“Following a joint assessment of local needs, which should be published with plans, PCT clusters need to agree policies, plans and budgets with local authorities and voluntary groups to support carers, where possible using direct payments or personal budgets. For 2012/13 this means plans should be in line with the Carers Strategy and: be explicitly agreed and signed off by both local authorities and PCT clusters; identify the financial contribution made to support carers by both local authorities and PCT clusters and that any transfer of funds from the NHS to local authorities is through a section 256 agreement; identify how much of the total is being spent on carers’ breaks; identify an indicative number of breaks that should be available within that funding; and be published on the PCT or PCT cluster’s website by 30 September 2012 at the latest.”
So there is already a lot going on within the NHS. Let us not forget that the Department of Health is providing the NHS with £400 million over the four-year period from 2011-15 to support carers in taking breaks from their caring responsibilities. The Department has also funded the national carers strategy demonstrator sites programme, which is focused on three areas of support to improve carers’ health and well-being, carers’ breaks and health checks, with better NHS support. The new idea of national carers strategy demonstrator sites has been independently evaluated by the Centre for International Research on Care, Labour and Equalities at Leeds university, which has prepared an excellent report on how successful it has already been.
Clause 5 seeks to place a duty on a local authority to ensure that within 12 months of Royal Assent
“it takes all reasonable steps”—
again, we have no idea of what “reasonable” may amount to—
“to ensure that in relation to…any school within its area and under its control, and…any functions it discharges…there is in place a policy”
to identify and support young carers. However, the clause makes no mention of academy schools. Perhaps when the hon. Member for Worsley and Eccles South winds up she will be able to explain why academy schools would not be covered, because they are state schools that are independent of local authorities but still funded—
Barbara Keeley: To ensure that the hon. Gentleman does not mislead the House or any of the very large number of people who are watching him try to destroy this debate, let me point out that as the promoter of the Bill I do not have an opportunity to wind up. That is not how these debates work.
Mr Nuttall: That is absolutely right. I should have said that the hon. Lady might explain by way of intervention why these schools are not included, as she did not mention it in her opening speech.
There is already a lot of very good work going on in this area. In 2009, the Association of Directors of Adult Social Services and the Association of Directors of Children’s Services published a model local memorandum of understanding entitled “Working Together to support Young Carers”, which was aimed at providing staff in schools and other adults with a framework to develop support for young carers and their families.
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Madam Deputy Speaker (Dawn Primarolo): Order. I have been following very closely what the hon. Gentleman has been saying for the past hour. I have been able to do that because much of it is in the House of Commons research paper on the Bill. I sincerely hope that he is not just taking quotes verbatim from that. If he is, as he knows, he will be falling foul of Standing Order No. 42. Perhaps he can therefore assure me that in continuing his remarks I will not be able to read them first in this document.
Mr Nuttall: Thank you, Madam Deputy Speaker. I have indeed been helped by the Library’s document, which is extremely useful in analysing the Bill.
I will move on, if I may. As I understand it, there is nothing to prevent local authorities from carrying out the various actions proposed by the Bill, so it might be worth asking why they are not already going down that route.
Jacob Rees-Mogg: Is my hon. Friend referring to the general power that the Government’s Localism Act 2011 gave to local authorities, allowing them to carry out a much wider range of activities than was the case under the previous limitation whereby everything had to be identified by statute? Are parts of this Bill therefore unnecessary because of the abilities that local authorities already have?
Mr Nuttall: My hon. Friend is right that, under the Localism Act, local authorities now have a general freedom to do what they want without being given specific powers by central Government.
I pay tribute to the important and valuable work of various charities in this sector, for which they should be warmly commended. The Carers Trust charity’s website is a good source, packed with useful information. A particularly useful function enables anyone who is seeking help to find the location of their nearest centre simply by typing in their postcode. It covers the Princess Royal Trust for Carers network and the Crossroads care schemes.
Barbara Keeley: On a point of order, Madam Deputy Speaker. Is it not now the case that the hon. Gentleman is departing too far from the Bill’s content? I do not think that a discussion of the website of the Princess Royal Trust for Carers has anything to do with this Second Reading debate.
Madam Deputy Speaker (Dawn Primarolo): This is a matter for the Chair. There is an argument that reference to the trust’s details is relevant to the Bill. The trust is also identified clearly in the House of Commons research paper.
Although this is not on a point of order, while I am on my feet I remind the hon. Member for Bury North (Mr Nuttall) that, in principle, it is not permitted to read a speech in the Chamber. It is permissible to refer to notes and read short extracts from documents, but I think that he is stretching that widely now. He is in order and I hope that he will stay in order. I am sure that he is about to conclude to allow others to speak.
Mr Nuttall:
I am about to conclude, Madam Deputy Speaker. I was not going to go into the website in detail. I pay tribute to all those who help run the Bury carers centre and the Bury Crossroads group in my constituency.
