Children’s Heart Surgery

Diana Johnson Excerpts

Wednesday 12th June 2013 Commons Chamber

[Mr Hunt]

If there are management consultants responsible for what went wrong, I am sure that the NHS will draw the appropriate conclusions.

[Diana Johnson (Kingston upon Hull North) (Lab)]

I am pleased to hear that care pathways as a whole will be looked at and given consideration. Will the Secretary of State confirm, as he made clear in response to a number of questions, that the genuine concerns of constituents, including mine in Hull, will be listened to? Transport and access are very important to my constituents because of the city’s geographical location. Whoever makes these decisions should fully understand the geography of the country and be able to make a proper decision.

Heart Surgery (Leeds)

Diana Johnson Excerpts

Monday 15th April 2013 Commons Chamber

[Mr Hunt]

I agree with my hon. Friend. There are two types of reason for people going into hospital. With geriatric care, for example, there are clear advantages in someone being treated as near as possible to their home. All other things being equal, it makes sense for people to be treated where it is easy for friends and family to visit them, as that can aid recuperation and convalescence. When more complex surgery is required, however, there is clinical evidence that mortality rates are better if we specialise surgery in a fewer number of centres. That is the debate that we are having about children’s heart surgery, and I hope to resolve the matter as quickly as possible.

[Diana Johnson (Kingston upon Hull North) (Lab)]

Given that the Safe and Sustainable review is being dogged by so many problems, and given the inaccuracies and the prejudice against Leeds in particular, has the Secretary of State thought about scrapping the whole process?

[Mr Hunt]

That is the subject of legal proceedings at the moment, and I want to ensure that we have a process that is fair and that is recognised to be fair by all the people who are affected by this possible decision. I therefore want to ensure that the decision will be judicially robust, but I also want to get independent advice from the IRP before I make my final decision. If that means that it takes longer to get to a decision, then I am afraid that that might be the case, but the most important thing is to get to a decision that is fair and that is recognised to be so.

Mid Staffordshire NHS Foundation Trust

Diana Johnson Excerpts

Tuesday 26th March 2013 Commons Chamber

[Mr Hunt]

My hon. Friend is right: we have to ensure that the inspectorate works in the successful way that Ofsted has worked in the school system, and does not make the mistakes that have been made by other regulators inside the NHS system. It is important that it is based on respected peer review, is thorough and is respected in terms of the input that it is able to give hospitals on improving their performance. We will work hard to make sure that we deliver that.

[Diana Johnson (Kingston upon Hull North) (Lab)]

Who is expected to pay for the additional year that nurses will spend as health care assistants?

[Mr Hunt]

We are piloting the scheme to ensure that we do not end up discriminating against nurses for financial reasons. We want to attract the best people into the profession, whatever their financial background.

NHS Commissioning Board

Diana Johnson Excerpts

Tuesday 5th March 2013 Commons Chamber

[Norman Lamb]

I congratulate my hon. Friend on getting an issue of local concern into his question. He is entirely right: I will take no lessons from the Opposition, given what happened when they were in government, and patients’ interests must indeed always come first.

[Diana Johnson (Kingston upon Hull North) (Lab)]

Will the Minister tell me which part of the NHS preferred provider status, which was introduced by the last Labour Government, his Government do not understand?

[Norman Lamb]

According to my recollection, at the last general election all three parties committed themselves to any willing provider. The degree of hypocrisy that we sometimes encounter beggars belief.

Social Care Funding

Diana Johnson Excerpts

Monday 11th February 2013 Commons Chamber

[Mr Hunt]

I can absolutely confirm that, yes.

[Diana Johnson (Kingston upon Hull North) (Lab)]

On the financial products that will be available, will the Secretary of State produce evidence so that constituents in Hull can find out what kind of figures we are talking about as regards their protecting themselves for the future?

[Mr Hunt]

I am making the announcement today, so we have to give the financial services industry some time to respond to the proposal. However, the indications are encouraging, and I think that we will all see, in plenty of time for the 2017 start of this plan, what products are available. There may be separate products, but it may also be something that becomes part of people’s pension planning. In the same way that people decide what arrangements they want in their pension for an annuity and for a lump sum payment, payment towards these costs up to the level of the cap may become another part of the pension plan. We need to let the pension and insurance industries have the time to respond and to come up with these plans.

Winterbourne View

Diana Johnson Excerpts

Tuesday 30th October 2012 Commons Chamber

[Norman Lamb]

First, abuse is unacceptable and horrifying wherever it takes place, whether in the public sector or the private sector. The review that followed Winterbourne View being exposed revealed poor standards of care in too many places in both the public and private sectors. We need to be clear on that. Secondly, I have questioned whether there is adequate corporate accountability and whether adequate rules and regulations are in place to ensure that accountability. If people are making a profit out of providing care, they have to be held to account for the standards of that care.

