(14 years, 5 months ago)
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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.
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.
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.