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Their details can be accessed through the website. They provide enormous help for carers in need of help, advice and assistance in my constituency.
As I said at the outset, the hon. Member for Worsley and Eccles South should be commended for bringing this issue to centre stage. I am sure that every hon. and right hon. Member has nothing but praise for the army of carers in this country who look after loved ones. The Bill is a genuine attempt to improve the lot of carers, but I fear that there are dangers associated with it. We have to be careful how we use scarce resources; I do not want them to be diverted away from front-line services.
The consultation period on the Government’s draft Care and Support Bill is now open until 19 October. It is a substantial draft Bill, with 83 clauses and 8 schedules. I hope that the promoters of this private Member’s Bill will take advantage of the consultation to suggest how the draft Bill could be amended and improved. The Minister has also given an undertaking my hon. Friend the Member for Banbury. I will conclude now, because I want to hear from the Front-Bench representatives and other Members, so that this can be a good, wide-ranging debate.
12.44 pm
Liz Kendall (Leicester West) (Lab): I thank my hon. Friend the Member for Worsley and Eccles South (Barbara Keeley) for bringing forward this excellent Bill, and warmly congratulate her on doing so. She is a long-standing advocate and champion of unpaid family carers and wider social care issues. Today, she has again displayed her invaluable contribution to these issues and the House.
The Bill is important because it seeks to change in two fundamental ways the way in which we support disabled people and the family members who care for them. First, it seeks to shift the care system away from focusing predominantly on the needs of people whose care is funded by the state, to recognising the millions of individuals and families who fund their own care. The vast majority of those people are not hugely wealthy, but live on low or modest incomes. When a person whom someone loves becomes frail or ill, it comes as not only an emotional shock, but a financial one, because they have to pay for the care. When they then ask for advice, information or support, they do not get it. People do not even receive the information that is available. That is a big and important change that the Bill seeks to achieve.
Secondly, the Bill seeks to shift the nature of the support that is available to disabled people and their family carers, so that people’s broader needs are met as individuals, not just as carers. That includes their health needs and their needs for skills and training, so that they can build a full and fulfilling life. Crucially, it includes their need or desire to get work and to stay in work. The Bill would make a significant difference in allowing disabled people and their carers to achieve a better quality of life. It would also provide better value for money for taxpayers.
There have been big improvements in the care system over the past decade, with new rights for carers to have their needs assessed, new rights to request flexible working,
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improvements in respite care, a training and support programme for carers, and strengthened rights for carers in their entitlements, for example to the state pension. However, like many hon. Members, I know from my constituents and my own family that a desperate daily struggle is still faced by too many people who are looking after someone whom they love and who is disabled, is physically frail or has Alzheimer’s—sometimes even all three.
As hon. Members have said, many people do not think of themselves as a carer, but are just trying to be a good daughter, son, husband or wife by looking after the person they love. They therefore do not realise what support is out there. Often, it is only when somebody reaches crisis point and can no longer cope that they look for support. However, people do not know where to go and often the right services are not available to them. The result is that millions of carers see their own health suffer. One in three unpaid family carers of working age has to give up work or reduce their hours, adding financial worries to their already stressful lives.
As has been said, that often happens to women aged 50 to 65, or even older, who still want, and may need, to work. Indeed, as the population is ageing, they will need to work for longer. They face the awful double whammy of having to care and work for longer, and may be unable to balance the two. Any kind of social life or leisure time—something that many people look forward to when they retire—is nothing but a pipe dream. That is not good for carers, and it costs us all more through increased costs to the NHS and a higher benefits bill.
One issue to consider is the statutory framework within which local councils work. Particularly when they are under intense financial pressure, as they are at the moment, they understandably and inevitably focus on delivering their statutory duty to provide care for those in the greatest need. Indeed, they are focusing more and more on a small number of people with intense needs, because of the financial pressures that they face. The bigger agenda of prevention and early intervention is going by the wayside. The Bill’s provisions are intended to change that framework so that councils have a duty to assess the range of care needs in their area and then stimulate the market to ensure that services are available to meet those needs.
The Bill also includes important provisions to ensure that schools and further and higher education bodies identify young carers. Many Members have spoken about that issue, and I will not go into detail because I want to give others time to come in. However, the idea of involving further and higher education providers is groundbreaking and very welcome.
The Bill also addresses how we can get NHS bodies to better identify people who are, or are about to become, carers so that their health needs are assessed too. Many Members have talked about changes that are already being made in some parts of the country to achieve that. My hon. Friends have talked about the work that is taking place in Stockton and Salford, and the hon. Member for South Thanet (Laura Sandys) mentioned Torbay care trust, which I visited earlier this year. It is doing brilliant stuff in schools, but also in hospitals. Its staff know that if an elderly person who has had a stroke comes in with a husband, wife or
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partner, the latter will probably end up being a carer. It has a package of measures in place to identify such people.
