Oral Answers to Questions
Debate between Alex Cunningham and Caroline Dinenage(3 years, 6 months ago)
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Alex Cunningham (Stockton North) (Lab)
The Minister for Digital and Culture (Caroline Dinenage)
We are working flat out with the industry to support creative workers to tour the EU, and we have a dedicated DCMS-led working group to achieve that. Our priorities are to provide clarity for artists on any rules, to work bilaterally with other EU nations to ensure that the new processes are as easy and straightforward as possible, and to try to secure transitional funding support.
Alex Cunningham
We are extremely proud of our Stockton International Riverside Festival, which, as well as attracting street acts from across the world, commissions its own work to showcase what our own talented people can do. Now those same people face those barriers of fees and all other manner of problems—and they are still barriers today—if they want to take their work into the EU. That is due to the Government adopting that attitude of “it’ll be alright on the night”. Well, it will not. I heard what the Minister said, but what guarantees will she give artists from Stockton and the rest of the country that the Government will sort out the travel problems soon and that we can share our art and culture with the world?
Caroline Dinenage
As I have already explained, we have been working non-stop since the transition period finished to make sure that we were working through those issues. We have confirmed that portable musical instruments do not require carnets. We have confirmed that touring artists will not be double-charged social security contributions, and we have published new guidance for touring to other EU nations. Through bilateral discussions, which have been taking place at official level between me and the Secretary of State and our opposite numbers in the EU, we have established that at least 17 member states allow some visa or work permit-free touring activities, and we are continuing to do that work on a daily basis.
Mental Capacity (Amendment) Bill [ Lords ] (Fifth sitting)
Debate between Alex Cunningham and Caroline Dinenage(5 years, 10 months ago)
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Caroline Dinenage
It is clear in our minds, and it will be clear in the code of practice that hon. Members can approve.
Alex Cunningham
Will the Minister indicate what the code of practice will say in that respect?
Caroline Dinenage
I cannot give the exact wording because, as I have said, we are engaging with stakeholders and we wish to get the provision exactly right. If I were to provide the wording it would be just the opinion of a politician, and we will all agree that we need the voices of experts, and that the views of those with lived experience of having to support people should be taken into consideration.
Caroline Dinenage
I will in a moment, but I also wish to consider those parts of the amendment with which I fundamentally disagree, as that is important. The amendment would require all 16 and 17-year-olds to have an IMCA as well as an appropriate person. I feel strongly that automatically appointing an IMCA for a 16 or 17-year-old would risk freezing out parents from providing representation and support, and parents are often best placed to take such a role.
The hon. Member for Worsley and Eccles South often talks about the desperately distressing case of Bethany and countless others, where parents’ wishes and concerns are not listened to or heeded. We have been clear about giving families a strong role in this model, and we do not want to risk that. As with an appropriate person, a parent or family can request the support of an IMCA, or for their role to be performed by an IMCA.
Alex Cunningham
I share my hon. Friend’s paranoia. I do not understand why we would put any barriers at all in the way of people’s having a proper assessment within a reasonable time. Detaining someone for 14 days is effectively locking them up for 14 days. It means depriving them of their liberty and there may be no real necessity. An assessment, as quickly as possible, is essential.
Of course, if we allow those authorisations to go on for longer than 14 days or any other reasonable timeframe, we are putting people at risk of abuse, as the Law Society has said. I say to the Minister that we must put vulnerable people first. We must always put the individual first. We must have the safeguards in place, because to do anything else is to risk their liberty, and that is a risk I am not prepared to take. I hope she accepts the amendment.
Caroline Dinenage
Clause 2 allows caregivers, in limited situations, to deprive someone of their liberty for a short period of time prior to an authorisation being in place or in an emergency. That can be done only to provide the person with life-sustaining treatment or to prevent a serious deterioration in their condition. The clause enables a care home to place restrictions on the person for their own protection ahead of an authorisation being approved. That interim legal cover will be decision-specific and it will be targeted to life-sustaining treatment and care or to a vital act. Once those acts are completed, the conditions no longer apply and legal cover for depriving someone of their liberty ends.
In that way, the clause replicates clause 4B of the Mental Health Act 2005, already in DoLS. The emergency authorisation system applies in exactly the same way when a court application being made relates to a deprivation of liberty. There is no evidence at this time that it would lead to any lengthy deprivation of liberty, and the provision of the Bill builds on an existing and well-understood provision. The previous system also included an urgent authorisation. That has gone because it was used too often and its time limit was ineffectual.
Under the Bill, the legal cover is provided simply for as long as the life-sustaining care is needed and no longer. It is therefore a limited power and a better safeguard. An emergency is defined as a situation where there is an urgent need to act and it is not “reasonably practicable” to make an application under the liberty protection safeguards to the Court of Protection or under part 2 of the Mental Health Act. It was carefully considered by the Law Commission, which looked at the inclusion of a time limit and decided against it. We agree with its conclusion that a time limit could encourage care providers to aim for the time allowed rather than to adhere to best practice for that case and that person, which is certainly what we have seen in some urgent cases.
Given the seriousness of depriving someone of their liberty, it should be limited to the shortest possible timescale and should reflect the huge range of causes that it can be required to cover. The amendment would create a blunt, one-size-fits-all approach, rather than allowing us to reflect the different approaches called for.
Mental Capacity (Amendment) Bill [ Lords ] (Sixth sitting)
Debate between Alex Cunningham and Caroline Dinenage(5 years, 10 months ago)
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Caroline Dinenage
The hon. Gentleman might be slightly misquoting me. I have spoken in general terms about the code of practice, and have indeed circulated a draft of what will be included in it among hon. Members, as well as what we have committed to including in it as part of the discussions in the House of Lords and during this Committee.
Alex Cunningham
It is never my intention to misrepresent anyone. All I am concerned about is that we should have clear detail as soon as possible in order for us to understand what will happen. It is not just for us to understand—it is also for people outside in the world who have to deal with this on a day-to-day basis. The Minister just answered the question I would have posed at the end, so I will not bother asking it.
Caroline Dinenage
I thank hon. Members for initiating this discussion. Amendment 52 would delay the introduction of liberty protection safeguards until the Department has fully responded to the report of the independent review into the Mental Health Act.
The hon. Member for Worsley and Eccles South said that I was stubborn. I am sure that a number of people, not least my husband, would agree with that sentiment. I think she would agree that I have committed to looking again. A number of issues have been raised during the Bill’s passage through Committee, not least ensuring that people get information as early as possible—I agree with her on that—and how we can maximise protection for those being cared for in an independent hospital. I am sure she would agree that I would be being equally stubborn if I were to take the amendments on board without giving them careful and due consideration, and without checking the legal ramifications and making sure that we are offering all the protections that we need to. I am sure that the hon. Lady, other Opposition Members and stakeholders will forgive me for making sure that we consider everything thoroughly and properly.
On amendment 52, I welcome Sir Simon Wessely’s landmark report and I am sure that it will very much set the direction for improving the way the Mental Health Act works for thousands of vulnerable people. The Government have already committed to bringing forth mental health legislation when parliamentary time allows, taking that very important report into account. We have already accepted two important recommendations, which will give service users more choice and control, but it will take time for us to consider the rest of the recommendations, of which there are 152. We will respond to the remaining recommendations in due course, but Sir Simon said that the Government would need to consider the “practical implications” of the interface recommendations, and that it would be “problematic” to introduce those recommendations in this Bill.
