Unpaid Carers: Inequalities

Debate between Daniel Francis and Stephen Kinnock

Thursday 20th November 2025 Westminster Hall

[Stephen Kinnock]

I will be very happy to do that. We have launched the 43 sites, so I would be happy to share the documentation on how we launched them and the terms of reference. [Interruption.] I can see the representative from my private office is taking notes.

[Daniel Francis]

I do not expect an answer now, but can I also ask the Minister to take away a point about the complexity of some of these disabilities? Sometimes people are under several different consultants in several different hospitals, perhaps for a neurological condition, for their sight, for epilepsy and so on. I am thinking about both the complexity of the different apps, and different parts of apps, used by different NHS trusts and hospitals, and the complexity of the distances travelled —it is the carer who manages all those aspects. How can we take that away and support the carer in managing the care of the person for whom they are caring?

[Stephen Kinnock]

I absolutely agree with my hon. Friend’s points; I think that neighbourhood health, as a strategy, addresses his points about both the proximity and complexity. By definition, through shifting from hospital to community, we are addressing the proximity point. The fact that neighbourhood health will be based on multidisciplinary teams creates the idea of a one-stop shop for the patient, where their complex needs are addressed in one place.

To ensure that local areas can meet their duties under the Care Act, the 2025 spending review allows for an increase of more than £4 billion in additional funding for adult social care in 2028-29, compared with 2025-26, to support the sector in making improvements. The Health and Care Act 2022 strengthened expectations around identifying and involving carers and ensuring that services are shaped by carer feedback.

NHS England is helping local systems to adopt best practice through co-produced tools, case studies and events such as Carers Week and the Commitment to Carers conference. Initiatives such as GP quality markers for carers, carer passports and digital proxy access are already making a real difference and increasing the number of carers who are identified in the NHS.

Balancing paid work and caring responsibilities remains a significant challenge, and too many carers risk financial hardship as a result. That should never be the case. Supporting carers to remain in or return to work is central to our plan for a modern, inclusive labour market. Employers benefit enormously from the skills, dedication and experience that carers bring. That is why in April we increased the carer’s allowance earnings limit to £196 a week—the largest rise since its inception in the 1970s—meaning that carers can now earn up to £10,000 a year without losing the allowance.

The Carer’s Leave Act, which came into force in April 2024, gives employees one week of unpaid leave each year to help to manage planned caring commitments. We are now reviewing how the Act is working in practice, listening to carers and to employers of all sizes. That includes exploring the potential benefits and implications of introducing paid carer’s leave. To ensure transparency, and as hon. Members have noted, the Department for Business and Trade yesterday published the terms of reference for that review and we will hold a public consultation in 2026 on employment rights for people balancing work and care.

Young carers make an extraordinary contribution, often taking on responsibilities far beyond their years. Our ambition is that every young carer should receive the support that they need to succeed at school and beyond. This autumn, we published key stages 2 and 4 attainment data for young carers for the first time—an important step in understanding and addressing the educational disadvantage that they face. Reforms across education and children’s social care will strengthen identification and support. Ofsted’s new inspection framework, introduced on 10 November, explicitly references young carers in the expected standards for inclusion, safeguarding and personal development.

Local authorities must identify young carers who may need support and assess their needs when requested. We strongly support the “No Wrong Doors for Young Carers” memorandum of understanding that promotes collaboration across children’s and adults’ services, health partners and schools. I encourage all local authorities to adopt it.

NHS England is supporting the identification of young carers through GP guidance and improved data sharing. It is also leading a cross-Government project, co-produced with young carers and voluntary, community and social enterprise partners, to support identification, strengthen support pathways and join up services across education, health and local organisations. Engagement workshops have already helped to shape the next young carers summit, in early 2026.

Our 10-year plan sets out strong foundations for change, and we are now fully focused on delivery. Baroness Casey’s independent commission will shape the cross-party and national consensus around longer-term reforms, including proposals for a national care service. As noted by the shadow Secretary of State, the right hon. Member for Daventry (Stuart Andrew), however, supporting unpaid carers requires commitment across Government. That is why I chair a ministerial working group, working closely with my counterparts at the DWP, the DBT and the Department for Education, to ensure that our policies reflect the realities of caring.

