Social Care (Local Sufficiency) and Identification of Carers Bill
Hywel Francis Excerpts(12 years, 3 months ago)
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Barbara Keeley
I very much agree, and I am sure that that is why the Bill has received such strong support from Employers for Carers.
Other countries have put in place development strategies for home care. In France, the first phase of its development strategy for the home care sector led to a growth of 100,000 jobs year on year. However, even after the worldwide recession, such strategies have led to 50,000 more jobs there each year.
There is a real need for care and support services to enable carers and disabled people to work, but the social care picture in England is one of growing need, shrinking provision, and totally inadequate information and advice about what is available. I have discussed the cuts to social care budgets during previous debates on social care funding.
Dr Hywel Francis (Aberavon) (Lab)
My hon. Friend makes a powerful case. Is she aware of good practice in Scotland and Wales that England should be following?
Barbara Keeley
I have not followed that as closely as I might have done, so I hope that we will hear from my hon. Friend later about the practice in Wales. However, we have much to learn from other countries.
It is important that we bear in mind the shrinking provision of social care because we know that demand is growing. Since 2010, local councils’ adult social care budgets have been cut by more than £1 billion, and a further £1 billion of cuts is expected. The number of vulnerable older and disabled people who have their home care services fully paid for by their local authority has fallen by 11% over the past two years. According to a survey by the Care and Support Alliance, services have been cut to 24% of disabled adults. Research by Age UK shows that cuts to council budgets mean increased fees for services—in fact, service fees have increased by 13% over two years. Almost half of all local councils are charging more, or making new charges, for home help or day care. One in six councils has reduced personal budgets for care packages, and almost half of all councils have frozen the rates that they pay for residential care. In addition, the fees for both residential care and nursing home care have increased by 5% on average during the past year.
Those are important statistics, but sadly they are not routinely gathered so that they can be scrutinised by, for example, the Health Committee. They were mainly gathered through freedom of information requests by my hon. Friend the Member for Leicester West (Liz Kendall) and various organisations. Local authorities do not have a full picture of local care provision, particularly that needed by the 80% of care users who are self-funding. Those self-funders—people whose assets exceed the means test for local authority support—spend £5.5 billion a year on care, with top-ups to statutory services costing them another £1.15 billion. It is vital that we have a better and more complete picture of social care provision, including that very large amount for self-funders.
Clauses 1 and 2 introduce a strategic duty on local authorities in England to ensure that sufficient social care services exist in their local area to meet the care needs of disabled people and carers. They seek to move towards local authorities having a total and accurate picture of what is purchased and provided in their area. Existing duties on local authorities relate only to those for whom the local authority has a statutory responsibility—disabled people and carers who meet eligibility criteria and who do not exceed means-testing thresholds.
It might be argued that the Government’s draft Care and Support Bill introduces a duty on local authorities to establish and maintain the provision of information and advice relating to care and support for adults and carers. The draft Bill says that a local authority must promote the efficient and effective operation in its area of a market in services for meeting care and support needs. However, that duty does not cover an assessment of local sufficiency, and it is that picture that can truly help carers and disabled people, particularly in terms of working, as we have just discussed.
Andrew Dilnot, in his 2011 report, set out the need to place duties on local authorities to provide information, advice and assistance services in their area, and to stimulate and shape the market for services. Moving to embrace a duty to develop a full picture of care and support services, and to assess the sufficiency of those services, will assist local authorities in developing their role as market shapers.
Clause 2 includes a duty to promote sufficiency of the supply of care, which, as we have discussed, would bring a new focus on the importance of social care in promoting and enabling work for disabled people and unpaid family carers. Carers UK has analysed local authority joint strategic needs assessments, which is really the only assessment that we have, but this analysis has shown that the majority of those assessments do not link care provision with work, so clause 2 would link well with Government strategies around work for carers and people with disabilities.
Barbara Keeley
I am sure that there are similarities. This field of work is opening up, but much more needs to be done.
It is interesting to talk to organisations such as the Carers Trust and the Children’s Society, which run the young carers projects, about identification, which my hon. Friend the Member for Washington and Sunderland West (Mrs Hodgson) mentioned. Young carers are already eligible for assessment under carers legislation and as “children in need” under the Children Act 2004, but very few of them are identified or ever assessed for support. In supporting the Bill, the Carers Trust says that
“clear duties on local authorities and further and higher education institutions to identify and support young carers will help ensure that inappropriate caring is prevented or reduced so that young carers can enjoy the same opportunities and outcomes as other children and young people.”