In my constituency, Leicester city council has recently set out its plan for improving support for carers. As far as I remember, the plan says a lot about what schools can do, but I do not believe it mentions Leicester college, Leicester university and De Montfort university. The Bill would ensure that such issues were considered in every area, which would make a big difference.
I want to take a few moments to talk about something that we have not focused on so far in the debate but that is critical, which is how the Bill could help our economy. Creating jobs and growth is the biggest challenge that the country faces at the moment. As my hon. Friend the Member for Worsley and Eccles South said, the business forum Employers for Carers has clearly spelled out the mounting costs not just to families but to businesses of a care system that is not helping families to juggle their work and caring responsibilities. As our population ages and people have to work, and probably care, for longer, we have to understand that changing our care system is as important as continuing to make improvements in child care in helping families balance those responsibilities.
Using research from the London School of Economics, Age UK has shown that the cost to the economy from carers’ inability to balance their working and caring responsibilities is now £5.3 billion in lost earnings and more than £1 billion in lost tax revenues and benefits bills.
Norman Lamb: Does the shadow Minister agree that extending the right to request flexible working is also important? It will enable people with all sorts of caring responsibilities to enter into a discussion with their employer to see whether there might be flexibility for them to be able to work in a different way.
Liz Kendall: I have always been a champion of the right to request flexible working, which has made a big difference. I hope the Minister will not listen to the voices of some Members sitting behind him who want employment rights, including the right to request flexible working, removed from those working for a business employing three or fewer people. That would be a mistake and would not help us to address the issue. Employers for Carers has stated that if we stimulate the care market, as measures in the Bill seek to do, that could—as my hon. Friend the Member for Worsley and Eccles South said—deliver a triple economic win: better services for families, infrastructure to help employers retain skilled staff, and a boost to economic growth.
The Bill introduces the big challenge of flipping the care system on its head. Instead of seeing the ageing population and growing care needs and demands as a drain and burden on the country, we should see it as an opportunity for growth. The population is changing; it is ageing. Demand for care and support services will grow, and there is a huge opportunity to develop and stimulate jobs, companies and growth in that area, as has been done in France. In 2005, the French Government launched a plan to develop what they call services à la personne—a range of home care services, home visits and domiciliary care, and different types of services such as those provided by handymen and handywomen, drop-in services and support.
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Between 2005 and 2007, 100,000 jobs a year were developed through the different incentives introduced and, as my hon. Friend said, even after the financial crash, 50,000 jobs a year were stimulated in that way. I urge hon. Members to read the report by Carers UK, “Growing the Care Market”, which sets out an important challenge. As we seek to develop and rebalance the economy, growing the care market will deliver better services for families who desperately need them, and a better, bigger, vibrant care market in the future, which is vital.
My hon. Friend’s Bill builds on many of the previous Government’s improvements and on recommendations in the Law Commission’s review of adult social care legislation. That review began under the previous Government, and reflects many aspirations in the current Government’s White Paper and draft Bill on care and support. There is much cross-party consensus that we must move forward on these issues.
Norman Lamb: Does the hon. Lady also agree with the Law Commission’s view that it is best to get everything codified in one place so that one piece of legislation addresses all issues of care and support?
Liz Kendall: Opposition Members, myself included, want to ensure that the draft Bill on care and support covers all the issues that we wish to see progress. However, we also want to see the provisions in my hon. Friend’s Bill on the statute book. I welcome the Minister’s commitment to engage with my hon. Friend on the draft Bill, but when he rises to speak will he go further and commit to including those clauses for which he has specific responsibility in the Department of Health? Those will include the duty on local authorities to assess people’s needs, ensuring sufficiency of provision, and for NHS bodies to identify carers. I understand that the Minister needs to engage with colleagues in different Departments—notably the Departments for Business, Innovation and Skills and for Education—but it would be a welcome step forward if he committed to including in the Bill those clauses for which he has responsibility as a Health Minister.
I should, of course, welcome the Minister to his new role. He has a track record—certainly before the previous election—of commitment to social care. He will also know, however, that we cannot deliver the vision of a transformed system of care and support that Ministers claim to want in their White Paper and Bill, and which Opposition Members certainly want, without the money to deliver it. My hon. Friend’s Bill will make a big difference, but we cannot deliver without getting more money into the system.
As the Minister will know, there are two key challenges. First, we need to address the current funding gap in social care. Because local councils’ budgets are being cut by a third, social care services are being reduced and cut. That is inevitable. Adult social care makes up around 40% of local councils’ budgets, and up to 60% in some areas—it their biggest discretionary spend. When their overall budgets are being cut by a third, it is inevitable that those services will be cut. We need to address that immediate challenge and the immediate care crisis.