My hon. Friend the Member for Shipley and others asked about the Government’s response to the Sayce review. I can confirm that we will publish that response this year and I am receiving regular updates from DWP colleagues on that matter. Additionally, our research arm, the National Institute for Health and Care Research, is evaluating local carer support programmes to identify what works and where improvements are needed.

As we look to the future, prevention must sit at the heart of our approach. Too many carers reach crisis point before they receive help. That not only places huge strain on families, but leads to avoidable pressure on hospitals, primary care and social services. By intervening earlier—through better identification in primary care, strengthened community networks and improved signposting —we can ensure that carers receive the right support before challenges escalate.

Terminally Ill Adults (End of Life) Bill (Ninth sitting)

Debate between Daniel Francis and Stephen Kinnock

Tuesday 11th February 2025 Public Bill Committees

[The Minister for Care (Stephen Kinnock)]

It is a pleasure to serve under your chairship, Sir Roger. As was noted earlier, the Government remain neutral. My role here is not to offer a Government view on the merits of the amendments but to provide a factual explanation of their technical and practical effect, to assist the Committee in its scrutiny. This group of amendments focuses on the concept of mental capacity. As drafted, the Bill, in clause 3, states that

“references to a person having capacity are to be read in accordance with the Mental Capacity Act 2005”,

with sections 1 to 3 of that Act establishing the principles and criteria for assessing a person’s capacity to make decisions. New clause 1, which would replace clause 3, and amendments 34 to 47, would collectively introduce the concept of an individual having the ability to make the decision to request assistance to end their life. A person’s ability would be determined by whether they could

“fully understand, use and weigh the relevant information in accordance with regulations made by the Secretary of State”.

That is intended to replace the term “capacity”, used in the Mental Capacity Act 2005, which provides a very specific definition of what it means to lack capacity in relation to a particular decision. A lack of capacity under this framework means that a person must be unable to understand, use and weigh information relevant to the decision, and that that must be directly caused by

“an impairment of, or a disturbance in the functioning of, the mind or brain.”

The “ability” proposal, as drafted, deals only with the use and weight of information.

[Daniel Francis (Bexleyheath and Crayford) (Lab)]

To go back to the point I made this morning—I am happy to stand corrected, but nobody has disputed it—two issues continue to concern me in relation to the Mental Capacity Act and the code of conduct. The first is that the doctor would have a choice, under chapter 5 of the guidance, as to whether it is practical and appropriate to consult other people—with regard to learning disability, for instance.

Also, we have not discussed principle 2 in chapter 2, which says that the doctor has to do everything practicable to try to help the person to make the decision for themselves, before concluding that they do not have the capacity to do so. The principal concern for some Members remains those issues in relation to the Mental Capacity Act, which have not been considered for this scenario. I would like the Minister to address them and the fact that that Act, which was written 20 years ago, was not written for this scenario.

[Stephen Kinnock]

The fundamental position of the Government is that the Mental Capacity Act as it stands is a known quantity. It provides the legal base for a whole range of measures and interventions, and the Government’s view is that it would be an adequate legal base to operationalise the Bill should it receive Royal Assent. Our position on it goes no further than that; it is simply a matter of fact that there is a piece of legislation that is a known quantity.

Oral Answers to Questions

Debate between Daniel Francis and Stephen Kinnock

Tuesday 11th February 2025 Commons Chamber

[Daniel Francis (Bexleyheath and Crayford) (Lab)]

The NHS South East London integrated care board provides services to my constituents, and I have discussed some ways in which we could better deliver services by redeveloping the Erith community hospital site in Northumberland Heath. Is the Minister able to provide an outline of the Government’s plan to provide capital funding for expanding community services like those at Erith hospital?

[Stephen Kinnock]

I would be delighted to meet my hon. Friend so that we can get into a bit more detail about what is happening in his constituency, but he is absolutely right to point to the need for more and better community health services. That will be at the heart of our shift from hospital to community in the 10-year plan that we are delivering.