Dr Francis
Does my hon. Friend agree that as the Bill progresses it will be important for the Minister to look at the excellent work that Crossroads Care did in the recent past in supporting young carers through projects of the kind that she has described?
Barbara Keeley
I am sure that it will. The difficulty with capturing this in the Bill, as in any legislation, is that it spreads across Departments. It is something for us to work on, and there is much to be done.
Young carers do not enjoy the same opportunities and outcomes as other children and young people. The Carers Trust tells us that young carers frequently experience worry, stress, anxiety, depression and feelings of loss and panic, as well as mental health problems and risk of self-harm. They fear for the condition of the person they care for, but they often have more fear of being taken into care. They feel angry and resentful because they have such responsibilities, yet they are not recognised. Most of all, they experience a lack of time for play, leisure and sport, and miss out on social time with their own age group. A serious consideration for all of us, given that we are talking about 8% of the secondary school population, is that a caring role also leads to missed educational opportunities, poor educational outcomes, and, later on, reduced employment opportunities. Over a quarter of young carers aged 11 to 16 miss school owing to caring, and that figure rises to 40% when the parent is mentally ill or misusing drugs or alcohol. Young adult carers are twice as likely as their peers not to be in education, employment or training. It is common for them to move into full-time caring after they finish compulsory education, particularly if they are receiving no support.
Clause 6 would place a duty on colleges of further and higher education to identify students who are carers and to have in place policies of support for them. When we included this proposal in the Bill, I did not realise that it was quite ground-breaking and new. A report in 2008 by Young Carers International for the Princess Royal Trust for Carers reported that there were 290,000 young adult carers in the UK. The figures move between 300,000 and 800,000; nobody really has any idea. The report said that apart from statistics that could be obtained from the census,
“Little is known about young adult carers aged 16-24 in the UK”
and:
“Information is sparse about the issues and challenges that they face due to being carers”.”
Young adult carers at university or college have to balance giving care with their academic studies and learning. Some do this by caring at a distance, returning home at weekends or holidays to provide care, but 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. The report told us that none of the young adult carers at university it surveyed was aware of any specific carer support being available at their university. Similarly, they were often unaware of local services for carers that might be able to support them because, sadly, those services have not reached out to university student populations. There is a mismatch in that regard.
That was the situation in 2008. It is interesting that only this year greater awareness of the needs of student carers seems to be developing. The Fair to Care campaign in Scotland is lobbying for the development of carers’ strategies in universities.
Sir Tony Baldry
I am grateful to my hon. Friend for that undertaking. I would understand if the Government did not want the Bill under discussion to progress, but that must be balanced against his undertaking.
Dr Francis
I welcome the new Minister’s statement. Does the hon. Member for Banbury (Sir Tony Baldry) agree that the Minister should also be invited to engage with the national carer organisations and with the Health Ministers of the devolved Administrations, particularly because, as a good Liberal, he is an enthusiastic supporter of democratic devolution?
Sir Tony Baldry
We all know the organisations and bodies that are concerned about carers policy. I heard my hon. Friend the Minister say clearly that he was willing to engage with us and others to make sure that, when the Bill on social care is presented to the House, those parts of it that deal with carers are as robust as possible. For the first time, we are at last acknowledging that a large number of people in this country are carers and that there need to be robust policies in relation to them.
Sir Tony Baldry
The hon. Lady has raised two important points and I will deal with them both, because I do not want there to be a scintilla of misunderstanding.
The private Members’ Bills brought forward by the right hon. Member for Torfaen (Paul Murphy), the hon. Member for Aberavon, Lord Pendry and others were valuable contributions. The difference with this private Member’s Bill is that since the hon. Lady and those who are proud to sponsor it brought it forward, the Government have published a substantial White Paper covering this policy area. We are dealing with a policy that the Government are still consulting on and thinking about across Whitehall and with other organisations.
It is in all our interests that effective carers legislation is, as far as is possible, contained in one piece of legislation, namely the Government Bill. I am not for one minute suggesting that codifying existing carers’ rights is sufficient. I am saying that if and when the Government bring forward the Bill on social care, I hope that a large part of it will deal specifically with carers, and that within that part there will be a codification of existing carers legislation, which the Minister has acknowledged there will be.