[Diana Johnson (Kingston upon Hull North) (Lab)]

May I raise with the Minister my concerns about the relaxation of checks on people who work with vulnerable adults and children, as set out in the Protection of Freedoms Act 2012? As a new Minister, will he undertake to look at the specific provisions in that Act and see whether he is satisfied that our most vulnerable people are protected?

[Norman Lamb]

I am happy to discuss the matter further with the hon. Lady. It is clear, though, that when a care home provider seeks to recruit a member of staff to work with people in a care home setting, they have to—[Interruption.] They are obliged in law to carry out criminal records checks on people who work within that setting. I repeat, however, that I am happy to discuss the matter with the hon. Lady and to look again at the issues.

Social Care (Local Sufficiency) and Identification of Carers Bill

Diana Johnson Excerpts

Friday 7th September 2012 Commons Chamber

[Barbara Keeley (Worsley and Eccles South) (Lab)]

I beg to move, That the Bill be now read a Second time.

I welcome the Minister to his new role and to his first debate, I think, in the main Chamber as Minister responsible for care services. After being drawn third in the ballot for private Members’ Bills, I knew that I wanted to introduce a Bill to improve quality of life for carers. I have been able to introduce a ten-minute rule Bill on the identification of and support for carers three times in the past, in 2006, 2007 and 2010. A number of the sponsors of this Bill also supported the earlier Bills. I particularly highlight the support of the hon. Member for Banbury (Sir Tony Baldry) and my hon. Friend the Member for Kingston upon Hull North (Diana Johnson), who both supported each of those three Bills. I also want to highlight the support of the former Minister for social care, the hon. Member for Sutton and Cheam (Paul Burstow), who supported my Bills in 2006 and 2007. I thank the former Minister for his work on this Bill and for meeting me and the Bill’s sponsors to discuss the issues.

The issues addressed by this Bill are of great importance to carers and the people for whom they care. The Bill is supported by 28 national organisations and I shall mention some of them now: Age UK, the Alzheimer’s Society, the Carers Trust, Carers UK, Independent Age, Leonard Cheshire Disability, Marie Curie Cancer Care, Parkinson’s UK, the Royal National Institute of Blind People and the National Union of Students. In addition, 57 local organisations and three NHS bodies support the Bill, as well as more than 2,000 individual carers.

Clauses 4 to 6 focus on the identification of carers. I will talk about them later, but first I shall speak to clauses 1 to 3, which address the sufficiency of social care. We know that demographic pressures are increasing the demand for care services, which is often described as the care crisis. I, like other hon. Members, have argued many times that we need to close the funding gap for social care. The provision of sufficient social care is complex. As Andrew Dilnot says in the report of his commission on the funding of care and support:

“It is a matter for celebration that people are living longer. For many, these are extra years of good health and quality of life. For others whose care needs grow, we see much fear and uncertainty. Caring for and supporting each other should be something to celebrate. In the life and work of individuals and carers we can see dignity and independence made possible, and much that is good about our communities and society.”

We should indeed celebrate the fact that we are living longer and that more than 5 million carers are willing to provide care and support to a family member or friend, but we should also ensure that we support those carers and acknowledge that they have a right to work, and to have a social life and leisure, alongside their caring commitments. The Government frequently express that as their aspiration in carer strategy documents, but it is not what happens in many parts of the country.

A lack of identification of carers and of appropriate support for them has costs for not only the individual but our economy. Carers UK estimates that 1 million carers have given up work or reduced their working hours so that they can care. Its 2011 survey found that 31% of working age carers gave up work or reduced their working hours to care because support services were insufficiently flexible, because the person for whom they cared did not qualify for support, because there were no suitable services in the area, or because the services were too expensive or not reliable enough.

There are many case studies showing the great impact that giving up work to care has had on carers’ lives. Salford carers centre told me of carers who, after seeing no way of avoiding giving up the work that they loved in order to care, felt “desperate” or

“upset at being pushed into a corner”.

Carers UK cites the example of Susan who cares for her adult son, Tom, who has severe autism. Tom needs a lot of care, including constant supervision, because he regularly has fits. He has no sense of danger and does not eat unless prompted. Susan used to be head of English at her local school, but she was forced—she had no alternative—to give up her job to care for Tom because his college holidays did not fit the school holidays, and it was impossible to find suitable replacement care for him. Susan would like to work but, without appropriate care services, she can fit in only 12 days of supply teaching each year around caring for Tom.

