Carers

Debate between Alistair Burt and Barbara Keeley

Thursday 9th June 2016 Commons Chamber

[The Minister for Community and Social Care (Alistair Burt)]

I congratulate my hon. Friend the Member for Eastleigh (Mims Davies) on securing this debate and on the way she opened it, and I thank the Backbench Business Committee for allocating time for this important debate during carers week. I will start where the hon. Member for Worsley and Eccles South (Barbara Keeley) ended, and thank all those who are involved in caring in our society. As we have heard from every speaker, carers make an invaluable contribution to the UK that we could not do without, and perhaps I can illustrate that by citing some of the remarks made by colleagues during the debate.

I will touch on some of the points raised by my hon. Friend the Member for Eastleigh in the remarks I have prepared for this debate, and I will also comment on her other points. She started with a graphic description of what might happen if carers were not around and if they decided not to do what they do every day, which brought the point home to us. She spoke about how people become a carer, and said that it could happen to any of us at any time. At last year’s national care awards I remember watching a video in which the point was made vividly that any of us in that hotel room could become a carer within 24 hours, and we can all understand that. As others pointed out, carers are no longer a minority group but people we all know—many of us are closely connected to carers, if not carers ourselves—and we are all only going to become more closely involved in the future. She, like others, made that point very well.

My hon. Friend also spoke, as did others, about the need to identify people not solely as carers but as husbands, wives, partners, employees—everything else they still are—and about the great danger of someone being pigeonholed because they have become a carer. It is important to remember that someone does not lose their identity when they become a carer. Hon. Members also highlighted the importance of carers week. I am proud to be the president of Carers in Bedfordshire—I have been for some years—and I thank it for its work. All hon. Members have thanked their local groups.

My hon. Friend was not the only colleague to speak of her personal experiences of caring. As I have mentioned from the Dispatch Box before, the range of Members’ experiences goes far beyond what the media are keen to portray and touches on virtually all aspects of life outside. When I hear the cares and experiences that colleagues bring to this place, I always hope that people outside read our debates and understand a bit more about us, why we want to be representatives in Parliament and the personal experiences we bring.

The hon. Member for Workington (Sue Hayman) and others spoke about finances, on which subject I could spend the whole 15 or 20 minutes. I know that this subject is particularly important to the hon. Member for Worsley and Eccles South, the spokesperson for the Opposition. On carers allowance, which the hon. Member for Workington focused on, the Government keep the earnings limit under review and keep under consideration whether an increase is warranted and affordable. The increase of 8% in 2015 far outstripped the increase in wages. The earnings limit is currently £110 a week, but that is a net figure, and if allowable expenses, such as childcare and pension contributions, are deducted, a claimant might earn significantly more. The limit enables a carer to maintain some contact with the employment market and achieve greater financial independence, but I recognise and would not minimise the constant financial pressures and difficulties facing families. The limit is kept under review. Also, as I said, there is a wider review of the carers strategy, which has allowed a lot of people to make contributions on finance, not just the amount but the important interlinking of benefits. That point will not be missed, and I thank her for raising the matter.

[Barbara Keeley]

Carers charities often raise with us the link with things such as the national minimum wage. The Minister talked about the figure last year, but the national minimum wage changed in April, and many of the carers trying to keep a part-time job going will be at that level, so it seems sensible to link the threshold with the national minimum wage so that when the national minimum wage increases, so does the threshold.

[Alistair Burt]

I cannot make that specific commitment, but I understand fully the hon. Lady’s point. As I said before, the earnings limit and all the factors affecting it are kept constantly under review, but I am sure that Treasury colleagues will not have missed the remarks made today.

My hon. Friend the Member for Chippenham (Michelle Donelan) also made the point about carers not being a small minority. She commended Carers in Wiltshire, and I commend her for being a volunteer—another example of the experience we all bring to this debate—and she raised the important issue of entitlement to benefits and signposting. In our call for evidence as part of the review of the carers strategy, respondents raised the importance of people being directed towards the things they need as soon as possible. The moment someone becomes a carer, their world changes, and they need as much information as possible at that time. She was right to mention the importance of signposting in particular. She spoke with great passion on the subject.

The hon. Member for Ayr, Carrick and Cumnock (Corri Wilson), who also spoke from personal experience, made a point about access to work. I shall talk about employment later, but she made her point strongly, and again she was not the only person to recognise that, although we all wish for a world in which burdens are shared equally, in truth they are not. Women carry the biggest burden when it comes to caring, and will probably continue to do so for some time. Recognising the extra pressures on women is particularly important. The hon. Lady made that point very well.