Dr Francis
May I clarify what happened with my Bill? It was part of the wider strategy of the Labour Government to advance equalities legislation. It is therefore slightly disingenuous of the hon. Gentleman to suggest that my Bill was somehow separate from the wider advances that were made. Similarly, he should be saying, as the joint chair of the all-party parliamentary group on carers, that he supports this Bill, irrespective of the wider advance in social care legislation under this Government, whenever it comes.
Sir Tony Baldry
I am clearly being uncharacteristically incapable of communicating what I am seeking to achieve. I do not in any way resile from the provisions in the Bill. The provisions that the hon. Member for Worsley and Eccles South has put forward are necessary and valuable. I am simply trying to find a constructive way to ensure that as many of those provisions as possible eventually arrive on the statute book.
The hon. Member for Aberavon has to recognise that the Government have a strategy for carers, which is set out very clearly on pages 34 and 35 of the White Paper on reforming care and support. It states:
“From April 2013 the NHS Commissioning Board and clinical commissioning groups will be responsible for working with local partners to ensure that carers are identified and supported.”
That existing strategy has a number of parts that we would all want to discuss with the Ministers and officials who have responsibility for this policy. For example, much of the hon. Lady’s Bill is rightly about how we help and support carers in the world of work. The White Paper states,
“we will produce and publish a road map setting out action to support carers to remain in the workforce.”
I am always a bit suspicious of phrases such as “road map”, because I am never sure what legislative force a road map has. We will want to discuss with Ministers, in fairly robust terms, how we can ensure that the Bill that the Government bring forward in due course meets the aspirations and needs of the millions of carers in this country, for whom all of us present in the Chamber are concerned.
Dr Hywel Francis (Aberavon) (Lab)
It is a pleasure to follow the hon. Member for Banbury (Sir Tony Baldry) who has made an eloquent case—I say this as an act of generosity—for the Bill. I must declare an interest as I am the honorary vice-president of Carers UK, and patron of a number of carers organisations in my constituency.
I warmly congratulate my hon. Friend the Member for Worsley and Eccles South (Barbara Keeley) on introducing this vital Bill, and on all the hard work she has done on behalf of carers since she joined the House in 2005 and became an active member of the then new all-party group on carers.
As has been indicated, I have a strong interest in the Bill. As past carers, my wife and I know some of the great challenges that are experienced by carers, and the desperate need for recognition, identification and support, especially for those who wish to work or return to education and training. The Carers (Equal Opportunities) Act 2004, which had been my own Bill, introduced an important dimension to carer support services, not least by helping carers who wished to work or access education, training or leisure activities. Then and now, right hon. and hon. Members speak for all our constituents when we seek justice for carers and their families. Indeed, we are part of a great disability and carers movement throughout the country, although sadly we recently lost two of its mighty champions—Lord Ashley of Stoke and Lord Morris of Manchester. They supported the 2004 Act and campaigned successfully for the advancement of the rights of disabled people and their carers. I am sure that they would be proud to support the legislation proposed today as a discrete private Member’s Bill.
The 2004 Act covered England and Wales, but this Bill applies only to England. It is nevertheless instructive to outline briefly what has happened in both countries and in Scotland since 2004. A measure to identify carers was included in the original drafts of the Carers (Equal Opportunities) Bill. It was dropped in Committee when the UK Minister and the Welsh Government agreed to consider alternative measures via guidance, or other measures. In England, no further steps were taken beyond the inclusion of guidance to ensure that carers are indentified. The Welsh Assembly Government, however, saw carers as a key issue and used their first primary legislation-making powers under the Wales measure to bring forward legislation on carers. That led to the successful and ground-breaking Carers Strategies (Wales) Measure 2010, and I congratulate the Welsh Minister responsible for carers, Mrs Gwenda Thomas, on her visionary work. I also congratulate the Welsh Affairs Committee, which I previously chaired, on its early scrutiny work of the legislative competence order on carers which, in a way, led directly to the Welsh measure.
England is now lagging firmly behind in legislation to identify carers, and it is therefore incumbent on hon. Members to rectify that situation today. When the opportunity to frame new legislation arose, Carers Wales argued strongly for the Welsh Government to place a duty on NHS bodies to identify carers. As I said, such a provision was in the original text of my 2004 Bill, although it was omitted in the Act.
