Carers

Baroness Keeley Excerpts

Thursday 20th June 2013 Commons Chamber

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

The number of carers is growing, as is the impact of caring on the lives and health of carers. The right hon. Member for Sutton and Cheam (Paul Burstow) has touched on some of those issues, but I will go further.

Analysis by Carers UK of data published from the 2011 census has shown that the number of carers has increased substantially, by 11%, since 2001, and there are 35% more carers over the age of 65. We know that carers often combine paid work with raising their own children, as well as caring for other family members. In fact, one in four women and one in six men aged 50 to 64 have caring responsibilities for family members who are older or disabled. If we think about that for a moment, we start to realise the difficulties. Of course, many of us know people in that situation, or may be in it ourselves. Some 3 million carers juggle caring with paid work, so it is not surprising to learn that full-time carers are more than twice as likely to be in poor health as people without caring responsibilities.

Given all these stresses, carers should be getting advice and information to help them care, but it is becoming ever clearer that they are not. During the recent carers week, to which the right hon. Gentleman referred, Members met carers to find out about their issues. Last week I went to a speed networking event, as I think it is called, here in the House, at which I met six carers. Two were carers of family members with cancer, two had cared for a partner or family member at the end of their life, and two were carers of spouses with Parkinson’s. Despite the differences in their caring, the one thing they shared was not having been given the information, advice and support they needed to be carers. As the right hon. Gentleman touched on to an extent, Macmillan Cancer Support tells us that carers of people with cancer come into contact most with health professionals, by whom they need to be identified and signposted. However, 95% of cancer carers are not getting a carers assessment.

It was revealing to talk to carers of people with cancer about how this had affected them. Cancer patients, as we know, may have long days of treatment in hospital, yet no one had told the carers I spoke to that a discount was available on expensive hospital car parking costs. One of the carers had to buy a hospital bed for use at home by her daughter, yet she was given no advice on where to buy one.

Similar issues crop up for carers of people with a terminal illness, but those carers are also juggling with the knowledge that they only have a limited time with the person for whom they are caring. Carol and Lucy were the two carers I met. One had cared for a partner and the other for her mother, both through to the end of their lives. Both said how much financial hardship they had had to accept to undertake that caring. The carer of her terminally ill mother could only get unpaid leave from her job and took it for 11 months. She lost her flat because she could no longer afford to pay the rent. It seems wrong that carers have to struggle on unpaid leave while caring for someone who is terminally ill. She never told her mother that the leave was unpaid or of the difficulties she was having.

Carers of people with cancer and of people who are terminally ill both cited the same issue: as carers, they were mainly ignored by the health professionals they encountered. They rarely asked them if they were coping and they did not signpost them to carers centres or carers associations for help and advice. In the cases of the very few carers of people with cancer who managed to have a carer’s assessment, that had most often been prompted by a referral from a GP. As the right hon. Member for Sutton and Cheam says, 70% of cancer carers surveyed had come into contact with a GP, doctor or nursing staff, but they are in the health world—the NHS world—not the local authority world. Very few of them have contact with local authority staff.

I think I met the same people at the event as the right hon. Gentleman, because I met John and Karen, who were each caring for a spouse with Parkinson’s. We have already heard some of the points that those carers made, but John said:

“In more than 30 years caring for my wife, my own GP has never asked how I am. He provides excellent support for my wife, but has never asked me how I am coping as her carer”.

Karen cares for her husband, who has Parkinson’s and was diagnosed only shortly after they were married. She says:

“I gave up work to help support him. I’ve never been told about a carer’s assessment nor has my GP asked how I am. It’s as if you are invisible.”

Parkinson’s is a long-term condition, but despite the fact that they might be caring for many years, only one in 10 Parkinson’s carers have been offered a carers’ assessment. Parkinson’s UK tells us that most are full-time carers, caring for someone for more than 50 hours a week—even up to 24 hours a day as the Parkinson’s progresses. Such carers are those most in need of advice, support and respite care or breaks.

That all matters because the Care Bill puts great emphasis on carers’ assessments rather than the identification of carers and the need to signpost them to sources of advice and support. Last September, I introduced a private Member’s Bill, the Social Care (Local Sufficiency) and Identification of Carers Bill. Three sponsors of that Bill are in the Chamber. The Government, sadly, did not support my Bill and their Back-Bench Members talked it out. The clauses on the identification of carers would have ensured that NHS bodies had the procedures in place to identify carers, promote their health and well-being and ensure they receive information and advice. Those are the exact areas from which the carers to whom I have talked would benefit. As I said during the debate on the Bill, I believe that the key focus in identifying carers should be those with the heaviest caring commitments.