The hon. Member for Paisley and Renfrewshire North (Gavin Newlands) was particularly helpful in saying that although it is carers week for us, it is just another week for carers. I also liked it when he said that it was a week to talk “with”, not “to” carers. That was a particularly well made point. He spoke forcefully about the reality of life—the sleepless nights and other issues that carers experience.

My hon. Friend the Member for Bexhill and Battle (Huw Merriman) brought up the issue of care homes. I am not going to linger on that subject, but, as some colleagues know, I am particularly exercised about safety in care homes. It is my belief that someone in the care of the state, whether it be the NHS, local authorities or anyone else, needs to be as safe in a care home, a mental health institution or in learning disability facilities as they would be in an intensive care unit. As I expressed in yesterday’s debate about Southern Health, that is simply not the case.

I am very conscious of issues surrounding care homes. I have a round-table meeting on Monday with those responsible for the monitoring and regulation of care homes, and I pay tribute to the Care Quality Commission and others who are trying to do a good job of regulation, but this also involves some of the groups that are critical of regulation, want to see more done and want to ensure that there is safety in care homes. Some of the stories of abuse that we read about in the papers need to become fewer and fewer until they are extinct.

I want to praise the National Care Association because there are many good care homes, as my hon. Friend the Member for Bexhill and Battle said. It is important to keep the right balance in recognising the quality of good homes without minimising the pressures on them. When things that should not be happening are going on, it is quite difficult to maintain that balance. I appreciate the fact that my hon. Friend mentioned this important issue. I commend, too, the ideas coming forward from the carers team in East Sussex, and I urge members to ensure that the ideas put to my hon. Friend will be put into our national call for evidence. They have until the end of this month to do so. I do not envisage a statutory instrument to extend that still further, should there be a rush of evidence at the end of the month, but we never know in the present circumstances. Getting that information in would be very helpful.

The hon. Member for South Antrim (Danny Kinahan) was not the only one to refer to the pressures on our own caseworkers, who do so much work to look after people in the House. I appreciated his mention of that point. He hoped that the carers strategy would be a long-term strategy. I hope it will, too. The strategy should be reviewed from time to time—this is the first review for two or three years—and that is certainly the aim. That is why I would like the strategy to look slightly beyond the immediate and consider how to build for the future rather than simply having a snapshot now.

My hon. Friend the Member for Strangford (Jim Shannon)—I call him my hon. Friend—is exceptionally generous and courteous to all Front-Bench Members when he speaks. I would like to tell him how much that is appreciated—it really is—when he is so genuine in expressing his views. He spoke of his personal experiences, pressures in Northern Ireland and the Crossroads young carers in Newtownards who particularly stressed the difficulties faced by young carers and the things that they often miss out on. My hon. Friend spoke about a singing group. A few weeks ago, I went to Biggleswade at the request of the Alzheimer’s Society to join a singing group, and I sang some songs with the people there. It was certainly an uplifting experience that morning. I commend those groups and the carers who work with them.

The hon. Member for Central Ayrshire (Dr Whitford) made a considered and thoughtful contribution, as usual. She spoke about all the financial pressures. Particularly telling was her comment that although there are a relatively fixed number of carers and although it is steadily growing to 6.5 million, it is a replaceable 6.5 million and about a third leave for all sorts of reasons.

On bereaved carers, I was contacted through Twitter by someone in that position who asked whether the strategy and review would cover them, and I answered “Yes, it will and it should”. The moment that caring for someone stops because of bereavement, the carer’s life has changed—perhaps in an anticipated way, but it is has still changed. Caring for people in those circumstances is really important. We must not forget this group, so I greatly appreciated what the hon. Lady said. She also spoke of the need to ensure that social care is seen as a profession as much as nursing and domiciliary care are throughout the NHS and elsewhere, and I thoroughly agree with her.

The hon. Member for Worsley and Eccles South (Barbara Keeley), whose background in caring requires her to be listened to seriously every time she speaks about this issue, made a number of comments. I shall deal with the subject of finance a little later. Let me say first that I will ensure that the review that we are conducting will cover early identification in the NHS. We are trying to ensure that it takes place earlier and earlier. The issue of GP identification is very important, and I am pleased that the hon. Lady raised it again.

[Barbara Keeley]

I should be happy to send the Minister a copy of my Bill and the explanatory notes if that would help to elucidate the points that we have made.

[Alistair Burt]

I have no doubt that those are already deep within the recesses of the Department of Health, but if it would speed things up and provide encouragement, I should be grateful if the hon. Lady did indeed do that.

The hon. Lady also made an important point about our staff in the House. She said that we should look after them. I appreciate the point that she made about the staff of the Independent Parliamentary Standards Authority, and I will look into how we can best ensure that we recognise properly—in line with best employment practice elsewhere—that those who work for us bear considerable burdens of caring from time to time.