Age UK told me about Christine who cares for her mother, Margaret. After Christine’s father died, and owing to her mother’s mobility problems, Christine offered her mother the chance to live with her. She intended to carry on working, but her mother’s mobility deteriorated, and the strain of caring and also working in a demanding job led to the total collapse of her health. After giving up work and using all her savings, Christine found that she had to go on benefits, which wounded her pride and played on her health. Employers for Carers, a business forum of 55 employers representing nearly 1 million employees, supports the Bill as a measure that is important for our country’s future economic productivity.

[Diana Johnson (Kingston upon Hull North) (Lab)]

Given the country’s economic circumstances, we all recognise the importance of keeping people in jobs whenever possible and of creating jobs as part of an attempt to grow the economy. Does my hon. Friend agree that the Bill would go some way towards helping that to happen?

[Barbara Keeley]

Absolutely; I thank my hon. Friend for that point.

The Bill is also supported by British Gas, BT, Bright Horizons and PricewaterhouseCoopers because they believe that its measures are important. Caroline Waters OBE, the director of people and policy at BT and the chair of Employers for Carers, says:

“We are seeing the mounting costs, not just to families but to business of a care system that often cannot support carers trying to juggle work with care. Stimulating the care market can deliver an economic triple win—better services for families, the infrastructure to help employers retain skilled staff and a real boost to economic growth. The debate started 20 years ago with childcare and there is now a pressing need to bring the same focus and progress to care for older and disabled people. This Bill would start this important process by placing a duty on local authorities to ensure a supply of care as is already the case for childcare.”

Members of the Employers for Carers forum increasingly report staff leaving work at short notice to take on caring responsibilities. The peak age for caring is between 45 and 65, and that age frequently coincides with the peak of an employee’s skills, knowledge and experience. Losing such employees can lead to large retraining costs on top of recruitment costs.

A recent report by Dr Linda Pickard of the London School of Economics shows that carers giving up work to care costs about £1.3 billion a year in lost tax revenue and benefits. Also on costs to the economy, a recent report by Carers UK suggests that the failure to address the funding of adequate care provision, as other countries have done, means that we are missing out on jobs and growth.

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[Barbara Keeley]

Very much so. It sometimes involves social workers and very often teachers. Teachers need this awareness because young carers may fail to turn up at school, not do their work on time, and not be there for exams. It is often said by young carers’ organisations and projects that GPs and health professionals ignore young carers. A 10 or 11-year-old is expected to care for someone with perhaps an alcohol problem or a mental health problem, and yet the GP or doctor involved in that situation simply ignores them, treating them as if they were not there.

[Diana Johnson]

Given what my hon. Friend is saying about young carers, there appear to be similarities with looked-after children. Measures have been put in place in schools to ensure that looked-after children are given the support they need in difficult circumstances. Could we transfer those measures to children who are caring for siblings or parents?

[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.”

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[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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[Laura Sandys]

Legislation is important and is part of what the Government are doing to get a grip on the situation. The forthcoming social care Bill is extremely welcome and it is important that these measures be considered and incorporated in it. I do not question the importance of legislation.

Humanity is also important, however, and that is about education, understanding and people being able to identify the problems in front of them. On the long-term care issue, let us consider the system operating in Torbay. That did not need legislation. It needed common sense and an understanding of how to integrate the provision of care. It needed agencies to talk to each other and to think about how to deliver service to individuals and families, rather than thinking of themselves as institutions.

[Diana Johnson]

I am listening carefully to what the hon. Lady says. She points to examples of good practice, but those often require a champion who sees young carers as an important issue that needs to be addressed. Unfortunately, however, not all head teachers, heads of colleges or vice-chancellors take the same view about young carers or student carers, so having legislation to underpin what is required of those institutions is important, as too are champions.

[Laura Sandys]

I do not dispute the need to ensure that everybody within these institutions has a responsibility towards carers. There is no question about that. They also have responsibility for the welfare of children. They have to understand that this is bigger than just the responsibility of carers. It also involves attainment at school and young people’s mental health. It is interesting and a bit concerning that some teachers do not even know that there is such a thing as a child carer. I find that remarkable, but solving that problem does not require legislation; it requires the education of the educators. This private Member’s Bill is part of the way to ensure that we start to normalise what is required from these organisations and institutions.

We have an opportunity here. Perhaps we, as the Bill’s sponsors, should be making representations to the Select Committee on Health, which will be doing the pre-legislative scrutiny of the forthcoming social care Bill. We should ensure that the Committee appreciates the importance of the measures in the private Member’s Bill and puts in its report provisions to ensure that the Government respond not only to this debate and the private Member’s Bill but to the Select Committee’s report.