The 2001 census found that 10% of all UK carers were caring for more than 50 hours a week. By 2011, that figure had more than doubled to 22%. It is worth noting, as I said during the debate on my Bill, that the proportion of carers in Salford who provide full-time care at that level has been higher for all of the last decade. It has not just changed, and I am sure that it is related to health inequalities.

Two wards in my constituency have high numbers of people caring for people with stroke disease, heart disease or cancer, which means that they have the heaviest caring commitments. We know that full-time care can take a toll on the carer’s health, and the health needs of those carers must be recognised. We know that those caring for more than 50 hours a week are twice as likely to suffer ill health and that those caring for a person with dementia or stroke diseases are even more at risk. Early identification and support for those carers would mean that they can maintain their health and sustain their caring role better.

The Carers Trust has a centre in Salford with a project to identify carers within primary care and at the Salford Royal hospital. Let me take this opportunity to pay tribute to that centre for its work in identifying carers, which it has been doing within primary care for many years. GPs and primary health care teams in my constituency have started to tackle the task of identifying carers, but there is much more to do. The manager of the centre tells me that having established a network of links within GP practices to identify carers, local GPs made 300 referrals last year, but we have 20,000 carers in Salford, 5,000 of whom will be caring at the heaviest levels. So we need to ensure that health bodies take action that meets the scale of the task of identifying carers and referring them to advice and support.

Young carers are the most hidden of all carers, and my Bill would have required local authorities to have a policy in place for identifying young carers and providing support for pupils in schools who are young carers. It would also have placed a duty on colleges of further and higher education to identify students who are carers and have in place policies to support them. Young adult carers at university or college have to balance giving care with their academic studies and learning. Some do that by caring at a distance, returning home at weekends or holidays to provide care, whereas others have to balance care and study by continuing to live at home and travelling to their local university so that they can maintain their regular caring roles. Hardly any of the carers I have talked about in my speech are in contact with local authorities or are likely to have had a carers assessment from a local authority. So the duty on carers assessments in the Care Bill would not help the carers I have met recently—the carers of people with cancer or of people who are terminally ill. And, as I have said, the local authorities are reaching only one in 10 of carers of people with Parkinson’s disease.

Young carers are also not being reached or supported adequately. The Carers Trust feels that the current law surrounding identification, assessment and support for young carers is complex and incoherent. Young carers are vulnerable and compared with other children they are at risk of poorer outcomes if they take on excessive and inappropriate caring roles because the adult’s needs are not being met. We know that inappropriate caring roles have an adverse effect on a child’s educational and emotional development.

The current position we have reached on that issue is most unsatisfactory. In its evidence to the Joint Committee on the draft Care and Support Bill, the Law Commission made it clear that it felt that young carers should be given the same rights as adult carers, so that the Bill became a single statute covering carers. Yet, young carers still do not have the same rights as adult carers in the Care Bill and there is no mention of them at all in the Children and Families Bill. That is not acceptable. The care services Minister and the children’s Minister have been making reassuring noises about meetings they have had to discuss this and about their intentions, but they have so far ignored a cross-party consensus among MPs and peers that they should act to improve young carers’ lives. Young carers should not be left with unequal rights compared with adult carers.

[The Minister of State, Department of Health (Norman Lamb)]

The hon. Lady said that we have so far ignored what she has been arguing for in terms of action. I just wanted to reassure her that I have absolutely not ignored that. I have said, I believe in the debate on the Queen’s Speech, that I would seek to meet the Minister dealing with the Children and Families Bill, and I have done that. I take the point the hon. Lady makes very seriously and I want to see action to address the concerns that she and others have raised.

[Barbara Keeley]

I thank the Minister for that point, but I have to tell him that he and the children’s Minister have to start to accept that making reassuring noises and having meetings is not enough.

[Paul Burstow]

The hon. Lady is absolutely right to be pushing this issue forcefully. We were given a commitment by the Under-Secretary of State for Education, the hon. Member for Crewe and Nantwich (Mr Timpson) last week that amendments would be drafted, and presumably they will be tabled in the House of Lords. It would helpful for us to know, and to hear from this Minister, that the Government will shortly be publishing the amendments that will be made to the Care Bill as well as those that will be made to the Children and Families Bill.