I am grateful for the opportunity to come to the House and share the important work that is under way to develop a new cross-Government strategy for carers. I continue to be humbled by the many powerful, honest and informed contributions that we have heard throughout the afternoon from Members who have described the carers whom they know and represent, as well as their personal experiences. Those views, and the many others that we have received so far, will be fully taken into account as the Department works with Government colleagues, stakeholders and, crucially, carers themselves to develop the new strategy.

Today we have been reminded that behind the statistics stand spouses, partners, parents—in fact, all manner of relatives, friends and neighbours—who are providing care right now in our communities. Their commitment can scarcely be quantified or questioned, and we must ensure that our own commitment to support people is demonstrated clearly as well.

I pay tribute to the national care awards, which are sponsored by LloydsPharmacy, Carers UK and The Sun. I was at the awards ceremony a couple of weeks ago, and we met the winners at lunchtime. The Prime Minister was kind enough to offer No. 10 Downing Street for a lunchtime reception, and we took people round. We are always struck when people like that say that it is a privilege to be there. We say to them, “No, it is our privilege that you are here with us. It is the other way round.” Those people were a great group—great winners. We went to a dinner that night. Radio 2 was very good: there is always a table of wonderful people to support the awards. When we hear the personal stories—which have been reflected in some of what we have heard in the House today—we are all immensely impressed. Let me again pay tribute to those awards: they do one of the jobs that we have all been speaking about this afternoon—valuing and recognising carers for what they do in so many different circumstances.

Before we go any further, may I offer a small philosophical comment? I picked this up from a piece in The Guardian by a writer called Madeleine Bunting. I do not read The Guardian all the time, contrary to the belief of many of my colleagues, but every now and again I am struck by something that is really good, and what Madeleine Bunting wrote is important. She was writing about what care is. We talk about it—we talk about the facts and figures and the finance here in the House—but what is it precisely, and where is it going? Madeleine Bunting wrote:

“We recognise instantly when we experience it: an interaction that acknowledges a moment of human connection. It may be brief, but it expresses and confirms a common humanity, a recognition of the individual—and always involves a particular quality of attention.

But the characteristics needed to provide this kind of care are losing cultural traction. Attentiveness requires two crucial ingredients: patience and the willingness to put one’s own preoccupations aside and to be available to another. Yet in a myriad of ways we are all being groomed by consumerism and digital media—to be the opposite: impatient and self-preoccupied. That impatience makes us easily distractable, addicted to the next stimulus.”

I think that Madeleine Bunting was making a really important point. The people about whom we have been talking have avoided that: they have patience, and a commitment to others that is beyond many of us. However, there is concern about society—concern about where it is going and the pressures that it is under. Demographics suggest that we will need more care, and yet certain pressures are making it more difficult for that to be realised. What will carers be like in the future if they have become too distracted and too self-occupied? That is not the case with carers now, but it is a valid point to raise with regard to the future.

We owe a duty of care to this vast army of people, who show their patience and their compassion for others. I am talking about not just providing them with the support, tools and information that they need to care well, but ensuring that their own health, wellbeing and life goals are not compromised. Our respect is unreserved, but respect is not enough. We must never lose sight of that fact if a new carer strategy is to succeed.

I should say at this point that I do not wish to paint a negative picture of caring. Although personal sacrifices are made each and every day, many carers have told us that it remains a privilege to care, and that they have a strong desire to repay the kindness of others. Indeed, carers derive immense satisfaction and peace of mind from being the primary source of comfort and reassurance for friends and loved ones. However, that satisfaction must not be at the expense of carers’ own mental and physical health.

We have also heard this afternoon about the great diversity in types of caring. There is no such thing as a typical carer—carers are people of all ages and from all walks of life, and those for whom they care have different needs. In particular, we neglect at our peril the needs of children and young people with caring obligations. They are most at risk of having not just their health and wellbeing compromised, but their education and career ambitions too.

There is no “one size fits all”. We must be alert to that as we attempt to craft new and improved support for all those providing care in our communities. It is no surprise that one in six of us is currently caring. As lifespans extend and our population grows, caring for others has already become part of the fabric of our lives. All those who have spoken today have made it clear that they are not affected by the lazy mindset that tells us that carers are other people; carers are all of us. As a constituency MP, I have had the privilege of visiting carers and carers’ groups in Bedfordshire. As a Minister, I have spoken to carers’ groups in relation to pulling together the new carers strategy. I strongly commend those who work in my own county.

