Caring Responsibilities

Gary Streeter Excerpts

Wednesday 15th June 2011 Westminster Hall

[Barbara Keeley]

I very much agree. I have a point to make later about that topic, because the staff who work on the young carers project in my constituency have said that they are very concerned about carers losing their education maintenance allowance. That is the one support that the state gave young carers and it is going, which is a worry.

To return to the testimony from Parkinson’s UK, the final points were about more carers contacting the staff member to ask for help finding respite because they are struggling to cope; financially, they cannot now afford a break, a treat or a holiday. I am glad that the hon. Member for Banbury raised that point. The staff member said:

“I know of one carer who has had to take on a part time cleaning job in the early evening because money is so tight. She puts her husband to bed before she leaves”—

for work—

“at 4pm so that he is safer and so she won’t worry that he will fall while she is out.”

I think that we would agree that we would rail at care agencies that put a person to bed at 6 or 8 o’clock, yet this carer has to put her husband to bed at 4 o’clock because that is the only way that she can do the cleaning job that she has to do.

I also had some input from a branch of Age Concern in Greater Manchester about how cuts to grants are affecting its dementia support service, which is important because it is another line of support. Cuts to grants of 40% over the next three years are affecting its capacity to deliver individual and group support. That goes against objectives 5 and 7 of the national dementia strategy. The staff member told me:

“Carer support groups have had to close. These are groups where carers can get a break, have a chat to other carers and get advice and information from staff. These groups help to maintain morale and prevent carers from becoming socially isolated.”

Even though there are personal budgets, which will come in in Greater Manchester, carers of people with dementia often find it hard to mix in other social groups because of the “different” behaviour of the person with dementia. Carers have described the groups as a “lifeline” and something “to look forward to”. The fact that they are being cut back is important.

The proactive support to carers of phoning them every few weeks is another aspect of Age Concern’s work that is being cut. The staff member said:

“We now have to wait for them to contact us for time-limited intervention. We know that many older people are proud and longsuffering and will often suffer in silence rather than ask for help.”

Before the cuts, branches of Age Concern in Greater Manchester ran special events for carers such as a carers day each year, parties and trips. The reduction in funding means that it can no longer offer the extras that it knows give people a better quality of life. I am very concerned to hear that carers in my area in Greater Manchester are starting to suffer.

I want to return to the two sides to the debate—values and choices. We are fortunate in Salford because, due to the way in which the cuts and the organisational turmoil in the NHS are being managed, we are not suffering as much as other areas. There are choices. Labour-run Salford city council is now one of only 15% of local councils still providing support to people with moderate care needs, as well as to those with substantial or critical needs. We are fortunate to have an excellent carers’ centre run by the Princess Royal Trust for Carers. Salford has tried to ensure that carers continue to be supported through these difficult times. As I mentioned earlier, however much the council and our local NHS bodies support carers and try to maintain what they are providing, the national changes and cuts affect our carers.

The young carers project will be affected when the young carers lose their education maintenance allowance. The centre manager told me of two other concerns: the changes to benefits and disabled people being called in to take work capability assessments. The extra worry of having to take them and of having benefits curtailed are starting to affect carers.

The centre manager also said that a major concern for her organisation was that although the carers’ centre was very well established, the service has to go out to tender through the joint commissioning process next year. She said:

“We are aware of a number of carers’ services which have gone out to tender in other areas, and bids have come in from organizations and agencies which have no experience, knowledge or expertise in carers and carer issues, including organizations from abroad.”

What reassurance can the Minister give to staff of the carers’ centre that an established, trusted and effective organisation such as theirs will not be undercut in the tendering process by organisations with no local knowledge and no experience or expertise with carers or in carers’ issues? Our carers in Salford would lose out if they lost the valuable support that they get from their carers’ centre.

The Government’s economic policies are damaging support to carers. Government cuts to local council budgets have gone too far, too fast. Councils pleaded not to have their budget cuts front-loaded. We have lost £1 billion from adult care services at a time of rising need, and we have lost billions in grants to the voluntary sector, but the worst thing is that we are only a few months into the first year of cuts, and we can already see the impact on carers. Carers are fearful about the cuts and distressed that they cannot manage financially. People with serious conditions such as Parkinson’s are being turned down for attendance allowance and made to feel like beggars if they appeal. Young carers are losing their education maintenance allowance. Carers are now unable to afford a break or holiday. It is shameful that a carer should have to take a part-time cleaning job and put her husband to bed at 4 pm.