Hon. Members will be aware that the reforms in the Bill are desperately needed—I cannot repeat often enough that we cannot wait any longer to improve the situation of the backlog of more than 125,000 people who have been deprived of their liberty without authorisation. As much as there are concerns among stakeholders—I have met a number of stakeholders and we will continue to consult them, to take their views on board and to make sure that we work with them at every step of the way when it comes to the code of practice—they also share our concern that 125,000 people have been deprived of their liberty without authorisation, that their loved ones have been deprived of peace of mind and that their care providers have been deprived of legal protection.
Caroline Dinenage
Yes, of course I will go on to talk about the transition between the two systems and the backlog. I also say gently to the hon. Lady that she and others may be in the fortunate position where their local authorities have got to the stage where they do not have a backlog—in many cases, that is due to a political decision to prioritise it—but I think all those local authorities would recognise that there is duplication and cost in the system that they could do without. They have had to take very tough decisions to prioritise this issue over other things that they could be spending their money on, when money is tight. I do not think the attitude of, “I’m alright, Jack, there’s no backlog in my constituency,” is a very good one, when 125,000 other people are waiting.
Alex Cunningham
I do not have a particular problem with what the Minister is saying—local authorities do want to see reduced costs and to ensure that responsibilities are carried out—but she used the expression I used last week. It was a “political decision” by local authorities such as Stockton to take money from other services and invest them in this matter. Surely local authorities should not have to face that choice. The Government should properly fund our whole social care service, never mind the issues around the Bill.
Caroline Dinenage
I agree with the hon. Gentleman—the whole of the health and social care system needs funding, and that is where the additional money for the NHS comes in. The Government have given councils access to more than £10 billion over this three-year period. The fact that they are still struggling shows the scale of the problem. We do not want to waste money on duplication when that money could be valuably spent elsewhere. The desire to streamline the system to avoid unnecessary duplication, which drives costs but does not offer any further protection, is what this is all about.
Alex Cunningham
It is has been estimated that the Minister will save about £200 million as a direct result of the changes in the Bill. What will that money be used for?
Caroline Dinenage
We have to be careful not to conflate our language. There is no intention to save money on the process. We know that if DoLS were implemented correctly all across the country, as they are in the hon. Gentleman’s constituency, the cost would be £2 billion. However, we are not looking to save money here; we are looking to ensure that it is spent more wisely—not on duplication, but in a way that offers people the protections that they need. This is not a cost-saving exercise; it is about ensuring that money is spent wisely and effectively to offer that protection.
Amendment 53 would delay the introduction of liberty protection safeguards until the Department has published an updated impact assessment and implementation strategy. I thank hon. Members for reminding us of those items, which are important for the successful implementation of the Bill. We are in the process of preparing the updated impact assessment to reflect the amendments made in the Lords. We are keen to make the Bill as successful as possible and to listen to the concerns of those in the other place. We will shortly publish the impact of the amendments made there, and the Government have also made changes to the Bill in this House that will require us to update the impact assessment further.
The noble lord, Lord O’Shaughnessy—I am not sure whether I am allowed to name him—has committed to publishing a training strategy before the Act comes into force. With regard to training, we will work closely with the sector, local authorities and NHS organisations on implementation as part of our strategy, and we welcome Members’ contributions. I completely agree with hon. Members that adequate training for health and social care staff is vital. Ahead of the implementation, we will consider the most appropriate way to ensure that everybody is appropriately equipped.
We have considered training costs as part of the updated impact assessment that we will publish shortly. We know that there will be an impact on transitional costs. We will support the sector and we will deliver training through a workforce development model delivered by and in partnership with Skills for Care, as we do for other things.
With regard to the implementation, ahead of day one we will work with local, national and Welsh DoLS networks in partnership with the Local Government Association and the Association of Directors of Adult Social Services to clear the existing backlog of applications. Those who remain in the backlog on day one will have their applications handled under LPS—a streamlined system that minimises duplication. Existing assessments can be used, if appropriate. For example, there may be no need to commission a doctor to do a new mental health assessment. That efficiency will allow local authorities and other responsible bodies to tackle the backlog effectively.
Cared-for persons who have an existing DoLS authorisation on day one will remain under that authorisation until it expires, after which a new application will need to be made under the new system. Those in settings that newly fall under LPS, such as those in the community, who may have an authorisation from the Court of Protection, will remain under that authorisation until it ends. A new application will then need to be made under LPS. We will work closely with responsible bodies and care providers to ensure that the transition period is as smooth as possible, and that vulnerable people are protected.
Amendment 54 would require the code of practice to be approved and published before the introduction of liberty protection safeguards. That statutory guidance is essential. It will outline the details of how the system should operate and will be a valuable tool for practitioners. The Government are required by section 43 of the Mental Capacity Act to consult when preparing the code of practice.
We are already in the first stages of developing the code. We will work with the sector to co-produce it. I am happy to commit to publishing the code of practice before the scheme comes into force. I also commit to laying the code in draft before Parliament, giving both Houses the opportunity to resolve not to approve it, as section 43 of the Mental Capacity Act also requires.
I hope that I have been able to provide reassurance and that the hon. Member is able to withdraw the amendment.
Mental Capacity (Amendment) Bill [ Lords ] (Fourth sitting)
Debate between Alex Cunningham and Caroline Dinenage(5 years, 10 months ago)
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Caroline Dinenage
I think that might just be my natural resting face. I understand what the hon. Gentleman is saying, but it depends who we are looking at. If the pre-authorisation review is being conducted by a local authority for a care home, the oversight of the senior members of the local authority would apply, as well as the Care Quality Commission, which deals with the quality of care homes. If it is something like a hospital, people will monitor other people’s work as happens already within hospitals, CCGs and health boards.
The Bill says that somebody who is involved in the direct care of a particular person cannot mark the homework of another person. In something as big and broad as a local health board, a CCG or a hospital trust, which can be enormous, exclusively saying that there could not be two people, who have never met each other before, looking at each other’s work seems to me a huge leap.
Amendment 36 is designed to prevent anyone with a prescribed connection to an independent hospital from conducting pre-authorisation reviews. I am sure that we can all agree that the pre-authorisation review is critical to the effective operation of the liberty protection safeguards in providing independent reviews of proposed arrangements that may deprive people of their liberty. We are talking about the most precious and vital of our human rights. The reviews have to be conducted by someone independent, who is not involved in the day-to-day provision of care or treatment of the cared-for person. That provides the necessary degree of separation to ensure that the model is compliant with the European convention rights.
By requiring authorisations in independent hospitals to be considered by an AMCP, regardless of whether the individual objects, we add a further level of security and build on other safeguards within the model. The AMCP will meet with the person, complete any relevant consultation and review assessments to decide whether the authorisation conditions are met. They can effectively veto proposed arrangements, if they feel that the proper conditions are not met. AMCPs will be professionals, such as experienced social workers, learning disability nurses and psychologists. Their practice will be regulated by and they will be accountable to their professional bodies—in answer to what the hon. Gentleman said earlier.
Alex Cunningham
The Minister just used the expression—I have lost my train of thought. I beg your pardon, Mr Pritchard.
Caroline Dinenage
I will take an intervention from the hon. Member for Worsley and Eccles South.