Secondly, we need to reform care funding in future. The Minister will know that the Opposition called for and initiated cross-party talks with his predecessor on
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the recommendations of Andrew Dilnot’s commission on the future funding of care and support. We remain completely committed to trying to achieve cross-party agreement and consensus on that vital issue. Will the Minister tell the House whether the quad of the Prime Minister, the Deputy Prime Minister, the Chancellor and the Chief Secretary to the Treasury have agreed to fund Andrew Dilnot’s recommendations, as was reported in the newspapers over the summer recess? I hope they have made such a commitment. We could then work with the Minister to secure the cross-party consensus on both the current gap and the future funding of care. That will enable us to make the vision that Opposition Members have of a better and fairer system of social care a reality.
The provisions in my hon. Friend’s Bill, which I hope will become legislation, would ensure that we deliver that better system of care and support for all those disabled people and family carers, whether they are funded by the state or self-funding, and whether they are younger or older carers. They will also ensure that we give people the decency and dignity they deserve when they are looking after frail, vulnerable and elderly relatives whom they love and whom they want to have a better life.
1.2 pm
The Minister of State, Department of Health (Norman Lamb): I thank the shadow Minister for her kind comments. I shall address her other comments in due course, but I should first thank the hon. Member for Worsley and Eccles South (Barbara Keeley) for introducing the Bill and giving the House the chance to discuss the vital question of how carers of all ages can be supported effectively.
I pay tribute to the hon. Lady’s work over a long period. She has been a doughty campaigner and is deeply knowledgeable. Whatever disagreements we have on elements of the Bill or on how to proceed—[Interruption.] It is quite important that the hon. Lady hears what I am saying. Whatever disagreements we have, I am keen to engage with her and her colleagues to ensure that we get it right. My only interest is ensuring that we go through a proper pre-legislative scrutiny process before the Government introduce our Bill. I am happy to confirm now—I am happy also to write to her—that I will meet her before our consultation ends in October to go through all the issues raised in the Bill that are relevant to my Department.
The shadow Minister asked whether I would commit to including all the Bill’s clauses in the Government’s Bill. I have been in the job for four days so I shall not make any commitment of that sort, but I shall commit to discussing seriously all the issues to ensure we get it right. There are significant areas of overlap and some areas of disagreement about the approach we should take. I am concerned that a plethora of duties could end up introducing new bureaucratic processes that could—I think the hon. Member for Bury North (Mr Nuttall) made this point—take money from the front line that provides care and support and introduce costly processes that do not deliver any results for the people we want to help.
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I accept absolutely that the proposal is well intentioned, but there is a risk of a plethora of duties. It is essential to have one code, written in plain English, that people understand. I will enter into discussions with her and her colleagues, and with the groups that support her measures, so that we can try to build a consensus. There has been a wide welcome for what the Government are doing in implementing the Law Commission proposals, the biggest reform for many years, so let us make sure that we get it right.
Barbara Keeley: I welcome what the Minister says, and it would help me and the organisations and individuals who have worked with me on the Bill if he confirmed it in writing. Opposition Members do not want a plethora of duties. The Bill, in imposing duties on local authorities, might be a little too extensive, but it contains two important points that must be taken forward. The first is to have a picture of sufficiency and not to have to do everything through freedom of information requests, which might require local authorities to go a bit further than they currently do. Secondly, although there is some wonderful practice among health professionals in identifying carers, we need to go further to ensure that health bodies understand that they must have policies in place. We need to do more than just encourage a few champions to take that forward. They are the people who will have the best picture of families and the caring situations of young carers. They are the only ones who can do it. I have wonderful practice in my constituency, as well as places where it is not happening at all and people are left to their own devices. Out of everything in the Bill, those are the two points that are important to take forward. One is—
Madam Deputy Speaker (Dawn Primarolo): Order. I think the Minister gets the point.
Norman Lamb: There is a degree of overlap on the sufficiency issue. I commit to discussing with the hon. Lady whether we have the framework right in the Government draft Bill or whether it could be improved—let us have that discussion. I will seek to address in my remarks the interesting philosophical argument about how best to approach identification, but parts of her Bill go beyond the responsibilities of my Department. To be clear, I am happy to engage with other Ministers to seek to address some of the issues she raises and I will maintain a dialogue with her on that.
Laura Sandys: In response to the point made by the hon. Member for Worsley and Eccles South (Barbara Keeley), is there not also an opportunity to create a strong role for the health and wellbeing boards?
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.
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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.
Barbara Keeley: On timetabling, clearly I could have done anything with this slot for a Bill, but we need to get on with things. I do not know whether the Minister can say what he thinks the timetable is now, but when we proposed the Bill it was not clear. People are in desperate need: carers are not being identified and there are big issues. That was the point of introducing the Bill. It is elegant to have everything in one statute, but it does not help people if that takes for ever.
