NHS Annual Report and Care Objectives

Andy Slaughter Excerpts

Wednesday 4th July 2012 Commons Chamber

[Mr Lansley]

Yes, I could not agree more. It was precisely because Professor Sir Mike Richards undertook an inquiry and produced a report identifying a lack of access in this country to new cancer medicines in the first year after their introduction that we instituted the cancer drugs fund. It is a matter of considerable regret to many of us that that example was not followed in a similar way in Wales.

[Mr Andy Slaughter (Hammersmith) (Lab)]

What message does the Secretary of State have for the 2 million people in west London, four of whose nine major hospitals are set to lose their A and E departments, including both Hammersmith and Charing Cross, in my constituency? That is the Secretary of State’s policy. He cannot pass the buck to the NHS on this or, indeed, on the threat to the Royal Brompton hospital’s children’s services; he has to answer for it.

[Mr Lansley]

No. Let me reiterate to the hon. Gentleman the point I have just made, because what he describes is not my policy. If there are proposals, they are proposals that have been generated in north-west and west London, and the safe and sustainable review is an independent review. It is not establishing the Government’s policy; it is an independent review in the NHS, looking at how services can be improved.

The review was not in any sense about costs; it was entirely about how we sustain the highest quality of excellent care for patients. The same will be—needs to be—true in relation to services in west London for emergency care. I will not go through this all again, but I reiterate that, if people object and say that such an aim will not be achieved, it is open to a local authority to refer the matter to a mere Secretary of State on the basis that the tests I have set down have not been met.

Health and Social Care Bill

Andy Slaughter Excerpts

Monday 31st January 2011 Commons Chamber

[John Healey]

I am surprised that the Health Secretary was asked a direct question and did not answer. I would simply encourage my right hon. Friend to keep asking the questions that he feels are important for the future.

[Mr Andy Slaughter (Hammersmith) (Lab)]

Mr Nash’s wife also bankrolled my opponent at the last election—for all the good it did him. However, something else was not in the Tory party manifesto, and that was cuts in the health service. I have in my hand a letter from the chief executive of my primary care trust that simply states that

“healthcare in North West London will face a £1bn shortfall in funding by 2014/15, given these upward pressures.”

Is that not something else that the Tory party did not tell the truth about, and something on which it is not following the Labour Government?

[John Healey]

My hon. Friend won his seat at the last election because he helped to expose the truth about the Conservative plans for housing—a truth that it denied but which has now come true. He is absolutely right. The truth about what is happening in the health service now is that patients are starting to see the signs of strain and services being cut, and that is not what they expected when they heard the Prime Minister, before the election and afterwards, promising to protect the NHS.

Contaminated Blood

Andy Slaughter Excerpts

Monday 10th January 2011 Commons Chamber

[Mr Lansley]

May I say two things to my hon. Friend? My hon. Friend the Under-Secretary has met those groups and will continue to meet them, because we want to ensure not least that those who are now eligible for enhanced payments and so on make proper applications. We have looked very carefully with the clinical expert group at the support that we ought to give. It is not compensation as such; it is an ex gratia form of support. We have made judgments, and if we were to go further, there would be significant additional costs. My hon. Friend the Under-Secretary and I have made it clear to the House in the past that to provide payments on the scale of the Republic of Ireland might involve up to, or perhaps even in excess of, £3.5 billion a year, so I am not in a position to say to my hon. Friend the Member for Colne Valley (Jason McCartney) that I expect to go beyond the support that I have set out today.

[Mr Andy Slaughter (Hammersmith) (Lab)]

It is to be regretted that the review’s terms of reference were so narrow, as it did not consider overall levels of compensation or HIV. If the Secretary of State believes that the Republic of Ireland case is simply too expensive, will he please say so and not rely, as the Department has, on either the idea that the Taintedblood campaigners and others are asking him to look at that and tying us to the Irish system, or the idea that they are asking us effectively to look at those levels of compensation because negligence was involved? That was not the case in Ireland. Is not the result likely to be more litigation? The levels of remuneration are still far too low.