Almost 20 years after the Carers Act 1995 first gave official acknowledgement to those providing “regular and substantial” care, the Care Act 2014 now gives carers new rights, including parity of assessment, advice and support with those for whom they care. Those new rights are a historic step forward. We have provided local authorities with £433 million in 2016-17 for new burdens arising from the Act.

We know that the Care Act is taking time to bed in. The hon. Member for Worsley and Eccles South referred to the matters that affect assessment, and I understand them very well. Care varies from place to place. A group from the Association of Directors of Adult Social Services working with the Department is looking at those variations in care, so that in places where assessments are much slower than in others, we are looking at what can be done and how things can be improved. That is very much on our mind.

[Barbara Keeley]

Having been present during discussions about certain groups of carers, perhaps the Minister will tell us whether he believes that carers of people who are at end of life should be prioritised for assessment. It is pointless to have people waiting six months when the person for whom they care may have only a few weeks or a few months to live.

[Alistair Burt]

I will ensure that that is considered as an important point of the assessment. I will write to the hon. Lady in relation to that.

Let me turn to finance now. There is always concern about the amount of finance that is available. It is almost impossible to get the right amount. By spending around £2.5 billion a year on benefits in Great Britain, benefiting more than three-quarters of a million carers, we are trying to respond to the needs that are there. That money provides a measure of financial support and recognition for people who give up the opportunity of full-time employment in order to provide care. As I said earlier, those allowances remain constantly under review. As this debate has made clear, it is not just about finance, but about all the other things, including supporting young carers and making sure that they are not forgotten and remembering that employers play an important part. I commend NHS England for the important work that it has done in relation to carers and for its commitment to carers.

I also want to mention the results that our call for evidence has produced, just to give people some assurance that these things are on our minds. We have received 3,800 responses so far, 85% of which are from carers themselves. A great number of the responses have been candid and honest, and it will frighten my officials if I read them out. They describe financial hardship; a lack of recognition and involvement; the impact on carers’ health and wellbeing; the difficulty of maintaining life outside caring; and frustration with access to assessments and services. All these issues are on our minds.

The need to ensure that carers get the recognition they deserve has been well illustrated in the compassionate speeches that we have heard today. Carers are vital, and not just in carers week. There is also a young carers awareness day—it was on 27 January this year—sponsored by the Carers Trust. I also commend my hon. Friend the Member for Truro and Falmouth (Sarah Newton) for holding a round-table about carers recently. This matter is on the minds of everyone in the House and I appreciate the courtesy of hon. Members in giving their time to deal with this important issue this afternoon.

Oral Answers to Questions

Debate between Alistair Burt and Barbara Keeley

Tuesday 10th May 2016 Commons Chamber

[Alistair Burt]

The better care fund has been adjusted to recognise that not all councils can raise a similar amount of money through the social care precept, so the issue that the hon. Lady raises has been noted and recognised. The only way in which the NHS can achieve better outcomes and meet the challenges of rising demand is through an increased focus on preventive community health and social care, and closer working with local authorities. That is what the pooled budget is designed to deliver, and that is what it will do.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

Indeed, good morning, Mr Speaker.

A big challenge for local authorities and adult social care is how to fund the increases in the minimum wage that care providers have to pay. As my hon. Friend the Member for Newcastle upon Tyne Central (Chi Onwurah) just detailed, the 2% social care precept does not cover all the increased costs and, indeed, in some areas, it is not even being passed on to care providers. The Local Government Association asked Ministers for £700 million from the better care fund to help with that increased cost this year and next year—not in 2019. When will Ministers listen to local councils and agree to bring forward that much needed funding to support what is effectively their own policy in the care sector?

[Alistair Burt]

I do not think that anyone fails to recognise that the next couple of years in social care will be very tight, but that is why the better care fund is there. Work has been done to increase the amount of money available to meet the challenges that the hon. Lady raises. I have to repeat that to fund this properly there has to be a sufficiently strong economy. There has to be the commitment to funding that the Government have been able to make almost uniquely in the House. I sometimes think it would help if she recognised the strength of the economy that has been able to do that by assisting local authorities, rather than complain about the amount of money available.

Community Pharmacies

Debate between Alistair Burt and Barbara Keeley

Tuesday 23rd February 2016 Westminster Hall

[Alistair Burt]

The hon. Gentleman makes a fair point, and that is indeed being done in the NHS, but we are looking at where efficiencies can be made and at what different parts of the health sector can contribute. In doing so, we can see what changes are inspired in the service provided to patients.