That is not a record of which the coalition Government can be proud, and it is so early in this Parliament. I hope that carers week gives Ministers time to rethink the impact of the cuts that they are making.

[Mr Gary Streeter (in the Chair)]

Colleagues, three Members have sought to catch my eye, and we have 19 minutes before winding-up speeches begin, so can we regulate ourselves to about six or seven minutes each?

--- Later in debate ---

[Grahame M. Morris (Easington) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Streeter, for the first time in a Westminster Hall debate. I echo the tributes to my hon. Friend the Member for Edinburgh East (Sheila Gilmore), whom I congratulate on securing this important debate on the effects of spending reductions on families with caring responsibilities, not least because of the important changes being made in the House of Commons in the Welfare Reform Bill.

I want to confine my remarks to a couple of issues, because of the shortage of time. A survey of more than 2,000 carers was recently carried out for carers week. It shows that 80% of unpaid carers are worried about cuts to services and that about 50% are unsure how they will be able to cope without the vital support that they currently receive. For the record and for anyone who is not involved directly as a carer, it is worth stating that three out of every five people will be an unpaid carer at some point during their lives. To respond to the point made by the hon. Member for Banbury (Tony Baldry), those unpaid carers save the economy a huge sum. It is difficult to quantify it, but it may be more than the total NHS budget—£103 billion each year.

We have done some research in County Durham. I am proud to speak up for the vulnerable, the disabled and for carers. My county alone has 61,000 carers and the estimated moneys saved to the public purse by the very important work that these unpaid carers carry out are £1 billion a year. We should not be dismissive of their needs and requirements. Each carer who works for nothing saves the Government, the taxpayer and the Exchequer the cost of a care worker, which is about £18,000 a year.

My own constituency of Easington is characterised by long-term ill health. As the hon. Member for East Londonderry (Mr Campbell) has mentioned, many carers, particularly in my area, are themselves victims of ill health. That was highlighted by a recent report by Carers UK. The legacy of coal mining and heavy industry has left many thousands of people debilitated in later life by long-term disabilities and in need of care, which is often provided not by the state, but by close family members.

I shall speak briefly about a number of issues. In particular, I want to draw Members’ attention towards, and place on the record, the effects being felt by some of my constituents as a result of the transport costs they now face due to local government cuts, and towards respite care, which has been mentioned. I also want to ask the Minister a couple of questions—I hope that she will answer them—about carer’s allowance and the provisions in the Welfare Reform Bill.

A constituent who came to see me recently is a full-time carer for her husband. She has one day a week of respite care. Her husband attends a day-care centre in Grampian House, in Peterlee in my constituency, once a week for four and a half hours. That is the only break she has. It is an excellent facility and I pay tribute to its care staff. I have visited it myself and a close relative of mine is in there. They do tremendous work in terms of physiotherapy and rehabilitation. However, from September, due to the front-loading of cuts of £67 million this year to my local authority of Durham county council, transport to the centre will be cut. It will cost my constituent £72 for specialist transport, which means that she will not be able to take her break and take advantage of the respite care.

The issue of transport has been raised by many of my constituents. They understand that cuts to social care by local authorities are due almost entirely to the swingeing, front-loaded cuts that the Government have imposed. Councils are struggling to cope with massive funding reductions from central Government.

People are also aware of the impact that the Government’s £18 billion package of cuts to the benefits system will have on carers in particular. The Government accuse Labour of rejecting welfare reform, but I am proud to say that we stand firm on the principle that the most vulnerable should not be paying that £18 billion when some of the richest in society—most notably, the bankers and the banking sector—contribute only between £2 billion and £5 billion to the cost of the deficit.

I shall conclude my remarks, because time is short. Another big issue that has been raised is that of ring-fencing moneys for social services, with a distinctive sum identified for carers’ services—the carer’s grant. Although it was not ring-fenced under the previous Government, councils at least knew how much money they were receiving for that purpose. The Minister has responsibility for public health and I would like to congratulate my own soon-to-disappear primary care trust, County Durham PCT, on clearly ring-fencing, identifying and spending its allocation from the Department of Health on the provision of respite care for people with disabilities and their carers.