Caroline Dinenage
It is in there—it is in both. In addition we have the AMCPs. As I said when discussed amendment 19, I fully understand hon. Members’ concerns around independent hospitals. I know the hon. Lady shares my concerns, and this matter has been raised by Members across the House. I said to her, in relation to amendment 19, that I wanted to go away and consider it further.
Alex Cunningham
I did not realise I was going to have to declare an interest in the Bill, in view of my lapse a few minutes ago. My question is about the reference the Minister made to the AMCP always meeting the person. Does the AMCP meet the person in every circumstance? We tabled amendments because we want everybody to have access to that sort of professional person—not just for them to see a report, but to actually see the person.
Caroline Dinenage
Yes, by requiring authorisation in independent hospitals to be considered by an AMCP, we add that extra level of scrutiny and build those safeguards into the model.
Given that I have committed to look at independent hospitals again, as I said in relation to amendment 19, I hope that the hon. Lady is willing to withdraw the amendment.
Alex Norris
I have specific trouble with the word “practicable”. From my time in local government—I know things have not got better in the 18 months since then—I would argue strongly that the current assessment workload is not practicable for the individual. Earlier in our consideration of the Bill, my hon. Friend the Member for Birmingham, Selly Oak compared social work case loads when he was active in the profession with what they might be today. Putting in legislation how practicable it is for an individual to go and do an assessment creates the chance of a loophole that does something that we do not intend the Bill to do.
It is striking, as my hon. Friend the Member for Birmingham, Selly Oak said, that the Minister has at all turns been careful about what has been put in the Bill so as not to create future loopholes. We know that traditionally, this area has been tested very heavily in case law and it will be tested again in court. She has been very careful not to put those words in there, but this one is problematic. We know that in a time of rising demand and diminished resources, there will be pressures. To put something in that suggests that if it is just too difficult for a social worker to go and do an assessment, that assessment will not take place, is dangerous. I do not think that is what we are trying to do. I believe that it will lead to a serious problem.
The market for providing very high-need care is not very developed. We are talking about very small numbers of people, so there are not masses and masses of providers. When it comes to all of us being older, there are facilities in all constituencies and communities for older people to have residential care, because it is a high-demand area. The very specific, individualised care packages that involve things such as depriving liberty are not found in every community. Often, we hear horror stories in children’s mental health of people being sent a long way away to find the right facility. Are we then saying that a reassessment might not be practical, because the AMCP is in Nottingham and the care placement is a long way out on the east coast in Lincolnshire? That might not be considered by an individual to be a “practicable” thing to do, so I have a real problem with that word.
If the Government are saying that there are circumstances—my hon. Friend the Member for Worsley and Eccles South mentioned the exchange in the other place—where they are relaxed about an AMCP not seeing an individual face-to-face, I think that is a bad idea, for the reasons detailed by my hon. Friend the Member for Stockton North. If the Government are saying that there are circumstances where they are relaxed about that, they should name them and put them on the face of the Bill and be exhaustive with them, so that we can be clear and test the will of the Committee as to whether we agree.
We need to have a greater sense of what we are saying in respect of dialling back people’s rights to see a qualified professional when they are having their liberty removed. If we are rolling that back, let us be really clear about how we are rolling it back—the exact circumstances and what recourse they might have if they or their carers believe that to be wrong. I think this is out of step with all the discussions we had on Tuesday and this morning. I believe it creates a loophole and we need greater clarification.
Caroline Dinenage
I thank those hon. Members who have spoken and tabled these amendments. Amendments 42 and 43, as we have heard, would require an approved mental capacity professional to meet with the person in every case where they are carrying out a pre-authorisation review, rather than—as we propose and as is written on the face of the Bill—where it is “appropriate and practicable”.
The Bill currently states that where an AMCP is carrying out a pre-authorisation review, they must meet with the person where practicable and appropriate. In the vast majority of circumstances it will be practicable and appropriate. This qualification comes from the Law Commission draft Bill, which recognised—we agree with this—that the AMCP will be required to meet with the person in virtually every case. This is an important protection within the liberty protection safeguard system.
Caroline Dinenage
Let me make a bit of progress and I will hopefully answer the hon. Gentleman in the process, but if I do not, he can intervene again.
The exceptions where it would not be practicable and appropriate would depend on the circumstances of the case. Things such as workload, cost and distance would not count under the qualification of not appropriate or practicable. It might be not appropriate or practicable, for example, where the person is in a coma and the family has requested that the AMCP does not interview the person, because it would cause distress. Another example is where someone at the very end of their life needs to be deprived of their liberty in their last few days, and they do not want to see an AMCP. In many cases, we feel it would not be appropriate to override the person’s best interests and force them to meet with an approved mental capacity professional.
Mental Capacity (Amendment) Bill [ Lords ] (Second sitting)
Debate between Alex Cunningham and Caroline Dinenage(5 years, 10 months ago)
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Caroline Dinenage
I thank the hon. Gentleman for his suggestion; we will definitely take it into consideration. I fully understand where the concerns about independent hospitals acting as a responsible body come from. We must be careful not to stigmatise all independent hospitals. Every time we have such debates, we hear horror stories, but then I always get emails from parents who feel that their children’s lives have been saved by such hospitals. We must make preparations to care for those who are most vulnerable and at risk.
Alex Cunningham (Stockton North) (Lab)
Following up on what my hon. Friend the Member for Birmingham, Selly Oak, said, does the Minister agree that if she took up the idea of the CQC having such a role, we would need something in the Bill to ensure that if it identified a cosy or questionable relationship, someone could do something about that? In CQC reports now, homes are identified as totally inadequate, but no one can do anything about it, because the CQC will take a decision only at the very, very last minute, by which time it is matter of closure.
Caroline Dinenage
The hon. Gentleman makes a good point; we have to look at that interaction. The AMCP will be a professional social worker, will be accountable to a professional body, and will have the high level of skills and training to enable them to carry out their job with great professional integrity. However, the reasonable concerns that have been raised by hon. Members need to be taken into consideration, and I find the suggestion that they make in this amendment very interesting; I have a good deal of sympathy for it, and am certainly willing to reflect further on the amendment. The problem is that its exact wording does not work. We need to ensure that any changes work for the whole system. We also know that there are examples of NHS England commissioning the care from an independent hospital; it is not just CCGs. With that in mind, I commit to considering this amendment further. I hope that answer enables hon. Members to withdraw it.
Alex Cunningham
Some people say that all I need now is to be a lawyer and an accountant, and then I will have done all of the bottom four professions when it comes to public confidence and respect. However, I enjoyed my time as a journalist, my time in the gas industry and even my time running my own business. I have always believed that more information is better than less, because people can then take what they want from it. They can understand what they want and they can challenge it.
However, the information also has to be timely and easily understood. In moving the amendment, the Government actually want people to have less information, and for it to be less timely. The Minister is shaking her head. Maybe even if there is the same amount of information, it will not come at the right time, and people will not be able to use it to understand, to decide a way a forward and to advocate for the person in care. In the light of what I just said, which the Minister refuted by shaking her head, what measures will the Government actually take to ensure that the information provided to the person being cared for and to appropriate persons is actually understandable, and in clear and simple language?
Many organisations and individuals submitted evidence to us that the consultation process for the Bill had been complicated and excluded people with learning difficulties. The very fact that we did not have an evidence session probably bears that out. Are there are any guarantees that those with learning difficulties will actually be able to understand the copy of the authorisation record and other materials and what they mean?
