HIV: Ending Transmissions

Baroness Clark of Kilwinning Excerpts

Tuesday 1st December 2020 Lords Chamber

[Lord Bethell (Con)]

I reiterate the tribute of my noble friend to the Lord Speaker. Over three decades, he has campaigned tirelessly on these issues, and was instrumental as Secretary of State for Health and Social Security in launching the ground-breaking “Don’t Die of Ignorance” campaign, which made an indelible mark—its impact is remembered today. The tenacity that he has shown in making evidence-based decisions in the fight against HIV is a model for us today.

My noble friend makes a very valid point on the need for a plan. We will issue a sexual health and an AIDS plan in short order; they have been delayed by Covid. He reminds us that it is D minus 10, a goal that we take extremely seriously.

[Baroness Clark of Kilwinning (Lab)]

We know that stigma, even fear, can often prevent people going for tests. What does the Minister think we can do to improve the uptake of testing, particularly from those who are at the highest risk of contracting HIV? What does he think we can do to improve the training of those who provide testing to make sure that in future people are more likely to take tests?

[Lord Bethell (Con)]

My Lords, we have made great progress in the area of tests, hitting the UNAIDS 90-90-90 target for the third consecutive year, with 94% of those living with HIV diagnosed, 98% of those diagnosed getting treatment and 97% of those undergoing treatment having an undetectable viral load. The noble Baroness is entirely right: one of the greatest challenges is those who are not tested because they do not know that they should be tested. Part of that is stigma and part of it is encouraging people to step up to get tested. That is the focus of the recommendations in the HIV Commission’s report, which we take very seriously. It has clear recommendations on marketing, which we will be looking at very carefully.

Covid-19 Update

Baroness Clark of Kilwinning Excerpts

Monday 30th November 2020 Lords Chamber

[Lord Bethell (Con)]

I thank the noble Baroness for her characteristically compassionate question. I can reassure her that there are exceptions for essential travel. The kind of scenarios that she just described would seem to me to fit into the definition of exceptional travel. I am happy to look into whether some form of registration process is necessary but, as far as I understand, that has not proved to be the case.

[Baroness Clark of Kilwinning (Lab)]

Many scientists are expressing concern that the easing of restrictions at Christmas is going to lead to a surge in cases in January. Given this and the high incidence of Covid among 11 to 16 year-olds, are the Government actively considering extending the Christmas break for secondary school children as a way to try to curb the spread of the virus?

[Lord Bethell (Con)]

The noble Baroness is right that we are concerned about a post-Christmas surge, but the opening of schools is an absolute number one priority. We will do everything we can to keep the schools open, and that includes schools for 11 to 16 year-olds.

Covid-19: Local Restrictions

Baroness Clark of Kilwinning Excerpts

Friday 9th October 2020 Lords Chamber

[Lord Bethell (Con)]

Our approach is based on the partnership between central and local government. Local government has a distinctive and unique role to play; local authorities work with employers, businesses and other relevant commercial groups to help prevent and control outbreaks, and their local outbreak plans will provide opportunities to build on that information best to support businesses and other local services to return to normal operations in a safe way. It is that partnership between national and local government that will build a successful response to the Covid epidemic.

[Baroness Clark of Kilwinning (Lab)]

Parliamentarians on all sides in both Houses say that they feel that they have not been included in decision-making so far. Mayors and leaders of local authorities have made it really clear over the last few days that there has not been communication with them; they seem very angry about the way the Government have conducted themselves. There was huge compliance with the restrictions imposed during the lockdown. Surely the Minister accepts that he needs to ensure that local authorities, mayors, and indeed local MPs need to be on-side and he needs to rebuild that trust. What can he do to make sure the Government take on board the points being made?

[Lord Bethell (Con)]

My Lords, I completely recognise the importance of stakeholder engagement, building alliances and collaboration. I emphasise our commitment to the partnership between local and national government. When it comes to Parliament’s engagement in these measures, I can only repeat what I said earlier: my right honourable friend has made it very clear that for significant national measures with effect in the whole of England or UK-wide, we will consult Parliament and, wherever possible, hold votes before such regulations come into force. Until then, it is through the usual channels that the schedule of the House of Lords will be arranged.

