Social Care (Local Sufficiency) and Identification of Carers Bill

Tony Baldry Excerpts

Friday 7th September 2012 Commons Chamber

[Sir Tony Baldry (Banbury) (Con)]

The Government published their White Paper, “Caring for our future: reforming care and support”, just before the summer recess, and I think we would all agree with its statement:

“Carers make a vital contribution to promoting the wellbeing and independence of the people they care for…The support provided by millions of carers is testament to the strength of our society and our communities. However, we also recognise that caring brings challenges. Providing better support to carers is therefore crucial to ensure that they can maintain their own health and wellbeing, care effectively and have a life of their own alongside caring.”

Earlier this year, various all-party groups, including the all-party group on social care, which is chaired by the hon. Member for Worsley and Eccles South (Barbara Keeley), who has so ably introduced this Bill, and the all-party group for carers, which I co-chair, met to consider the measures needed to do exactly what the Government say they want to do in their White Paper, namely provide better support for carers, so that they can

“care effectively and have a life of their own alongside caring.”

The hon. Lady was fortunate enough to come reasonably high in the ballot for private Members’ Bills and, with the help of a number of carer organisations, such as Carers UK, drafted a Bill that addresses the challenge of how we can give effective support to carers.

The Government then published their much-awaited White Paper on social care, which was widely welcomed. I am delighted to say that, for the first time, it makes substantial commitments to carers, which I will come to in a moment. Unfortunately, but perhaps understandably, most of the press commentary on the White Paper centred on what the cost of residential social care would be. The new policy and the contribution to the support of carers were not necessarily highlighted sufficiently, but they are included in the White Paper.

The hon. Lady and those involved in promoting the Bill examined the measures in the White Paper and considered what other measures would be of further benefit to carers. A number of the Bill’s provisions are, therefore, not included in the White Paper, but I acknowledge that there is some overlap. For example, clause 1, which would introduce a duty to ensure sufficient social care support, is probably covered by the provisions in the draft Care and Support Bill.

I am anxious to find a way forward whereby we do not wake up tomorrow morning to headlines stating that the Government have killed off a Bill that would give more support to carers. We need to find a grown-up way to do this. My hon. Friends the Members for Shipley (Philip Davies) and for Bury North (Mr Nuttall) are present, and I suspect that these sextons on duty—these pallbearers of private Members’ Bills—will make lengthy contributions that may well not enhance the nation’s understanding of the problems faced by carers.

Before we make any further progress, I therefore want to make a request to the Minister of State, Department of Health, my hon. Friend the Member for North Norfolk (Norman Lamb), who I am delighted to see taking responsibility for this issue at the Dispatch Box for the first time. The White Paper contains a welcome chunk of policy on carers, but people involved with carers feel that some areas could be further enhanced. All I want my hon. Friend to do is give a clear undertaking that, between now and the eventual Second Reading and debate of the Government’s Bill on social care, he would be willing to have meetings with the relevant all-party groups to discuss how provisions relating to carers could be further enhanced.

I fully accept—the interventions on the hon. Member for Worsley and Eccles South demonstrated this—that there are tensions in relation to how one balances duties on various organisations and partners in ways that are reasonable to their costs, and to some of the changing patterns resulting from the fact that local governments are now seen more as enablers than deliverers. I want my hon. Friend to give an undertaking that he would be willing to have discussions with those of us who are concerned about carers policy, to try to ensure that, when the Government’s Bill on social care is presented to the House, those parts relating to carers are as robust and as resilient as possible.

I hope that my hon. Friend is willing to give that undertaking. Given that he has only taken up his brief this week and has probably yet to read the briefing for incoming Ministers in his red box, I would fully understand it if he felt unable to respond in detail today and say, “Well, I can accept those bits of the Bill, but not those bits.” That would be difficult. It would be disappointing, however, if there were any scintilla of a suggestion that the Government want to “kill off” this Bill because they do not want it to pass. I hope that my hon. Friend will see this as an opportunity to have a constructive debate on policy on carers and their needs, and trumpet his willingness to engage with us to make sure that those parts of the Government’s new Bill relating to carers are as good as possible.

[The Minister of State, Department of Health (Norman Lamb)]

I am grateful to my hon. Friend for his comments, and I am happy to give, straight away, the undertaking that he seeks. I will engage fully with the hon. Member for Worsley and Eccles South (Barbara Keeley), who is the Bill’s promoter, and with the relevant all-party groups. It is important that we get this right and that we do not let down those people with caring responsibilities. I am very happy to give a firm commitment to engage fully between now and when the Government’s Bill is presented to this place.