The rationale of Carers Wales was that although most carers have no relationship with social services, all will have contact with the national health service, even if only through their GPs. A compelling part of the evidence base was the Welsh Government statistics showing that the number of people, including disabled children, with long-term conditions, frailty or disabilities who receive services from social services, made up a tiny proportion of those identified as disabled in the 2001 census. Furthermore, the number of carer assessments carried out by local authorities were, sadly, a tiny percentage of those listed as carers in the census.
Carers Wales demonstrated that the duty to identify carers would be the most effective way of getting information and, indirectly, support for the greatest number of carers. In Wales we are on track to achieve that goal, and it is something that the Bill also aims to achieve. That is why we should support its progress today.
Practice on the ground in other areas shows that we are not entirely without hope that such a measure can be achieved in England. Carers UK is funded in Kensington and Chelsea by the royal borough, and part of its work is to provide advice surgeries in three key GP practices. As a result of several different methods of identification, many families have found the support they need, much of which comes from outside social services. Those individual carers would not otherwise have been identified.
Elsewhere in England, Carers UK has a link worker in Islington whose task is to identify carers in a hospital setting. Again, evidence suggests that carers are not receiving advice and information at the right time to make the correct decisions for them and their families. The Bill we are discussing wishes to achieve good practice universally across the whole of England.
My county borough of Neath Port Talbot has the highest proportion of carers of any county borough in the United Kingdom—20,067 according to estimates from 2011, which is an 8% increase on 2001. That care is valued at £461.9 million per year, which is a 34% increase on 2007. That indicates to all hon. Members the growing challenge before us; it will not go away and it requires identification and quantification.
As I said, it is instructive to look briefly at Scotland. To Scotland’s credit, it has had legislation since the Community Care and Health (Scotland) Act 2002 took effect. The first drafts of my 2004 Act were based on experience in respect of those provisions, as was the measure introduced in Wales. NHS bodies in Scotland have a legal requirement to develop a carers information strategy, which includes, for example, the provision of training for carers on carers’ issues in the work force, especially for those on the front-line. There is much for the Minister to learn from the devolved Administrations of Wales, Scotland and—dare I say it?—Northern Ireland.
The Bill is a modest and yet revolutionary proposal, with widespread cross-party support in the House.
Barbara Keeley
I value my hon. Friend’s support given his knowledge of passing previous measures. May I take this opportunity to say that I intend to press the Bill to a Division and have no intention of withdrawing as it was suggested earlier I should do? As I said in the conclusion to my speech, the measures are needed by carers of all ages. That is why I introduced the Bill and I am grateful for his support.
Dr Francis
As a vice-chair of the all-party parliamentary group on carers, I warmly welcome my hon. Friend’s intervention. I am sure the group endorses her decision.
As I said, the Bill has massive support throughout the country. There is considerable support from employers, but—this has not been said—there has also been considerable support historically, as there is currently, from trade unions, and particularly the Union of Shop, Distributive and Allied Workers, which has always campaigned for carers. I warmly welcome the endorsement of the Bill by Caroline Waters OBE, director of people and policy for BT group and chair of Employers for Carers. Furthermore, the Association of Directors of Social Services and many individual directors of social services have endorsed the Bill.
A number of hon. Members have spoken of the importance of young carers and supporting young people going through university. I commend the work of the Open university, which has identified carers as a target group to support. I am very pleased with the work done by my good friend Rob Humphreys, the excellent director of the Open university in Wales, who is organising a conference on carers and higher education, which will take place later this year.
The Prime Minister only this week spoke of the importance of all Government Departments focusing on regenerating the economy. What better way to achieve that than by identifying our valued, unpaid carers so as to assist them back to work or into training, or by supporting our young carers in their studies? He could do so today by supporting this admirable Bill.
Laura Sandys (South Thanet) (Con)
It gives me great pleasure to follow the hon. Member for Aberavon (Dr Francis), in particular because of his history; he has been involved in the carers agenda for many years. I am pleased to be a sponsor of the Bill. The hon. Member for Worsley and Eccles South (Barbara Keeley), who introduced it, has a huge track record on social care and carers.