[Mr Lansley]

With respect to the hon. Gentleman, in response to previous questions I made it very clear that the question was not simply about the amount of money. The situation in the Republic of Ireland is unique in respect of its determination of liability because of mistakes made by the Irish Blood Transfusion Service. To that extent, we are making ex gratia payments. The nature of our payments stands comparison to other countries, particularly now, in respect of hepatitis C and my announcements this afternoon.

Contaminated Blood and Blood Products

Andy Slaughter Excerpts

Thursday 14th October 2010 Commons Chamber

[Mr Andy Slaughter (Hammersmith) (Lab)]

I wish to say a few words about my constituent, Andrew March, who is a victim of contaminated blood. He is not only a remarkable man and campaigner; he is the reason we are talking about this today, because he was the claimant in the judicial review that led to the written ministerial statement. That statement was correctly attacked by my hon. Friend the Member for Coventry North West (Mr Robinson) today.

I am new to Mr March, in the sense that he has been a constituent of mine since May, as he lives in the Hammersmith and Fulham part of the constituency that I inherited. However, I have caught up quickly with what he has been doing over many years and decades. The easiest way for me to summarise his predicament and what he has done is to read from a letter that he sent to me on 23 July. He said:

“I was one of the young children at the time of the AIDS outbreak, and I had to cope with being told that I had HIV at the age of 9. It was extremely difficult to deal with back then—and the devastation was compounded by the stigma. Before that, I had already been ill from Hepatitis B, again, from blood products because of my haemophilia condition. By 1992, whilst I was studying at the Royal College of Music on a 4-year degree, I was informed that I had also been exposed to hepatitis C, and only 5 years later, I was given another blow when I was informed that I had been exposed to two batches of Factor VIII blood products taken from a donor who later went on to develop vCJD. I had been treated with over 110 bottles of this vCJD-implicated material being injected directly into my bloodstream.”

[Lorraine Fullbrook]

Does the hon. Gentleman agree that this very debate helps to raise awareness of those people suffering from hepatitis C contracted from contaminated blood products and helps to remove the stigma attached to hepatitis C? I am thinking of people such as a constituent of mine, who wishes not to be named but is suffering from hepatitis C1a, which is the severest form of hepatitis.

[Mr Slaughter]

I think that this debate does do that, and I am grateful for this opportunity to increase my own knowledge. However, I think that we need to move on to some very specific recommendations because, as the mover of the motion eloquently said, this is a time for action more than contemplation. That is exactly what Mr March did when he brought the judicial review in April, and the matter has been just been clarified, as my hon. Friend the Member for Foyle (Mark Durkan) described, in relation to the mistake that the previous Government made on the situation in Ireland. That was the error made by that Government. That was the finding of the judicial review, and it is what the Government are responding to today.

I shall not read from the judicial review, other than to quote its final paragraphs, because they again relate to Mr March. The learned judge, Mr Justice Holman, said that counsel for the claimant

“paid a warm but measured tribute to…Andrew March, ‘for his tenacity and balance in the asking of questions and soliciting of information, and not taking no for an answer when the reasons are not good ones.’ My impression is that that tribute is justified and well judged, and that the many other people interested in this cause owe gratitude to Mr March for his tenacity or persistence.”

I say again that Mr March has done that for many years, suffering as he did not only from his original medical condition but from the effects of the contamination.

Taintedblood, an organisation that has done a lot of excellent work in briefing us all and preparing us for this debate, states:

“The Under-Secretary of State for Health”—

the hon. Member for Guildford (Anne Milton)—

“recently held a series of meetings with campaigners, the Haemophilia Society, the Macfarlane and Eileen Trusts, the Skipton Fund and others. In those meetings she demonstrated a new willingness by Government to face up to and deal with what has happened to the Haemophilia Community.”

Those organisations must be very disappointed today by the amendment that the Government attempted to move and by the written ministerial statement.

I welcome what is said in the terms of reference about hepatitis C, as has been mentioned. I want to clarify whether the Minister is offering full parity for hepatitis C sufferers with what AIDS sufferers experience, including the £12,800 per annum payments, and that that will be susceptible to the review.

[Mr Marcus Jones (Nuneaton) (Con)]

The constituent whom the hon. Gentleman mentioned is the son of one of my constituents in Nuneaton. I want to mention the families of those affected by this disaster, because they have also had to bear a real burden in supporting people such as Mr March over the years. Does the hon. Gentleman welcome the terms of reference that the Minister announced in her statement about supporting the families who have had to bear that burden?