To emphasise where we are with pharmacy, there are 11,674 pharmacies in England, which has risen from 9,758 in 2003—a 20% increase—while 99% of the population can get to a pharmacy within 20 minutes by car and 96% by walking or using public transport. The average pharmacy receives £220,000 a year in NHS funding. On clusters, which my hon. Friend the Member for Plymouth, Sutton and Devonport mentioned, the Government contend that money can perhaps be saved in one place and used elsewhere for the delivery of new services. That is the reality of life. It would be great if new money was always coming from somewhere, but bearing in mind that the Government are dealing with an Opposition who could not commit to the extra £8 billion that the NHS was looking for, we have to make the changes that others were not prepared to make and still deliver services.

Let me move on to where we are going. Everyone in this room, Government Members included, recognises the quality of the best pharmacy services around the country. We are familiar with the valued role that community pharmacy plays in our lives and those of our constituents. I am grateful to my hon. Friend the Member for St Ives for giving me the opportunity to put on public record the high esteem that we hold them in and to set out our plans for the future.

I am a firm believer that the community pharmacy sector already plays a vital role in the NHS. I have seen at first hand quite recently the fantastic work that some community pharmacies are doing across a wide range of health services that can be accessed without appointment. Many people rely on them to provide advice on the prevention of ill health, support for healthy living, support for self-care for minor ailments and long-term conditions, and medication reviews. There is also real potential for us to make far greater use of community pharmacy and pharmacists in England. For example, I am due to speak at an event tomorrow that is looking at the role that pharmacy can play in the commissioning of person-centred care for vulnerable groups.

Our vision is to bring pharmacy into the heart of the NHS. We want to see a high quality community pharmacy service that is properly integrated into primary care and public health in line with the “Five Year Forward View”. I cannot answer all the questions that the hon. Member for Worsley and Eccles South (Barbara Keeley) asked, but she did at least mention the integration fund for the first time in the debate.

[Barbara Keeley]

There is a difficulty, in that funding for integration should recognise that the extra work needs to be done. The point of today’s debate has been about the Government using blunt instruments, such as a 6% cut in funding, reducing the number of pharmacies in clusters, changing dispensing charges, and the warehouse pharmacy that my hon. Friends mentioned. It is the use of those blunt instruments, not the working with the sector, that is the fault.

[Alistair Burt]

That working with the sector is ongoing. That is what the negotiations with the Pharmaceutical Services Negotiating Committee are all about. I take the hon. Lady’s point, but those discussions are under way. We are consulting with a wide range of groups, not just the PSNC, including patients and patient bodies.

As part of what we are doing for the future of pharmacy, we want pharmacists and their teams to practise in a range of primary care settings to ensure better use of medicines and better patient outcomes and to contribute to delivering our goal of truly seven-day health and care services. As part of that, I want to work with NHS England to promote local commissioning of community pharmacy within the health community, so that we can ensure the best use of this valuable resource. That is why we are consulting on how best to introduce a pharmacy integration fund to help to transform the way pharmacists and community pharmacy will operate in the NHS of the future. By 2020-21, we will have invested £300 million in the fund.

While it is understandable that the focus of most colleagues’ comments today was access to existing services, little was said about where pharmacy might be going and what new opportunities there will be. That is part of the overall development that we are hoping to achieve, which will include the work not only of the access fund, but of the integration fund.

Colleagues asked several questions about access. I want to provide some reassurance. We recognise that some of the Government’s proposals have caused concern, and that will take some time to distil as the negotiations are worked through. We are committed to maintaining access to pharmacies and pharmacy services. We are consulting on the introduction of a pharmacy access scheme, which will provide more NHS funds to certain pharmacies compared with others, considering factors such as location and the health needs of the local population, both of which were raised today. Qualifying pharmacies will be required to make fewer efficiencies than the rest of the sector. We certainly recognise that rural pharmacies will need to be considered in that, and we want to ensure that location matters in areas of sparsity. That work is ongoing.

In conclusion, the process has some way to run. I simply put it to colleagues that, in relation to good community services on the high street, there is more for modern pharmacy to do. Looking at the proposals of the past, we hope that the profession shares the Government’s determination to move pharmacy into a new future, and I am convinced that the future will be good.

Care Homes: England

Debate between Alistair Burt and Barbara Keeley

Wednesday 13th January 2016 Westminster Hall

[Alistair Burt]

We are constantly evaluating the better care fund. We work on it with local authorities on a regular basis, and with the Association of Directors of Adult Social Services, so it is constantly being evaluated. I do not know whether something else would add to that process.

[Barbara Keeley]

I have made the point about choices to the Chancellor in the past. Perhaps the Minister has not got the Chancellor on side yet; I hope that he will do so. However, the inheritance tax giveaway that this Government have enacted will cost £1 billion by 2020. How far would that £1 billion go in social care? A long way.

