Caring Responsibilities

Tony Baldry Excerpts

Wednesday 15th June 2011 Westminster Hall

[Tony Baldry (Banbury) (Con)]

The whole House owes the hon. Member for Edinburgh East (Sheila Gilmore) a great “thank you” for having secured this debate in carers week. As co-chair with Baroness Pitkeathley, who is in the other place, of the all-party group on carers, I am particularly glad to have the opportunity to take part in this debate.

In the US Congress, there is a wonderful device that allows people to read a chunk of their speech into the record. I am beginning to feel that for Westminster Hall debates I should have a standard set of three paragraphs about the budget deficit, which I will put on my website, and that those paragraphs should be read into the record. I say that because I think that it will be very tedious during the course of this Parliament if Labour colleagues simply come to Westminster Hall and say, “Woe is us, the Government are having to make budget reductions”, and I then have to explain, “Well, actually…”

I calculated all the money that the Government give to my district council, county council, the Thames Valley police authority and the health authority in my area. We are spending more in 11 days simply on funding the budget deficit than we are on funding all those services in Oxfordshire. That is just not sustainable. So we all have a collective responsibility to be grown-up about the challenges that the Government have to face on the national finances.

[Grahame M. Morris (Easington) (Lab)]

We have had this type of discussion before about productivity, deficit reduction and so on. However, is it not the case that the Government have made a firm commitment to protect the most vulnerable people in society and is it not right that Labour Members, who have turned out in numbers for this debate today, should hold the Government to account on that commitment? This issue is about choices and the Government are making a choice here that will affect some of the most vulnerable people in society.

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[Tony Baldry]

Of course all of politics is about choices. However, the hon. Gentleman might want to reflect on the fact that the international credit-scoring agencies are now rating Greece as one of the countries that is at greatest risk of having its finances collapse; only Ecuador and Jamaica are at greater risk in that respect. If one does not take responsible actions to maintain the nation’s finances in good order, one runs that type of risk. The Government have made sensible choices about increasing spending on the NHS in real terms, but that means that there are consequences elsewhere and other choices have to be made. I think that we have to be grown-up about that.

[Jack Dromey]

The hon. Gentleman is of course right that those in government, whether that is central or local government, should be wise custodians of the public purse. Can he explain, therefore, why Birmingham city council defied advice that it was acting in breach of the Disability Discrimination Act 2005 and spent £750,000 on pursuing a case that ultimately failed? Would it not have been wiser for the council to have spent that money on care for the elderly and disabled in Birmingham?

[Tony Baldry]

With respect to the hon. Gentleman, it is often difficult for statutory bodies to know where their responsibilities lie and that is particularly so in the world that we all have to live in—a world of emerging human rights legislation. I must declare an interest as a practising barrister. I have to say that the main growth area for the Bar at the moment is judicial review, including judicial review in the Supreme Court, to test the statutory responsibilities of local authorities, and I am sure that we will see more of that. Having said that, I do not think that that gets away from the Government’s responsibility to try to bring the nation’s finances back into some balance.

[Anas Sarwar]

Will the hon. Gentleman give way?

[Tony Baldry]

I am sorry, but I will not give way any more because these exchanges demonstrate why I need to read into the record for future debates the three paragraphs that I mentioned earlier. We would all love to have lots more money that we could spend, but alas that is not the case.

With regard to this particular debate, it seems to me that there is a lot more that can be done to help and support carers without necessarily spending a huge amount of extra money. The first thing that we ought to do, or at least we ought to make a much greater effort to do, is to identify which people are carers and to encourage carers to see themselves as carers. Local authorities provide considerable services for carers, but of course they can only provide those services if people identify themselves as carers.

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

Will the hon. Gentleman give way?

[Tony Baldry]

I will not give way, as I just want to make a little more progress.

I was quite interested in a note from Sainsbury’s. Sainsbury’s has been pursuing an initiative in Torbay to help to identify “hidden” carers. It was working with the Torbay Care Trust and it sought to identify customers in its supermarkets who might have caring responsibilities. Staff talked to customers and if it seemed that a customer might be a carer, they were asked if they were in fact a carer. If the customer said, “Yes”, they were then directed to a trained member of the Torbay Care Trust. In a very short period, that initiative led—in just one supermarket—to 140 new people signing up with the Torbay carers’ register.

Sainsbury’s is going to expand that initiative to other stores across the country. I suspect that huge numbers of people who act as carers do not know that that is what they are, for example, husbands and wives who look after loved ones, and young people who look after parents. We should be working as hard as possible to help people to recognise that they are carers. Considerable help and support are available for people who know they are carers. In carers week, one can see that a range of organisations have come together—

[Barbara Keeley]

Will the hon. Gentleman give way?

[Tony Baldry]

I will give way to the hon. Lady in a moment.

