Social Care (Local Sufficiency) and Identification of Carers Bill

Heidi Alexander Excerpts

Friday 7th September 2012 Commons Chamber

[Mr Nuttall]

We are less than halfway through the time allocated for the debate, which did not begin until after 9.45 am. I do not think that there is much danger of our not being able to hear the views of Front Benchers. I entirely agree with the hon. Gentleman that there are plenty of things that we want to hear from those on the Opposition Front Bench. I am particularly interested to know why, if this measure is so important, the Labour party did not present it in the form of a Government Bill during the 13 years in which it had the opportunity to do so.

[Heidi Alexander (Lewisham East) (Lab)]

If the hon. Gentleman thinks that it is so important to hear from Front Benchers, does he also think that it is important to hear from those of us who want to make the case for carers in our constituencies, and who have expressed to you, Madam Deputy Speaker, our desire to speak in the debate? I wonder whether he will be allowing those of us on this side of the Chamber to make our contribution.

[Mr Nuttall]

Absolutely. I completely agree. We want to hear from as many Members as possible, including the hon. Lady.

--- Later in debate ---

[Norman Lamb]

I am grateful for that intervention. I do not have a specific figure but I am sure that the position varies around the country, with some universities being exemplars of good practice and others not. We must do everything we can. This debate is about whether to impose a specific legal duty or to use other, softer means, but I think we are agreed on the ambition that we must ensure that students with caring responsibilities get access to help and support through the institution where they are learning. We are completely agreed on that.

NIACE has produced the “Really Useful Book of Learning and Earning for Young Adult Carers”—RUBLE—that they can use to plan their time and plan ahead both in respect of their caring responsibilities and in pursuing education and employment opportunities. It also provides information about budgeting and money management. Young adult carers often manage finances on behalf of the whole family, which can be an incredibly onerous responsibility.

The national institute has also produced a resource pack for further education colleges about ways in which they can support young adult carers to engage effectively in learning. That has positive outcomes for young adult carers because it enables colleges and other support services to work together to ensure that the individual carer’s needs are met and that they do not fall through the gap in services at important times, such as the move from school to college, because those transitions are often the most difficult. The national institute is building on that work with the Carers Trust and Barnardo’s, especially so that its excellent resources are disseminated more widely.

One young adult carer who has used RUBLE said:

“The RUBLE has helped me to feel positive about myself. Last year I was really depressed. The RUBLE has reminded me that caring for my mum is really important. It’s also helped me to realise I have lots of positive attributes. I feel good about myself, what I do and my future. The RUBLE has improved my relationship with my mum and helped me to ask for help. Now I know what I’m doing and have plans for the future.”

Those are powerful words.

Some colleges, of course, are already supportive of young adult carers. For example, Loughborough has a transition mentor who engages with young adult carers, their families and staff to provide support that is tailored to individuals’ needs. Such support includes flexible timetabling and allowing the carers to keep their mobile phones switched on during classes so that they can keep in touch with what is happening at home. Although legislating to place a requirement on further and higher education establishments is seductive in many ways, it might override such emerging welcome, impressive and flexible arrangements.

[Heidi Alexander]

Far from undermining what universities and colleges are doing, would not legislating underpin their excellent work?

[Norman Lamb]

The hon. Lady makes a clever intervention. We need to have that debate, because we agree about the ambition of achieving much better support for young people with caring responsibilities who are in education.

The proposals set out by the hon. Member for Worsley and Eccles South include ensuring that there are “sufficient” local care services, and she spoke about that specific point. I assure the House that the Government are committed to supporting that outcome. We want care users and carers to have a real choice of a range of high-quality services—whether state funded or paid for by individuals—and to have the information that they need to make an informed choice that is right for them. The “Caring for our future” White Paper is clear that enabling people to choose from various care and support providers that offer different ways of meeting people’s needs and goals will drive up the quality of care and support, including support for carers. Under the provisions of the draft Care and Support Bill, we propose to place a duty on local authorities to promote diversity and quality in local care and support services, to facilitate choice, and to meet the care and support needs of all local people and their carers.

Enabling carers to have a life outside caring, and helping those with caring responsibilities to fulfil their employment potential, are among the key priorities outlined in our cross-Government strategy “Recognised, valued and supported: next steps for the Carers Strategy”. In designing local care provision and drawing up joint strategic needs assessments, local authorities should recognise the importance of identifying carers’ needs, including their need to work. Local authorities’ assessments and reviews should take account of a carer’s wishes to remain in or return to work, as well as whether a carer’s involvement in employment is at risk because of their caring role. It is extraordinary that carers are rarely asked about their wishes with regard to employment. By simplifying the law, we will ensure that this existing requirement is given far greater emphasis.

The White Paper also set out a commitment to offer support to every local authority in England to fulfil this duty and, in particular, to develop or improve its market position statements. Effective market position statements make public key market intelligence, including the data from the joint strategic needs assessment and data from local consumer surveys and specific groups. They will send a clear signal to the market about the current and future level and nature of local demand for care and support services. The hon. Member for Worsley and Eccles South specifically highlighted the importance of how we develop the local market. For the first time, organisations large and small, be they private companies or charities, will have a clear picture of the demand for care and support and be able to innovate and invest in their services and staff accordingly.

--- Later in debate ---

[Heidi Alexander (Lewisham East) (Lab)]

I am grateful to the hon. Member for Shipley (Philip Davies) for keeping his remarks brief and giving me the opportunity to contribute to the debate. I was determined to remain in the Chamber until the bitter end, and I think it will be bitter because the Government are clearly determined to kill off a Bill that could make a significant difference to the lives of carers, particularly young carers. It would also make a difference to the way in which local authorities understand the nature of the social care problem—the social care crisis—with which they are having to deal.