Norman Lamb:
I am happy to write to the hon. Lady with more information about timetabling. I absolutely want to get on with this. Pre-legislative scrutiny is important because it will ensure that we get the legislation
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right, but I am not interested in delay. I want to get the Bill on to the statute book, but I also want to get it right.
Dr Francis: Will the Minister meet the all-party parliamentary group on carers at the earliest opportunity to outline his proposals? Will he also seriously consider consulting the health Ministers in Scotland and Wales, where considerable progress has been made?
Norman Lamb: The hon. Gentleman raised those points earlier. Yes, of course I am keen to engage with Scotland and Wales, and I would certainly be happy to meet the all-party group. I want to be as open and inclusive as possible in this process.
As I have said, there is also a concern that the Bill would impose a range of new, additional burdens on public and private bodies at a time when we are committed to reducing such legal duties. We agree with much of the intent of the Bill, but there are a number of ways in which we can pursue our common goals effectively. In July, the Government published the draft Care and Support Bill, which will undergo pre-legislative scrutiny later this year. That is information on the timetable for the hon. Lady. We can use that process to discuss the provisions relating to adult carers. In addition, earlier this week the Department for Education published draft legislation on the reform of provision for children and young people with special educational needs. That will also present an opportunity to consider how we might improve the identification of and support for young carers. I urge the hon. Member for Aberavon (Dr Francis) to engage with that process as well.
Private Members’ Bills have played a central part in the history of carers legislation. I would like to take this opportunity to pay tribute to the hon. Member for Aberavon for the significant contribution that he made by promoting the Carers (Equal Opportunities) Act 2004. He has been involved in these matters throughout the period since, and I want to express my gratitude to him for that. I also want to thank other parliamentarians, including the right hon. Member for Coatbridge, Chryston and Bellshill (Mr Clarke), the right hon. Member for Croydon North (Malcolm Wicks) and Lord Pendry. Their contributions to the development of carers’ rights date back to the mid-1980s.
I also want to thank my predecessor, my hon. Friend the Member for Sutton and Cheam (Paul Burstow). He has championed carers, both from the Back Benches and while Minister with responsibility for care services, and I am certain that he will continue to do so. I want to take this opportunity to pay tribute to the work he has done as a Minister. He has shown utter dedication to the cause, and I know that that has been widely appreciated.
Carers make a vital contribution to society, as many Members have said, and we are taking concerted action to support them. We set out our priorities in “Recognised, valued and supported: next steps for the Carers Strategy”, in November 2010. Between 2011 and 2015, we will provide an additional £400 million to the NHS to support carers, including through the provision of carers’ breaks. My hon. Friend the Member for Bury North mentioned this earlier. The White Paper commits to over £125 million of additional resources being allocated to carers.
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Carers are central to the Government’s proposals for care and support. For the first time, carers will be placed on the same legal footing as the people they care for. That is an incredibly important breakthrough. We will extend the existing right to a carer’s assessment and provide carers with a new entitlement to support to meet their needs. The hon. Member for Aberavon mentioned Scotland and Wales. Both are planning new legislation, but neither is proposing to require councils to meet the eligible needs of carers for support, as our draft Care and Support Bill does. That should be acknowledged. I understand that Wales and Scotland are proposing a discretionary power to provide services to carers. We are taking groundbreaking measures to improve the position of carers. We are providing resources to the Royal College of General Practitioners. In opening the debate, the hon. Member for Worsley and Eccles South referred to GPs in her own constituency and some of the interesting, innovative things they are doing. I accept that this is not widespread enough at the moment, but interesting things are happening around the country, which we should acknowledge. We are providing resources to the voluntary sector as well as to the Royal College of General Practitioners to help increase awareness among health professionals of the importance of supporting carers to identify themselves as such and to direct them to relevant information, advice and support.
Our care and support White Paper, “Caring for our future”, together with the draft Care and Support Bill published in July, set out the Government’s plans for the biggest transformation of care and support in England since 1948.
It is vital that carers are able to take a break from their caring responsibilities. To help support them to do this, the Government have made available an additional £400 million to the NHS between 2011 and 2015 to provide carers with breaks from their caring responsibilities to sustain them in their caring role. Under the White Paper proposals, carers would benefit from a diverse range of supportive personalised interventions. This might take the form of providing additional support for the care user either through respite care or in their own home; it might give the carer the opportunity to take a short break, perhaps a weekend away to see friends; it might mean being free to get a hospital appointment to look after the carer’s own health—a point raised by many hon. Members.
Liz Kendall: Will the Minister clarify how we will be able to keep track of the money allocated for respite care? It is often given out nationally but not ring fenced, which can be a problem when it sort of disappears. How will we know where the money is going? Is it going to clinical commissioning groups, for example? How will we keep an eye on it and how will we know that it has been spent effectively?
