Carers Action Plan 2018-20: Supporting Carers Today

Baroness Manzoor Excerpts

Thursday 21st June 2018 Lords Chamber

[Baroness Manzoor (Con)]

My Lords, I congratulate my noble friend Lady Redfern on securing this important debate and thank all noble Lords for their powerful contributions. It has been a very thought-provoking and considered debate. However, I note that of the 10 speakers in our debate the noble Earl, Lord Listowel, was the only the noble Lord speaking. I am personally grateful for his insight as a carer in this debate.

As my noble friend Lady Redfern, the noble Baroness, Lady Pitkeathley, and the noble Earl, Lord Listowel, have all so elegantly expressed, caring for a relative, friend or neighbour is something that many people do. In fact, around one in 10 adults in the UK is currently providing significant unpaid care, many of whom are women, as the noble Baroness, Lady Brinton, said. Carers do an amazing job. I pay particular tribute to the noble Baroness, Lady Pitkeathley, for her work over the last 30 years in supporting carers, caring for them and raising issues that they have faced. Thank you.

To the people whom they care for, carers are the indispensable family member, friend or neighbour who makes each day possible. I know, because I too am a carer. To health professionals, they are the experts-by-experience, who turn treatment plans into reality. Being a carer can be rewarding but, as we have heard from across the House, it can also have substantial negative impacts. We need to support and recognise carers and help them to provide care in a way that allows them to invest in their own health and well-being, employment and other life goals, as the noble Baroness, Lady Wheeler, highlighted. We fail to do so at our peril.

Our population is ageing, and growing at an unprecedented rate. One estimate suggests that the number of disabled older adults receiving informal care in England will increase from around 2.2 million in 2015 to around 3.5 million by 2035. In the UK, this care is worth billions of pounds to the economy each year, as the noble Baroness, Lady Pitkeathley, reminded us.

The cross-government Carers Action Plan is an essential step towards realising our commitment to carers, and I am grateful to all noble Lords for recognising that. As noble Lords have said, it makes a bridge. It sets out a two-year programme of targeted work to support unpaid carers, focusing actions around five themes. First, it focuses on the importance of carers being recognised and supported by public services, which is essential. I know how important that is. My noble friend Lady Redfern as well as the noble Baroness, Lady Tyler, my noble friend Lady Browning and the noble Baroness, Lady Gale, among others, alluded to this. Carers often have extensive contact with the health and care system, and we are seeking to improve awareness and understanding among health professionals and social workers so that they can help to identify carers and be proactive in helping them and providing them with support and information.

The Care Act introduced important new rights for carers, giving them a legal entitlement to assessment of, and support for, their needs. But I have heard that these are not being consistently applied. That experience has been identified by my noble friend Lady Browning, as well as the noble Baronesses, Lady Pitkeathley, Lady Tyler and Lady Gale. The noble Baroness, Lady Gale, also stressed the importance of data collection—because, if we do not have proper data collection, we do not know who the carers are and how we can care for them—particularly in relation to Parkinson’s. Of course, I shall look very carefully at the recommendations in the APPG report that she mentioned to see what we can take forward and learn from. Because of the variation, we have committed to working with local government on a sector-led improvement programme to focus on the implementation of these duties.

A number of noble Lords alluded to mental health and respite care, and it is a key concern. The noble Baronesses, Lady Brinton and Lady Tyler, highlighted the importance of what more needs to be done in this key area. We know that carers often report feeling tired and less resilient, both physically and mentally. A recent report by Carers UK, which noble Lords have cited, found that one-third of carers felt that poor mental health would mean they will be able to provide less or no care in future. Young carers need to be supported particularly to take a break, refresh and re-energise, as much as older carers—and we must not forget that. The noble Baroness, Lady Brinton, highlighted the importance of this. That is why, since 2015-16, we have allocated £130 million funding per year through the better care fund to support carers’ breaks. I take on board the issues around disability and the funding that may be needed, and I shall, of course, feed back concerns that the noble Baroness, Lady Brinton, raised, to the department.