[Barbara Keeley]

I thank the right hon. Gentleman for that point. I am, however, going to push the matter with the Minister because there was an opportunity in this regard. New clauses were moved during the remaining stages on the Children and Families Bill last week that were copies of clauses from my Bill, and they would have required those bodies that I talked about to have policies in place. We are not talking about a large financial commitment; we are talking about bodies having policies in place. Our schools, our colleges and our higher and further education institutions should have policies in place to recognise young carers, but up and down the country they do not have those. The disappointment that organisations outside here that support young carers will have felt results from the fact that the debate was managed last week so that those new clauses were not reached. That does not show good faith, and if I were a member of the coalition of organisations that support young carers, I would look at that and say, “I don’t know what the Government are going to do.” The Minister will have to accept that they are still disappointing people who have not been protected sufficiently by the law.

I conclude by touching quickly on the financial context of social care and how it affects carers. Giving carers rights in the Care Bill is indeed a positive step, but the Local Government Association reminds us that the Government’s austerity programme and the need for further savings do not fit well with the aspirations of the Bill. Councils have had to reduce their adult social care budgets by 20% over the past three years. At least a quarter of those cuts are from reductions in services and increases in charges. Almost 90% of councils only meet needs that are at the substantial or critical threshold.

Staff at our local carers centre told me that carers are being affected by the bedroom tax, the increase in the value of non-dependent deductions, fewer sources of grant funding, and reductions to care packages that appear to be driven by cutting costs, not by changes in need. That is particularly true where they are caring for somebody with a learning or physical disability. Worries continue into the future when the change from disability living allowance to the personal independence payment starts to affect carers. The Government’s own impact assessment published in February indicated that almost 10,000 fewer carers will be entitled to carers allowance by 2015 as a knock-on consequence of the loss of disability benefits following the introduction of PIP. Carers UK has calculated that this represents a £31 million cut in support to carers. We should bear in mind that if those carers were left unable to care as a result of not having access to those carers benefits, replacing the care that they provide would cost at least £300 million in replacement adult social care services. That is a serious point.

This morning I asked a question about the loss of £28.3 billion of income for disabled people over the next five years through the combination of the welfare changes being made. We must take on board the fact that that loss of income will hit the carers of those disabled people. Carers, as we learned during carers week, are prepared to care. We must do better in supporting them.

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[Sir Tony Baldry]

That is an extremely good point. These things are organic. A few years ago big employers such as Sainsbury’s would not necessarily have been involved in that way. Having been involved in carers policy over the years, what I find encouraging is that each year a further step is achieved.

[Barbara Keeley]

I had not intended to make this point earlier, but I will make it now because so much has been said about employers. The Independent Parliamentary Standards Authority does not allow MPs’ staff to take compassionate leave; it allows MPs to give only sick leave or maternity leave, as I discovered late last year. Given all the good work that has been done with employers, that is an issue the whole House should take forward.

[Sir Tony Baldry]

One of the non-executive members of the IPSA board will shortly be work-shadowing me for a day, so I will certainly raise that valid point with her. I will give her lunch, out of my own taxed income, along with other colleagues who might want to talk with her, and the hon. Lady would be very welcome. I think that the board’s non-executive members have to take some responsibility for the way IPSA functions.

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[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

I congratulate the right hon. Member for Sutton and Cheam (Paul Burstow), the hon. Member for Banbury (Sir Tony Baldry) and my hon. Friend the Member for Worsley and Eccles South (Barbara Keeley) on organising this debate. I am grateful for the opportunity to speak after such thoughtful contributions. I want to focus on unpaid carers; I will leave others to talk about the care system as a whole.

As we have heard, carers play a vital role, not just for their family members and friends but for the country. In the past decade, the number of carers has grown from just under 5 million to nearer 7 million. By 2037, it is estimated that the number will have increased to nearly 9 million. In my constituency, there are 11,076 unpaid carers, nearly a quarter of whom provide care for more than 50 hours a week. As has been said, we know that this is an underestimate of the actual number who provide care. My hon. Friend the Member for Worsley and Eccles South talked about the lack of information and advice, which has certainly been identified in my constituency. Age UK in Oldham recently opened an information and advice centre, and I hope that people will avail themselves of that. Like other Members, I, too, have had the plight of carers increasingly brought to my attention in my surgeries. Their situation is a growing problem.