A person with a specific speech and language problem may be able to make some decisions if information is presented to them in a way that they understand. Has the Minister made any assessment of the use of speech and language therapists to communicate the authorisation records and subsequent information relevant to a person’s deprivation of liberty?
We have seen evidence from family members of those being cared for, and I have been contacted by constituents on this. They have told me that they are finding out about the authorisation of deprivation after the record has been issued, and that they are concerned that the cared-for person would not have been effectively communicated with. Does the Minister agree that speech and language therapists should be involved prior to the authorisation, to fully understand the circumstances?
Alex Cunningham
The Minister is nodding her head, which is very good news. She has given me that reassurance, so perhaps I do not need to continue with this particular line of questioning.
We should be very careful that a communication issue is not missed prior to an authorisation being recorded. Just because somebody cannot communicate in the same way that we can does not mean that they cannot communicate.
Alex Cunningham
Again, the Minister nods her head, but that opportunity must be long before a final decision on the deprivation of liberty. We must take every possible precaution to ensure that those with an interest in the wellbeing and care of the cared-for person are informed at every possible stage—before the point at which the Minister proposes that should happen. She must be clear that timely information must be given, and she must accept that to remove paragraph 13 of schedule 1 would weaken the rights of the vulnerable person, their family and any advocate. We need reassurances on those matters now, or on Report.
Caroline Dinenage
I completely agree that information sharing is vital in the system, and that it should be done at the earliest possible point. Liberty protection safeguards are not something that should simply happen to an individual, but something they need to be involved in from the outset. The Bill specifies that information must be shared after an authorisation is granted, purely because that is a legally cogent point. It includes having a watertight trigger point for information sharing from a legal perspective, but it does not prevent information from being provided beforehand.
Unlike the amendment tabled in the other place to existing paragraph 13, this amendment provides a clear trigger point to specify when information about the authorisation must be provided. We are clear that that point is absolutely the latest point at which information should be shared. In the vast majority of circumstances, that should be done much earlier, or at the very beginning of the process. The amendment does not prevent that from happening. The code of practice will provide detail regarding when it is appropriate to do that, and I have already made a commitment to the Committee to set out what will appear in the code of practice—
Caroline Dinenage
No, I do not have that to hand, but I have explicitly said that we will set out what the draft code of practice will include. I hope that that will give the hon. Gentleman more reassurance.
Caroline Dinenage
We will do that during Committee. The hon. Member for Stockton North spoke about the involvement of expertise, particularly in assessing those with speech and language difficulties. That is something that I am really interested in. It was also raised on Second Reading by the hon. Member for Swansea West (Geraint Davies), whom I met yesterday to discuss the matter. I am aware that sometimes a speech and language difficulty can be misinterpreted as somebody lacking mental capacity.
Speech and language therapists already play an important role. We are putting an individual’s voice at the heart of the process, meaning that speech and language therapists will play an even greater role. We agree that their skills are essential and that all relevant health care professionals will recognise the role of speech and language professionals. That will be part of the training for this new role.
Alex Cunningham
Indeed that is the case. There are probably thousands of people in the system at this time who are illegally detained, or whose freedom has been denied them; we can do without additional problems of the sort that my hon. Friend describes. I talked about the fall-back position: if there is nobody in the care home who can do this work, and it does fall back on the local authorities or some other organisation, they are already dealing with very strained budgets and an overload of work, so how do we fill that gap? Again, I ask the Minister how she will ensure that these organisations have the resources that they need, even if the duplication that she was describing earlier in the day is sorted out and the systems run far more effectively. I am aware that if our amendment is successful and these duties do not sit with care home managers, the bill for work by these other organisations will be all the greater. Again, how on earth will that be funded?
Of course, the system can work. I cite the case of the north-east of England, where the DoLS system probably works better than in other parts of the country—albeit that local authorities have chosen to take the political decision I talked about earlier. However, that is letting other services down because they feel that they must protect the interests of people whose liberty is at risk. I will return to my point about the north-east a little bit later, as I want to go back to the topic of care home managers. Does not the Minister agree that most of them should be working to improve or maintain their CQC ratings and all that comes with that, rather than carrying out those assessments of individuals in their care?
I intervened on the shadow Minister to talk about charges. Some care homes may even charge a self-funder an administration fee for the assessments. Who says that is fair, right, or proper—Members can use whatever word they like? Who on earth governs that, and who is protecting the person who is having to shell out the cash? What is to stop a care home manager from unnecessarily charging fees for “administration purposes”? Who is there to say otherwise? I said this morning that we need to protect the public purse and the purses of those who live in these establishments; this is another example of that. One of the pieces of written evidence we have received comes from a collective of organisations, including the Registered Nursing Home Association and Care England. It says:
“There is no reason for singling out care home managers for extra responsibility, over their colleagues in other care settings, except for to transfer significant costs from struggling local authorities to struggling care homes. The effect will inevitably be that some providers who continue in the sector…pass on the costs to the affected residents.”
My hon. Friend the Member for Nottingham North discussed that.
So there we are: care home associations do not want the responsibility of assessments; the persons involved will not want the care home to have that responsibility; and we Labour Members, who probably matter less than them, do not want care homes to have responsibility for assessments, so why are the Government continuing to push this? Any opportunity a care home manager has to improve their organisation’s financial outlook is bound to be considered. That is all the more reason why it should not be their job to carry out assessments for a person when they have a vested interest—and a financial interest, at that. The Alzheimer’s Society also has a concern; it argues that we urgently need clarification of the role of care home managers, and how to protect the independence of the person being cared for. That is currently dealt with by best-interests assessors. My council of Stockton-on-Tees has raised concerns with me about the fact that the decision as to the necessity of assessment still appears to rest with care homes.
I thank Angela Connor and Natalie Shaw from the Stockton DoLS team for taking the time to talk to me about their work and how it will be affected by the Bill. They provided me with some follow-up notes, for which I am very grateful, because in one hour they built my understanding more than all the reading that I had tried to do. Like others, they posed many questions. Where is the quality assurance? Who is going to check that what they are doing is both correct and within the law? Despite the obvious conflict of interest, local authorities rely on assessments made by a care home manager, including allowing care home managers to carry out a consultation to determine a cared-for person’s wishes.
Between 2013 and 2018, there was a 5,000% increase in the number of applications under the Mental Capacity Act that my local authority received. Stockton-on-Tees Borough Council created the DoLS team in 2014 to manage the applications. As I said earlier, we are quite lucky in the north-east because there has been a regional arrangement in place that means that mental health assessors are paid a fixed fee of £175 for three assessments—buy two, get one free—and best-interests assessors are paid £175, again for three assessments.
As I mentioned earlier, the number of completions of DoLS in the north-east was higher than in the rest of the regions, and applications are taking a shorter time to process. Dedicated DoLS teams have been established across the region. Independent assessors are used, and that raises awareness with managing authorities. Yet the Alzheimer’s Society tells me that the Bill would remove the post of best-interests assessor; part of their responsibility will shift to care home managers, who I think are ill equipped to perform the role. The DoLS team in Stockton tell me that they believe that the Government’s proposals will lead to a diluted assessment.