[Mr Slaughter]

No, I definitely do not. I ask the Minister to clarify—if not now, when she makes her speech—whether the terms of reference will allow hepatitis C sufferers to be treated at least as HIV/AIDS sufferers are under the current scheme. I hope that she will do that. However, all that could have been done today. The limited amount that is offered in the review could quite easily have been announced today. If there had to be a review, I should have liked it to have been along the terms of Lord Morris’s Bill, which considered all the remaining provisions of the Archer inquiry and said specifically—this is the contentious part:

“When making the regulations the Secretary of State shall have regard to any comparable compensation schemes offered in other countries.”

The noble Lord’s Bill was a good Bill, but I would say—this is the only criticism that I would make of my hon. Friend the Member for Coventry North West—that I think today’s motion goes a little too far. It calls specifically for parity with the scheme in Ireland. I do not think that it gives the Government sufficient room. I would ask the Government—this is the commitment that I would look for today—to widen the terms of the review and to reconsider all the matters that Lord Archer raised, including compensation. Even if the conclusion is that parity is unlikely with Ireland, where the situation is different even given the judicial review—that was suggested in the opening speeches—in the current financial climate we need to look at the levels of compensation that are paid.

I also think that the motion, while criticising previous Governments, could at least have acknowledged that the previous Government responded to the Archer review by making regular annual payments at a higher level, although I understand that my constituent and many others regard that as inadequate. I regard it as inadequate. We are looking, I think, for something between the two. The unfortunate thing about the Government response today is that it cuts off that option. The amendment and the ministerial statement do not allow the option of considering more generous compensation in the light of Lord Archer’s proposals. That is why I would have voted against the amendment and that is why I think it is wrong for the Government to have given false hope to sufferers and to have dashed that hope with their announcement today.

--- Later in debate ---

[Anne Milton]

I thank my hon. Friend for his question. We are talking about a long time ago; that is the trouble. I know that campaigners have been concerned about cover-ups, and that not all the documents have been released. I assure him that officials have told me that all documents have been released, but somewhere in the back of a cupboard, somebody at some point might discover more. It is a mistake to think that there is any conspiracy, however. I do believe, in all honesty, that previous Governments and the current Government have done, and continue to do, all that they can to ensure that all information is in the public domain.

As the consensus on the virus developed and technological advances occurred, the Government and the NHS moved quite quickly to address the risks. Heat treatment was introduced in 1985, and that effectively killed the hepatitis and HIV viruses. Validated tests for screening blood donations were also introduced. Since then, Governments have introduced a number of important safeguards to protect the blood supply, not least, as we heard today, from newer risks such as new variant CJD. We carefully assess, and shall continue to assess, all new evidence as it comes to light, and we now have EU directives that set standards of quality and safety.

I fully understand again the financial difficulties that many of those affected by contaminated blood products face. I have met some of them, and they have told me in some detail of their extraordinary experiences of living with the aftermath of infection. Not only were many of them infected, but they went on to infect their partners. They are, understandably, very concerned about their own and their family’s financial security, and they look to the Government to provide a degree of certainty in the years ahead.

Going—what may feel like—cap in hand to the state is demeaning, I know, but it is worth laying out the financial settlements that are currently available. Those infected with HIV receive a flat-rate payment of £12,800 per year, and they may also be eligible for additional discretionary payments. In the year ending April 2010, the average total payment to an individual infected with HIV was £17,400, although of course some received less and some received more. Those infected with hepatitis C are eligible to receive an initial one-off lump sum payment of £20,000 when they develop chronic infection. Despite contracting the virus, some people will make a full recovery, but many do not and go on to develop serious liver disease. For that group, there is a second one-off payment of £25,000. All those payments are tax-free and not used when calculating an individual’s eligibility for state benefits. Therefore, if they were unable to work for health reasons they would receive those benefits, but I take the point made by the hon. Member for Kingston upon Hull North (Diana R. Johnson).