[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.

[Dame Joan Ruddock (Lewisham, Deptford) (Lab)]

Will the hon. Gentleman give way?

[Sir Tony Baldry]

Before I give way to the right hon. Lady, I want to say that I hope that the Government’s Bill will codify all the existing legislation relating to carers. Over the years, a whole number of private Members’ Bills, one of which was introduced by the hon. Member for Aberavon (Dr Francis), have enhanced the role of carers. It is confusing and difficult for people to find their way around different bits of legislation, so it would be good if all of the legislation relating to carers were collected in one piece of legislation.

[Norman Lamb]

I am grateful to my hon. Friend for allowing me to intervene again.

It is the Government’s ambition to codify all the provisions relating to carers and care and support in one Act of Parliament. A big problem, as he rightly identifies, is that the law has developed in a haphazard way. Getting it all into one Act of Parliament, written in plain English, would be of real benefit to carers and others in the sector.

[Sir Tony Baldry]

I am genuinely delighted to hear my hon. Friend say that. It is really good news. If we continue on that basis, we will make substantial progress.

[Dame Joan Ruddock]

I wanted to intervene to say that I was surprised that the hon. Gentleman was satisfied with the Minister. I say to the Minister that it would be a miracle if one could get every piece of legislation into one consolidated Act; it just does not work in that way.

I say to the hon. Gentleman that it would be a great shame if the Bill were talked out today, after all the work, all the effort, all the support in the country and all the Members who have come here today to support it. The place to deal with the issues that the Government may or may not want is in Committee. A vote in favour of Second Reading today would send an important message on all the matters that my hon. Friend the Member for Worsley and Eccles South (Barbara Keeley) has spoken about so ably this morning.

[Sir Tony Baldry]

Having been a Minister in the last Government and as a grown-up and senior Member of this House, the right hon. Lady has a clear understanding of how legislation works and evolves. A large number of private Members’ Bills during the 13 years of the last Government did not make progress in the form in which they were drafted. The point is not that the Bill must pass today in this form, but that it contains a number of provisions, some of which are not in the White Paper.

The grown-up and responsible undertaking that I have received from the Minister is that he will have intelligent discussions with all of us who are concerned about carers policy over the next few months to see whether we can get some of these provisions into the Government Bill when it is brought forward. If not, all of us will want to hear good reasons why, given that some of the work in the private Member’s Bill builds on previous legislation, for example on child care, where there are clear precedents for what we are seeking to achieve.

[Barbara Keeley]

It is not without precedent for Conservative or Labour Governments to accept private Members’ Bills relating to carers. I think that I am right in saying that of the three pieces of legislation brought forward by Labour MPs, one was brought forward with the agreement of a Conservative Government and the other two with the agreement of a Labour Government. For all the pious aspirations in the carers strategy documents that are rolled out by Governments, it is the concrete rights and measures in those private Members’ Bills that have made the difference, as I said in my speech. It is important to recognise that sometimes a specific measure is needed, rather than a lot of consolidation and aspiration, which make no difference to carers on the ground.

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[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.

[Mr Nuttall]

Will my hon. Friend give way?

[Sir Tony Baldry]

I give way to my hon. Friend, who is one of the pallbearers.

[Mr Nuttall]

I am most grateful to my hon. Friend for giving way. I hope to be helpful to him. Does he agree that rolling up the thrust of the private Member’s Bill into the Government Bill, which I think is the line that he is going down, would be entirely in line with the first recommendation of the Law Commission’s “Adult Social Care” report, which states that there should be a single statute in this area?

[Sir Tony Baldry]

Absolutely; having a robust single statute is in everybody’s interest. We need to understand that we are not abandoning, resiling from or giving up any of the provisions in the Bill, but saying, to use a rather boring lawyers’ term, that they are adjourned generally with liberty to restore. In other words, we want to make quite sure that we have the opportunity to have a series of meetings with the Minister and his officials, so that we can go through the details of what is proposed for the Government’s Bill and how many of the private Member’s Bill’s provisions we can incorporate in it. The Minister has given his undertaking that we will have those meetings, and I know it was given in good faith.

It is the Government’s clear intention and policy to support as many people as possible to be in work, and one challenge for carers is the difficulty of retaining employment. The Government, hon. Members and everyone else have common cause on that, so it is just a question of how to make effective policy.