Norman Lamb:
The hon. Lady makes a very good point. I remember challenging the Labour Government on similar grounds when I was in opposition. Money had apparently been allocated to primary care trusts to provide carers with support, but nothing ever happened.
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I made that point as strongly as I could at that time. I will come on to explain how we shall deal with the legitimate point that the hon. Lady raises.
This extra support might mean the carer and the cared-for person taking a day trip together, so they can spend time outside of the confines of the caring relationship. It might also be through a direct payment—pursued under the Labour Government and now developed under this Government—that could be used to buy a laptop so that the carer can keep in touch with family and friends. In all these matters, we need to be as open as possible to the different ways in which the money can be spent.
There are some excellent examples of good practice in the area of carers’ breaks. In Surrey, the new GP carers’ breaks pilot has been running since 1 December 2011. So far, 80% of the 136 practices in Surrey have signed up and over 250 breaks have been provided, with 75% to parent carers. Surrey has been working with Carers UK on the evaluation of the pilot to tie up with its work on the GP carers’ champions project. In Cambridgeshire, Crossroads Care is part of a very good scheme whereby PCT money for supporting carers is used to support a GP prescription service. This is really good, innovative stuff. The GP can simply prescribe a carer a break, send a request to Crossroads, which will quickly contact the carer to discuss what sort of break they would like, and then arrange it. I urge GP practices across the country and the emerging clinical commissioning groups to look at this best practice that is emerging around the country and to implement it in their own areas in a way that suits their own local circumstances. We must do more to spread the best practice that is starting to emerge.
Let me say a few words about the mandate. In July, we published for consultation the first draft mandate for the NHS Commissioning Board. The mandate will be at the heart of the accountability relationship between the Department of Health and the Commissioning Board from April 2013. The draft mandate contains a specific objective: to improve the support that carers receive from the NHS by early identification of carers—that is dealt with in the Bill—by signposting to advice, and by working collaboratively with local authorities and carers’ organisations to enable a range of support to be provided. The consultation on the mandate is currently taking place, and I welcome Members’ engagement in that process.
Barbara Keeley: The Minister may not know the answer to my question, but it would be interesting to know how progress will be reported. Will the NHS Commissioning Board report progress to the House? It is good that the provision has been included, but it will be only as good as its implementation.
Norman Lamb: Four days into the job I am not entirely sure of the details, but I will ensure that the answer to the hon. Lady’s question is included in the letter to her. I certainly want the process to be as transparent as possible.
The NHS operating framework for 2012-13, published last November, contains stronger requirements for supporting carers, and is more specific about the plans of PCT clusters. Those plans should be in line with the
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“Recognised, valued and supported: next steps for the Carers” strategy. Plans should be explicitly agreed and signed off both by local authorities and by PCT clusters. Local authorities and PCT clusters should identify the financial contribution for supporting carers. They should identify how much of the total is being spent on carers’ breaks—this deals with the point raised by the shadow Minister—with an indicative number of breaks that could be made available within that funding.
PCTs or PCT clusters should publish their plans on their website by the end of this month, so we shall be able to see which areas are doing the job well and which are failing. Area authorities need to be held to account, whether they are PCT clusters or commissioning groups. People need to know what is available in their areas. A number of PCTs have already put resources into support for carers, significantly enhancing their existing support for them.
The current legal framework for care and support is out of date, complex and confusing. More than a dozen Acts of Parliament relate to adult care and support, and four relate specifically to support for carers. We can imagine how hard it must be for people out there, beyond this place, to understand what their rights might be. People who need care, carers, and even those who manage the system find it difficult to understand how statutes operate and interrelate. That is why one of the overarching objectives of the Government’s draft Care and Support Bill is to consolidate the existing law on care and support into one clear Act, making the law far easier to navigate. Introducing yet another stand-alone Act would only prolong fragmentation and militate against the thrust of the draft Care and Support Bill, which is to consolidate provision for carers in Government legislation. That point has been made by my hon. Friend the Member for Banbury (Sir Tony Baldry).
As I said earlier, the Government’s Bill has been published for pre-legislative scrutiny, which we expect to begin later in the autumn. We should view that process as an opportunity to explore how we can make legislation fit to support carers in the 21st century.
I am afraid I must disagree with the assertion by the hon. Member for Worsley and Eccles South that her Bill will be cost-neutral. Placing new duties on public and private sector bodies inevitably involves cost. New processes must be developed and operated, and will surely be a potential drain on the already tight social care, NHS and education budgets. That goes against the Government's commitment to reduce the overall regulatory burden. Inevitably, organisations confronted with a new legal duty must establish processes enabling them to demonstrate, when challenged, that they are observing it, and that means costly bureaucratic processes. As other Members have pointed out, it is much better to ensure that the money is being spent on the front line. We are committed to spending significant amounts on carers in the coming years, and we should be spending that money on supporting people, not on expanding bureaucracy.