How will the Government fulfil their pledges to improve the support for carers in the face of massive cuts to local government? How will the Government ensure that the proposed reforms, outlined in the Welfare Reform Bill, do not result in carers losing their carer’s allowance? The Government could give two promises that would give confidence to those who are most vulnerable and most in need. First, budget cuts should not result in carers losing the services that they rely on. Secondly, carers should not lose out under changes to the benefits system.

[Mr Gary Streeter (in the Chair)]

I call Rosie Cooper, who has four minutes.

--- Later in debate ---

[Emily Thornberry (Islington South and Finsbury) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Streeter. The debate could clearly have gone on for twice or perhaps three times as long. A feature of it has been the number of people who wanted to speak and have not been able to. My hon. Friend the Member for Newport East (Jessica Morden) wanted to speak, as did my hon. Friend the Member for Birmingham, Erdington (Jack Dromey). My hon. Friend the Member for Glasgow Central (Anas Sarwar) had also prepared something, and my right hon. Friend the Member for Croydon North (Malcolm Wicks) had told me that he wanted to make a contribution. The fact that many people have shown an interest in the matter demonstrates its huge importance.

I congratulate my hon. Friend the Member for Edinburgh East (Sheila Gilmore) on securing the debate. It is very easy to come out with a number of platitudes about carers, but carers want to hear what we will do to help them. Carers probably save this country more in money than is spent on the national health service. By 2017, it is likely that the UK will reach a tipping point, as the number of older people needing care will exceed the number of people of working age with families. There will be a crisis and we need to ensure that we are up to dealing with it. We must be able to support those people on whom we rely entirely. As has been said, if anyone is demonstrating the Prime Minister’s big society, it is carers up and down the country, so we need to look after them.

Where is the good news? There is some good news, which has come from the Law Commission. It has published a report that has largely received broad support from social care groups. A number of proposals are well thought out and will be well received, for example, rather than the carer needing to request an assessment, the local authority will have a duty to provide one. In addition, those assessments should be made for people who provide some care, rather than being restricted to those providing substantial care. Both those proposals are sensible. The third proposal is to ensure that a national system of eligibility assessments will provide some consistency across the country and allow people to move from one local authority to another without there being a huge time lag, which causes great distress to families. That will allow some portability of care.

The Under-Secretary’s brother Minister who is responsible for care, the Minister of State, Department of Health, the hon. Member for Sutton and Cheam (Paul Burstow), has so far welcomed the Law Commission’s report. In his pre-coalition past, he expressed support for many of the ideas it recommends. However, many of the issues will not come within the Department of Health’s ambit, but within that of the Department for Communities and Local Government. Given that the Secretary of State for Communities and Local Government has indicated that he wants to conduct a review of local authority duties, there is some concern that he may be resistant to a new duty being put on local authorities to ensure that carers are assessed as well as the person needing care. I hope that that is not the case and that people are speaking strongly in his ear, so that the Law Commission’s recommendations can be implemented in full because they are to carers’ advantage.

The other piece of good news may be the Dilnot inquiry. I met Mr Dilnot again today. He is very generous with his time and is meeting a broad range of people. The meeting he had with me and my right hon. Friend the Member for Wentworth and Dearne (John Healey) was the first of eight meetings that he is holding today. Of course, we all agree that we need to make fundamental changes, that the status quo will not do and that we must have a fundamentally reformed care system. The Opposition believe that there should be high-quality care for those who need it and that care needs to be funded in a fair way, with proper accountability for those who deliver it.

We repeat the Leader of the Opposition’s invitation, which was made on Tuesday 7 June. We welcome cross-party talks and we would like them to happen as soon as possible. We will come with an open mind because we want to be able to work together for the best way forward. I understand that the Prime Minister has welcomed that approach, but we still have an empty diary and we want to be able to get on with it. If the failures of the past are repeated, we will not be forgiven by those who use the care system or their families. It is important to remember that, even with co-operation and a fair wind, we are unlikely to see any of Dilnot’s suggestions implemented until 2014-15. The current problem for carers is what is happening now to the social care system and their support .