The issue of carers not only impacts the constituents of every Member of Parliament; there is probably not one MP who does not have a friend, a friend of a friend, a cousin or other family member who is caring or very close to somebody who is. Carers permeate every part of society, and every socio-economic and age group. For that reason, it is crucial that carers legislation and policy are taken extremely seriously.
I am pleased that the Government have taken the initiative to develop a White Paper that, for the first time in many years, deals with the gritty, extremely complicated—it does not lack pain—policy on long-term social care. We are facing a big problem in this country and globally. Carers are very much at the heart of how the policy needs to develop and evolve. In many ways, they are front-line troops.
The legislation and media coverage is all about care homes—the scandals involve the institutional support for people who are not well—but the important thing is what happens behind closed doors, and we need to address the quantity of people who need care and support. Those people are in some ways hidden from the system. They are invisible to the authorities, but they need both recognition—they need to know that we know and respect them—and practical support. We need policies to ensure that they are given the support they need and deserve because of the sacrifice that they are making.
Support for carers is a crucial long-term health care policy, but it hit me personally and changed my life. I was 17 when my father had a massive stroke and it changed our life dramatically. I was going to go to university, but I went out to work as a dispatch rider. My mother’s life changed dramatically. I did not go to university—I helped her to care for my father. Over the five-year period that it took for my father ultimately to die, my mother probably aged by about 15 years. That is the example of my life, but those things are happening around the country. People who are frail and have health problems find the moral responsibility of caring both physically and sometimes financially extremely difficult.
My experience changed my life and certainly my education, but it also taught me of the extraordinary self-sacrifice around the country. The issue of young carers is very important. I have done a lot of work in my constituency with them. The Bill needs to ensure that local authorities and all institutions around young people look to identify those who take responsibilities way beyond their years. I go regularly to a young carers group. The young children in the group look and behave as though they are older than their age. That is fantastic—they are maturing and taking extraordinary responsibilities—but caring changes how they grow up, including their access to a social life. They age before their time.
I make the situation clear to my local schools, but I am very lucky because they have taken a lot of personal responsibility to identify those young people. I appreciate, however, having listened to other Members, that some schools and even some people in social services do not understand the dynamic of these households and the additional responsibilities being put on these children.
Identification is extremely important for another slightly more controversial reason. A teacher in my area said to me, “Although the parents of some of these children have been ill, they are no longer ill but have become dependent on the child delivering care services to them.” There are all sorts of issues within this pathway of being a young carer that need to be identified so that support can be provided. We need to ensure that schools, social services and the institutions around these young people understand the issues, and we need to ensure that clear action is taken to alleviate the situation of children providing support to parents who have entered into this relationship of dependency.
Dr Francis
The hon. Lady talks about lessons and is making a powerful case, but however much we sympathise with carers, surely the real lesson is that there is no substitute for legislation.
Mr Nuttall
I am grateful to my hon. Friend. I feel that there is a danger that some of the content of the Bill may cause scarce resources to be diverted from front-line services to carers for the purpose of the production of assessments, surveys and strategies, rather than providing real, genuine help for those who need it most.
Dr Francis
If we take the hon. Gentleman at his word—and I do take him at his word: I believe that he is genuinely concerned about carers—it must be said that he has posed a series of very valid questions. Is it not time for him to allow the official Opposition to express their view, and, more important, to allow the Minister to respond to those questions? Should he not end his speech now?
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.
Mr Nuttall
I am grateful for that intervention. I appreciate that a pilot cannot be done in the same way that the Government could have done it, but as we have already heard this morning, there are many initiatives going on in local authorities throughout the country, and I am sure that it would have been possible for one local authority to have picked this up and trialled the Bill to at least give us some idea, or put some information before us this morning, of the likely cost, even if it was a matter of someone sitting down and trying to work it out for themselves. There will inevitably be a substantial cost.
Dr Francis
If the hon. Gentleman had listened carefully to what I said he would have heard that Carers UK has piloted something similar in Conservative Kensington and Chelsea and Labour Islington. There is good practice everywhere. What about the actual saving to the taxpayer from the tax take as a result of people going back into work? We are not talking about costs here, but about savings to the Exchequer.
Norman Lamb
I am happy to write to the hon. Lady with more information about timetabling. I absolutely want to get on with this. Pre-legislative scrutiny is important because it will ensure that we get the legislation right, but I am not interested in delay. I want to get the Bill on to the statute book, but I also want to get it right.