Through the Carers Action Plan, we have committed to funding a project to promote best practice. I know that the noble Baroness, Lady Tyler, said that, when looking at rural areas, she did not want Ministers to say, “We’re just going to disseminate best practice”. I will come on to her quite specific question, but we are looking at what is best practice, what works and how we can disseminate that much better than I think we are currently doing. This is so that we can ensure that carers receive the support to which they are entitled and need. A number of noble Lords mentioned the funding gap and palliative and respite care. I agree that we need to address this issue and recognise the challenges that are being faced. That applies also to Parkinson’s, dementia and drug addiction, which were mentioned.

The action plan considers employment and financial well-being, which I know the noble Baroness, Lady Tyler, in particular, highlighted. Many carers juggle work commitments with their caring responsibilities, but it is rarely easy or straightforward. The cost of caring can be life changing. Those caring for more than 20 hours per week, as the noble Baroness, Lady Pitkeathley, highlighted, have average incomes around 10% lower than non-carers. In some cases, professional careers can be delayed, curtailed or never even start. The action plan sets out our commitment to raising the profile of carers with employers to encourage them to be more flexible in their employment practices. The Department for Business, Energy and Industrial Strategy has established a flexible working task force to improve the recruitment, retention and progression of carers and other groups. We are also considering the question of dedicated employment rights for carers. I think it was the noble Baroness, Lady Tyler, who asked about statutory pay and, as we look into these issues even further, we will take that into consideration.

As my noble friend Lady Redfern stated, the Carers Action Plan will also consider how we can better support young carers. This was raised across the House, particularly by the noble Baroness, Lady Brinton, and the noble Earl, Lord Listowel. As they will be aware, in 2015, we changed the law relating to young carers and now they are all entitled to an assessment of their needs for support, the same as for the person for whom they care. Noble Lords are quite right to say that it is one thing having something in place and entirely another ensuring that carers know about what is available. I was not even aware of this provision and, as I have stated, I am a carer. We need to make sure that the message gets out into the community much more than it does currently.

As I have said, while some caring can be rewarding for young carers, research shows that they can experience poorer mental and physical health and miss out on opportunities in education and employment as a result of their caring responsibilities. The actions in the plan focus on improving the identification of young carers and providing them with better support to access services. There will be a review to look at best practice in this area. I was really quite moved by what my noble friend Lady Redfern said, because I entirely agree with her that young carers are the hidden army.

The plan also considers how carers can be supported by the wider community but, before I move on to that, there were some specific questions raised by the noble Baroness, Lady Brinton, and the noble Earl, Lord Listowel, regarding foster carers, which is an important issue. There are many extraordinary families fostering children; they selflessly devote their lives, relationships, resources, experiences and homes in order to provide love, care, support and stability to the country’s most vulnerable and traumatised children, often for many years. In February, the report of an independent review led by Sir Martin Narey and Mark Owers was published. This makes recommendations about what can be done to make foster care more effective and the Department for Education is considering how to take these recommendations forward.

I want to tackle the issue of carers often feeling isolated or ignored. As I have already said, carers are crucial to the wider community and the economy and we recognise that we need to better support their role. Carers rightly describe the practical frustrations they face—such as difficulties in trying to access services at times that do not fit within regular working patterns—which make their caring roles more challenging than they need to be. We need to address this and it should be easy to do. To that end, we will be launching a £500,000 carers innovation fund to find creative models of support, such as the use of technology to assist caring responsibilities. I know how frustrating it was for a member of my family who needed carer responsibility for an older member of the family. They needed to have technology in case that older member of the family fell out of bed, or so that they could just take a few hours when they knew that they were safe and go to the shops without fear. That simple technology, when it was brought to their notice, helped them, because they knew that there was a helpline to call. We know that carers can feel very isolated and lonely, and this needs to change. We will ensure that, across government, through the loneliness strategy, the needs of carers are carefully considered.

We know that there are gaps in our knowledge about the experience of carers across the country. The action plan sets out the ways in which we will work to develop the evidence base by funding more research into the drivers influencing carers. This will ensure that future policies can do full justice to the role that carers play.