I congratulate my hon. Friend the Member for Worsley and Eccles South (Barbara Keeley) on promoting this Bill. She is a long-standing and effective campaigner on these issues, and I was delighted when she asked me to co-sponsor the Bill, which I believed would give hon. Members the opportunity to talk about the social care crisis, and take steps to improve the lives of carers.

Let us be under no illusion: there is a crisis in social care. I say that for two main reasons. The first is a personal reason linked to my family’s experiences, and the second is that when I was a local authority councillor I saw the huge pressures that council budgets were under from increasing demand for social care, particularly for elderly people and adults living with disabilities.

My experience of the crisis in care relates to my nan, who sadly passed away last year. She was a working-class woman who had worked hard all her life and had to sell her home to fund care at the end of her life. She was from suffering from Alzheimer’s and was frail in her later years, and all her life savings were effectively used up to pay for her care. She had to sell her house, and when she passed away her estate was the £23,000 that people are allowed to keep after they have paid the costs of their care. It upset me to think that my nan, who had worked hard all her life, had to use her life savings in such a way and was not able to pass them on to her family. I do not begrudge the use of that money for the excellent care she received, but it is an issue faced by families across the country.

I mentioned my experience of local government, where I saw the huge pressure put on local authority budgets by the rising demand—it rose virtually every day. The Local Government Association recently produced research showing that councils currently spend about 40% of their budgets on social care, but that is expected to increase in the next seven to eight years. In 2019-20, 60% of councils’ money will be spent on social care— £2 in every £3 they spend. The problem is therefore huge. Any steps that the House can take to encourage local authorities better to understand services, demand and how best to meet needs in the local area are incredibly important.

As has already been said in the debate, when people reach a crisis point in their lives—perhaps they are caring for a loved one—they often turn to their local town hall for help and advice. If they have moderate means, they could face the problem of funding their own care. There is a woeful lack of information and advice for self-funders—people who pay for their own care package. That is the current situation. People do not understand what costs they must cover. They do not know whether they will have to pay for the next three or five years.

What happens when the money runs out? That was my family’s experience, and it happens in 25% of care self-funding cases. The cost to local authorities of people falling back on to the state is about £1 billion every year, but that is anticipated to rise. Local authorities, in planning how they will deal with such enormous costs, need to understand the demand and need, and the services that are provided, in their local area. In that way, they will not only be able to plan better, but to give appropriate and quality advice to individual carers and their families who come to them for support.

There is a current demand, but another question is whether the Government will proceed with the funding for the Dilnot proposals—we still do not know. Press reports in the summer suggested that they would like to proceed with Dilnot, but where will the money come from? Dilnot is not the whole answer. It covers social care costs, but it does not cover “hotel” costs—accommodation costs that can be significant for individuals who enter residential care.

All politicians need to level with the public about the scale of the challenge and what people are likely to have to pay for in their later life. If people know that they must sell their home to pay for their care or a proportion of it, they can start to plan, but there is currently complete uncertainty. Dilnot is heralded as the fantastic answer to the social care crisis: it might be part of the answer, but it is not all of it.

Local authorities need to be able to provide that high-quality advice to people who come to them for help and support. I recently met Partnership UK, which is one of the few companies in this country to provide an insurance product for elderly people and those moving into later life and who want to insure themselves against the costs of their care. Partnership UK informs me that in 2009-10, 53,000 people who were going into care homes were self-funders. Of those, only 14,000 had received financial advice and only 7,000 had received financial advice from a properly qualified person. That situation cannot be allowed to continue. Local authorities have a role in signposting people to relevant places and organisations where they can get independent, high-quality advice.

I have spoken about why the Bill is important in improving local authorities’ understanding of the social care needs and demands of their local population. Before I finish, I will say something briefly on the importance of the Bill for the early identification of young carers.

During the summer recess, I was fortunate to visit Carers Lewisham, which does fantastic work with a range of carers in Lewisham, south-east London. It works with about 500 young carers who are referred to it by schools in Lewisham. When I met young people at Carers Lewisham, what struck me was the enormous support they give each other. There is not just support from the adults to help understand the system; there is also support on a human level, reassuring each other that they are not the only individuals facing the very difficult challenge of caring for their loved ones.

In Lewisham, this works quite well. Schools refer young people to Carers Lewisham and they receive good, high-quality support. However, it is not like that everywhere and the issue is too important for it to be a postcode lottery dependent on whether there is a great head teacher in the school, or a great local organisation or great ways of local working. It would be hugely positive if we could underpin the excellent work that is happening at the moment through this Bill. It would not undermine the excellent work that is currently done, as the Minister suggested it would. It would make a positive contribution to the lives of young carers.

The duties in the Bill that would require parts of the NHS to identify carers are also critical. Carers in Lewisham told me that they face a constant battle to get the support they need from various different parts of the public sector—the council or different parts of the NHS. They spoke about the lack of join-up between hospitals, GPs and councils. If we have the duty to identify carers, hopefully that will foster better working between those different parts of the public sector. A survey conducted during carers week found that two in five carers put off having medical treatment because of the pressures of caring for loved ones. Paying attention to the health of carers, as well as the individuals they care for, is important, and the Bill would do a lot to improve that.

This is an excellent Bill. Sadly, it is obvious that the Government are determined to defeat it. It would have made a small difference to part of the big jigsaw that needs to be solved in the social care crisis. It would have provided immediate, effective steps in getting support in place for carers. Sadly, it is obvious, from the position that the Government have set out, that these provisions will not go through immediately. I hope the Minister lives up to his word and works with my hon. Friend the Member for Worsley and Eccles South to find other ways for the provisions to find their way on to the statute book.