earn a living.
In conclusion, I can confirm that the Government fully support the Bill. It will achieve the broad objectives envisaged by its sponsor in the other place. As many noble Lords have said, the Bill offers real and tangible benefits for carers, recognising their status as individuals with personal needs, as well as the prospect of more flexible and responsive services, developed through collaboration. I am delighted to add the Government's unreserved support to the Bill, and I hope that the House will give it a Second Reading today and a speedy passage.
My Lords, I express my warm appreciation to all speakers in this high-class debate. I also express my appreciation to Hywel Francis and his wife, Mair, for initiating the legislation. It was a great achievement.
There were many speeches, and I do not propose to comment on any individual contribution, except to say that the noble Baroness, Lady Falkner of Margravine, made a fine speech. I could use many words to describe it, but the two that I will go for are "moving" and "impressive". Congratulations.
It has been heartening to hear all the speeches in the debate, and the House has spoken with a clear voice on a major issue of social policy. The Bill is a landmark in social policy, and I hope that the House will give it a Second Reading.
On Question, Bill read a second time, and committed to a Committee of the Whole House.