While the action plan sets out the practical actions that we intend to take over the next two years, we recognise that there is still more to do. That is why the needs of carers will be central to the forthcoming Green Paper. Although I am, like other noble Lords, disappointed that it will not be available sooner, I understand the rationale behind its slight delay, because we need to ensure that there is success within it. This point was highlighted by my noble friend Lady Browning and the noble Baronesses, Lady Pitkeathley, Lady Tyler, Lady Jolly and Lady Wheeler.

The Green Paper will be key in how we move further forward and in the integration of the carers strategy. Our ageing society means that we need to reach a longer-term sustainable settlement for social care, and further reform is required to meet this challenge. The Government, as noble Lords know, have committed to publishing the Green Paper in the autumn, setting out proposals for reform. This is so that the plans for social care can be integrated with the new NHS plan, which will be published around the same time. The Green Paper will build on the additional £2 billion over the next three years that we have already provided to meet social care needs. I recognise the points made by my noble friend Lady Browning, the noble Baroness, Lady Pitkeathley, and others about the need for the funding of carers to be revisited, perhaps by the twice-yearly review that will take place as we look at evidence and take on board the action plan and the gaps in services that there might be.

I turn briefly to specific questions raised by noble Lords. The noble Baroness, Lady Tyler, asked about access in rural areas. By passing the Care Act, the Government established the national threshold that defines the care needs that local authorities must meet. This eliminates the postcode lottery of eligibility across England. That applies equally in rural areas. She also raised carers’ respite in rural communities. Local authorities have a duty to offer information and advice to carers, including signposting carers to support, be that through the council directly or through local voluntary organisations. Of course, this is equally true in rural communities as in urban areas.

The noble Earl, Lord Listowel, asked about policy on carers in Parliament. The All-Party Group on Carers brings together carers from across the political spectrum to promote awareness and share knowledge and understanding of the needs of unpaid carers in Parliament. I am afraid I do not know too much more about its work, but of course the noble Lord can seek further information.

The noble Baroness, Lady Brinton, said that short breaks and respite care for children should be included, and I addressed that issue in my earlier remarks. However, like her, I agree that funding is absolutely crucial to be able to give those breaks, and we need to look at that area. Although I indicated that we have made some money available, we need to assess whether those resources will be sufficient in the longer term.

The noble Baronesses, Lady Gale, Lady Brinton and Lady Wheeler, raised issues around amendments to benefits to ensure that they meet specific needs. Carers have access to the full range of social security benefits according to their personal circumstances. Since 2010, the rate of the carer’s allowance has increased from £53.90 to £64.60 a week, which means an additional £530 a year for carers. I cannot say what will be in the Green Paper, but I will feed back the comments made about resources and benefits.

I am conscious that the clock now shows 18 minutes. The noble Baroness, Lady Jolly, and my noble friend Lady Redfern raised the issue of a named social worker. As in the NHS, where we have a named nurse, it is clear that we should look at that, if we can. Obviously I cannot commit to that, but I will look at that area and feed back. The noble Baroness also asked whose responsibility it is. This action plan is cross-government, but it will be for the Department of Health and Social Care to look at actions, and we will carry out a two-yearly review.

The noble Baroness, Lady Brinton, asked about funding and the engagement of carers returning to work. I will write to the noble Baroness on that, and will write to all noble Lords if I have not answered any questions. The department has developed e-learning resources in partnership with Carers UK to look at opportunities for learning in volunteering and work.

The noble Baroness, Lady Jolly, asked who will assess the cap, and which sponsoring Minister will be responsible for the assessment. As I indicated, it will be the Department of Health and Social Care.

An interesting point on teacher identification was made by a number of noble Lords, particularly the noble Baroness, Lady Jolly. The DfE and DHSC are carrying out a review of identification that will lead to young carers being identified and therefore receiving better support.

I am conscious that my time is up. However, I want to put on record that this has been a valuable debate. I understand the issues that noble Lords have raised, and I will take them all back to the department and feed back noble Lords’ views.