Covid-19 Update

Baroness Clark of Kilwinning Excerpts

Tuesday 6th October 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, the case of the SNP MP has shocked the nation. I do not want to comment on it in detail. I do not have the details of what after all is a private matter. That is for the police and the House authorities to examine.

However, the principle to which my noble friend refers is very clear and simple. If you are positive, you isolate. If you are contacted by the contact-tracing system, you discuss your recent contacts with the contact tracers, who will coach you and rehearse with you fully the length and proximity of those contacts and will give a thoughtful clinical judgment on which ones need to be subjected to further contact and isolation procedures.

This is absolutely essential to breaking the chains of transmission. It has a huge amount of support among the public and a tremendous amount of compliance, and we are building on the existing compliance with the enforcement regime that we brought in recently. I call upon all members of the public to support this important approach.

[Baroness Clark of Kilwinning (Lab)]

The Minister will appreciate that the 10 pm curfew, the restrictions already in place in many parts of the country and, indeed, the likely further restrictions that will be brought in, given the levels of Covid, will have a big impact on employment. Other countries are continuing with their furlough scheme, but the scheme that we are introducing to replace it is not as generous. Will the Minister not accept that unless the Government put significant further financial support in place, we will face huge levels of unemployment in this country, with millions of people out of work, an increase in poverty and probably the worst recession that any of us have ever known?

[Lord Bethell (Con)]

My Lords, the impact of all the restrictions, on the hospitality sector in particular, are particularly acute. I completely recognise the noble Baroness’s point that this touches on the lives of many hard-working people from low-income backgrounds who have casual labour arrangements with the hospitality sector. There are millions of people involved, and this epidemic has hit them particularly hard. That is why we put schemes in place like the furlough scheme.

The Chancellor spoke very movingly this morning on the “Today” programme about his intentions and his determination to ensure that people are protected from the worst outrages of Covid. We are also putting in economic measures to avoid the kind of recession which the noble Baroness describes. The honest truth is that other parts of the economy are doing extremely well. It is an awful shame and sadness that, once again, Covid is hitting the most vulnerable the hardest, and the noble Baroness is quite right to identify the people she does.

Coronavirus Act 2020: Temporary Provisions

Baroness Clark of Kilwinning Excerpts

Monday 28th September 2020 Lords Chamber

[Baroness Clark of Kilwinning (Lab) (Maiden Speech)]

My Lords, it is a pleasure to be able to speak for the first time in this House and to thank noble Lords on all sides for their courtesy and assistance during my first few days here. In particular, I would like to put on record my gratitude to all the House staff for their professionalism and for the risks they are taking in these difficult times. I thank my noble friend Lady Healy, whom I have only met in the last few days but who is now my mentor and has shown me great kindness over that time.

I also thank my two sponsors, whom I have known for a considerably longer period of time. My noble friend Lord Foulkes met me when I was a young child and, as I like to remind him, he has now known five generations of my family, including my grandmother, Agnes Davies, who was chair of his constituency Labour Party when he was the Member of Parliament for South Ayrshire. I met my other sponsor, my noble friend Lady Chakrabarti, in 2005 when I was first elected as the Member of Parliament for North Ayrshire and Arran and she was lobbying and advising on civil liberties aspects of legislation going through the other place. I suspect that her skills will be of great use in today’s debate.

My election as the Member of Parliament for North Ayrshire and Arran was the biggest honour of my life. It is a beautiful and diverse constituency. I come from Ayrshire, so I am well aware of many of the challenges that Ayrshire, and indeed the whole of the west of Scotland, faces due to deindustrialisation and a lack of investment over many years. I hope to have the opportunity to speak about some of those issues in this House. The advice that I got from the clerks was to make an uncontroversial maiden speech. Given the nature of some of the legislation coming before the House, that has been very difficult to do.

