(11 years, 2 months ago)
Commons ChamberThat is a key point, and one that I want to put to the Government very strongly. Carers can only be helped to remain in the work force and balance their working lives with their caring responsibilities if the right substitute care and flexibility are available, and if employers have the right attitudes in the first place.
I will take one more intervention, but I must not take too many more, because I have only 15 minutes in which to speak.
Could not public sector employers be exemplars in this respect? Can the right hon. Gentleman suggest any ways in which such good practice could be spread throughout the public sector?
The hon. Lady is absolutely right to say public sector employers should be—and could be, and must be—exemplars in this. Indeed, it would be great if the NHS itself was an exemplar in this area, yet as I will come on to say, I think in too many ways institutionally the NHS is rather biased against carers, and certainly blind to their needs in too many cases.
There is an economic reason why we need to do more in this area. It is estimated that as many as 50% of those involved in personal and household services operate in the grey economy. This represents a further missed opportunity in terms of job creation and lost revenue to the Exchequer. Looking across the channel to France where work began almost a decade ago to address a number of these issues, market development for homecare services has led to the creation of an additional 2 million jobs, with the industry becoming one of the biggest growth sectors in that economy.
There are clearly lessons to be learnt in how to support and strengthen carers’ ability to care in a way that supports the wider UK economy. I hope the Minister will be able to tell us when the “task and finish group” recommendations will be published.
Moving on, one of the most practical ways to support carers is to provide them with breaks from caring. That can help reduce the stress and the often constant demands that caring involves, and allow them to have the time to improve their own physical and mental health.
In recognition of the value of carers breaks, the Government committed in the 2010 spending review to spend £400 million over four years on breaks for carers living in England. As the Minister at the time, I was convinced of the importance of giving carers a break and knew that it would make a huge difference to their lives. I therefore regret that the evidence suggests that that has not happened. Monitoring by the Carers Trust for the year 2011-12 found that action on the ground had often been slow or non-existent. Despite clear reporting requirements, in many areas it was impossible to track how money had been spent, and in a small minority of cases nothing at all had been spent on services for carers. Some fantastic work has been done, but progress has remained appallingly slow. To be fair, this problem has dogged not just the coalition Government, but successive Governments.
I ask this question: what is the common factor? The common factor is the institution we are using to direct the money, which is the NHS. It does not see carers as significantly important contributors to it, and therefore it does not see this money as worth spending on them. That has to change.
(12 years, 1 month ago)
Commons ChamberThat is why we have to explain this clearly. By lifting the means-test threshold to £100,000, the interaction between the absolute cap and the means test means that the amount the individual will ultimately pay as their lifetime contribution towards their care costs is related to their wealth. I urge the hon. Gentleman again to look at both the tables and the graphs in the progress report, as he will see exactly how it protects the assets of a family, even in the scenario he has described.
It is also important to understand that redrawing the boundary between what the individual pays and what the state pays does not—things all too often were conflated in this way last week—add any new spending power to the system. That leads me to the question of getting funding into the system. Before the 2010 spending review, the Dilnot commission urged the Government to protect baseline funding for social care, and we did just that. In October 2010, we confirmed an extra £7.2 billion of support for adult social care, which, together with a programme of efficiency, was sufficient to protect access to support. That included an unprecedented £4.2 billion of NHS resources to support social care, to promote integration and innovation, and to support the expansion of reablement services. The Labour party wants to paint a picture of doom and gloom up and down England on these services, tarring every council with the same brush of being crude cutters of services, when that is not the case.
Perhaps I could describe to the Minister what is happening in Trafford, which has a Conservative council and is where my constituency is located. We are seeing a twin squeeze, despite the Minister’s apparent sanguinity about the funding. On the one hand, we are seeing thresholds for access to care being raised as a means of rationing the way in which the money is spent. On the other hand, as care providers are telling me, commissioners are reducing and reducing the price they are prepared to pay providers to the point where they can hardly sustain their business at all or meet minimum wage legislation.
We know from the surveys that although last year there was a cash freeze in the increases that local authorities paid to provider organisations, this year across the country the average was a 1.4% increase. Again, that does not quite tally with the picture that some hon. Members want to paint.
It is also worth saying that the picture of local authorities grappling with tough budget settlements is complex. Different councils are responding to the pressures on budgets in different ways. Some are acting in a very smart way, as the Demos report, “Coping with the Cuts”, revealed. Such councils are protecting access by focusing on reablement services, helping more people to get back on their feet without the need for long-term support, which is better for the individual and more cost-effective. Indeed, the latest figures from the Association of Directors of Adult Social Services reveal that councils are protecting front-line care.