The Minister for Community and Social Care (Alistair Burt)
I congratulate my hon. Friend the Member for Eastleigh (Mims Davies) on securing this debate and on the way she opened it, and I thank the Backbench Business Committee for allocating time for this important debate during carers week. I will start where the hon. Member for Worsley and Eccles South (Barbara Keeley) ended, and thank all those who are involved in caring in our society. As we have heard from every speaker, carers make an invaluable contribution to the UK that we could not do without, and perhaps I can illustrate that by citing some of the remarks made by colleagues during the debate.
I will touch on some of the points raised by my hon. Friend the Member for Eastleigh in the remarks I have prepared for this debate, and I will also comment on her other points. She started with a graphic description of what might happen if carers were not around and if they decided not to do what they do every day, which brought the point home to us. She spoke about how people become a carer, and said that it could happen to any of us at any time. At last year’s national care awards I remember watching a video in which the point was made vividly that any of us in that hotel room could become a carer within 24 hours, and we can all understand that. As others pointed out, carers are no longer a minority group but people we all know—many of us are closely connected to carers, if not carers ourselves—and we are all only going to become more closely involved in the future. She, like others, made that point very well.
My hon. Friend also spoke, as did others, about the need to identify people not solely as carers but as husbands, wives, partners, employees—everything else they still are—and about the great danger of someone being pigeonholed because they have become a carer. It is important to remember that someone does not lose their identity when they become a carer. Hon. Members also highlighted the importance of carers week. I am proud to be the president of Carers in Bedfordshire—I have been for some years—and I thank it for its work. All hon. Members have thanked their local groups.
My hon. Friend was not the only colleague to speak of her personal experiences of caring. As I have mentioned from the Dispatch Box before, the range of Members’ experiences goes far beyond what the media are keen to portray and touches on virtually all aspects of life outside. When I hear the cares and experiences that colleagues bring to this place, I always hope that people outside read our debates and understand a bit more about us, why we want to be representatives in Parliament and the personal experiences we bring.
The hon. Member for Workington (Sue Hayman) and others spoke about finances, on which subject I could spend the whole 15 or 20 minutes. I know that this subject is particularly important to the hon. Member for Worsley and Eccles South, the spokesperson for the Opposition. On carers allowance, which the hon. Member for Workington focused on, the Government keep the earnings limit under review and keep under consideration whether an increase is warranted and affordable. The increase of 8% in 2015 far outstripped the increase in wages. The earnings limit is currently £110 a week, but that is a net figure, and if allowable expenses, such as childcare and pension contributions, are deducted, a claimant might earn significantly more. The limit enables a carer to maintain some contact with the employment market and achieve greater financial independence, but I recognise and would not minimise the constant financial pressures and difficulties facing families. The limit is kept under review. Also, as I said, there is a wider review of the carers strategy, which has allowed a lot of people to make contributions on finance, not just the amount but the important interlinking of benefits. That point will not be missed, and I thank her for raising the matter.
Barbara Keeley
Carers charities often raise with us the link with things such as the national minimum wage. The Minister talked about the figure last year, but the national minimum wage changed in April, and many of the carers trying to keep a part-time job going will be at that level, so it seems sensible to link the threshold with the national minimum wage so that when the national minimum wage increases, so does the threshold.
Alistair Burt
I cannot make that specific commitment, but I understand fully the hon. Lady’s point. As I said before, the earnings limit and all the factors affecting it are kept constantly under review, but I am sure that Treasury colleagues will not have missed the remarks made today.
My hon. Friend the Member for Chippenham (Michelle Donelan) also made the point about carers not being a small minority. She commended Carers in Wiltshire, and I commend her for being a volunteer—another example of the experience we all bring to this debate—and she raised the important issue of entitlement to benefits and signposting. In our call for evidence as part of the review of the carers strategy, respondents raised the importance of people being directed towards the things they need as soon as possible. The moment someone becomes a carer, their world changes, and they need as much information as possible at that time. She was right to mention the importance of signposting in particular. She spoke with great passion on the subject.
