Carers (Identification and Support)

Baroness Keeley Excerpts

Wednesday 14th July 2010 Commons Chamber

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

I beg to move,

That leave be given to bring in a Bill to require health bodies and general medical practitioners, and certain other organisations, to identify patients who are carers or who have a carer; to require identified carers to be referred to sources of help and support and to make further provision in relation to such arrangements; to make provision in relation to the responsibilities of local authorities and schools for the needs of young carers and their families; and for connected purposes.

In April 2007, I introduced a similar Bill aimed at helping to ensure that carers and young carers were identified and referred to sources of advice and support. I am reintroducing the Bill today because, although some progress has been made, there is still much work to be done. We have a population that is living longer and living more often with dementia, illness or a long-term condition. It has become clear that more and more families are stepping in to provide full-time and high levels of care.

The 2001 census found that 10% of all carers in the UK were caring for more than 50 hours a week. Provisional figures published last month by the NHS Information Centre show that that figure has now more than doubled to 22%. In Salford, which is the local authority that covers my Worsley and Eccles South constituency, the proportion of carers providing full-time care has been at a higher level for some time. In 2001, some 24% of Salford carers provided care for more than 50 hours a week, which was more than twice the national figure for those with the heaviest caring commitments.

Carers play a vital role in helping with social care. They are key partners in care for the NHS, but their own health is threatened by caring. We know that full-time care can take a toll on carers’ health, so the health needs of carers must be recognised. Carers who care for 50 or more hours a week are twice as likely to suffer from ill health, while those caring for a person suffering from dementia or stroke disease are even more at risk of ill health. We must act to ensure that those who care for more hours than are associated with a full-time job are identified and then supported.

Early identification and support for carers means that they can maintain their health, and better manage and sustain their caring role. My Bill would require GPs to identify patients who are carers, or who have a carer, and to take the carers’ needs into account. It would also require schools to have a policy to identify young carers.

Some progress has been made over the past 10 years on identifying carers and referring them to support. We started with the first national carers strategy in 1999, when GPs and primary health care teams were given a five-point checklist for use with carers in their practice populations. By 2008, The Princess Royal Trust for Carers and the Royal College of General Practitioners had created a best practice guide and self-assessment toolkit called “Supporting Carers: An action guide for general practitioners and their teams”. GP training pilots followed, as did awareness training modules on carers in the skills for care and skills for health programmes.

Research shows, however, that the work done nationwide by GPs to identify carers in their practice populations is still inconsistent. Only a small proportion of the total number of carers is identified. Even those GP practices with good links to their local carers centres are not identifying all the carers whose health might be affected by caring responsibilities. A pilot programme in Devon that was featured at the recent international carers conference reported that one of the crucial factors in the sustainability of such work in primary care was having a lead GP in each practice to act as a strategic figurehead. The Princess Royal Trust Salford carers centre is working on that so that the lead GP ensures that their GP colleagues are on board and making the necessary referrals. Salford carers centre works jointly with many local practices and gives them access to the list of carers of whom the centre is aware. I have no doubt that such work in primary care has increased the registration of carers and is leading to positive outcomes. “Personal Social Services Survey of Adult Carers in England—2009-10”, which was the first national user experience survey of carers, found that carers in Salford whose GP knew that they were a carer reported that they always or usually felt supported by their GP.

The Bill also contains an important provision for schools to recognise the needs of young carers and their families. Young carers are the most hidden group of carers. Research conducted in May by The Princess Royal Trust for Carers found that only 40% of young carers said that their teachers were aware of their caring role. Figures in the last census suggested that 2% of all children in the UK were young carers, but it is difficult to obtain accurate figures because of the hidden nature of such caring, so the percentage could be much higher.

Young people and their parents are often silent about the extent of the support that a child provides because of guilt or fear of separation. To combat that, we need to introduce measures so that schools and local authorities recognise the problems faced by young carers. It is likely that the most vulnerable young carers will continue their caring role throughout their childhood without any support. Young carers might have parents with substance misuse or alcohol problems. The extent of that problem is not fully understood, but according to the charity Turning Point, up to 1.3 million—or one in 11—children in the UK live with parents who misuse alcohol or are problem drug users. Such children might find themselves responsible for their own and their parents’ safety. My Bill would place duties on social services authorities to consider what support services are needed to sustain the parenting role in such families. When a parent is assessed for community care services, support should be offered if it is found that the adult relies on the caring role of his or her child so that we ensure that the health, education and well-being of the child or young person are not impaired by such caring responsibilities.

Young carers may have a parent with an illness or with a learning or physical disability, and the parent may rely on the care from their child. Such children miss out on their education and can find themselves misunderstood at school. When they are missing from school due to caring responsibilities they are treated as truants by teachers and often bullied by other children. My Bill would require that both schools and local authority children’s services have written policies in place to support such young carers. The Princess Royal Trust for Carers is campaigning for schools to have a nominated lead on young carers’ issues, and this could be implemented by the Bill.

Many health and social care professionals are frustrated by the different thresholds for service provision for different client groups. An adult mental health worker may be aware of children affected by their parent’s mental health condition, but unless the children are at risk of serious harm, the health professional will probably not be able to help them, so the general duties to young carers and their families outlined in my Bill would help. A simple joint working protocol between children’s and adults’ services, combined with a training programme for staff, would help with this problem.

The measures in my Bill would ensure that health professionals identify carers and refer them to much needed help and support. My Bill is supported by Carers UK and The Princess Royal Trust for Carers. I would like to thank Carers UK and Luke Clements for helping me to draft the Bill, and Gordon Conochie of The Princess Royal Trust for Carers for his input. I would also like to thank Julia Ellis and Dawn O’Rooke from The Princess Royal Trust Salford carers centre, whose work has created an excellent example of good practice in identifying carers within primary care.

I thank you, Mr. Speaker, and the House for giving me the opportunity to present the Bill today.

Question put and agreed to.

Ordered,

That Barbara Keeley, Diana R. Johnson, Andrew Gwynne, Ann Coffey, Kate Green, Nia Griffith, Luciana Berger, Mr. David Anderson, Tony Baldry, Annette Brooke and Caroline Lucas present the Bill.

Barbara Keeley accordingly presented the Bill.

Bill read the First time; to be read a Second time on Friday 12 November 2010, and to be printed (Bill 55).