[Alistair Burt]

We could all pick items of Government spending that we do not particularly fancy and say, “Oh, if only it was applied to this, it would be great.” Every single Government and every single Chancellor have faced the same argument. We are where we are. We have made choices about a whole variety of things, and we have a range of obligations to deliver to the public. In this particular instance, however, I want to talk about what we are spending and what is new. I will do so briefly, but I must cover that.

The Government are giving local authorities access to up to £3.5 billion of new support for social care in 2019-20. We believe that the precept could raise up to £2 billion a year, and with that money and the £1.5 billion that was included in the spending review, we believe that by 2019-20 there will be the opportunity for a real-terms increase in spending on social care.

[Barbara Keeley]

Will the Minister give way?

[Alistair Burt]

No. I have only three minutes. If I give way, I will not be able to cover everything now.

[Barbara Keeley]

I just want the Minister to say how councils such as the Essex council that wrote to the Prime Minister will manage until 2019.

[Alistair Burt]

I will give two responses to that and talk about the equalisation of funding. First, we are working closely with local authorities and with ADASS. I do not pretend in any way that the situation will not be tough for the next couple of years; it will be. However, we believe the resource is there. Secondly, the social care precept will come in this year, and that money will be made available more quickly. It will be difficult and it will be tight, but a lot of changes are being made and a lot of work is being done to ensure that services are more efficient. Those things are going on all the time.

I want to address the problem that was raised about the precept and explain how it will be used to ensure that local authorities do not miss out. The Department for Communities and Local Government published for consultation a provisional local government finance settlement in December. Recognising that local authorities have varying capacity to raise council tax, it is proposed that the additional funding for the better care fund that will be available from 2017 should be allocated using a methodology that provides greater funding to authorities that benefit less than others from additional council tax flexibility for social care. That will include consideration of the main resources available to local authorities, including council tax and business rates.

Oral Answers to Questions

Debate between Alistair Burt and Barbara Keeley

Tuesday 17th November 2015 Commons Chamber

[Mr Speaker]

Equally briefly, the last question and answer. I call Barbara Keeley.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

The ResPublica report, “The Care Collapse”, states that our residential care sector is in crisis. It says:

“Providers are being faced with an unsustainable combination of declining real terms funding, rising demand for their services, and increasing financial liabilities.”

It also states that a £1 billion funding gap in older people’s residential care would result in the loss of 37,000 care beds, which is more than in the Southern Cross collapse. No private sector provider has the capacity to take in residents and cover the lost beds, so those older people will most likely end up in hospital. What is the Minister doing to protect the care sector from catastrophic collapse?

[Alistair Burt]

As the House is aware, social care is a matter of great importance as we head towards the spending review round. We are aware of pressures in the system, and there is always contingency planning to identify particular problems. We are working hard with the National Care Association to improve the quality of care provided by the sector, and my right hon. Friend the Secretary of State has commissioned Paul Johnson, of the Institute for Fiscal Studies, to look at pressures in the care home sector and how to ensure that we can meet the challenges. If challenges require more money, which they always seem to do according to the hon. Lady, she needs to come up with ideas for how to provide that money, but she never does. It is the Government’s responsibility to meet those challenges within the context of the overall economic position.

Hospital Parking Charges (Exemption for Carers) Bill

Debate between Alistair Burt and Barbara Keeley

Friday 30th October 2015 Commons Chamber

[Barbara Keeley]

This is about more than just sending a message. We are increasingly not exempting carers who are on this very low basic income of carer’s allowance—only £3,229 plus whatever extra benefits they might qualify for. They are not exempt from the bedroom tax because the Government have not made them so, they are not exempt from the benefit cap, and now they are not exempt from car parking charges. Some hospitals can do this: Torbay can make concessions, and Scotland and Wales can do it, so clearly it is not impossible.

[Alistair Burt]

No, it is not impossible, but the whole point of what we are talking about is to provide discretion, and I will come back to one or two of the elements related to carers.

As I have discussed with the hon. Member for Burnley, we are looking at the strategy for carers in the round, and I have got the responsibility of doing that. We will look at all sorts of things for the future. The economics will come into it—I take that point—and I think it is best to look at this as an overall strategy. I have offered to involve the hon. Lady, who has agreed; indeed, I would like one or two Back-Bench colleagues from all parties to assist me when that consideration of strategy gets up and going because of their particular interest in the subject. The overall impact on carers of all sorts of things that are happening at present can be taken into account. There will still be finite financial limits, which I will come to soon, but where life can be made easier, we obviously are looking to do that.