The independent public inquiry on NHS-supplied contaminated blood and blood products, chaired by Lord Archer of Sandwell, investigated the circumstances surrounding the supply of blood products. It made several recommendations, the majority of which are in place in one way or another. However, a small number of recommendations have not been implemented. These primarily relate to aspects of the ex gratia payments, free prescriptions in England, and access to insurance.

I have instigated a review of those recommendations to see what more can be done. I know that hon. Members would love me to finish that review before Christmas. I will do what I can in the time available; I know that time is of the essence. The review will be conducted by Department of Health officials, but with the support of relevant clinical experts and external groups. The terms of reference should be in the Library. At this stage, let me put on record that I will place in the Library how the costs of implementing the Irish scheme in the UK were arrived at. I know that that has caused some concern, but I will come back to it, because time is very short.

I do not have time to go into detail on what happened in Ireland, but it is important to place on the record that in an article in The Irish Times—I will ensure that this is also in the Library—Brian Cowen, then Minister for Health and Children in the Republic of Ireland, and currently Taoiseach, confirmed that the Irish Government knew in 1995 that the Blood Transfusion Service Board had been negligent and had attempted to conceal that fact.

[Mr Slaughter]

Will the Minister deal with the two points that I raised in my remarks? First, do the terms of reference permit the inquiry body to consider the issue of hepatitis C in it widest sense—that is, to give it full parity, including in relation to the ex gratia payments of £12,800 a year for HIV? Secondly, given that she says that there are only a small number of recommendations to be addressed, why does not the new inquiry consider all those remaining issues, including the level of ex gratia payments?

[Anne Milton]

I thank the hon. Gentleman. I will admit to a certain amount of ignorance. I do not know what I can do, but I will do everything I can within what I am allowed to do. It is important to say that I am very keen to get on with this. The danger with an inquiry that extends its remit is that it drags on and on, and this issue has dragged on for more than 25 years.

No fault has ever been found here in the UK—a fact that has been tested in the courts. In 1988, a group of haemophilia patients and their families sued the Government of the day. They settled their case outside court, midway through the proceedings, as their solicitors had advised that they had very limited chance of success.

Whatever happened all those years ago does not change the facts of today. In the United Kingdom, decisions over tax and spend are made here in this Parliament. The decisions of the Irish Parliament, like those of any other national Parliament, have no authority here in the UK. The debate on contaminated blood products has continued for many years, and I would like to close my remarks by again offering my sympathy and expressing my deep regret at the events, and by saying how sorry I am that this ever happened.

Supporting Carers

Andy Slaughter Excerpts

Thursday 1st July 2010 Westminster Hall

[Mr Andy Slaughter (Hammersmith) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Benton, although the matters that I have to deal with are somewhat distressing. I wish to address the proposed closure of the Hammersmith and Fulham carers centre, which is the main carers centre in my constituency. Hammersmith and Fulham council is closing the centre at the end of July in the most irregular and arbitrary way, and that will leave no service for carers in the borough for the foreseeable future.

I should perhaps begin by declaring an interest. The centre was set up in 1998, when I was the leader of the council, and I have been a strong supporter of it over the past 12 years. The centre occupies substantial premises in Hammersmith road, which is about five minutes’ walk from Hammersmith Broadway, so it is located in the centre of the borough and highly accessible for the carers who use it. It has a lot of space, so it can run activities, and it has—or had—six staff. It has provided a service to many thousands of people, and I shall read some of their testimonials in a moment, but let us just say for present purposes that it has run a good service. It should now be delivering a service to adults and young people using its budget of £300,000, which is split roughly 70:30 between those two groups. In addition to providing services in the main building, it also provides outreach services across the borough.

In 2008, the then relatively new Conservative council decided to conduct a tendering exercise. It is a moot point as to whether that was necessary, and the council failed to identify whether the body involved should be voluntary or whether staff would be employed by the council, but it went ahead. The problem was not the exercise itself, but the fact that it was so incompetently managed that three separate tendering exercises were carried out over the ensuing two years with no successful resolution. Despite the council going to great lengths and spending a lot of money on the process, the most recent exercise had only one bidder, which was the existing carers centre. The centre passed its appraisal, at least as far as the adult part—the majority part—of the quality assessment was concerned, so it anticipated being awarded the contract. However, at that point—again, entirely arbitrarily—the council decided that it would terminate the contract with immediate effect. Indeed, it should have been terminated yesterday, on 30 June, but a winding-up extension has now been granted until the end of July.