I agree with what the Minister said this morning about ending the duplication of assessments, cutting out waste and targeting limited resources where they are most needed, but that must not be done by diluting the assessment process. I am interested to hear what the Minister has to say to address the concerns of so many stakeholders in this area.
The Government’s proposals, under which care home managers, who are held responsible for providing care, are also responsible for assessment, are not in the best interests of the person affected. I do not believe that the Government intended to create this clear conflict of interest. If care managers are not to be removed from the process entirely, I hope the Minister will outline in detail exactly how this serious situation is to be avoided. We may have to rely on information provided later. A code of practice is all very well, but we need the detail now. If we do not have the assurances we require, how on earth can we support the Bill?
Caroline Dinenage
I thank hon. Members for raising important issues today. We have heard what amendments 20 to 29 would do. It is worth setting out that care homes already have an important role in the DoLS system. They are responsible for identifying where a person lacks capacity, and for working out where restrictions might be needed as part of care. They are responsible for making an application to a local authority. Because of the current backlog, they are responsible for chasing that deprivation of liberty safeguard, which gives them the legal protection that they need when they are keeping somebody in their care.
It is important that care home managers continue to play a central role in the liberty protection safeguard system, but we completely recognise that it would be a conflict of interest to have care home managers completing assessments. I am not sure whether the hon. Member for Stockton North was a bit confused, or whether I misinterpreted what he said, but there is no plan for care home managers to do the assessments; they are just gathering the information required. We amended the Bill in the other place to reflect that.
Caroline Dinenage
I am grateful to the hon. Gentleman for that kind offer, but we intend to build on the role that care homes already play. Care home managers already daily identify that a person may lack capacity and need restrictions, take part in constructing a care plan, and liaise with mental health professionals. We are committed to supporting them further in doing that, ahead of implementation. We want to make sure that training for the workforce is delivered, and want the development-type model that I have spoken about.
I spoke a lot today about reducing the backlog. That will help enormously in reducing the burden that falls on care homes. They will not have to keep chasing applications that are in local authorities’ backlog in order to get protections regarding the legal right to hold somebody in their care. The care home manager is often in a strong position to identify whether a person objects to the arrangements. Having a role in the consultation allows them to do this.
Alex Cunningham
We can all acknowledge that there is a role for care home managers in the system, but I see them as a small cog in the engine, rather than the driver of the machine. Does the Minister understand the issues around the lack of competence in many homes? How will she spell out somewhere in the legislation who picks up the pieces? She replied to my hon. Friend the shadow Minister on this, but she has not been clear on who does the work that she is expecting the care home manager to do if the care home manager does not exist or is not competent.
Caroline Dinenage
I am more than happy to do that, and I will deal with that shortly. The amendments would remove the role from the care home manager entirely, and would separate the liberty protection safeguards from the wider care planning that is already being done. It risks recreating the existing failing system, in which DoLS are too often considered a separate, overly bureaucratic, one-size-fits-all, box-ticking exercise.
We have to be careful. The hon. Member for Worsley and Eccles South rightly spoke about not castigating local authorities. She also mentioned that we must not demonise care providers. I agree. Of our care providers up and down the country, 83% are rated good or outstanding. They provide an incredible level of professional integrity and care, as well as daily vocational commitment, sometimes in difficult circumstances.
Mental Capacity (Amendment) Bill [ Lords ] (First sitting)
Debate between Alex Cunningham and Caroline Dinenage(5 years, 10 months ago)
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Caroline Dinenage
With your leave, Mr Austin, I will address the amendments in my name before I speak to the Opposition’s amendments. This group of amendments relates to pre-authorisation reviews, which are conducted by an approved mental capacity professional, or AMCP. The AMCP provides an additional level of scrutiny for cases that need it, such as where somebody has raised an objection. Amendment 9 requires an AMCP to conduct the pre-authorisation review should arrangements mean that the cared-for person receives care or treatment mainly in an independent hospital. It also clarifies that cases can be referred to an AMCP by the responsible body, providing that the AMCP accepts the referral. The other amendments in the group are consequential on this.
I am sure that hon. Members of different parties have been as distraught and dismayed as I have at the widespread reporting of cases of inappropriate restrictive practices, such as the prolonged use of seclusion. They will recognise that the scrutiny of cases in independent hospitals must be absolutely robust. Stakeholders are right to raise their concerns about this, as many did in the debate on the Bill in the other place. The Government have acted to address those concerns by requiring authorisations in independent hospitals to be considered by an AMCP, regardless of whether an individual objects to their arrangements. We have added a further level of security to the process. The AMCP will meet the person, complete any relevant consultations, and review assessments to decide whether the authorisation conditions are met.
Amendment 9 also clarifies that the AMCP can conduct pre-authorisation reviews in any case, not just where an individual objects. The Government’s view has always been that certain cases might benefit from scrutiny by an AMCP due purely to their complexity or nature. The amendment will apply to all cases, not just cases where the independent hospital is the responsible body. The statutory code of practice will be used to explain in detail how these powers should be exercised. For example, authorisations that relate to people with an acquired brain injury might benefit from consideration by an AMCP, as the nature of their illness means that it can often be difficult to establish whether they have capacity, and their capacity might fluctuate. AMCPs will also play a key role should particularly restrictive arrangements be proposed.
The code of practice is a statutory document that will be approved by both Houses and will form the basis of the responsible body’s decision to refer cases to an AMCP, which could extend to cases in which physical restraint is used. The approved mental capacity professional will then decide whether to accept the referral, in line with the code of practice. It is important that AMCPs are focused on cases that need additional scrutiny, so that the system can be targeted and can deliver protection to all those who need it more quickly. That is why AMCPs have a role in making a judgment about whether to accept referrals. The amendments strengthen the safeguards in the Bill, and I hope the Committee will support them.
Let me turn to the amendments tabled by the Opposition. I thank hon. Members for initiating this important discussion about objections and access to AMCPs. Amendment 37 would provide for access to AMCPs in specific circumstances. The Government absolutely agree that AMCPs should review authorisations where appropriate, but the issue is that, by putting too much detail in the Bill, we can sometimes be caught out by what is left out. The Bill already requires that an AMCP completes the pre-authorisation review if it is reasonable to believe that the cared-for person does not want to reside in, or receive care or treatment at, a certain place. The objection can be raised by anyone with an interest in the cared-for person’s welfare. The Bill already requires that arrangements are necessary, proportionate and the least restrictive possible. That is to be considered as part of the pre-authorisation review.
The Government amendment previously discussed requires that an AMCP reviews every authorisation from an independent hospital, even if there is not an objection. That is an example of our commitment to protecting the most vulnerable.
Alex Cunningham (Stockton North) (Lab)
I am interested in the expression that the Minister used a moment ago—“where appropriate”. There is no clear definition anywhere in this material of who will determine what “where appropriate” means, and who will be involved in the decision making. I would welcome an explanation of what the Minister means by that. I would much rather see everybody covered by this provision.
Caroline Dinenage
Everybody is entitled to an AMCP if they are in an independent hospital. That is on the face of the Bill in terms of decision making, case studies and how we make sure people have the training and information to implement the Bill in the way it is intended. Let us not forget that we started with a well-intended Bill with DoLS, but because of the way it was worded and subsequent decisions by judges, we have now got a one-size-fits-all Bill. That is why we have a statutory code of practice, which runs alongside the Bill. It is a legal document and will be approved by both Houses. It will be put together with stakeholders and will set out very clearly the guidelines that dictate how and when action should be taken. It will include case studies and will be compiled very closely with stakeholders, who are on the frontline and deal with individuals.