There is also an opportunity, in this legislation and the wider general practice of local authorities, in respect of the health and wellbeing boards. Health and wellbeing boards and the doctors’ commissioning units need to be focused not just on the patient who walks in the door but on the person looking after that patient. I am sure that many of us in the Chamber—and, I hope, beyond—always, as I do, say to the doctor, “You look at the patient, but do you always ask, ‘How is the carer? How well is that carer?’” Sometimes the carer will be less well than the so-called patient, but they will not present to doctors. It is crucial that doctors take the initiative and understand that if the carer ends up in hospital, we end up with two people in crisis, not just one. I would welcome clear statements from the Secretary of State and the Minister that GP commissioning and what I call practices of humanity need to be drilled through the health service in order to address these problems, which will present themselves and which will cost everybody in money and suffering.

I am very supportive of the provisions in the Bill, and I urge the Government to consider them as part of their overall legislation. The hon. Member for Worsley and Eccles South is a member of the Health Committee and I am sure she will be a great advocate, but it would be useful if proponents of this legislation were also to put in a submission to the Committee. I hope that this Bill will be encapsulated in the forthcoming Government Bill.

[Alex Cunningham (Stockton North) (Lab)]

I am delighted to speak in the debate and to follow the hon. Member for South Thanet (Laura Sandys), who made an eloquent speech, illustrated in particular by her mention that we are all affected—we all know somebody who is a carer and who probably has a tough life because of it.

The Bill is long overdue and I hope that the Government will allow it to reach the Committee stage for further discussion and development. For too long, we have taken carers for granted. We underestimate their invaluable contribution to the well-being of their families and communities—not to mention the economy. We fail to support carers, including children and young people, who often themselves suffer ill-health, and neglect the needs of carers who want to work outside their home. That is why the Bill is so important. It will go far in meeting carers’ needs, without placing huge additional financial burdens on local authorities already struggling to cope with the deep cuts they are having to implement.

I want to talk in particular about young carers—those under the age of 18 who undertake significant and, I would argue, often inappropriate caring responsibilities for their parents, grandparents or siblings. Let us be clear: they are children. Indeed, the average age of a young carer is a mere 12 years—12-year-olds whose only concerns should be enjoying their youth and playing with their friends. Instead, very often they simply lose their childhoods as they care for disabled parents, parents who may be drug dependent, and parents whom they love deeply. No one wants to get too graphic about the things children do for their parents, but among other things they feed them, get them to the toilet, help bath them and help them get dressed.

To take on that level of care for a loved one is remarkable. Carers provide constant support, comfort and companionship. As my hon. Friend the Member for Darlington (Jenny Chapman) once said, “They make the good days good and the hard days better.” We know how young carers are passionate about supporting their families. The majority of young carers want to care and few ask to stop caring altogether, but they also need to be supported. Many young carers, however, struggle through the education system without being recognised as young carers. Their needs and those of the people for whom they are caring are often identified only during a crisis.

The Bill would create a strategic duty on local authorities to ensure that schools are proactive in identifying young carers as soon as possible, with a similar duty on further and higher education bodies. The earlier young carers are identified, the more support can be made available to them and the person for whom they care. Many young carers go without being identified, and a key reason that young people drop out of university and college, as others have said, is that they are caring for someone, often a parent.

Let us not underestimate the scale of the problem. Recent surveys have pointed to a hidden army of UK young carers, with four times as many young carers in the UK as are officially recognised. The 2001 census identified only 175,000 young carers, 13,000 of whom care for more than 50 hours a week, but a survey of schoolchildren has indicated that there are about 700,000 young carers in the UK—an astounding figure. Even that does not tell the whole picture. In the UK almost 3 million children under the age of 16—equivalent to 23% of all children—live in households in which one family member is hampered in daily activities by a chronic physical or mental health problem, illness or disability, meaning that countless young people have caring responsibilities, including administering medication, washing, cooking and cleaning.

We have some great support for young carers in my constituency, and my wife Evaline is a volunteer director of the Eastern Ravens Trust, a local children’s charity that has been working for more than 50 years to support children and young people from the Stockton borough area who are experiencing social isolation. One scheme is the young carers project, which provides young carers with the opportunity to meet and socialise with other carers, letting them simply have fun and blow off steam. I love spending time with them and was delighted to see them in this very Chamber not long after I was elected.

The project has also received a grant from the Princess Royal Trust for Carers to focus on identifying those young carers in households with substance-misusing parents who need support to help them be children as well as carers. The grant has made it easier to identify and help some of the most vulnerable carers in our area. The steering group, Young Carers Aloud, also aims to raise awareness of young carers and their issues in Stockton and has devised a young carers card that it hopes can be used discreetly in schools to let teachers and staff know who young carers are, ensuring that they get the support they need. Often, those young carers do not want their peers to know about their personal situations.