A range of organisations that provide advice and support have come together, including Age UK, Carers UK, Counsel and Care, Crossroads Care, Dementia UK, Macmillan Cancer Support, the Multiple Sclerosis Society, Parkinson’s UK and the Princess Royal Trust for Carers, but they obviously cannot give advice unless people actually recognise that they are carers.

[Barbara Keeley]

I agree that identifying and supporting carers is important. Will the hon. Gentleman therefore communicate to the Minister with responsibility for care services that he should support my Carers (Identification and Support) Bill, which the Government have indicated they would not support? The Bill would provide a basis for the proper identification of carers by NHS bodies, local authority bodies and schools. It is more appropriate that public bodies help to identify carers, rather than the task being left entirely to supermarkets such as Sainsbury’s.

[Tony Baldry]

I do not dissent from that, and in a second I will come on to the Law Commission’s report. It is important that we recognise carers, and if statutory bodies can help to identify them, that too is important.

We are fortunate this afternoon to have the Under-Secretary of State for Health present, and I wish to make a couple of points about carers and health. Often nowadays, when a person being cared for goes to see their GP or a specialist, the carer is treated as if they were invisible. The concept of patient confidentiality is being used as a mechanism for denying the person who is being cared for the support of their carer, whether it is children taking their aged parents to see the doctor, or a husband taking his wife or vice versa. Often, the carer is able to provide counsel and care for the person they are caring for, and they should not be seen by the GP or the health service as invisible. The NHS, GPs and the Royal College of General Practitioners need to work out a protocol for how the NHS deals with carers. There obviously have to be some balances concerning patient confidentiality, but it must be possible to work out how the NHS should deal with and respond to carers.

Carers are most concerned about the people they are caring for needing access to the NHS in the evenings and at weekends, when there are out-of-hours systems in place. The out-of-hours GP system was, as it happens, brought in by the previous Government, and it is of variable quality across the country. I think that the Minister will find that one of the growing pressures on the NHS is the number of people who self-refer to accident and emergency departments in the evenings and at weekends, because they can at least be confident of being seen, even if they do not need A and E treatment. They cannot be turned away at the door because the NHS has a duty of care when they turn up. It might be sensible to have primary care triage in A and E departments. We have a Darzi centre in Banbury, but I see no reason why one should not have primary care triage at the door of A and E so that people who do not require A and E services can be confident of accessing primary care without having to hang on on various helplines, or talk to distant voices in which they have no confidence. That would give much greater confidence to carers and to those for whom they were caring, and would significantly reduce the cost to the NHS of the significant number of inappropriate treatments and admission at weekends and in the evenings.

Another responsibility of the Department of Health are carers’ breaks, about which many carers are very concerned. One of the longest running campaigns of the all-party group on carers over the years has been on carers’ breaks. There are supposedly significant amounts of money in the system—some £400 million—for carers’ breaks but, as is the case with so much money, it is not ring-fenced. Some PCTs have been extremely good about that, but we will need to watch where the money goes, particularly as we transfer to GP commissioning. Can we develop systems of best practice? It is not just a question of talking about carers’ breaks; we also need to ensure that systems are in place.

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On resuming—

[Tony Baldry]

Let me conclude this part of my speech by asking whether the Minister will give an undertaking that her Department will closely monitor what happens to the money that is allocated for breaks for carers as we move from primary care trust funding to GP commissioning.

Finally, I want to make two brief points. First, the hon. Member for Edinburgh East spoke about the Law Commission’s proposals for reforming social care law. That sounds a rather dry topic, but an enormous amount of Back-Bench time has been invested in it. Most carers’ rights have come about in law because various private Members’ Bills have been brought before the House over the years by the right hon. Members for Coatbridge, Chryston and Bellshill (Mr Clarke) and for Croydon North (Malcolm Wicks), Lord Pendry and the hon. Member for Aberavon (Dr Francis). They have had carers’ rights at their heart, but the need for a carer’s assessment is the gateway.

Often, carers do not know that they are entitled to a carer’s assessment, and many local authorities, perhaps for understandable reasons, do not prompt people to think about asking for one. If such major social care rights for carers were incorporated in primary legislation, it would be the first time that a Government had taken such a step. It would therefore be helpful to know whether the Government intend to accept the Law Commission’s recommendations on carers. The only difficulty with the Law Commission’s proposals is that they deal only with adult carers. Any legislation needs to address the rights of parents of disabled children as well as the rights of the growing number of young carers.

Secondly—I will not repeat the points made by the hon. Member for Edinburgh East—will the Minister help the House in relation to carer’s allowance? To get it, people need to get a certain level of disability living allowance or, in future, personal independence payment. There is some concern and, indeed, confusion about who will be entitled to carer’s allowance in future. It is a significant allowance for many carers, because it is a non-means-tested benefit that signals and validates the fact that someone is a carer. It is therefore a valuable allowance in terms of not only the monetary value, but the recognition that someone is a carer. It would be helpful to have some clarification on that point.