Caroline Dinenage
With deprivation of liberty safeguards or liberty protection safeguards, roughly 80% are in care homes, 20% are in hospitals and—I know this will add up to over 100%, but it is there or thereabouts in each case—about 1% are in independent hospitals. We have to avoid recreating the painfully inadequate DoLS system we have at the moment. Where something is straightforward and simple, we do not want to take the power and decision making out of the hands of families, loved ones and those trusted to help people in decisions about their care.
We have put in this clause about independent hospitals because Members from both sides of both Houses have had particular concerns. I know that the hon. Member for Worsley and Eccles South shares these concerns with me. That is why we felt that the clause was particularly important.
We know that situations can be complex and incredibly far-ranging, which is why we intend to use this code of practice to capture the full scope of circumstances to which it may apply. We will set out in detail the circumstances that may trigger a review by an AMCP. I am keen to take input from all Members from across the House on this document.
Amendment 38 relates to the involvement of approved mental capacity professionals in arrangements for 16 and 17-year-olds. We understand that many 16 and 17-year-olds would benefit from the additional scrutiny of an AMCP. This is why the Government amendment clarifies that relevant cases should be referred to an AMCP.
Alex Cunningham
Again, the Minister uses words I am uncomfortable with—the word “relevant”. Who determines what is relevant in the case of an individual young person?
Caroline Dinenage
With the greatest respect, I do not think the hon. Lady listened 100% to what I said. I said that in a case where the young person agrees to their care, their parents are happy with their care and all professionals agree that it is in their best interests, what does an AMCP add when there is already pre-authorisation scrutiny? It is not to do with resources but with wanting a targeted system that focuses resources where they are most needed, protecting vulnerable people in the very best way we can. We understand that there are particular concerns about the use of restrictive practices on young people with learning disabilities or autism. That is why we have tabled an amendment to clarify that responsible bodies can refer cases other than those with objections to an AMCP. In many cases, we would expect that to happen.
The code of practice keeps being referred to as something peripheral, but it is key. The hon. Member for Birmingham, Selly Oak talked about not having the ability to scrutinise it. There is not only the ability to scrutinise the code of practice; hon. Members can contribute to it. That is why it is very important that it is laid out in the way my hon. Friend the Member for Halesowen and Rowley Regis said. That is exactly the place where we lay out the case studies, individual concerns and the very complex cases that need to be definitively scooped up by this Bill. Trying to do a catch-all in the Bill would not provide sufficient protection for the people we all care so desperately about.
Alex Cunningham
I want to come back to resources. The Minister is right that we need to target resources where they are most needed, but the fact remains that there are insufficient resources in the system. My local authority has lost 55% of its budget since 2010. It still makes the political decision that I mentioned earlier to try to pull money from other areas to bolster the work that is needed in this area. The Government must commit to putting more resources in. It should not be left to local authorities to let other services suffer to subsidise this type of activity. The Minister needs to take that away and think seriously about resourcing.
Caroline Dinenage
I completely understand where the hon. Gentleman is coming from, but as he says, that is a political decision taken by local authorities up and down the country. He spoke with great knowledge about the fact that his local authority has decided to clear its backlog. Others do not have that capacity. We know that some local authorities are under a lot of pressure.
Alex Cunningham
That can be corrected in the system. Some would say that £2 billion is a small price to pay to ensure that everything in our system is legal—there are tens of thousands of cases where people are being held illegally. We need to do something about resourcing and looking at that backlog. I take the point that we do not want repetition, and the legislation needs to knock out the repetition that the Minister describes, but the bottom line remains that local authorities, clinical commissioning groups and others are extremely stretched as far as resources are concerned, and we want to put even more responsibilities on some of them through this legislation, albeit maybe doing things a bit more efficiently.
Caroline Dinenage
I disagree. We are not putting more responsibilities on to local authorities—we are just targeting them better. The hon. Gentleman says £2 billion would be a small price to pay. That would be £2 billion wasted on a system that all the stakeholders across the board say is not fit for purpose, whatever their feelings about the Bill at the moment. The hon. Gentleman worked in his local authority, and he will know that there is desperate waste in the system. We are trying to get to the bottom of that waste here; we are trying to make sure that the money is much better spent, supporting the vulnerable.
Respite Care for Vulnerable Adults: Teesside
Debate between Alex Cunningham and Caroline Dinenage(6 years, 8 months ago)
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The Minister for Care (Caroline Dinenage)
I am grateful to the hon. Member for Stockton North (Alex Cunningham) for raising his concerns this evening, and indeed to his colleagues, the hon. Members for Stockton South (Dr Williams) and for Redcar (Anna Turley). They have stated the justifiable concerns of their constituents powerfully and articulately. Whenever change is afoot, people have a tendency to feel concerned, and it is absolutely right that those concerns are articulated.
Supporting the most vulnerable in our society—those with complex needs, those with autism and those with learning disabilities—is one of the most important but exacting tasks that health and social care commissioners face. It is a task that must be undertaken with a genuine desire to get the very best outcomes not only for those who need support, but for those who care for them.
It is important to remember that many of the services that we are discussing today are focused on people with autism and learning disabilities—conditions that can manifest with very different requirements. They may need care and help ranging from routine, occasional help in the home to full-time personal support, with perhaps two or more people at a time providing that personal assistance.
Our mandate to NHS England includes a clear objective to improve outcomes for people with autism or learning disabilities. That means making sure that they are fully supported in the community, that hospital admissions are reduced and that they have the opportunity to live an ordinary life. Building the right support is our plan to use concerted local action to deliver that community support and to reduce the number of in-patients by March 2019.
We know that respite services are extremely important and a significant element of community-based support. They benefit not only the individual receiving that care, but their family and carers. Members have spoken very powerfully about that tonight. The hon. Member for Stockton North rightly points out that family carers in particular play an invaluable role—a role that is often unsung and undervalued. Often, they do so not out of a sense of duty or compassion, but out of pure love, and they deserve nothing other than our unbridled respect and our thanks. He asked me about the work that we are doing to support carers. They will of course be an integral part of our thinking in the Government Green Paper on social care that will be produced later in the year. In the interim period, we have a carers’ action plan, which I care passionately about and which will set out some short-term steps that we want to introduce to support carers and their valuable work more fully.
Alex Cunningham
It is very clear that the Minister gets this, and I admire the way in which she is putting her argument across, but this is also about resource. I am very concerned about the current problem on Teesside, but in the longer term young people in their 20s are coming through the system and approaching 30. These are children who in a previous generation would never have survived, and they are going to need more and more services. More children are becoming adults who will require more provision. What are the Government doing in terms of longer-term planning?
Caroline Dinenage
The hon. Gentleman articulates a real issue with which we have to contend. That is why we have increased NHS spending every single year since 2010, so that our NHS now has about £13 billion more to spend on caring for people than it had in 2010. That goes to the heart of the issue that he has identified. We need to ensure that care, particularly respite care, is responsive to the needs of individuals. That implies both a need to assess and determine the right kind of support, and a need for flexibility to allow for personal choice, as I believe is being looked at in Teesside.