Likewise, it is clearly crucial that carers are identified, that they know themselves to be carers and that the supporting machinery identifies them as such. The provision of respite care has helped. In the past, I have asked GPs, “Why don’t you identify patients in your practice who have carers?” They have said, “Well look, Tony, there’s not really much point, because there’s not much that we can do to help them. We can identify them, but how much further does that get us?” At least now, with the NHS being able to provide respite care, there is a real purpose to GPs’ doing that. We need to ensure that the system sends the right signals and provides the right support.

[Diana Johnson]

I listened carefully to what the hon. Gentleman said about employment. The Bill contains provisions to do with young carers’ education and colleges of further education. I am concerned that the Department for Education’s direction of travel is not towards providing regulation on those matters to schools, colleges and universities. The Department for Business, Innovation and Skills, which holds the universities portfolio, should also be involved in that. The Minister has given an undertaking from the Department of Health’s side, but other Departments are also involved. I am not convinced at the moment that the Bill’s provisions will find their way into the Care and Support Bill. I would like this private Member’s Bill to go forward, because it contains additional measures that we want in place.

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[Sir Tony Baldry]

It is very rare that an area of public policy, particularly on something as important as carers, can be dealt with by just one Department. I have absolutely no doubt that the Government’s White Paper on social care is the subject of an enormous amount of interdepartmental discussion. One task of the various all-party groups is to highlight to the Department of Health the issues that relate to other Departments, so that it can negotiate with those Departments before bringing forward its Bill. There will be cost implications in different areas, and I am sure there will be a robust debate about money on Second Reading of the Care and Support Bill. We have not yet come to that.

I say to the hon. Lady that the White Paper was published only shortly before the summer Adjournment. There has been little opportunity for any of us to interrogate Ministers in other Departments about policy areas such as those that she rightly identifies. Of course, a number of Ministers, like the one who is here today, have only just taken on new ministerial briefs. I believe that at Minister of State and Parliamentary Under-Secretary of State level, only 11 Ministers will be opening the same red boxes this weekend as they did last weekend. Those of us who have been Ministers know that it takes two or three weeks just to absorb the briefing for incoming Ministers, so we should not be impatient. What is important is to ensure that those of us who are in all-party groups relating to carers, or who are concerned about carers policy, can support the Government’s social care Bill on Second Reading.

[Philip Davies]

Will my hon. Friend give way?

[Sir Tony Baldry]

I give way to the other sexton.

[Philip Davies]

I am grateful. I have been trying to decode what my hon. Friend said about me and my hon. Friend the Member for Bury North (Mr Nuttall). I do not know whether he was trying to be insulting, but in his characteristically charming way, or whether he was merely saying that we take a close interest in each private Member’s Bill, which I would say was a compliment, even though perhaps a rather ham-fisted one.

Is my hon. Friend trying to say that if we get the undertakings that I am sure we would all like from the Minister today—he has already made some—it would be helpful if the hon. Member for Worsley and Eccles South (Barbara Keeley) were to withdraw her Bill?

[Sir Tony Baldry]

We all have to be grown-up about this. The hon. Member for Worsley and Eccles South has come up in the ballot, and it is a matter for her how she deals with the Bill. She is perfectly entitled to take it forward. I am just concerned to ensure that there is no scintilla of a suggestion that we will get ourselves into a hole. I was in the House when Nick Scott was the Minister responsible for the disabled. We got ourselves into a terrible hole over a private Member’s Bill by giving the impression that we were not interested in policy relating to the disabled, which of course was totally untrue. I do not want there to be any suggestion of that happening in relation to carers. I hope that we have now found a constructive way forward.

[Roberta Blackman-Woods]

Will the hon. Gentleman give way?

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[Sir Tony Baldry]

I had not intended to take so much time, so I will conclude after giving way to the hon. Lady.

[Roberta Blackman-Woods]

I am grateful to the hon. Gentleman for giving way when he was about to conclude. I am having some trouble following Government Members’ logic. Surely it would help if we could get into legislation the measures to support carers that we all want to see. We should give a strong message that the House supports the Bill.

[Sir Tony Baldry]

Let me have one last crack at this; then I will sit down. I believe everyone in the Chamber agrees that supporting carers is incredibly important. One privilege of being an MP is that people invite us into their homes and open up to us about their problems. I suspect that we have all been to many a house where an elderly wife looks after an elderly husband, or the other way around, who has early or age-related dementia. Given our tendency to live longer, the costs of nursing home care and sometimes the difficulties of local authority budgets, the reality is that more and more people with Alzheimer’s or other age-related dementias are having to stay at home longer and be cared for by loved ones.