The Bill will enable such work to be performed all over the country. Young carers I meet tell me that they often feel isolated at school, and that they are a frequent target for bullies, as other Members have said. They have difficulties concentrating in lessons, worrying about their parents or family member—“Are they at home?”, “Are they okay?”, “Have they had an accident?”, “Have they lost their memory today?” Young carers are often unable to complete their homework as they simply do not have enough time due to their caring responsibilities. As a result, such young people, because no one knows about their situation, are often punished—they might be given a detention after school, which means that they cannot be present for family members who rely on them.

Examples of young carers in my constituency include someone whom I will call Susan. She is only 12 years old, yet she is the primary carer of her disabled mum. She used to be quiet and shy, but since accessing support at the Eastern Ravens Trust she has blossomed into a confident, lovely girl. Another carer is Peter—again, not his real name—who, despite being only 14, has been supported by the Eastern Ravens Trust for over four years. Peter himself suffers from learning difficulties and epilepsy, and yet he is the primary carer for his disabled mum, who also has mental health issues.

Schools in my constituency try to help young people whom they know to be carers, but throughout the country there is a tremendous lack of support for young carers, who can feel stigmatised by teachers and peers lacking understanding of their situation and leave school or college prematurely, without completing qualifications.

[Diana Johnson]

I am interested in what my hon. Friend says about detentions. Was he as disappointed as I was when the Government introduced measures in the Education Act 2011 that removed the requirement that 24 hours’ notice be given when a child is given a detention? A number of representations were made about how that could affect young carers who had to return home speedily to look after the person they were caring for. Does that not show that other Departments are not as aware as they should be of issues affecting young carers?

[Alex Cunningham]

I very much agree with my hon. Friend. I have tremendous concerns, because a child who faces a detention might not turn up for it and end up getting deeper and deeper into trouble because of a lack of understanding among their teachers. That is all the more reason why we need the provisions in the Bill to ensure that young carers are identified and that responsibility is placed on schools to provide them with the necessary support.

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[Mr Nuttall]

I am grateful. I was dealing with the point about definitions in response to an intervention from my hon. Friend the Member for Shipley (Philip Davies), but it is part of my wider concerns about the Bill. The Bill’s general aims are entirely laudable. Who would not want to help those who provide care for others, particularly for those who need help, assistance and care? All of us can unite on that. I am fully behind the idea of providing what care we, as a society, can afford to provide for those who need it. However, I think that there is a genuine debate to be had about how much further we can go at present, and about whether the Bill is the right vehicle to provide such support or whether—and I think this is an important point—we should heed the substantial report from the Law Commission, which stated in its first and very clear recommendation that a single Act should replace all the existing legislation. I think that we should give further thought to what has been said this morning about the possibility of incorporating the provisions of this Bill in the draft social care Bill.

[Diana Johnson]

Does that mean that the hon. Gentleman does not support this Bill?

[Mr Nuttall]

As I have made very clear, I support the general aim that the country should continue to provide support, as it does already—

[Diana Johnson]

What about this Bill?

[Mr Nuttall]

I think that this Bill is too wide in its implementation, and not clear enough. I shall be dealing with each clause and explaining what the difficulties are, but we are not there yet. The hon. Lady is jumping the gun slightly.

The Bill has two general aims. The first is to place a duty on local authorities to ensure that there are sufficient social care services to support carers and those who are disabled.

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[Norman Lamb]

I absolutely agree with what the hon. Lady is saying: the information, guidance and support have to be made available. That is the key point, and I do not think there is any disagreement between us on it.

However, imposing a duty on public and private bodies to identify carers could be seen by some as intrusive. This depends on how the body seeks to exercise the duty, but it will be exercised in a variety of ways and this could conceivably be intrusive for some who want to be private about their family circumstances. We know that some families in which a young person is providing care can be very wary of letting others know. It is very important that they are given all the information, guidance and support they might need, but they may be afraid that the child will be taken into care, or they may be concerned about the opinions and reactions of others, including schoolteachers; the hon. Lady herself talked about the stigma that, outrageously, sometimes attaches to young carers. Public and private sector bodies need to be aware of such sensitivities, as I believe she accepts. They need to tailor the way they act and support carers in order to be responsive to the individual needs of the child and their family. This Bill runs the risk of preventing such sensitivity and flexibility.