Some needs may be best met through a stay in a suitable service that provides overnight beds, with appropriately trained staff to support people’s individual care needs, but that may not be true for everybody. Those with less severe physical or learning disabilities may find that action in the community is more desirable and appropriate for them—for example a visit, leisure activity or even visiting family members with the right personal support. We do not want those opportunities to be written off for them because we have a very restrictive system, which is why it is right that commissioners have the means to seek new approaches and to be flexible in how they meet people’s needs. I understand that the intention in North Tees is exactly that, but it must be based on suitable engagement, as the hon. Gentleman said, to assess people’s individual needs.
Having listened to hon. Members’ comments, I understand their concern that not everyone can currently access respite services and that these services may not be flexible enough. Local commissioners are rightly looking to change respite provision. The hon. Gentleman will understand that it is not customary for a Minister to comment in detail on specific commissioning decisions or on the extent to which there was appropriate consultation, unless that is part of a formal review process. I understand that the local CCG has consulted on the proposals for 10 weeks and is now in the process of designing the service.
Alex Cunningham
Does the Minister recognise that the CCG has acknowledged that it will have to get more people into the system, so the service will be diluted? Having recognised that, what can she do about it?
Caroline Dinenage
As I have already said, it is up to CCGs to commission the local services that they feel are appropriate in their local communities. It is not for the Government to force a top-down diktat on how they need to spend their resources. I understand that local councils are, quite rightly, scrutinising the proposals right now. This is an important means of quality assurance and is informed by local people with local knowledge. I hope that the hon. Gentleman will find some reassurance in that. However, although it is right that service reconfigurations are considered locally and are not driven from the top down, any significant changes to services are subject to the Government’s four tests. The changes should demonstrate support from clinical commissioners, strengthened public and patient engagement, clarity on the clinical evidence base, and support for patient choice.
There is a clear set of expectations in relation to the provision of respite care and the role of commissioners. Alongside provisions in the National Health Service Act 2006, all CCGs must secure services to meet the needs of their population to a reasonable extent. Respite care may be routinely commissioned or made available as part of a package of NHS continuing healthcare, and is often also provided as part of social care. The Care Act 2014 requires that where an adult or carer appears to have care and support needs, the local authority must carry out an assessment and meet any need where the person has met the eligibility criteria.
Alex Cunningham
The scrutiny groups on Teesside—at least some of them—are thinking of referring the matter to the Secretary of State. What happens when it is referred, and what can the Government do then?
Support for Care Leavers
Debate between Alex Cunningham and Caroline Dinenage(7 years ago)
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The Parliamentary Under-Secretary of State for Work and Pensions (Caroline Dinenage)
It is a pleasure, as ever, to serve under your chairmanship, Mrs Gillan. I, too, thank my hon. Friend the Member for Brentwood and Ongar (Alex Burghart) and congratulate him on securing this important debate on the support given by the Department for Work and Pensions to care leavers. I also thank hon. Members across the House for their valuable input to this important discussion. They have raised a number of really important issues on how the Government and, indeed, my Department support care leavers. I am very pleased to have the opportunity to address all—or at least most of—the questions that have been raised, and to set out some of the actions that we are taking.
Let me start by reassuring my hon. Friend, and indeed all Members, that the Government are committed to improving the lives of, and outcomes for, care leavers. We recognise that care leavers are among the most vulnerable groups of young people. We of course understand that sadly many were taken into care because of neglect or abuse as children. We understand that as they leave care, they often have to make the transition to adulthood and independent living at a younger age than their peers, and usually without the support of a family network, as other Members have said.
The exceptionally difficult challenges that care leavers face mean that their educational, health and employment outcomes can be significantly worse than those of their peers. That is why we introduced the first ever cross-government care-leaver strategy in 2013, and updated that strategy in 2016. The strategy sets out the steps that the Government are taking—from housing to health services; from the justice system to educational institutions; and from financial support to work—to support care leavers to live happy, healthy and independent lives. The Department for Work and Pensions was proud to play a full and active role in supporting the Department for Education in developing that strategy. In the time available today, Members will forgive me if I focus as specifically as I can on the actions that the Department for Work and Pensions has taken, but it is important to remember, of course, that they are part of a cross-Government approach, which needs to be joined up as far as possible.
My Department has put in place a comprehensive package of support and protections for care leavers who need to claim benefits to make the transition from local authority care to independent living. That support ensures that they are offered the help that they need to take that important step, including the necessary assistance to find employment. That is where universal credit is an enormous benefit. The new work coach model means that each claimant stays with the same work coach throughout their claim, giving continuity of support for claimants. It also means that work coaches are able to identify very early a claim by someone who has complex needs—someone who may require individualised, tailored support. That, of course, includes care leavers.
A couple of hon. Friends and hon. Members mentioned that very important data collection exercise. My Department is working very hard to try to collect better data on claimants with complex needs, including care leavers. Information that someone is a care leaver is held on the claimant profile as part of the universal credit system. We are at the very early stages of the process, and we are still working through what data is being collected and what the data is telling us. We will, of course, keep a very close eye on that, and see if further markers are needed. That is why we have built into the universal credit system a pause-and-learn approach, which means that we can incorporate the benefits of our learning as we go. The Department for Education continues to publish valuable care leaver outcome data for 17 to 21-year-old care leavers. A data-share agreement is in place between Her Majesty’s Revenue and Customs, Department for Work and Pensions, and the Department for Business, Energy and Industrial Strategy to explore the link between educational achievement and labour-market outcomes. They will also explore the quality of outcome information that the data-sharing provides for specific groups, such as care leavers.
In universal credit, work coaches can tailor interventions to the needs of the individual, and the support that they can offer is incredibly wide-ranging. It can address a variety of barriers to work, and might include improving job-search skills, referral to skills and other work-related training, and other types of support. The work-related training can include traineeships, apprenticeship places, and work experience. I will speak a little more about apprenticeship places later on.
Jobcentre Plus districts work closely with their local authority care leaving teams to put in place protocols and processes to support care leavers who need to claim benefits. There are some great examples across the country of effective working protocols between job centres and local leaving care teams. Barnet care leaver hub, for example, involves a Jobcentre Plus work coach, co-located in the local authority leaving care premises with the Drive Forward foundation, the care leaver charity that delivers intensive one-to-one work support. Jobcentre Plus partnership managers are working with their local authority leaving care teams to facilitate contracts and joint working protocols. We are working with the Department for Education to encourage local authority leaving care teams to contact Jobcentre Plus.
A key element of that is the facility to prepare a claim in advance of the claimant’s 18th birthday. With the support of their local authority leaving care adviser or a Jobcentre Plus work coach, a care leaver can begin preparing to make that benefit claim four weeks before their 18th birthday. That ensures that all the identification and evidence checks are completed before they leave care and prevents any unnecessary delays in benefit payments. It also provides the opportunity to arrange advances and to direct rent payments to landlords where appropriate.
Alex Cunningham
The Minister is describing lots of good practice, but I wonder how we can get to the stage where a young person can be asked at their first point of contact with the DWP whether they are a care leaver, so that identification can follow them through the system?
Caroline Dinenage
That is something that we have discussed at length, and we are looking in detail to see whether that proposal could be incorporated. I would like to reassure my hon. Friend the Member for Brentwood and Ongar and other hon. Members across the House that we have worked hard, and are continuing to work hard, to ensure that universal credit works and is beneficial, not only for the majority of straightforward cases but for care leavers and those with complex needs too. That is why we have introduced a series of measures aimed at safeguarding and supporting care leavers.