Liz Kendall: The Minister seemed to be coming to the end of his speech, but I hope he is going to reply to my question about whether the quad has agreed to fund Andrew Dilnot’s recommendations, as has been reported over the summer.
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Norman Lamb: I am not a member of the quad, and I have not read any notes or minutes of the meeting. Obviously, the hon. Lady will understand that the whole issue of funding social care and the Dilnot proposals is high on my agenda. I am happy to talk to her about it in due course, once I have got my head around where we are with that debate, but I am in no doubt that we need to reach a settlement and ensure that adequate resources are available for them. We also need to ensure that the system gets the incentives right so that people who are committing their own resources to the system feel that it is worth doing and that it keeps them in good health and well-being.
The Bill seeks the early identification of carers in order better to support them. Although we fully support that notion, we do not think that a formal bureaucratic process is either the right or best way of going about it. As has been said, many people with caring responsibilities do not see themselves as carers. Indeed, many people do not wish to be labelled as such, and we must respect how they want to be seen. People with caring responsibilities should be able to choose for themselves whether they want to be identified as a carer, and that should be an informed choice by the individual.
Barbara Keeley: I really must challenge that. A process or procedure does not have to be formal, and nothing in any of the good practice that I have talked about seeks to force on a carer a recognition of being a carer. The people I know who work on this in primary and secondary care in Salford are very sensitive to these points. We have to make things available: information, support and referrals. The connection has to be made. We cannot proceed on the basis of, “This is bureaucracy and carers would be better off without it.” Carers are very rarely better off not knowing where they can go for help and support.
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
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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
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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.”
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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.
Heidi Alexander: Far from undermining what universities and colleges are doing, would not legislating underpin their excellent work?
Norman Lamb: The hon. Lady makes a clever intervention. We need to have that debate, because we agree about the ambition of achieving much better support for young people with caring responsibilities who are in education.
The proposals set out by the hon. Member for Worsley and Eccles South include ensuring that there are “sufficient” local care services, and she spoke about that specific point. I assure the House that the Government are committed to supporting that outcome. We want care users and carers to have a real choice of a range of high-quality services—whether state funded or paid for by individuals—and to have the information that they need to make an informed choice that is right for them. The “Caring for our future” White Paper is clear that enabling people to choose from various care and support providers that offer different ways of meeting people’s needs and goals will drive up the quality of care and support, including support for carers. Under the provisions of the draft Care and Support Bill, we propose to place a duty on local authorities to promote diversity and quality in local care and support services, to facilitate choice, and to meet the care and support needs of all local people and their carers.
Enabling carers to have a life outside caring, and helping those with caring responsibilities to fulfil their employment potential, are among the key priorities outlined in our cross-Government strategy “Recognised, valued and supported: next steps for the Carers Strategy”. In designing local care provision and drawing up joint strategic needs assessments, local authorities should recognise the importance of identifying carers’ needs, including their need to work. Local authorities’ assessments and reviews should take account of a carer’s wishes to remain in or return to work, as well as whether a carer’s involvement in employment is at risk because of their caring role. It is extraordinary that carers are rarely asked about their wishes with regard to employment. By simplifying the law, we will ensure that this existing requirement is given far greater emphasis.
The White Paper also set out a commitment to offer support to every local authority in England to fulfil this duty and, in particular, to develop or improve its market position statements. Effective market position statements make public key market intelligence, including the data from the joint strategic needs assessment and data from local consumer surveys and specific groups. They will send a clear signal to the market about the current and future level and nature of local demand for care and
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support services. The hon. Member for Worsley and Eccles South specifically highlighted the importance of how we develop the local market. For the first time, organisations large and small, be they private companies or charities, will have a clear picture of the demand for care and support and be able to innovate and invest in their services and staff accordingly.
Barbara Keeley: It is obvious that the Minister’s officials have given him a lot of material. I do not know whether he intends speaking until 2.30 pm, but at least four other Members are anxious to speak. I am aware of the commitment that Members have made to be here today and I just wanted to make him aware of that.
Norman Lamb: I do not intend to speak until 2.30, and I am moving towards the end of what I have to say. I absolutely take the hon. Lady’s point.
Effective market position statements will also set out a local authority's future commissioning intentions, their brokerage plans and the types of services that it wants to see develop to meet the needs of local people and their carers, regardless of how they pay for their care. We expect to see a more flexible market develop; one that will enable carers and care users to pursue their own goals more easily, including education and employment opportunities.