Dr Francis
Will the Minister meet the all-party parliamentary group on carers at the earliest opportunity to outline his proposals? Will he also seriously consider consulting the health Ministers in Scotland and Wales, where considerable progress has been made?
Norman Lamb
The hon. Gentleman raised those points earlier. Yes, of course I am keen to engage with Scotland and Wales, and I would certainly be happy to meet the all-party group. I want to be as open and inclusive as possible in this process.
As I have said, there is also a concern that the Bill would impose a range of new, additional burdens on public and private bodies at a time when we are committed to reducing such legal duties. We agree with much of the intent of the Bill, but there are a number of ways in which we can pursue our common goals effectively. In July, the Government published the draft Care and Support Bill, which will undergo pre-legislative scrutiny later this year. That is information on the timetable for the hon. Lady. We can use that process to discuss the provisions relating to adult carers. In addition, earlier this week the Department for Education published draft legislation on the reform of provision for children and young people with special educational needs. That will also present an opportunity to consider how we might improve the identification of and support for young carers. I urge the hon. Member for Aberavon (Dr Francis) to engage with that process as well.
Private Members’ Bills have played a central part in the history of carers legislation. I would like to take this opportunity to pay tribute to the hon. Member for Aberavon for the significant contribution that he made by promoting the Carers (Equal Opportunities) Act 2004. He has been involved in these matters throughout the period since, and I want to express my gratitude to him for that. I also want to thank other parliamentarians, including the right hon. Member for Coatbridge, Chryston and Bellshill (Mr Clarke), the right hon. Member for Croydon North (Malcolm Wicks) and Lord Pendry. Their contributions to the development of carers’ rights date back to the mid-1980s.
I also want to thank my predecessor, my hon. Friend the Member for Sutton and Cheam (Paul Burstow). He has championed carers, both from the Back Benches and while Minister with responsibility for care services, and I am certain that he will continue to do so. I want to take this opportunity to pay tribute to the work he has done as a Minister. He has shown utter dedication to the cause, and I know that that has been widely appreciated.
Carers make a vital contribution to society, as many Members have said, and we are taking concerted action to support them. We set out our priorities in “Recognised, valued and supported: next steps for the Carers Strategy”, in November 2010. Between 2011 and 2015, we will provide an additional £400 million to the NHS to support carers, including through the provision of carers’ breaks. My hon. Friend the Member for Bury North mentioned this earlier. The White Paper commits to over £125 million of additional resources being allocated to carers.
Carers are central to the Government’s proposals for care and support. For the first time, carers will be placed on the same legal footing as the people they care for. That is an incredibly important breakthrough. We will extend the existing right to a carer’s assessment and provide carers with a new entitlement to support to meet their needs. The hon. Member for Aberavon mentioned Scotland and Wales. Both are planning new legislation, but neither is proposing to require councils to meet the eligible needs of carers for support, as our draft Care and Support Bill does. That should be acknowledged. I understand that Wales and Scotland are proposing a discretionary power to provide services to carers. We are taking groundbreaking measures to improve the position of carers. We are providing resources to the Royal College of General Practitioners. In opening the debate, the hon. Member for Worsley and Eccles South referred to GPs in her own constituency and some of the interesting, innovative things they are doing. I accept that this is not widespread enough at the moment, but interesting things are happening around the country, which we should acknowledge. We are providing resources to the voluntary sector as well as to the Royal College of General Practitioners to help increase awareness among health professionals of the importance of supporting carers to identify themselves as such and to direct them to relevant information, advice and support.
Our care and support White Paper, “Caring for our future”, together with the draft Care and Support Bill published in July, set out the Government’s plans for the biggest transformation of care and support in England since 1948.
It is vital that carers are able to take a break from their caring responsibilities. To help support them to do this, the Government have made available an additional £400 million to the NHS between 2011 and 2015 to provide carers with breaks from their caring responsibilities to sustain them in their caring role. Under the White Paper proposals, carers would benefit from a diverse range of supportive personalised interventions. This might take the form of providing additional support for the care user either through respite care or in their own home; it might give the carer the opportunity to take a short break, perhaps a weekend away to see friends; it might mean being free to get a hospital appointment to look after the carer’s own health—a point raised by many hon. Members.