The hon. Member for Worsley and Eccles South mentioned the bedroom tax. The relevant rules already take account of the needs of carers. For example, non-spouse resident carers plus others who need to stay overnight are allowed an extra bedroom—[Interruption.] Well, if that is not true, perhaps the hon. Lady would like to intervene on me, but that is what the law says. Discretions are also offered by local authorities, and that too provides an opportunity to take account of what carers might need.

[Barbara Keeley]

The figure of 60,000 carers who are having to pay the bedroom tax comes from the Department for Work and Pensions. There are at least 60,000 of them who have to pay.

[Alistair Burt]

As I have said, the opportunities for discretion exist, but perhaps the way in which discretion is exercised is something that the carers strategy can look at.

It was this Government who passed the Care Act 2014. For the first time, carers—as well as those they were caring for—were given the right to be assessed by a local authority. We gave an extra £400 million for respite care, to be used by those who needed it during the last Parliament. It is therefore reasonable, given the availability of the carer’s allowance and the other measures I have mentioned, for the Government to indicate that carers are valued in ways that they have not been in the past. There has been an incremental increase in support for and recognition of the carer’s role over the years.

I stand four-square behind what my colleagues have done. The Secretary of State’s determination to devise a new carer strategy, on top of what is already there, is a recognition of the fact that more might well need to be done, but it also recognises the value of carers. Nothing we have heard today on either side of the House, including some graphic examples, has suggested that we do not value carers.

Before I respond to the points on car parking charges, I should like to mention the speeches that have been made today. The hon. Member for Burnley set out her case extremely well, and I shall come back to that in a moment. My hon. Friend the Member for Shipley (Philip Davies) is a necessary piece of grit in the oyster of the workings of Parliament. Mrs Thatcher said that every Government needed a Willy, but in addition, every Parliament needs either an Eric Forth or a Philip Davies. They remind us that, at the end of the day, this is not a game. If we pass a piece of legislation, it has consequences and, accordingly, it has to be right. Occasionally, my hon. Friend will say things that people find uncomfortable, but he is just doing his job.

The process of a private Member’s Bill is not easy. Indeed, as I go on talking for a while this afternoon, there will be plenty who say that these processes should be handled differently, but they are not. This is the way in which some things are examined. My hon. Friend made a good speech. Above all, he talked about the problems of economics that I referred to earlier. There are many things that we would all love to do, but often we cannot. We have to make choices. When the Government of the hon. Member for Worsley and Eccles South were in office, they had to make choices, and so do we.

The hon. Member for Birmingham, Perry Barr (Mr Mahmood) made a strong personal plea for the Bill. He mentioned patients on dialysis, and I would like to reassure him that those patients are already covered in our principles as frequent out-patient attenders. The amendment that we have just made to our provisions will ensure that carers of patients on dialysis will be covered by the guidance.

My hon. Friend the Member for Bury North—God bless it!—(Mr Nuttall) went into forensic detail about the Bill. I ask him to convey my good wishes to all at Fairfield hospital, which I remember very well. Both my children were born there, and my wife still has a plaque up on the wall from when she opened a piece of equipment there. My hon. Friend also went into forensic detail when he described the difficulties that would be created by the Bill. He gave it a necessary examination.

The hon. Member for Heywood and Middleton (Liz McInnes), whom we should thank for her services to the NHS over many years, made it clear how passionate she felt about this issue. In a perfect world, everything would be wonderful, and she finished by saying that it would be great if everyone could park for free at hospitals. They cannot do so, however, because the money would have to be found from somewhere. I will come back to that point in a little while.

My hon. Friend the Member for Solihull (Julian Knight) detailed his own personal campaigning for fairer charges in his constituency. He is a perfect example of how an MP of any party can take up an issue and how, when something is wrong that can be worked through, it can be done in a local capacity. He provided a series of perfect examples of what to do as a local Member.

The hon. Member for Ealing Central and Acton (Dr Huq) made a passionate plea for change. My hon. Friend the Member for Christchurch (Mr Chope) examined the Bill in depth, especially in relation to clause 1. He gave examples of where the present discretionary arrangements could work to people’s advantage, and we will come back to those later. If there was no example anywhere of guidance and of opportunity for discretion being used, then the strictures of the hon. Member for Burnley would be much stronger. The fact is that discretion is used in some areas. Various figures were quoted: some 63% of hospitals do not charge, and some 86% or 87% offer discretion. That allows local areas to take notice of the principles and make their own decisions about what is necessary.