The hon. Member for Ayr, Carrick and Cumnock (Corri Wilson), who also spoke from personal experience, made a point about access to work. I shall talk about employment later, but she made her point strongly, and again she was not the only person to recognise that, although we all wish for a world in which burdens are shared equally, in truth they are not. Women carry the biggest burden when it comes to caring, and will probably continue to do so for some time. Recognising the extra pressures on women is particularly important. The hon. Lady made that point very well.
The hon. Member for Paisley and Renfrewshire North (Gavin Newlands) was particularly helpful in saying that although it is carers week for us, it is just another week for carers. I also liked it when he said that it was a week to talk “with”, not “to” carers. That was a particularly well made point. He spoke forcefully about the reality of life—the sleepless nights and other issues that carers experience.
My hon. Friend the Member for Bexhill and Battle (Huw Merriman) brought up the issue of care homes. I am not going to linger on that subject, but, as some colleagues know, I am particularly exercised about safety in care homes. It is my belief that someone in the care of the state, whether it be the NHS, local authorities or anyone else, needs to be as safe in a care home, a mental health institution or in learning disability facilities as they would be in an intensive care unit. As I expressed in yesterday’s debate about Southern Health, that is simply not the case.
I am very conscious of issues surrounding care homes. I have a round-table meeting on Monday with those responsible for the monitoring and regulation of care homes, and I pay tribute to the Care Quality Commission and others who are trying to do a good job of regulation, but this also involves some of the groups that are critical of regulation, want to see more done and want to ensure that there is safety in care homes. Some of the stories of abuse that we read about in the papers need to become fewer and fewer until they are extinct.
I want to praise the National Care Association because there are many good care homes, as my hon. Friend the Member for Bexhill and Battle said. It is important to keep the right balance in recognising the quality of good homes without minimising the pressures on them. When things that should not be happening are going on, it is quite difficult to maintain that balance. I appreciate the fact that my hon. Friend mentioned this important issue. I commend, too, the ideas coming forward from the carers team in East Sussex, and I urge members to ensure that the ideas put to my hon. Friend will be put into our national call for evidence. They have until the end of this month to do so. I do not envisage a statutory instrument to extend that still further, should there be a rush of evidence at the end of the month, but we never know in the present circumstances. Getting that information in would be very helpful.
The hon. Member for South Antrim (Danny Kinahan) was not the only one to refer to the pressures on our own caseworkers, who do so much work to look after people in the House. I appreciated his mention of that point. He hoped that the carers strategy would be a long-term strategy. I hope it will, too. The strategy should be reviewed from time to time—this is the first review for two or three years—and that is certainly the aim. That is why I would like the strategy to look slightly beyond the immediate and consider how to build for the future rather than simply having a snapshot now.
My hon. Friend the Member for Strangford (Jim Shannon)—I call him my hon. Friend—is exceptionally generous and courteous to all Front-Bench Members when he speaks. I would like to tell him how much that is appreciated—it really is—when he is so genuine in expressing his views. He spoke of his personal experiences, pressures in Northern Ireland and the Crossroads young carers in Newtownards who particularly stressed the difficulties faced by young carers and the things that they often miss out on. My hon. Friend spoke about a singing group. A few weeks ago, I went to Biggleswade at the request of the Alzheimer’s Society to join a singing group, and I sang some songs with the people there. It was certainly an uplifting experience that morning. I commend those groups and the carers who work with them.
The hon. Member for Central Ayrshire (Dr Whitford) made a considered and thoughtful contribution, as usual. She spoke about all the financial pressures. Particularly telling was her comment that although there are a relatively fixed number of carers and although it is steadily growing to 6.5 million, it is a replaceable 6.5 million and about a third leave for all sorts of reasons.
On bereaved carers, I was contacted through Twitter by someone in that position who asked whether the strategy and review would cover them, and I answered “Yes, it will and it should”. The moment that caring for someone stops because of bereavement, the carer’s life has changed—perhaps in an anticipated way, but it is has still changed. Caring for people in those circumstances is really important. We must not forget this group, so I greatly appreciated what the hon. Lady said. She also spoke of the need to ensure that social care is seen as a profession as much as nursing and domiciliary care are throughout the NHS and elsewhere, and I thoroughly agree with her.