I am afraid that that takes me to the end of the good news and into the bad news. As has been said very eloquently by my hon. Friends, social care cuts are clearly having a fundamental impact on the lives of carers. I was going to congratulate the Minister of State, Department of Health, the hon. Member for Sutton and Cheam on finally taking his fingers out of his ears, stopping singing, “La la la la la,” and accepting that the cuts to social care will affect front-line services. That is inevitable; there is no other option. Given that social care is top-tier councils’ biggest area of discretionary spending, we simply cannot have 27% cuts to local authorities without there being cuts to social care. It just does not work. Unfortunately, the Government have ignored the advice of the Association of Directors of Adult Social Services and the Local Government Group, who know what they are talking about.

Although no centralised assessment of the impact of the cuts to local government on social care was carried out, several people have done the Government’s job for them. A wealth of evidence has been provided by ADASS, the BBC and my own survey. As has been mentioned, my survey of the directors of social care received 61 replies from councils and shows some very worrying results. I am pleased that the Minister of State, has complimented my survey as being robust, accurate and, indeed, more reliable than that done by the BBC. However, he needs to look at the impact of it and what it means. We will do the survey again next year and the year after, and I am afraid that we will not get good news.

ADASS has shown this year that the shortfall to adult social care spending is £1 billion. The Government have done their best not to affect adult social care, but next year they have to cut again and the year after they have to cut yet again. If things are bad now, as has been so eloquently reported by my hon. Friends, where are we going? Do the Government have any idea of the impact of these cuts on carers? This has already been asked, but I repeat: how many of those who no longer meet councils’ very narrow eligibility criteria will need to rely on the informal care provided by their families? Do the Government know how many carers will have to go without support from their local authorities and will, as a result, be forced to give up work to meet their new obligations?

I was particularly pleased to hear what the hon. Member for Banbury (Tony Baldry) said about respite care—I support him in that. The Government are right—our Government was right—to ensure that money is put aside for respite care. The difficulty is that the mechanics do not work. Primary care trusts have been given that money. It is not ring-fenced. It is not clearly labelled. There is no accountability. The Department of Health is very unclear about which PCTs have spent it, in what way, how much they have worked with local authorities, or how much they have worked with carers—there is no overall picture. Frankly, is that not the sort of thing that the Government should do? It is not just a question of handing out the money. Surely there needs to be some form of accountability.

The Princess Royal Trust for Carers has been doing its best to conduct an audit of that, just as I am doing an audit of local authorities and the impact of the cuts on social care, but surely that should be a job for Government. Surely the Princess Royal Trust for Carers has things to do other than conduct an audit of whether the money given by the Department of Health to PCTs for respite care for carers is actually being spent on carers. That is part of the knock-on effect of the chaos that has been created through the proposed partial abolition of PCTs in the Health and Social Care Bill. What action will the Government take if PCTs do not work with local authorities and carers of organisations to publish plans and budgets?

The other piece of bad news, which has been mentioned, is welfare reform. We welcome the Government’s announcement that carer’s allowance will be outside universal credit. We also welcome the news that disability living allowance will be excluded from the overall benefit cap. However, the bad news is that, when the Government talked about introducing personal independence payments, they said that there would be a 20% cut to DLA. It is not just a 20% cut to DLA. Those people will not be springing from their beds, suddenly well. People with dependants will still be there. Not only will they, but their carers will lose their money, because carer’s allowance will be attached to DLA. There will, therefore, be a huge impact on the families of those people who are losing their DLA. Do the Government have any idea of how many carers will lose out as a result of moving DLA to the personal independence payment and the 20% cut? Are the Government aware that carer’s allowance is not excluded from the proposed benefit cap, while DLA is? I am sure that the Minister would agree that that is, at the very least, not consistent, let alone fair.

[Mr Gary Streeter (in the Chair)]

Order. It may help the hon. Lady to know that the debate ends at 4.10 pm, and I want to give the Minister some time to respond.

[Emily Thornberry]

May I just come back to this last point? It is shocking that, at a time like this, carers suffer in the way that they do. It is a question of priorities and hard choices. As my hon. Friend the Member for Worsley and Eccles South (Barbara Keeley) so eloquently put it, it is not right that a woman has to put her husband to bed at 4 o’clock in order to do a part-time cleaning job to pull things together. It makes “We are all in it together” hollow rhetoric.