My first employment was in the Scottish legal profession, where I took civil actions based on human rights breaches. I then went on to work as a criminal defence agent and was an executive member of the Scottish Council for Civil Liberties before I headed up a legal unit for the trade union UNISON. All my instincts would normally be to strongly oppose legislation with some of the draconian provisions included in the Act which is before the House today.

However, as has been pointed out, we live in unprecedented times and the pandemic we are faced with means we have to look at the legislation in that context. The legislation is very wide-ranging—it is 360 pages of legislation, including schedules—ranging from making it easier to force compulsory treatment on individuals under the Mental Health Act to postponing elections and provisions relating to potentially infectious persons.

In the short time available, I am going to focus on only one aspect, which is statutory sick pay. Approximately 2 million people in this country are excluded from statutory sick pay. They are mainly women, but those on zero-hours contracts and the self-employed are particularly affected. The TUC says that, in this country, statutory sick pay is the equivalent of only 29% of average pay, compared with, for example, 100% in Germany and 93% in Belgium. I suggest to the Minister that, given that the state is requiring people to self-isolate and asking them to shield, perhaps this is something that we can look at this again. We need to make sure that we put people in a financial position where they are able to comply, to keep all of us safe.

Cervical Cancer Screening

Baroness Clark of Kilwinning Excerpts

Thursday 1st May 2014 Commons Chamber

[Mr John Baron (Basildon and Billericay) (Con)]

First, I congratulate the hon. Member for Liverpool, Walton (Steve Rotheram) on securing the debate. Needless to say, all our thoughts go out to Sophie’s family and friends at this time of loss.

The hon. Gentleman rightly focused on the importance of early diagnosis, which is crucial with not just cervical cancer but cancer in general. I hope, in a relatively brief speech, to remind the House of the importance of the figures that the Government are due to publish soon—one-year cancer survival rates broken down by clinical commissioning group. I and fellow Members of the all-party group on cancer believe that those figures could have a transformative effect in encouraging earlier diagnosis, thereby saving literally thousands of lives.

The recent period has been interesting, because we have had both good news and bad news on cancer. The good news is that, as Cancer Research UK announced only a few days ago, 50% of those diagnosed with cancer now are likely to make it to 10 years following diagnosis, which is twice the survival rate that existed back in the 1970s. That is extremely positive. The bad news is that in this country, shamefully, one in four cancers are still first diagnosed as late as when somebody goes to A and E. It is of further shame that figures suggest that if we were to match European averages for cancer survival rates—just the averages—we could save an additional 5,000 lives a year. If we believe the OECD’s figures, if we were to match international averages—again, just the averages—we could save up to 10,000 lives a year. That shows clearly that we have a long way to go and that early diagnosis is crucial. The all-party group describes it as cancer’s magic key. There are very few magic keys in life, with which we can open the door and find that there is suddenly a plethora of riches in front of us, but a magic key does exist for cancer, and it is early diagnosis.

[Katy Clark (North Ayrshire and Arran) (Lab)]

Does the hon. Gentleman agree that there is huge regional variation in cancer survival rates? In areas such as the one that I represent, where we have high levels of poverty and deprivation, survival rates are a lot worse than elsewhere, so we have massive challenges before us.

[Mr Baron]

The hon. Lady makes an excellent point, which leads me neatly on to the report that the all-party group produced back in 2009 on reducing cancer inequalities—I should perhaps declare an interest as the chairman of the group. The report, which was extensive and took in much written and oral evidence, found that this country’s health care system stood as much chance as any other of getting patients from the one-year point to the five-year point after diagnosis. However, where we fell down was on getting them to the one-year point in the first place. That suggests that the NHS is as good as any other health care system at treating cancer once it is detected, but very poor at detecting it. That underperformance in diagnosing cancer means that we trail other health care systems. We never catch up from that original loss.