The hon. Member for Worsley and Eccles South (Barbara Keeley), whose background in caring requires her to be listened to seriously every time she speaks about this issue, made a number of comments. I shall deal with the subject of finance a little later. Let me say first that I will ensure that the review that we are conducting will cover early identification in the NHS. We are trying to ensure that it takes place earlier and earlier. The issue of GP identification is very important, and I am pleased that the hon. Lady raised it again.
Barbara Keeley
I should be happy to send the Minister a copy of my Bill and the explanatory notes if that would help to elucidate the points that we have made.
Alistair Burt
I have no doubt that those are already deep within the recesses of the Department of Health, but if it would speed things up and provide encouragement, I should be grateful if the hon. Lady did indeed do that.
The hon. Lady also made an important point about our staff in the House. She said that we should look after them. I appreciate the point that she made about the staff of the Independent Parliamentary Standards Authority, and I will look into how we can best ensure that we recognise properly—in line with best employment practice elsewhere—that those who work for us bear considerable burdens of caring from time to time.
I am grateful for the opportunity to come to the House and share the important work that is under way to develop a new cross-Government strategy for carers. I continue to be humbled by the many powerful, honest and informed contributions that we have heard throughout the afternoon from Members who have described the carers whom they know and represent, as well as their personal experiences. Those views, and the many others that we have received so far, will be fully taken into account as the Department works with Government colleagues, stakeholders and, crucially, carers themselves to develop the new strategy.
Today we have been reminded that behind the statistics stand spouses, partners, parents—in fact, all manner of relatives, friends and neighbours—who are providing care right now in our communities. Their commitment can scarcely be quantified or questioned, and we must ensure that our own commitment to support people is demonstrated clearly as well.
I pay tribute to the national care awards, which are sponsored by LloydsPharmacy, Carers UK and The Sun. I was at the awards ceremony a couple of weeks ago, and we met the winners at lunchtime. The Prime Minister was kind enough to offer No. 10 Downing Street for a lunchtime reception, and we took people round. We are always struck when people like that say that it is a privilege to be there. We say to them, “No, it is our privilege that you are here with us. It is the other way round.” Those people were a great group—great winners. We went to a dinner that night. Radio 2 was very good: there is always a table of wonderful people to support the awards. When we hear the personal stories—which have been reflected in some of what we have heard in the House today—we are all immensely impressed. Let me again pay tribute to those awards: they do one of the jobs that we have all been speaking about this afternoon—valuing and recognising carers for what they do in so many different circumstances.
Before we go any further, may I offer a small philosophical comment? I picked this up from a piece in The Guardian by a writer called Madeleine Bunting. I do not read The Guardian all the time, contrary to the belief of many of my colleagues, but every now and again I am struck by something that is really good, and what Madeleine Bunting wrote is important. She was writing about what care is. We talk about it—we talk about the facts and figures and the finance here in the House—but what is it precisely, and where is it going? Madeleine Bunting wrote:
“We recognise instantly when we experience it: an interaction that acknowledges a moment of human connection. It may be brief, but it expresses and confirms a common humanity, a recognition of the individual—and always involves a particular quality of attention.
But the characteristics needed to provide this kind of care are losing cultural traction. Attentiveness requires two crucial ingredients: patience and the willingness to put one’s own preoccupations aside and to be available to another. Yet in a myriad of ways we are all being groomed by consumerism and digital media—to be the opposite: impatient and self-preoccupied. That impatience makes us easily distractable, addicted to the next stimulus.”
I think that Madeleine Bunting was making a really important point. The people about whom we have been talking have avoided that: they have patience, and a commitment to others that is beyond many of us. However, there is concern about society—concern about where it is going and the pressures that it is under. Demographics suggest that we will need more care, and yet certain pressures are making it more difficult for that to be realised. What will carers be like in the future if they have become too distracted and too self-occupied? That is not the case with carers now, but it is a valid point to raise with regard to the future.