In many areas, work is already under way to help to identify and support carers, without there being a specific legal duty in place. For example, NHS Surrey is developing a health care pathway to trigger the identification of carers, enabling them, where appropriate, to be pointed towards information and local authority carer assessments. The key issue—this is the point we have just debated—is not about labelling people as carers; it is about raising awareness and understanding of what a caring role can entail among those working in education, health and social care. We need to equip them with the knowledge to direct people to relevant sources of information, advice and support.

GPs and those working in the NHS have a vital role to play. Last year, the Department of Health funded a range of initiatives by the Royal College of General Practitioners, Carers UK and the Carers Trust to increase awareness in primary health care of the needs of carers and how to access support. GP carers champions and voluntary carer ambassadors have been appointed and much good practice in the early recognition of carers has already been identified. We will build on that programme and are considering how it can be extended to the acute health sector and community nursing services.

Awareness is already being raised in many areas. I know that in my constituency of North Norfolk, a new service to support carers has recently been piloted at GP surgeries. The initiative was developed by the North Norfolk clinical commissioning group and is being delivered by the Norwich and District Carers Forum in 20 GP surgeries in the north of the county. Two part-time support workers are available every month at each surgery to give support to anyone in an unpaid caring role and they have been able to refer carers for a carers’ assessment to help to meet their emotional and practical needs. They have also referred carers to other agencies for support as appropriate. Those are the sort of things that the hon. Lady’s Bill seeks to encourage and I am sure that she will welcome them as they emerge around the country.

The service was designed by North Norfolk’s CCG patient partnership, which was formed to give patients at the practices in North Norfolk the chance to influence and help to design local health services. That is exactly what we should be doing—involving patients. Subject to evaluation of the pilot, it is hoped that the service will be rolled out to other GP surgeries across the county.

Let me deal with young carers, as many hon. Members have mentioned the situation that they face. Local authorities already have a duty under the Children Act 1989 to safeguard and promote the welfare of children in need in their area. The Government are funding the Children’s Society and the Carers Trust to work with local authorities and voluntary organisations to encourage children’s and adult services to work more closely together and to adopt a “whole family” approach to identifying and supporting young carers.

Young carers involved in a recent series of whole family regional conferences, facilitated by the Children’s Society, were determined that they want to be seen as just like other children and young people. At the same time, they were very clear that timely and effective support for young carers and their families can make a real difference to their lives in a range of different ways. Their views have informed the development of a template for a memorandum of understanding between directors of children’s services and adult social services published last month by the Association of Directors of Adult Social Services, the Association of Directors of Children’s Services and the Children’s Society.

Let me say a word about students, whose situation was specifically raised by the hon. Lady and others. For students at university who are also carers, colleges and universities often have systems in place to identify specific needs through student unions and personal tutors. They provide a range of services, including the flexible provision of further and higher education, which can be very important in ensuring that students are not held in a straitjacket, and enabling learning on a part-time or distance learning basis, with students able to choose the best mode of study for them.

The Department has also has funded the National Institute of Adult Continuing Education to undertake a project to improve the lives of young adult carers and young adult carers with learning disabilities and, in particular, to support them in pursuing education and employment opportunities.

[Diana Johnson]

To return to the point about universities, can the Minister tell us how many have mechanisms in place to assist students with caring responsibilities?

[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.

--- Later in debate ---

[Mrs Hodgson]

I totally agree. Those organisations are out there doing good work, but often they still need guidance, and legislation can often be at the root of that and can really help to ensure that they are funded, rather than having to scrabble around for money left, right and centre.

[Diana Johnson]

I would like to draw my hon. Friend’s attention to the carers’ centre in Hull, which is led by Greg Harman. Unfortunately, it recently lost its funding, so it will now become part of the NHS and carers’ services will be provided through the local social community organisation we have set up. The organisation did a huge amount to support carers in Hull, and I know that over many years they saved lives, because people were desperate when they got to the carers’ centre and the support they were given was incredible.

[Mrs Hodgson]

That is exactly the point. We know that provision is patchy across the country. Where it is good, it is very good; but where there are gaps, that can lead to tragedy, which none of us wants to see ever again.

The first of the two cases I want to highlight is that of a middle-aged male carer who gave up his full-time job to look after his wife, who has multiple sclerosis. He encountered many health professionals because of his wife’s illness, but his caring role was never acknowledged; it was always about her needs, and rightly so. Because of the lack of recognition from professionals, he struggled on his own for three years without any real support, never realising that he should have had it. By chance he saw an advert inviting people to take part in Sunderland Carers’ “Caring with Confidence” programme, which was a major turning point in his life. He was able to access practical support such as getting adaptations for his home to make the physical aspect of caring for his wife easier. Lifting and carrying someone can have serious implications for a carer’s own health. People have to be trained in how to lift people in a caring environment; it cannot be done automatically without potentially causing injuries. He could access short break services that gave him brief respite from his 24/7 caring role. This allowed him to take a holiday with his wife, with the extra support regarding the physical aspect of caring for her that made it a genuine holiday for both of them as a couple. He also gained a lot of support from meeting other carers, combating the isolation that he was feeling.