In today’s terms, the role played by carers saves the economy £119 billion a year. That is more than the total NHS budget and nearly six times the adult social care budget. The country could not survive without the work that carers do, and that is even more so today, with the crisis that social care is facing. We are facing the double whammy of an ageing society—it is great that we are, on the whole, living longer, although austerity is certainly having an impact on life expectancy—and a meltdown in social care in local authorities, with cuts to their budgets having an impact on social care budgets. Unfortunately, carers are picking up the tab. A recent Carers UK survey showed that a third of those caring for more than 35 hours a week have no support at all. Although 3 million carers juggle work with caring responsibilities, one in five has been forced to give up work.

In addition to the lack of support for caring, carers across the UK are starting to see the impact of the Welfare Reform Act 2012. Changes to financial support with housing and council tax in some areas mean that many families are experiencing reduced financial support from more than one of the changes. The discretionary funding set aside by councils to support people affected by the bedroom tax is enough to help only one in 10 disabled people. Carers who require an additional room because they cannot share with partners who sleep in hospital beds, or parents of disabled children who need the space for care workers to provide overnight care are being seriously let down. More than 5,000 families with care needs are faced with either moving or finding an extra £700 a year.

The cumulative effects of the economic downturn, a squeeze on wages and the increasing costs of essentials such as food and fuel, along with the cuts in social security support, are making it more difficult for carers to manage. More than four in 10 carers in the Carers UK survey said they had been in debt as a result of caring. This year will see other changes to the benefits system, as the transfer of disability living allowance to the personal independence payment and the universal credit are introduced, which is also of considerable concern to many carers. DLA was the gatekeeper to carer’s allowance. The changes mean that 10,000 fewer carers will not be entitled to carer’s allowance. Many of us have already called on the Government to review these changes and undertake a cumulative impact assessment of the effects of these welfare reforms. For many, they will be the tipping point.

In addition to that, and as a consequence of debt and a lack of support, there are significant effects on the health of carers. Eight out of 10 carers report that their caring role affects their physical health and nine out of 10 say that their mental health has suffered. This is not only a human tragedy; we are storing up problems for the future by not caring for our carers.

I know about that from my personal experience of caring for my mum—I have spoken about her before—who died of Alzheimer’s last September. She had Alzheimer’s for 10 years, and for the last three years was unable to communicate or to feed or toilet herself. Although my mum lived in the States, I provided respite care during leave, so I can personally attest to the physical and emotional toll that it had on me. In the last few months of her life she was bedridden. I am little, but I am fairly fit and strong, yet physically trying to lift her to bathe her or change her continence pads was something I found really difficult to manage. The worst thing was the emotional toll, however, as I worried how everyone was coping.

I want to spend the last few minutes talking about young carers. One of the last research projects I worked on before I was elected to this place concerned the effect on young carers’ health of their caring role. Many people will be surprised to learn that, according to recent census figures, there are more than 178,000 young carers in England and Wales. Those are the official figures, but we know that they are an underestimate. Children as young as five are looking after family members who are physically or mentally ill or disabled, their roles ranging from doing household chores to providing nursing or personal care.

The effects on those children and young people are immense and lifelong. Because of their caring responsibilities, nearly a quarter of young carers often miss school or have educational difficulties. Young carers are also more likely to grow up in poverty, to be socially excluded, to have low aspirations and achievement and to have relationship issues. Those problems can follow them throughout their lives. There is also evidence of significant effects on their physical and mental health, with anxiety, depression and self-esteem issues being particularly prevalent. It has been shown that, after a year of caring, morbidities fail to return to pre-caring levels.

Services do not always respect young carers and the role that they play. My research indicated that many young people felt excluded from discussions about their family member’s care, even though they were providing much of it. Some of the responses to questions on whether the young carers should be allowed to see their parents in hospital, for example, were quite heartbreaking. Similarly, many young carers felt that there was a lack of understanding and support from their teachers and schools. I echo what my hon. Friend the Member for Worsley and Eccles South said about this. We must ensure that schools take seriously their role in supporting young carers.

[Barbara Keeley]

I have mentioned the fact that we have a young carers project in Salford that is doing great work. It was interesting, however, that one of the schools involved came back to the project and said, “We have no young carers at all”, when the project knew that it did. The perception among some head teachers is that they do not have any. Is my hon. Friend worried about that as well?

[Debbie Abrahams]

I totally agree with my hon. Friend; that is very worrying, and we must try to do better by those young people.