Comparisons are always dangerous. When we compare our system with that in France, for example, we are comparing it with centres of excellence, so we have to be careful in our comparisons. However, the figures of 5,000 lives a year that could be saved if we matched European averages and 10,000 that could be saved if we met international averages are generally accepted. They can largely be accounted for by the early phase, when we fail to pick up cancer early enough and so do not get enough people to the one-year point after diagnosis.

The all-party group therefore decided to ask how we could focus the NHS on earlier diagnosis. We have been laser-like and dogged in our campaign on that front.

--- Later in debate ---

[Katy Clark (North Ayrshire and Arran) (Lab)]

It is a pleasure to follow the knowledgeable contribution from the hon. Member for Cheltenham (Martin Horwood). I want to thank my hon. Friends the Members for Liverpool, Walton (Steve Rotheram) and for Wirral South (Alison McGovern) for bringing this matter to the House today on behalf of the family of Sophie Jones, who did so much work to collect the many signatures that ensured that we had this debate. I pay tribute to them for reacting in that way, because it is incredibly important that people such as them do this work to raise awareness of the condition, and to ensure that we have the health services required for this form of cancer.

I am speaking in today’s debate because of my constituent, Suzanne Fernando, who lives in Ardrossan. She was diagnosed with cervical cancer when she was pregnant, and describes herself as a survivor of cancer. She has campaigned tirelessly on the issue throughout my time as a Member of Parliament, and I have campaigned with her on many different aspects of the disease: ensuring that people use cervical cancer screening services and get smears; attending local schools with her and encouraging girls to get the HPV vaccination; and supporting her in her fundraising work. She was Scotland’s first campaigns ambassador for Cancer Research UK. She set up a cervical cancer support group in Ayrshire, which provides people with advice on the disease at any stage. We should pay tribute to all the women throughout the country who have experience of cervical cancer and who do everything they can to ensure that others do not go through what they have been through, that the condition is identified early and prevented and that people get the treatment to which they are entitled.

I listened carefully to the comments of my hon. Friend the Member for Wirral South about young women. Often, young women have the greatest contact with the health service when they have children. Many of us have been aware for generations how disempowering many women find that experience. It is incredibly important that the motion before us states clearly that when a woman asks to have a smear test, she should be entitled to have it. The case of Sophie Jones shows powerfully why that is important.

There are far wider issues, such as having a patient-centred service and actually listening to what people are saying—whether they are young or old, a woman or a man, and whatever ethnic or other background they come from—and ensuring that they are given access to the treatment they deserve.

Suzanne Fernando is taking part in cervical cancer awareness week, participating in a 5 km walk for fun at Eglinton Park in Kilwinning, Ayrshire, on 15 June. Of course, she is just one of the many women who are trying to raise awareness of this condition. I hope the message goes out clearly from this House today that we want the Government to do what is necessary to ensure that young women in particular are given access to the NHS facilities that they deserve, that we listen to what young women say, that we listen to what Sophie Jones’s family is saying and that we learn the lessons to ensure that such a tragedy does not happen again.

Adult Autism Strategy

Baroness Clark of Kilwinning Excerpts

Wednesday 5th March 2014 Westminster Hall

[Katy Clark (in the Chair)]

Order. Interventions must be brief.

[Robert Halfon]

My local autism charity, Parents and Children Together for Autism, has set up a pilot apprenticeship scheme focusing on people with autism. Does my right hon. Friend agree that that should be rolled out across the country?

--- Later in debate ---

[Mrs Gillan]

I agree entirely. I am amazed by the intellect and the unique and fantastic capabilities of some people on the autism spectrum. Many of them have the capability to repeat jobs that demand high intellect, such as the regular quality-checking of components. There are some really valuable people on the spectrum whose skills are being completely wasted, and if there is some way in which we can mirror the apprenticeship scheme and encourage employers to hire them and spread the word that they are the people they should be looking at, although they may require some rightly deserved special attention, that would be useful.