Finding Sunderland Carers changed that man’s life in almost as dramatic a way as becoming a carer had in the first place. However, we should be concerned about the fact that he could still be struggling out there on his own had he not seen the advert. All the professionals he saw could have signposted him towards that support but, for whatever reason, they did not. Whether it was because they did not know about the support available or did not think it was their job to tell him about it, I do not know. They could have helped him before he was forced to quit his job, which as well as cutting his social ties meant that the couple were in effect living on the breadline. That is why this Bill is so important.

A vital part of the Bill is about the identification of school-age and young adult carers. Caring can be tough at any stage of life, but for a child or a young person it not only impacts on their ability to enjoy the same kind of childhood as their peers but can define how the rest of their life will pan out. The figures are stark. Research by the BBC in 2010 suggested that there were as many as 700,000 young carers in the UK—about one in 12 of secondary school pupils. Further research says that there are almost 300,000 aged between 16 and 24, more than 61,000 of whom are 16 or 17, with one in five providing more than 20 hours a week of care. As I mentioned earlier, one of those 16-year-olds is my daughter’s best friend, so I have first-hand knowledge of the impact that this can have on a young person’s life. There are more than 220,000 young people aged between 18 and 24, and carers make up more than one in 20 people in that age group. That means that one in 20 of the 18 to 24-year-olds we come across is a young carer.

The situations that these young people are placed in and the demands that are made on them will vary greatly, but I want to give one example, again given to me by Sunderland Carers, to show the impact of caring on children’s lives and how much receiving the right support can help them. The example is that of two children who went to live with their grandparents at a young age because their mother was unable to care for them. The arrangement worked very well for a number of years. The children were thriving at school, had plenty of friends and took part in a number of other activities. But as time passed their grandparents grew older and their health and mobility suffered. They did not ask for help because they feared losing custody of their grandchildren. The children could not get out and about due to lack of transport, and this left the grandparents struggling to entertain them. As things progressed, the grandparents struggled to get the children to school, especially in poor winter weather conditions, because the grandfather relied on a mobility scooter, and occasionally he could not get them there at all. This affected their attendance, and even when they were at school they were often distracted because they were so worried about their grandparents’ health.

Thankfully, the school eventually recognised the children as being young carers and was able to get the family the support that they needed. A common assessment framework was put in place and a team was developed around the family. The children were then able to take part in activities that allowed them to get out and have a normal childhood and meet other young carers. Also, while they were out, the grandparents were able to get some much-needed rest, which meant they had more energy when the children were at home. The school transport problem was resolved, and now the children have a 100% attendance record. I have no doubt that they will still face challenges as they grow up, but now they have been identified as carers they should get the right support to help them to cope, and eventually to get qualifications and careers and to develop normal, fulfilling adult lives.

[Mrs Hodgson]

Exactly. Unfortunately, as my hon. Friend has said, many children are under the radar—some in even worse situations—and they will not be as lucky as those who have been identified. That is true of all school-age children, but it is arguably more true of young adults in further and higher education, who have less time with tutors or teachers who would be able to spot the obvious signs. That is what clauses 5 and 6 seek to address, which is why the Bill is so important and should be considered seriously. I hope the Minister will do that.

Teachers and educational institutions are not alone in their ability to identify young and young adult carers. I served on the Children, Schools and Families Committee in 2008 when we considered the issue of young carers, specifically children who are under the radar. I asked why GPs in particular were not more proactive in identifying such children, because it is a common-sense deduction that a parent with certain health conditions who is not receiving support from professionals or a spouse is probably relying on their children. The answer from Dr Jo Aldridge of Loughborough university was that GPs—and, for that matter, psychiatrists treating those with mental health issues—generally did not see such things as part of their job description. Clause 4 would take the long overdue step of making it part of their job description, which would be of particular benefit to young and young adult carers, as well as to all other unidentified carers. That is why the Bill is so important.

In conclusion, we want and need carers to provide care, because it saves the Government billions. Carers, by and large, want to continue to provide care, because they love the individual they are caring for, but the Government need to support them in doing so. Ignoring the needs of carers is simply not sustainable, because it leads inevitably to crisis; to a loss of expertise from the work force and of income tax for the Treasury; to, most importantly, children and young adults missing out on the opportunities available to them; and to poor educational outcomes, so it harms the life chances of those children who just want to look after their loved ones. That cannot be right, which is why the Bill is so important. I know that it will not progress today—the Minister has said as much—but I hope that he will pick up on the key measures that we have highlighted that are not in the draft Care and Support Bill and incorporate them into it, so that we can help carers of all ages with the best possible legislation.