Some people thought that these events might be connected with the fact that the council, as part of its fire sale of most of the borough’s capital assets, wanted to sell off the building for an estimated £1.7 million. It had initially tried to move the centre into small, unsuitable premises in a less accessible location, which had to be accessed through another charity’s premises, but it then decided to get rid of the centre altogether.

Events then take a more remarkable turn. The chair of the management committee, Kamaljit Kaur, who has an extensive background in the voluntary sector, has been trying to run the centre in an exemplary way over the past few years since taking over that role. She met the council’s director of adult services on 23 June and failed to persuade him—because his mind had already been made up by politicians—to reconsider or even to extend the centre’s tenure while alternative provision was made. We now know that there will be no alternative provision until at least April. After the failure of that meeting, she wrote a letter to carers and other interested parties, including me, in very mild terms given the circumstances. Part of her letter read as follows:

“The Council went through a tendering process for Carers Support Services and made three attempts to attract potential bidders for this contract. However, we were the only bidders for their adult and young carer’s contracts. Our bid was evaluated by the Council's TAP: our bid was successful in the adult carer’s contract and was recommended for funding by the TAP, but eventually turned down at senior officer level.

The Council have been informed that the prime reason for the lack of interest in this contract for potential bidders was the requirement to employ existing centre staff and the financial liabilities that go with this requirement. We now believe that the Council's sole intention behind closing down the Carers Centre is part of its strategy to remove existing staff, thereby removing the requirement for new bidders to take on this financial responsibility. We also believe that this will attract national organisations to bid for this contract.”

That is quite likely, because that is a method that the council has used before—getting rid of local organisations and bringing in national ones that they believe can handle matters cheaply if not as well.

The response to that letter, which also explained how people could protest about what was happening, was an extraordinary six-page letter from the director of adult services making serious personal allegations against the chair, including an allegation of an improper family relationship with someone who had a pecuniary interest in the contract. Late last night, the councillor responsible—Councillor Carlebach—and the director of community services had to issue an apology:

“Since issuing our letter of 28th June on this matter, we have received a single representation that we have misunderstood and mis-stated the position”.

They state that they are

“writing to clarify that it has now been made clear”

to them that the individual in question

“is not the brother of Kamaljit Kaur.”

The letter continues in an exculpatory way to try to excuse them for what happened. The chair informed me earlier that she now feels under an obligation to resign and is taking legal advice with a view to an action for defamation. I do not want to pursue that matter, but I simply set out those facts to show that the local authority is out of control and behaving in a highly improper way—as it is in many other respects.

Leaving aside the process, what is the effect on carers? Hon. Members might have seen in the debate pack an article from The Guardian of 16 June, part of which I shall quote:

“For 12 years, Margaret Turley has known where to go in a crisis. Eighteen months ago, when the 26-year-old learning-disabled son she cares for developed epilepsy and began going blind, Turley headed for the Princess Royal Trust Hammersmith and Fulham Carers Centre.

‘You’re among people who know what carers do,’ she says of the Hammersmith Road centre in west London. ‘I can come in here just because I’ve had a horrendous day.’ The centre provides advice and peer support, and runs a Department of Health-funded programme, Caring with Confidence, offering free training for carers who want to develop their caring skills.”

Later the article says:

“Pat Williams, who cares for her disabled son and runs the Caring with Confidence sessions, says: ‘It’s a fait accompli—get us out of the building, don’t give us the contract, and run the organisation down.’ ”

Hon. Members will not be surprised to learn that I have received an extraordinary number of letters about this matter. I will not take up too much time, but I want to read excerpts from some of them, as I think that hon. Members should realise what a serious matter this is for thousands of carers in my constituency. I shall not give names, but one letter states:

“I have been a member of Hammersmith and Fulham Carers Centre for the last 10 years and have relied on the Centre for support through all my times of crisis during those years…I am shocked and devastated at the closure of the Carers Centre…Not only will the Centre close, but there will be no co-ordinated service for carers…How can the Council close down our service and offer nothing in its place? What on earth are the Council playing at?”