To start with, we must establish base camp. Therefore, I particularly want to hear some assurances from the Minister today that the core elements of the original strategy and statutory guidance will not be lost once the revised strategy is in place. Local authorities and the NHS are at differing points in implementing the current strategy. The strategy has set them on the right path to ensure that the needs of adults with autism are properly accounted for in local planning and commissioning, because it clearly sets out that there must be local leadership on autism to help bridge the gaps in local services and it also makes it clear that every area must have a pathway to diagnosis, as well as appropriately trained staff, which was the point made by my hon. Friend the Member for East Worthing and Shoreham (Tim Loughton).

We must make sure that the progress that has already been made on those issues is recognised as the strategy is revised. I need to congratulate those areas that have taken forward all the key actions that were originally in the strategy, and I hope that the Minister will ensure that those areas that are yet to make progress on the fundamental aspects of the original strategy are clear that that is not acceptable and that they need to take immediate action.

Can the Minister reassure me and the House that the revised strategy will restate the importance of every local area guaranteeing to take the following actions, if they have not already done so? They are: first, appointing a local autism lead; secondly, establishing a local autism partnership board; thirdly, ensuring that autism is included in local data collection and the joint strategic needs assessment; fourthly, developing a local plan; fifthly, ensuring that there is a local pathway to diagnosis; sixthly, ensuring that autism is included in standard equality and diversity training for all staff across health and social care; and lastly, making sure that the community care assessors in the area have autism training. Of course, the restatement of those core actions will not be enough to ensure that change is happening at a local level, but the Government should set a timetable to check that those actions have been carried out across every area of this country, preferably by the end of this year.

I know that the Minister will say “What of the money that is available?” One of the key challenges that I and other colleagues regularly hear about is the financial constraints that face professionals when they seek to develop new and innovative local services. Gaining funding approval has been especially problematic, as there are few evidence-based models of good practice on which to base such approval, even though financial modelling has shown that these types of services can and do save money; it is my grandmother’s old adage again. Investment in new and dynamic service models will not only help local authorities to improve the services that are currently available to adults with autism, but will help to develop an understanding of the best way to deliver services and highlight areas of best practice.

I, and many other people, also place high importance on data capture between health, education and social services, so that those services have a better understanding of the number of children who will move into adult services. Capturing that data is not rocket science and it will mean that the provision of transition services can be better planned for and budgeted for. When I look at this area, it always amazes me that there is no co-ordination of the transition from childhood to adulthood, and people just fall through the gap.

I know that the Minister has agreed to consider the proposal from the NAS for an innovation fund as part of the review of the strategy, and when he responds to this debate I look forward to hearing an update from him about that proposal. I hope that he will be able to respond positively to what, in one way, is an ambitious proposal but, in another way, is very modest.

In conclusion, each and every person deserves the best possible chance to make the most of their talents and fulfil their potential, including people with autism. As illustrated by various reports on autism, including the National Audit Office’s report, with which the Minister is familiar, we are not only wasting large amounts of taxpayers’ money, but not providing adequate support to people with autism, we are also wasting human talent and lives.

The Autism Act has, with a lot of help from colleagues, been a catalyst for change, but more work needs to be done. I urge the Minister to make sure that he seizes this opportunity presented by the refresher to take forward ambitious actions, such as increased investment, which will help ensure that adults with autism throughout the country can be supported to live the life they choose and the life they deserve.

[Katy Clark (in the Chair)]

I remind hon. Members that interventions should be brief.

Social Care Reform (Disabled People)

Baroness Clark of Kilwinning Excerpts

Thursday 11th July 2013 Westminster Hall

[Liz Kendall]

I give much credit to the Minister, but the Bill is the continuation of a process that Labour established when we were in government—I want that on the record. [Interruption.] I fully and readily acknowledge that local council budgets have been under pressure for many years. He knows better than anyone that towards the end of Labour’s time in Government we tried to reach an agreement on a social care funding system, which I will come back to in a moment. [Interruption.]