I am encouraged by what the Minister has said today about the discussions, but I reiterate my hon. Friend the Member for Worsley and Eccles South’s sentiment that warm words are not enough. Will he tell us when we can expect to have the amendments included in the Children and Families Bill? The rights of parent carers of disabled children are also still in limbo, and the Government must bring forward changes to the Bill to ensure that the rights of that group of carers are not left behind. I recognise the Government’s commitment to carers’ rights, but I reiterate my earlier remarks: no matter how much we legislate for assessing carers’ needs, it is meaningless without the means to implement it. Local authority budgets have been pared to the bone, and that is having an impact on social care budgets. How are we going to deliver those assessments? A further £800 million of cuts are planned for this year alone. I would be grateful if the Minister would address that point as well.

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[Steve McCabe]

I think I probably would agree with that, although the right hon. Gentleman must recognise that the Government are moving increasingly towards systems that do not allow for face-to-face exchange. I understand that that is one of the major disputes about what is happening in the DWP. I think it would make classic sense, however. All of us hear enough about joined-up government, and this is one area where a bit of joined-up government could save money and provide a much better service.

[Barbara Keeley]

I was at an event the other day—as was the shadow Minister, my hon. Friend the Member for Leicester West (Liz Kendall)—at which somebody from the DWP was talking about this issue. They said they had tried a project to get their data to talk to the local authority’s data, but had given up because the local authorities all used different forms. That seemed to me to be appalling. The Minister might like to think about whether there could be guidance for local authorities. If local authority forms are all that is stopping this vital sharing of data, it is about time we dealt with that.

[Steve McCabe]

One of the penalties of having been a Member of this House for quite a long time is that we get fed up with hearing such excuses. We know fine well they are nonsense; if we want it to happen, we can make it happen. That is the approach we should take.

My hon. Friend the Member for Corby (Andy Sawford) talked about older carers and carers who have been caring for older relatives, and I want to touch on one particular aspect of that. What will happen under the Government’s deferred payment equity release plans to surviving spouses who are carers, or elderly children caring for even older parents—it is not uncommon these days for a 70-year-old to be the carer for somebody who is 95 or 96, for instance? What rights will they have? In such situations, when the person who is being cared for enters residential care, what will happen to a carer whose name is not on the deeds of the house, although it may be their family home and they may well have lived there since marriage, or even childhood?

We must ensure that these carers do not end up homeless, destitute individuals with no pot of money to support them when they end up needing care themselves. I am not sure that the deferred payment scheme as currently structured takes account of the risk for those carers, and it would be the cruellest of rewards if, after a lifetime of care, we left them in this predicament.

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[The Minister of State, Department of Health (Norman Lamb)]

I am grateful to the shadow Minister, the hon. Member for Leicester West (Liz Kendall), for her thoughtful speech, much of which I agreed with. This has been a thoughtful debate in which many good points have been made and I thank Members for raising this very important issue. Many Members who have taken part in the debate have been long-standing advocates for carers and I welcome their interest and commitment. I completely understand why various Members constantly pursue issues such as those to do with young carers and will not accept my determination to help with that problem until it is dealt with. I accept that that is their role and it is their right to do so. The debate has been a good one and I pay tribute to my right hon. Friend the Member for Sutton and Cheam (Paul Burstow) for securing it, together with his colleagues, and for all the work and championing he has done over the years for carers.

Let me make a preliminary point. Some of the Opposition speeches, including that made by the hon. Member for Stalybridge and Hyde (Jonathan Reynolds), focused on the difficult financial circumstances for local government, the impact of welfare reforms and so on. We could have a partisan battle about the issues, condemning the Government and so on. However, the shadow Minister recognised at the start of her speech the scale of the challenge we face, not just today but in the future. The numbers of people growing older with care needs, often with multiple conditions and a mix of mental and physical health needs, just keep growing. If we are all honest, both in this Chamber and with the public outside, we must admit that any Government of any political persuasion would face this challenge.

There is no easy solution. We cannot just find a magic pot of money to throw at the problem. There is an obligation on us all, as the shadow Minister made clear, to find ways of using the money we have available much more effectively than we do. We know that there is massive waste in the system because of the care silos—between health and social care, between mental and physical health and between general practice and secondary care. There is an absolute obligation on us all to engage in a debate about using money more effectively to achieve better care and support for people and to ensure that the system remains sustainable. I want to ensure that we elevate the debate by recognising the challenges we face.

The speech made by my hon. Friend the Member for Truro and Falmouth (Sarah Newton) was, I think, really valuable. Ultimately, we need collaboration among statutory services, which should not abandon their responsibilities, the voluntary sector and, crucially, people—that is, the community, families, neighbours and friends. We need to unleash particularly the power of the many people who have entered retirement fit and healthy and want to give something back, but often do not know how to do so. An army of people out there are able and willing to help to meet the enormous challenges. Some of the schemes that my hon. Friend the Member for Truro and Falmouth alluded to in her county are happening in many parts of the country, and they point us to a better future—a more caring future, where community strength is rebuilt.