May I just add a word about the phrase “postcode lottery”, which is a favourite of mine? A postcode lottery implies a situation in which there is no chance to do anything about it. Many of the things in modern political life that we term postcode lotteries are not postcode lotteries at all, because they all contain the opportunity for people to make a difference, or to change things. The point of local discretion and of transparency in the delivery of services is precisely that it enables people who represent an area to say, “Why isn’t it as good here as it is next door? What is it they are doing that we are not?” They can then apply pressure locally to get something done. They should not always run to Government to say, “It is your fault. You must standardise everything.” Neither should they throw their hands up in the air and say that there is nothing they can do about it. Therefore, I reject the term postcode lottery on most of the times that it is used. This is an example of where, if discretion is used in some areas, why is it not used in others, and what will people do locally to encourage it? Clearly, it happens in some, but not all, places, and it is not always the responsibility of Government.

My hon. Friend the Member for Shipley said that he longed for the day when Ministers could stand up at the Dispatch Box and say, “It is nothing to do with me.” Actually, local discretion is nothing to do with me. All too often people come running towards Government and demand that something is done, when, actually, the answer lies in their own hands, their own constituents’ hands, their own local decision-makers’ hands and, in this particular case, the hands of those who are making decisions about hospital charges. It is fair that responsibility is very widely spread.

Let me move on and say a little bit about the car parking matter. I will do my best to be quick. Everything that the NHS does is on an epic scale, and that is true even in relation to car parking. At hospitals alone, there are around half a million car parking spaces to finance, manage and maintain, and every day, millions of users need to be seen safely on and off the sites. Parking is an amenity that the NHS has to provide if the service is to function properly—or indeed to function at all. Problems are particularly thorny in large acute hospitals, but they also exist in others. Our aim is always to see that parking provision is sufficient, efficient and fair.

The level of car parking provision required is a reflection of massively increased car ownership. When I was a boy and used to go with my father, a GP, to visit our local hospital, there were no car parking charges and the car park was half empty. I was born and brought up in the late ‘50s and early ‘60s, and life was very different. The more people who use our hospitals, the more car parking spaces we will need. Very recently, I went to the Lister hospital, a local hospital used by my constituents, and saw its new car parking facilities, which make a huge difference, but they have to be paid for.

Car parking, like any other service, is provided at a cost. Owning land costs money, so hospitals have to meet finance costs as well as maintenance, lighting, security and so on. Across the NHS, we now see better and better facilities. It is inevitable that some form of charge needs to be levied to cover those very real costs. From this perspective, it is perhaps remarkable that the average cost of parking across the NHS is only £1.15 an hour—and has fallen slightly this year. Once we accept that there is a real and unavoidable cost associated with parking we have to ask ourselves, “If hospital parking costs are not paid for by drivers, who are they paid by?” Again, that was a hard question asked by Members on the Government Benches.

Oral Answers to Questions

Debate between Alistair Burt and Barbara Keeley

Tuesday 13th October 2015 Commons Chamber

[Alistair Burt]

In a way, the self-definition states its own problem: these are unidentified carers. I hope that the new responsibilities in the Care Act will encourage more people to come forward and that the greater work of carer support organisations, such as the one I preside over in Bedfordshire, Carers in Bedfordshire, will be able to identify more carers. We want more young people to come forward because, as the hon. Lady says, people are caring and they do not realise they are. We need a concerted effort all round to try to reveal them, so that more can be done.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

I am surprised that the Minister believes he is supporting carers in any way acceptably well. The recent personal social services survey found that 38% of adult carers now care for more than 100 hours a week but only one in five of those carers is getting support to take a break from caring. Government cuts have caused a funding gap in social care, which, it is estimated, will be £4 billion by 2020, piling additional pressure on those family carers, and the better care fund and integration will not, in themselves, fix that gap. When will Health Ministers admit that they have got this wrong and argue for more funding for social care, so that carers can get the support and respite breaks they should get?

[Alistair Burt]

Between 2010 and 2015, £400 million extra was found in order to provide respite for those who are caring for others. Any support that goes into local government, or indeed the NHS, is predicated on a decent economy and decent economic principles in order to fund it—I believe from what happened last night that that has been abandoned by the Labour party. We have to have the resources in the first place. That is what we are seeking to ensure and that is what the work is being done for.

Oral Answers to Questions

Debate between Alistair Burt and Barbara Keeley

Tuesday 15th March 2011 Commons Chamber

[Alistair Burt]

Obviously, we watch events in Bahrain with mounting concern. The sense is that the Bahraini Government should continue to give an opportunity for legitimate protest and that the dialogue should continue with opposition parties. It is incumbent on both the opposition and the Government to keep that process of reform going. On intervention from the GCC at the request of Bahrain, it is essential that that is consistent with the spirit of reform, and not repression.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

T1. If he will make a statement on his departmental responsibilities.