We owe a duty of care to this vast army of people, who show their patience and their compassion for others. I am talking about not just providing them with the support, tools and information that they need to care well, but ensuring that their own health, wellbeing and life goals are not compromised. Our respect is unreserved, but respect is not enough. We must never lose sight of that fact if a new carer strategy is to succeed.
I should say at this point that I do not wish to paint a negative picture of caring. Although personal sacrifices are made each and every day, many carers have told us that it remains a privilege to care, and that they have a strong desire to repay the kindness of others. Indeed, carers derive immense satisfaction and peace of mind from being the primary source of comfort and reassurance for friends and loved ones. However, that satisfaction must not be at the expense of carers’ own mental and physical health.
We have also heard this afternoon about the great diversity in types of caring. There is no such thing as a typical carer—carers are people of all ages and from all walks of life, and those for whom they care have different needs. In particular, we neglect at our peril the needs of children and young people with caring obligations. They are most at risk of having not just their health and wellbeing compromised, but their education and career ambitions too.
There is no “one size fits all”. We must be alert to that as we attempt to craft new and improved support for all those providing care in our communities. It is no surprise that one in six of us is currently caring. As lifespans extend and our population grows, caring for others has already become part of the fabric of our lives. All those who have spoken today have made it clear that they are not affected by the lazy mindset that tells us that carers are other people; carers are all of us. As a constituency MP, I have had the privilege of visiting carers and carers’ groups in Bedfordshire. As a Minister, I have spoken to carers’ groups in relation to pulling together the new carers strategy. I strongly commend those who work in my own county.
Almost 20 years after the Carers Act 1995 first gave official acknowledgement to those providing “regular and substantial” care, the Care Act 2014 now gives carers new rights, including parity of assessment, advice and support with those for whom they care. Those new rights are a historic step forward. We have provided local authorities with £433 million in 2016-17 for new burdens arising from the Act.
We know that the Care Act is taking time to bed in. The hon. Member for Worsley and Eccles South referred to the matters that affect assessment, and I understand them very well. Care varies from place to place. A group from the Association of Directors of Adult Social Services working with the Department is looking at those variations in care, so that in places where assessments are much slower than in others, we are looking at what can be done and how things can be improved. That is very much on our mind.
Barbara Keeley
Having been present during discussions about certain groups of carers, perhaps the Minister will tell us whether he believes that carers of people who are at end of life should be prioritised for assessment. It is pointless to have people waiting six months when the person for whom they care may have only a few weeks or a few months to live.
Alistair Burt
I will ensure that that is considered as an important point of the assessment. I will write to the hon. Lady in relation to that.
Let me turn to finance now. There is always concern about the amount of finance that is available. It is almost impossible to get the right amount. By spending around £2.5 billion a year on benefits in Great Britain, benefiting more than three-quarters of a million carers, we are trying to respond to the needs that are there. That money provides a measure of financial support and recognition for people who give up the opportunity of full-time employment in order to provide care. As I said earlier, those allowances remain constantly under review. As this debate has made clear, it is not just about finance, but about all the other things, including supporting young carers and making sure that they are not forgotten and remembering that employers play an important part. I commend NHS England for the important work that it has done in relation to carers and for its commitment to carers.
I also want to mention the results that our call for evidence has produced, just to give people some assurance that these things are on our minds. We have received 3,800 responses so far, 85% of which are from carers themselves. A great number of the responses have been candid and honest, and it will frighten my officials if I read them out. They describe financial hardship; a lack of recognition and involvement; the impact on carers’ health and wellbeing; the difficulty of maintaining life outside caring; and frustration with access to assessments and services. All these issues are on our minds.
The need to ensure that carers get the recognition they deserve has been well illustrated in the compassionate speeches that we have heard today. Carers are vital, and not just in carers week. There is also a young carers awareness day—it was on 27 January this year—sponsored by the Carers Trust. I also commend my hon. Friend the Member for Truro and Falmouth (Sarah Newton) for holding a round-table about carers recently. This matter is on the minds of everyone in the House and I appreciate the courtesy of hon. Members in giving their time to deal with this important issue this afternoon.