I would like to go through a few examples, which people may or may not be aware of. We have exempted care leavers from waiting days in universal credit. Those who are under the age of 22 do not serve the seven waiting days and are entitled to universal credit from the very first day that they make their claim.
We have introduced the second chance learning initiative to enable care leavers up to the age of 22 to catch up on the education they may have missed out on when they were younger. That means income support or universal credit are available to care leavers who take up full-time study in non-advanced education. We have exempted care leavers from the removal of automatic housing support for 18 to 21-year-olds in universal credit.
The hon. Member for Stockton North (Alex Cunningham) talked about exempting care leavers from council tax. The Government have given councils the flexibility to support vulnerable groups, including care leavers, to manage their council tax bills. The Department for Communities and Local Government wrote to all councils in 2016 to remind them of the powers they have under the Local Government Finance Act 1992 to support vulnerable groups. A number of councils have already taken the decision to support care leavers through an exemption or discount in their council tax bills, as I think he said his local council was doing.
Caroline Dinenage
The hon. Gentleman represents Birmingham beautifully—Selly Oak and also other parts of Birmingham, as we have learned today. He makes a good point.
Caroline Dinenage
He is clearly very talented. We would be very happy to do that, and I pay tribute to him for his work as chair of the all-party parliamentary group for looked after children and care leavers. I would like very much to accept his offer to come and join that APPG for at least one of its meetings.
Caroline Dinenage
I am grateful to the right hon. Gentleman for drawing attention to my former colleague, Edward Timpson, who was a most fantastic Minister in the Department for Education and a great advocate for care leavers. We are supporting the Staying Put arrangements that the right hon. Gentleman alluded to, which mean that care leavers who remain with their ex-foster carer can claim means-tested benefit from their 18th birthday up to the age of 21, but I will look at everything he has said.
In addition, we have exempted care leavers from the shared accommodation rate until they are 22. The shared accommodation rate is normally paid to single people aged under 35. That means that care leavers can claim the higher local housing allowance one-bedroom rate of housing benefit until their 22nd birthday.
I have listened to the arguments made by hon. Members about the issue today. I particularly welcome the comments of my hon. Friend the Member for Colchester (Will Quince); he gave an eloquent description. I also thank him for the significant contribution he has made as chair of the all-party parliamentary group on homelessness, where he does a sterling and very valuable job.
We have always said that this is something we would like to achieve, but at the moment we do not have plans to extend the exemption for care leavers from the shared accommodation rate to age 25. I assure my hon. Friend and other Members who have raised the issue today that we will continue to keep it under review and will consider evidence from stakeholders on the impact that the shared accommodation rate has on care leavers.
We have given care leavers priority access to personal budgeting support in universal credit. That includes benefit advances, rent paid direct to landlords, payments more frequent than monthly and budgeting advice, including debt advice, which was raised by the hon. Member for Stockton North.
We have a fantastic “See Potential” campaign—I say fantastic as it falls under my ministerial portfolio. It encourages employers to recognise the benefits of recruiting people from all kinds of backgrounds, including care leavers. I was so pleased to celebrate the inspiring workplace and training achievements of young people, including care leavers and others, at the Land Securities Community Employment Awards recently—we saw the incredible growth, development and achievement of some very inspiring young people.
I am pleased that the Government are leading by example by setting up a cross-Government scheme to provide employment to care leavers. My Department’s own care leaver team includes a quite brilliant care leaver intern, who I have had the pleasure of meeting, and who is providing us with very valuable insights into issues that care leavers face and helping us improve our services for care leavers. She is very cool as well—she is in the room, which is why I am saying that!
In developing our support for care leavers, we have worked closely with stakeholders. I am particularly grateful for the input from the Children’s Society, representatives of which I met shortly after being appointed to the Department. When I met with them, I was made aware of the fact that in some cases care leavers have difficulty taking up apprenticeships and a number of hon. Members have raised that today. We know that without the support of a family, they struggle economically. Having had that meeting, I hotfooted it straight over to the Department for Education and met the Minister for Apprenticeships and Skills to discuss the idea of an apprenticeship bursary, which would ensure that apprenticeships were an affordable option for care leavers, who do not have the family support that most apprentices can rely on.
The Department for Education are reviewing how the new apprenticeship funding approach is supporting all those who are disadvantaged, including care leavers, with the intention of improving how the system supports those individuals from 18 to 19, so that apprenticeships offer a more attractive opportunity to them and a greater chance of success. It has agreed to explore the proposal for an apprenticeship bursary.
The debate has raised some really important issues, and I am grateful to all right hon. and hon. Members for the points they have made, which will continue to inform our work to support care leavers, alongside our discussions with our valuable stakeholders.
Alex Cunningham
Just before the Minister sits down, there were two further points raised during the debate—first, the imposition of sanctions at a lower rate and, secondly, the opportunity to develop a way in which local authorities can work with care leavers applying for universal credit ahead of reaching their 18th birthday.
Caroline Dinenage
The hon. Gentleman is right to remind me about the sanctions—I pulled that little bit of paper out, but had forgotten to pick it up—but I think that I covered applications in advance of the 18th birthday earlier in my speech.
With regard to sanctions, I would like to stress that the Department for Work and Pensions recognises the unique set of circumstances faced by care leavers. Therefore, we allow care leavers to apply for hardship payments of 60% of their normal benefit payment from day one of the sanctions. Sanctions are used in a very small minority of cases, when people fail to meet each of the requirements that they agreed in their claimant commitment without good reason. That said, conditionality and sanctions are part of a fair and effective system that supports and encourages claimants to move into work, towards work or to improve their earnings. Work coaches are very well trained to deal with vulnerable claimants, and have the flexibility to tailor the requirements according to each individual’s circumstances, and that includes the needs of care leavers.
We do not impose sanctions lightly. Claimants are given every opportunity to explain why they failed to meet their agreed conditionality requirements before a decision is made. A well-established system of hardship payments is available as a safeguard if a claimant demonstrates that they cannot meet their immediate and most essential needs, including accommodation, heating, food and hygiene, as a result of their sanction. UC claimants are able to apply for a hardship payment from the first accounting period in which the sanction reduction is applied.
I have spoken to care leavers, and we do not do them any favours by insulating them from the challenges of the day-to-day reality and responsibilities that their peers face. The care leavers I have spoken to tell me that they do not want to be wrapped in cotton wool. They want a little extra support and help, but they do not want to be entirely insulated from the challenges and responsibilities that their peers face.
I am pleased to have been able to put on the record our commitment to supporting care leavers and the action we are taking, but I hope I have made it clear that we are not complacent. I am passionate about improving the lives of care leavers. We are determined to ensure that the welfare system in general and universal credit in particular help care leavers make a successful transition to independent living and working life, and that we support them as best as we can.
Oral Answers to Questions
Debate between Alex Cunningham and Caroline Dinenage(7 years, 8 months ago)
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Alex Cunningham (Stockton North) (Lab)
The Parliamentary Under-Secretary of State for Women and Equalities (Caroline Dinenage)
I eventually get to say something! The home learning environment is fundamental to early years development. This Government are investing over £6 billion a year in early years by 2020—more than any Government have ever spent before—and we will look very closely at how to improve the home learning environment.