[Katy Clark (in the Chair)]

Order. I ask the Minister to intervene formally if he wishes to say anything, for no other reason than it would assist the Hansard writer.

[Norman Lamb]

I formally apologise.

[Katy Clark (in the Chair)]

No problem at all.

[Liz Kendall]

I never mind interventions in debates; I warmly welcome them.

I shall make five specific suggestions to the Minister about how the Care Bill could be developed. First, the definition of well-being in the Bill is important. I welcome how broad it is. It covers mental, physical, social and economic well-being; personal relationships; and a person’s ability to contribute to society. The definition also includes ensuring that individuals have control over their day-to-day living, but I question whether the definition is as strong as it could be. The joint report from the all-party groups asks why it could not specifically include promoting independence, to strengthen the definition further.

An issue raised by my right hon. Friend the Member for Stirling relates to my point about definitions. The duty to co-operate in the Bill says that local councils will need to work with a range of partners. I understand that Ministers usually do not want to specify lots of organisation types, but I am concerned that although local councils would, we hope, know that they had to co-operate with the NHS, there is a real issue about the DWP. There is not that link-up locally, and if people’s ability to get training and to participate in the work force is so important, will the Minister consider whether, either in the Bill or in guidance, there needs to be more detail about who local councils should co-operate with? I am concerned that that local relationship might not be there.

Secondly, the eligibility criteria are, as the hon. Member for Bradford East said, the most crucial aspect of the social care system because they determine who is and is not eligible for social care support. We absolutely welcome the commitment to clear national eligibility thresholds, but the Minister knows that disabled people, organisations that represent older people and many of the groups involved are hugely disappointed that the draft regulations have set the thresholds at substantial rather than moderate. I am fully aware of the cost pressures on the system, but has the Department done a true cost-benefit analysis, to consider the potential saving? The hon. Member for South Derbyshire made a point about how investing up front can save money further down the line. Has the Minister discussed with his Treasury colleagues whether, if a longer time frame were used for assessing the costs, we would end up saving money for taxpayers if the moderate level was set?

My third point relates to the so-called capped care costs model—aka Dilnot. The Minister knows that I am concerned that the so-called cap on care costs is not really a cap. I am concerned not only because it does not cover hotel accommodation, but because it covers only what someone’s local authority would pay rather than the amount they might actually pay in residential care and because no one will benefit from the cap until 2020.

Carers

Baroness Clark of Kilwinning Excerpts

Thursday 20th June 2013 Commons Chamber

[Mr Iain McKenzie (Inverclyde) (Lab)]

I congratulate the Backbench Business Committee and the right hon. Member for Sutton and Cheam (Paul Burstow) on securing this important debate. It is a pleasure to contribute to it. I was delighted to be invited last week to Inverclyde’s national carers week event, the theme of which was “Prepared to Care?” A marvellous week of activities was organised to highlight caring, and special thanks must go to the secretary of the local carers forum in Inverclyde, Mrs Christina Boyd, who put together an interesting week of activities for the carers who attended.

On the day I attended, my local leisure company demonstrated keep fit with carers. It was announced as low-impact seated aerobics, and of course I took part. It is difficult to describe it, and perhaps difficult for Members to visualise it, without the accompanying music. Perhaps we should consider introducing it in the House, although I dare say that some members of the public think that we already have.

The focus should be on carers all year round, not just for one week. We need to recognise and support the work that they contribute, both on a personal level and to our community and society as a whole. That contribution has never been greater. The statistics on caring up and down the country are quite staggering. One in eight adults is a carer, which equates to about 6 million people. Every day, another 6,000 people take on a caring responsibility, equating to more than 2 million people a year. More than 1 million people care for more than one person. It has been estimated that carers save the economy £119 billion a year—an average of more than £18,000 per carer.

[Katy Clark (North Ayrshire and Arran) (Lab)]

I congratulate my hon. Friend on making those points. He will appreciate that many carers are older people. Has he, like me, been approached by constituents—women in particular—who are upset that they will lose their carer’s allowance when they reach retirement age? Does he agree that it would be appropriate to have some form of carer’s supplement for such people, not only in recognition of their contribution but to meet the additional costs involved in caring?