The letter continues:

“I can get no sense from anybody at the Hammersmith and Fulham Council…In the meantime, where will we H and F Carers meet for our support groups? Who will we talk to when we need help? Will a building be made available to us? Without a place to come to, when we are in distress, how will we manage?”

Another carer wrote:

“Dear Andy, I am one of the borough’s many fulltime carers and have learned this week that after some 12 months of what the council has termed ‘review’, they have pulled all funding from the carers centre…My 2 sons use the services of the Young Carers Group, and get the kind of support and respite that we will not, again, find anywhere else. I feel passionately that carers are such a soft target, as our responsibilities make it so hard to mount the kind of defence of these services that they deserve.”

Another of my constituents writes:

“I care for my mother who is over 90 years, and also my daughter who is disabled. I do use the carers centre and found that the people who run it are very helpful.”

A further letter reads:

“I have been caring for my wife with severe dementia for 20 years, and the aspect that worries me most is the fact that the centre holds the emergency contact to look after my wife, if anything happened to me; an accident or such like.”

This is the letter that touched me most:

“I am an eleven year old boy. I have a brother with cerebral palsy. My dad died when I was seven from a heart attack. I love my brother so much but I had to face very difficult things. Children have made fun of me because of my brother’s condition. People that don’t understand my brother’s condition treat me differently to other people. I didn’t go on holidays. People made fun of me when I was near my brother. I missed a lot of school. I felt stressed and unsure. I was unsure if I was doing the right or wrong thing. I didn’t have anyone to talk to.

When I first went to the young carers project I made friends quite quickly. I told them my experiences and they told me theirs. The young carers project took me on trips and I was able to express my emotions and feelings. They helped me to understand bullies and that there was nothing wrong with me. They helped me realise that I did do things correctly. They also took me camping, which was lots of fun and taught me different dances for example street dancing and martial arts style dancing. It is a chill out zone for all young carers and adult carers. It gives us freedom from our caring role.

If you close the young carers project, you'll be closing a family of people who came together because of difficulties. Which is unfair for all young carers and adult carers. I just can’t believe you’re closing down the young carers project for all the good work they have done.”

There is, of course, substantial resistance to the decision. There are daily pickets outside the town hall. I have written to the leader of the council to ask him, at the very least, to extend the contract until alternative provision is in place, and to allow the carers centre to bid again for the contract. The matter was debated at full council last night on a motion from the Labour opposition, but of course that was voted down by the Conservative majority on the council. Given the exceptional circumstances that I have set out, I ask the Minister to take a personal interest and to look at the matter. I believe that the situation has arisen not simply because the council is a Conservative one; the local authority is acting without its jurisdiction, in a highly improper way.

What I have described is not an isolated incident. Some hon. Members might know about the council newspaper in Hammersmith and Fulham. Last weekend, the Secretary of State for Communities and Local Government, referring in part to the Hammersmith and Fulham council newspaper, said:

“Councils should spend less time and money on weekly town hall Pravdas…our free press should not face state competition from propaganda on the rates dressed up as local reporting.”

To read the paper in question one would think that everything was well at the carers centre. According to its front page, the leader of the council says:

“We will sell assets we no longer need because, when times are tough, we have to put services before buildings.”

Last night, the council announced a fire sale of most of the public buildings in the borough, ranging from the Irish centre in Hammersmith Broadway, which has an international reputation, to Fulham town hall and many voluntary sector buildings, including one that was referred to in the article in The Guardian, Palingswick House, which is home to more than 20 voluntary groups but is to be sold later this year.

Lest there be any doubt, the incident that I am recounting is not a mistake or isolated incident; it is a calculated attack on the poorest and most vulnerable people in the borough of Hammersmith and Fulham, in the guise of putting through a policy that was never agreed. It is being put through not just callously, but without the remit of the local authority. I ask the Minister to take a particular interest in what is happening in Hammersmith and Fulham not just because of the staff and the build-up of expertise in the past 12 years, which will be lost for ever at the end of next month if a stop is not put to what is happening, but on behalf of the thousands of people—we believe that there are more than 11,500 adult carers and many young carers in the borough—who rely on an excellent service, but will be without it from next month.

[Mr Joe Benton (in the Chair)]

Before I call the next speaker, I ask all hon. Members to ensure that they have switched off their mobile phones.