We also go into homes like the one that I visited recently, where I found a mother looking after her daughter who had severe learning difficulties and was effectively bedridden. That mother has looked after her daughter lovingly for much of her life. As we know, the challenges and strains of such a situation often lead to the break-up of other relationships, with all the consequences that brings.

There are also many young carers, who are often the hardest group to reach and the most overlooked. People are not always conscious that there are young carers. When we go into their homes, it is sometimes unclear who is the parent and who is the carer, and how the parent can take parental responsibilities for the child while the child takes caring responsibilities for the adult. The swings in that situation can be extraordinarily difficult.

What is almost unique about this Bill is that since the hon. Member for Worsley and Eccles South came high in the ballot and brought forward her Bill on carers, which was fantastic, the Government have produced a substantial White Paper covering exactly that policy area. Part of the Bill overlaps with the White Paper and part does not, but the Minister has given the undertaking that he is willing to engage with us on the bits that are not yet established as Government policy in the White Paper, to see whether it is possible for them to become Government policy before the Care and Support Bill receives its Second Reading. I would rather have an undertaking to engage in constructive debate and discussion about trying to get those provisions into the Bill, than run the vagaries of whether the Bill gets a Second Reading today—of course, how we proceed is entirely a matter for the hon. Lady—and whether, when we get to the rather boring part, Report and Third Reading, the Bill fails to make sufficient progress because the Government do not want it to proceed.

I hope that all sides of the House will recognise the importance of supporting carers and getting the policy right. The Government have acknowledged the importance of carers in the White Paper, and we must all engage in further work. We would have had to do that anyway in Committee, but instead we will work with the Minister and his officials. We must ensure that all hon. Members can support the Bill, so that when it is published it does justice to the need to support millions of carers throughout the country about whom we are concerned.

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[Norman Lamb]

I am grateful to my hon. Friend for raising that point. Yes, absolutely, there is and I will come back to that. One concern I have is the focus in the Bill on social care, whereas the thrust of Government policy is the importance of integrated care. My hon. Friend and the shadow Minister referred to Torbay. I am passionate about that approach. We can do an awful lot more. The whole approach should be to integrate health and social care in our planning and our execution, rather than, as the Bills risks, silo-ing social care and assessments of social care and carers’ needs separately.

The shadow Minister commented on budgets. I absolutely understand that budgets are tight and that local authorities are in difficult times, but the new budget survey from the Association of Directors of Adult Social Services shows not huge cuts but that councils have risen rather impressively to the challenge and identified savings of £1.89 billion since 2010-11 by using resources more efficiently. Surveys show that councils’ spending on adult social care is due to fall by only £200 million or so. If the money can be used much more effectively, we can ensure that services are protected.

One thing I am interested in pursuing in my new role is how well we commission care. There is disturbing evidence of a race to the bottom, with care being commissioned on the basis of an hourly rate and the cheapest getting the contract. We need to do everything we can to ensure that commissioning provides incentives to improve health and well-being, prolong independence and improve mobility, thereby saving money and improving care, which is what we need to achieve. There is probably a widespread view that we do not commission care nearly effectively enough. There must be a substantial improvement in our expenditure on social care.

We agree with much of the intention of the Bill, but for a number of reasons we cannot support it. First, it would perpetuate the fragmentation of carers legislation, which we are seeking to end. My hon. Friend the Member for Bury North made the point that the Law Commission argued for a single statute. It seems irrational, at the very moment that the whole sector is celebrating the fact that we are seeking to bring everything together, to have a separate Bill introducing new duties. The debate about getting the framework right—putting everything together in one clear framework, written in plain English—needs to be part of the Government’s Bill.

[Sir Tony Baldry]

I urge my hon. Friend to be as conciliatory as possible. In fairness, when the hon. Member for Worsley and Eccles South (Barbara Keeley) started with her Bill, the Government had not published their social care White Paper, so she had no idea what it would contain. The important thing is to focus not on the Bill’s potential failings but on a process that enables us to look at its ideas and concepts and decide which will fit into the social care Bill that my hon. Friend will bring forward for Second Reading in due course.

[Norman Lamb]

I completely agree with my hon. Friend.