[Mr McKenzie]

I agree wholeheartedly with my hon. Friend. Many of my elderly and women constituents have approached me with that very big worry in mind. It is something that we need to look at, and that the Government need to respond to.

More than 3 million people juggle care with work, but the significant demands of caring mean that many carers are forced to give up work altogether. The main carers benefit is £58.45 for a minimum of 35 hours. That is the equivalent of £1.67 per hour, which falls far short of the national minimum wage. However, 1.25 million people provide more than 50 hours of care per week.

Carers’ health can also suffer. People providing high levels of care are twice as likely to fall sick. The fact that 625,000 people suffered mental and physical ill health last year as a direct consequence of the stress and physical demands of caring illustrates the true impact on carers’ health. Research by Carers Scotland found that almost half of carers with health problems reported that their conditions began after they started caring. Of those whose condition pre-dated their caring role, a quarter said that their condition had worsened since becoming a carer.

Caring clearly takes a huge toll on carers’ physical and mental health, and those not receiving respite are far more likely to suffer from mental health problems. The impact is often exacerbated by carers being unable to find time for medical check-ups or treatment for themselves, with two in five carers saying that they are forced to put off treatment because of their caring responsibilities. Research by Carers UK includes cases of carers discharging themselves from hospital because of an absence of alternative care.

I took questions from carers at the carers forum last Friday, and it was no surprise that their biggest worry at the moment is the bedroom tax. The Government should urgently review the impact that the charge is having on carers, because the vast majority of care in the UK is provided by family and friends. The work that family and relatives do so willingly is often ignored or goes unseen. Family carers are truly the unsung heroes of our communities. Social services and the NHS rely on carers’ willingness and ability to provide care, yet we as a society seem to put very little value on carers or recognise their commitment.

Social isolation and social exclusion are often remarked on by carers. They feel very isolated and report not having enough respite to have personal relationships of their own. They also report the stress and guilt associated with taking time off from their caring role. Many have not had even a day off in a whole year.

Many carers and carer households are often in poverty because carers have had to give up work or take on part-time work. They say that they could not otherwise fulfil their role as a carer. Of those in part-time work, many are in low-paid employment, and young carers are more often found in the NEET category—not in education, employment or training—or leave school with fewer qualifications.

What of the professional carers? According to a recent report on the plight of carers in the UK by the union Unison, the current system of home care is failing the people who receive it and the people who provide it. Unison describes the treatment of those receiving care and of workers as an outrage. It says private home care workers are being exploited—effectively paid below the minimum wage and given little or no training. Care workers are among the most poorly paid workers in the country; most are on the minimum wage, and there has been an increase in the number of zero-hours contracts. More than half of the care worker respondents to the recent survey reported that their terms and conditions had worsened over the last year.

What about the level of training? Can we say it is adequate? Well, 41% of care staff are not given specialist training to deal with their clients’ specific medical needs, such as dementia and stroke-related conditions. Standards and training are insufficiently regulated. We should compare this with Germany, where carers require several years’ training.

What of the care provided by our local authorities? Local authorities are being squeezed at this time of austerity and having made all the efficiency savings they can, they are now in a dilemma—at least they are in Scotland. They have to make very hard decisions and have to meet the challenge of delivering core services such as care with reduced funding while maintaining the same level of quality. I fear that things will only get more difficult for local government to continue to deliver high-quality care.

In conclusion, we owe the millions of carers out there the respect and all the assistance we can give them because some day we may just find ourselves performing a caring role or being cared for ourselves.

Alcohol Strategy

Baroness Clark of Kilwinning Excerpts

Tuesday 7th February 2012 Westminster Hall

[Several hon. Members]

rose—

[Katy Clark (in the Chair)]

Order. The winding-up speeches will start at 12.10 pm.