--- Later in debate ---

[Mr Burstow]

The hon. Member for Hammersmith (Mr Slaughter) made some important points about the situation in his constituency and what his local authority was doing. The hon. Member for Banbury (Tony Baldry) also made references to the impact of tendering. Those are issues to consider, but I am not going to become a Minister responsible for micro-managing every single local authority and the decisions that they take on the allocation of resources—that is not a Minister’s job. However, we do need to ensure that there are not unintended consequences with respect to the rules and procedures followed by local authorities that fall under the Government’s responsibility. I will be very happy to hear further from both hon. Members, either in this debate or afterwards, to ensure that we have the correct rules. We want to support local services that are appropriate to a local community and that the community actually values.

[Mr Slaughter]

For the avoidance of doubt, I just want to say that it is not so much the financial situation in my area that I am concerned about, because my local authority says that it will, in due course, provide a service for carers. I am more concerned about the impropriety and mismanagement that has led to a long-standing service being simply dissolved overnight although there is no provision in place for the best part of a year to come. I would have thought that that was something in which a Minister and the Government would be interested. It is not to do with involvement in individual cuts; it is to do with the fact that a local authority is unable to manage its own affairs.

[Mr Burstow]

The hon. Gentleman has been a Member for some time, so he will know that there are regulatory systems in place that would deal with local authorities that were performing in the way that he describes. I am not aware that the authority’s activity has been reported in such a way. However, I stand by the offer that I have made, and I will be happy to receive further representations about the impact of tendering arrangements.

I want to pick up on the references that were made to the operating framework because the hon. Member for Worsley and Eccles South was right to point out that, in the operating framework that the Government issued just last week, we identified a requirement in the local priorities for the publication of dementia strategies. We think that that is an important signal. It was a signal to local PCTs that we wanted them to be more public facing and accountable to their local communities, and that they should account for why they have chosen not to spend money on dementia strategies. The signal was not specifically about dementia, but that we expected more of that sort of transparency in general. People should not need freedom of information requests to get information from PCTs about how public money is being spent, and I hope that that message will be understood by our local organisations that deliver such services.

The hon. Lady also talked about ring-fencing more broadly. The Government are determined to ensure that there is as much flexibility as possible for local authorities to make choices about how they prioritise their resources to deliver what is necessary to meet the needs of their local communities. We have made it clear that because we see the social care transformation grant as such a priority for investment in changes to services, so that they are genuinely personalised in the future, the budget for the final year in which it is available to local authorities will continue to be ring-fenced. We wanted to send the signal that we considered that grant to be important, and we want to ensure that local authorities deliver that grant during the course of this year.

The hon. Lady made a number of very useful points about good practice and the way in which GPs, schools and others play a part in delivering early identification of carers, whether those carers are young, old or otherwise. That should certainly inform the thinking of any Government when it comes to delivering a good carers strategy.

The hallmark of this important debate has been the great consensus about what needs to be done and the value that Members from all parties place on carers. I shall now try to address some of the other points that have been made.

The hon. Member for Stretford and Urmston (Kate Green) talked about financial issues and benefit changes, and such concerns were echoed by others. The carers cross-government programme board, which is charged with providing cohesion around the carers strategy, will look at those issues and hold cross-government discussions about them to ensure that the way in which we go about simplifying the benefit system actually delivers the right results at the end of the day.

The hon. Lady also expressed concern about the impact of public service cuts, which was also referred to by several hon. Members. Again, it is important to remember that some of the measures that are already in place were not initiated by this Government. Nevertheless, we have to be mindful about the impact of any budget decisions that we make through the spending review process. That will certainly be at the forefront of Ministers’ thinking in the coming weeks and months as we consider all the options that will have to be considered as part of the review.

The hon. Lady also talked about the difficulties faced by carers coming back into the workplace—the cliff edge, as she described it. The coalition Government’s programme sets out very clearly a desire to improve this country’s tax system significantly so that we raise the amount at which someone starts to pay income tax to £10,000. We believe that as we move towards implementing that change, we will begin to smooth out some of that cliff edge and start to have a significant impact on easing people’s return to work.