[Diana Johnson]

I know that my hon. Friend is about to finish, but, given her experience in education, does she think that, considering the range of schools that are now available, such as free schools and academies, the Bill goes far enough? Should the duty be extended and placed on those new types of school as well?

[Mrs Hodgson]

Yes, and I hope the Minister will talk about this with his colleagues in other Departments. He said earlier that there is a lot of crossover with a couple of other Departments. He also gave a commitment to my hon. Friend the Member for Worsley and Eccles South to carry out a consultation and involve her in the next stages. I hope that he will look at all of the areas that need to be consulted and legislated on, and that require buy-in from other Departments, such as Education. I also hope that he will look at how academies and free schools, which are answerable totally to the Secretary of State, can be incorporated into the proposals, because they will not be answerable to their local authorities, which may lead on some of this work when it becomes a reality. I hope that this debate will not have been in vain and that some of the vital things that we have discussed will find their way into the Bill on care and support.

--- Later in debate ---

[Diana Johnson (Kingston upon Hull North) (Lab)]

This has been an interesting debate. I pay tribute to my hon. Friend the Member for Worsley and Eccles South (Barbara Keeley), who has fought for carers’ rights for many years. In the light of the very good debate to which many hon. Members have contributed, I do not wish to make a long speech. I hope that we will have an opportunity to vote on this important Bill, which could change the lives of many carers in this country.

Business of the House

Diana Johnson Excerpts

Thursday 6th September 2012 Commons Chamber

[Mr Lansley]

My hon. Friend makes an important point. This matter has exercised Foreign Office Ministers. They have made substantial representations in a number of countries about such situations. I will gladly raise the matter with Foreign Office Ministers and ask them to respond to him.

[Diana Johnson (Kingston upon Hull North) (Lab)]

I welcome the new Leader of the House to his post. Will he explain why only sacked male Ministers received honours, while none of the women who were sacked received honours, despite their having been more senior Ministers?

[Mr Lansley]

Matters relating to honours are matters for the Prime Minister.

Oral Answers to Questions

Diana Johnson Excerpts

Tuesday 17th July 2012 Commons Chamber

[Mr Burns]

I am extremely grateful to the hon. Gentleman, but as he will appreciate as a Scottish Member of Parliament, this is a devolved responsibility for the Scottish Government. On the specific issue—[Interruption.] If the right hon. Member for Leigh (Andy Burnham) would shut up, it would be helpful. It would probably be useful if the hon. Gentleman raised the specific issue with the Scottish Government, but on the general principle let me say that we are determined, certainly in England, to do all we can through education, the workings of the NHS and the operating framework to ensure that the number of people receiving pumps increases, as it already has in the last two years.

[Diana Johnson (Kingston upon Hull North) (Lab)]

6. How many children received milk through the nursery milk scheme in each of the last three years.

[The Parliamentary Under-Secretary of State for Health (Anne Milton)]

In 2009-10, the number of portions funded was 218 million. In 2010-11 it was 262 million, and in 2011-12 it was 271 million. Of course, children do not necessarily attend nursery five days a week, so the number of portions does not equate to the number of children, so, say, 1 million children attending full- time or 2 million attending 2.5 days a week.

[Diana Johnson]

In Hull the nursery milk scheme has never been more needed, at a time when poverty is increasing and food banks are expanding. Will the Minister guarantee that no child who currently receives nursery school milk will lose out after the results of the consultation have been published?

[Anne Milton]

As the hon. Lady will know, we are consulting on a range of options to modernise the operation of the scheme. The cost rose to £53 million in 2010-11, and is due to rise to about £67 million in 2012-13. Given those massive increases, we need to look at the scheme’s operation to ensure that we are getting good value for money.

Care and Support

Diana Johnson Excerpts

Wednesday 11th July 2012 Commons Chamber

[Mr Lansley]

I am grateful for the work of my hon. Friend and the all-party group. This is an important moment. If the House approves the draft Bill, the rights and entitlements of carers to assessment and support will be set out in law for the first time, in the same way as we have done for those for whom they care. He makes an important point. The draft mandate for the NHS that I published last week gives specific attention to the need to identify and support carers. I hope that these proposals will also enable the NHS and social care to join together in support of carers.

[Diana Johnson (Kingston upon Hull North) (Lab)]

May I return to the point that my hon. Friend the Member for Halton (Derek Twigg) made? Have local authorities confirmed that they are satisfied that the funding that has been made available will cover the new duties they have to undertake?