I wish to join everyone else in this debate in paying tribute to the extraordinary work that carers do, giving of themselves; it is self-sacrifice, and they get no plaudits from anywhere else. They are just committing to helping someone they love, often doing so in challenging and troubling circumstances, particularly where dementia is concerned, as the loss of recognition can be very distressing for a loved one. We also know that many carers are themselves frail, struggling to cope on their own. My hon. Friend the Member for Ceredigion (Mr Williams) mentioned the challenges in rural areas. My constituency of North Norfolk contains many elderly people who are often living in isolated communities and are struggling to get access to the services they need. We owe an enormous debt of gratitude to the work of every carer in our community. As we have identified in this debate, without carers the cost to the public purse would be enormous.

I therefore very much welcome this debate, coming, as it does, immediately after carers week. It gives us the opportunity to discuss how carers of all ages can be properly supported in their role and helped to have a better quality of life. That is what we should be focusing on: putting quality of life and well-being at the heart of the Care Bill. We should not be thinking about what service we deliver to passive recipients; we should always be thinking, “How do we make your life better? How do we make you happier in your life? What might you, as an older person, be able to offer to other people?” It should be about that, rather than about these people sensing that they have nothing more to offer and just facing dependency as they move towards the end of their life in a rather distressing way.

Carers are central to the Government’s proposals for improving care and support. The Care Bill, currently being discussed in another place, puts carers on the same footing as those for whom they care. We propose to simplify the assessment process for adult carers by extending their right to an assessment. The hon. Member for Birmingham, Selly Oak (Steve McCabe) made an absolute point: people need simplicity and they must not be faced with bureaucratic jungles to fight their way through. Our simplified procedures will consider the impact of caring responsibilities on the carer in order to help them to lead as independent a life as possible. We intend to remove the requirement that a carer must be providing

“a substantial amount of care on a regular basis”—

that is the test—in order to be entitled to an assessment. That will mean that many more carers—in essence, all carers—will be able to access an assessment. In addition, the Care Bill seeks to place a new duty on councils to meet carers’ eligible needs for support. Those measures will be underpinned by a Department of Health commitment to provide new resources for carer assessment and support, rising to £175 million per annum by 2020.

[Barbara Keeley]

Has the Minister really taken on board the message that has come from my colleagues in this debate, which is that assessment is not always the answer? A lot of carers do not go near local authorities and are not likely to know of, hear of or ask for an assessment. The people they are in contact with are GPs, doctors and nurses, so there must be much more onus on the NHS and its staff to undertake the task of identifying carers at the earliest stage and ensuring that they get information, advice and support.

[Norman Lamb]

The hon. Lady asks whether I have taken that message on board—I could not have missed it. I totally agree with what has been said and I am going to discuss the role of health professionals.

I know that there is a lot of concern about young carers, and it comes particularly from the hon. Lady. I said in the Queen’s Speech debate that I would meet the Under-Secretary of State for Education, my hon. Friend the hon. Member for Crewe and Nantwich (Mr Timpson), who has responsibility for children and families, and I have done so. I appreciate that until something concrete happens the hon. Lady will, rightly, keep pressing. I give her my assurance, again, that I understand and accept the case she is making. My hon. Friend the Minister and I are entirely clear that our joint aim is to ensure that young people are protected from having to undertake excessive and inappropriate caring responsibilities. During debates on the Children and Families Bill, he confirmed that he and I are of one mind on the need to protect young carers by using a whole-family approach to the assessment of adult care needs.

The Care Bill itself is not the place to go into the detail of how assessments should be conducted; that will be set out in regulations and statutory guidance. A whole-family approach will undoubtedly benefit children, but I am keen that it also encompasses other significant family relationships. We need to look genuinely at the whole family, whatever the relationships are between those receiving care and those giving it.

In last week’s debate, my hon. Friend the Minister confirmed that his Department will look at what it can do to remove any legal barriers preventing young carers and their families from receiving the support they need, and how we can ensure that children’s legislation works with adult legislation to support the whole family. I am clear that we have to address the concerns, and while we significantly advance the position of adult carers, we cannot leave young carers behind. The approaches do need to be different, because we need to recognise philosophically that children should not be caring inappropriately. Of course sometimes they have to do that, but we want to relieve the caring burden as far as is possible, while recognising that sometimes there will be a caring role for some.