The hon. Member for Kingswood (Chris Skidmore) made a very good speech in which he set out a number of the challenges that we face. In particular, he rightly discussed the current complexity in the benefit system and the way in which it can be an obstacle to take-up of benefits.

The hon. Member for Hartlepool (Mr Wright) made a very good speech. He set out a range of issues relating to young carers in particular, but he also raised other points. He made a very important point about the Hartlepool carers centre, which he mentioned a lot in his speech, and it clearly provides an important service in his area. He also cited the £150 million a year that it saves taxpayers by reducing pressures on NHS resources. We need to ensure that such examples of social enterprises playing a part in easing pressure on public services and helping carers are considered. Such mutual operations can really make a difference.

The hon. Gentleman, like several hon. Members, talked about the role of GPs. He also made some comments about benefits. I refer him to what I have said about how we intend to move forward on benefits.

The hon. Gentleman also asked specifically about young carers. The key point I would make is that the Department of Health is piloting personal health budgets. In my written ministerial statement on Monday, I announced how we intend to evaluate those schemes. The schemes should give us yet another way of smoothing and removing some of the cliff edge that we have heard about by providing access to resources for care and health in a way that allows people to exercise real control over them and therefore much more control over their lives. That is particularly important for managing and smoothing the transition from childhood into adulthood, and we all want to ensure that that transition is made smoother.

The hon. Member for Chatham and Aylesford (Tracey Crouch) spoke about the key issue of the identification of carers. She said that only 5% of carers in her area had been identified by the local carers centre. A large number of people are hidden at the moment and do not necessarily identify themselves as carers. The identification of carers is a key challenge as part of the process of refreshing the carers strategy.

We have heard about the importance of flexible support for carers. Again, that is why personalisation will remain an absolutely central part of how the Government take forward the development of services. Such services should be tailored to fit around people’s lives, rather than requiring people constantly to navigate around them, often for the convenience of the service provider rather than the convenience of the person or family themselves. We want to accelerate towards achieving that vital aim, and we also need increased use of more user-led organisations that are much closer to the circumstances of the family, meaning that they can play an important part in advocacy, brokerage and helping families to navigate around the system.

I think that I have already addressed the main point made by the hon. Member for Hammersmith, who clearly put on record a number of powerful testimonies from his constituents about the value that they place on the centre to which he referred. However, as I have said, I will not attempt to micro-manage the decisions of local government colleagues of any particular party persuasion, as it is for them to account to their electorate for the way in which they spend public money.

The hon. Member for Totnes (Dr Wollaston) discussed young carers and talked about the devastating impact that alcohol can have on people’s lives. She offered advice about some of the ways in which the Government might tackle that issue, such as a pricing policy, and cited advice that the NICE has given. I can tell her that we will be publishing a White Paper on public health later this year setting out the Government’s approach on such challenging issues. I hope that my right hon. Friend the Secretary of State for Health will say more about that White Paper in the not-too-distant future.

The hon. Lady also talked about safeguarding, and we have announced a review of the vetting and barring system. I am one of the Health Ministers with responsibility for safeguarding, so I will receive the recommendations from that review. We need to ensure that the system is proportionate to the risk and that it delivers the appropriate safeguards, but it must not be so bureaucratic and difficult that it actually becomes a barrier to people participating as volunteers, so that is one of the tests that we will apply to the system.

The hon. Member for Liverpool, Wavertree (Luciana Berger) talked about the USDAW campaign, as well as the importance that she attaches to the role of carers in her constituency, some of whom she has already visited. She also discussed the plight of working carers, their interaction with the benefits system and the need for an examination of tapering as a way in which people could retain an element of carer’s allowance. All I can say at this stage is that the Government are committed to reviewing the system with a view to simplifying it.

The hon. Lady also asked how we could ensure that there is greater awareness of the right to seek flexible working. Again, that is not just a challenge for the Department of Health. We will need a cross-government approach on the issue involving my colleagues in the Department for Business, Innovation and Skills and the Department for Work and Pensions. Together, we have a part to play in ensuring that people are genuinely aware of that right.

The hon. Member for Blackpool North and Cleveleys (Paul Maynard) spoke very effectively. I was in the House when he made his maiden speech and it was one of the most impressive that I have heard. I know that his speech was excellent compared with mine 13 years ago.