The Bill also seeks to place a requirement on local authorities to conduct an assessment of what sufficient social care means in their area, and what steps they could reasonably take to address the gaps in service provision. The Health and Social Care Act 2012 already requires local accountability to produce and deliver on strategic health and care needs assessments through the new health and wellbeing boards. From April 2013, health and wellbeing boards will take over responsibility for undertaking joint strategic needs assessments and must develop joint health and wellbeing strategies to meet the priorities identified. These will inform local commissioning plans. This is already happening.
A Surrey-wide survey was undertaken in 2011 to seek carers’ views on their experiences of health care services and to ask them about their own health and well-being. This information has informed the development of the Surrey joint strategic needs assessment. The Act requires that these assessments cover all current and future health and social care needs for the local population, and as such we expect them to cover the needs of carers as well as the needs of care users. This will ensure that health, social care and other services are fully integrated locally. I suspect that the hon. Lady completely agrees with this. A separate assessment of social care, as proposed by the Bill, would militate against the integration of health and social care as well as duplicating the existing legal requirement to assess social care needs.
In July, we published draft statutory guidance on joint strategic needs assessments and joint health and wellbeing strategies for consultation. I will certainly commit to enhancing the message, already contained in the document, about including the needs of carers. I make that point specifically as a result of the hon. Lady raising these issues in the Bill today. The Department of Health will also work with sector leaders to develop a suite of wider resources to support health and wellbeing boards in undertaking these joint assessments and strategies.
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I pay tribute to the hon. Lady’s long-standing commitment to improving the recognition and support of carers, which is widely recognised across the House. It is clear that we share the same objectives, but we differ in some respects in the way that they can best be achieved. Therefore, the Government cannot support the Bill, but I repeat my commitment to work with her and her colleagues and the caring organisations to ensure that we get the framework in a single Act as right as possible. I would be happy to have that further discussion with her and her co-sponsors of the Bill before the end of the consultation period on the draft Care and Support Bill, and we can maintain the dialogue as we head into pre-legislative scrutiny. We can then consider how we can progress our shared ambitions through Government legislation and other non-regulatory means.
As I have mentioned, hon. Members have a number of opportunities to engage in the work that is already under way: the draft Care and Support Bill, which is the draft legislation on reform of provision for children and young people with special educational needs; the guidance on the joint strategic needs assessments; and the programme of work relating to market position statements. That will ensure that the issues that this private Member’s Bill seeks to address will receive appropriate and proper focus.
1.49 pm
Mrs Sharon Hodgson (Washington and Sunderland West) (Lab): I am pleased to have to opportunity to speak in the debate and proud to be a co-sponsor of the excellent Bill introduced by my hon. Friend the Member for Worsley and Eccles South (Barbara Keeley). Quite simply, regardless of whether it proceeds today—it was sad to hear from the Minister that it will not—the Bill is about recognising the huge contribution that carers make to our society, the billions of pounds they save the Exchequer and, most importantly, the human cost that incurs: poverty, isolation, mental and physical exhaustion—the list is endless.
Provision for carers is patchy, but the most frustrating thing for me is the fact that, where there is support out there, in many cases carers are unable to access it. Perhaps they do not know about it, or perhaps they fear reaching out for help in case they are taken away from the person they are caring for. For far too many carers help comes only when they reach a crisis point, which can ultimately end in tragedy, as we know. That is what the Bill seeks to address and why it is so important.
In my constituency there is a fantastic organisation called Sunderland Carers, which provides the kind of support that all carers need, and I have met the group on a number of occasions to discuss what needs to be done to support the hidden army of carers. They completely support the Bill, and I am grateful to them, and in particular to Kevin Devine, for providing me with two case studies that I will use to illustrate the impact that the Bill could have.
Roberta Blackman-Woods:
I, too, do a lot of work with a carers’ support group in my constituency, Durham and Chester-le-Street Carers Support. Does my hon. Friend agree that such organisations would be greatly assisted by the measures set out in the Bill, because they
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would help them develop the range of support services that they and we want to see provided in their communities, and they really need additional help to give the support they want to give?
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.
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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.
Roberta Blackman-Woods:
In the case that my hon. Friend describes, it is good that the school managed to identify that there was a problem, but that does not always happen. What is so important about the Bill is that schools, colleges and universities will now have to
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proactively go out there to find the young carers and then think about how they are going to be supported. That is very much needed.
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
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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.
Mr Deputy Speaker (Mr Lindsay Hoyle): I am going to call Philip Davies, and I am sure he is aware that other Members are trying to get in.
2.4 pm
Philip Davies (Shipley) (Con): Thank you, Mr Deputy Speaker. I have not been left with much time, but I am conscious of the fact that other people wish to speak. I will therefore try to be as quick as possible, as is customary for me on such occasions. It is a pleasure to have you back in the Chair.
I commend the hon. Member for Washington and Sunderland West (Mrs Hodgson) for her closing remarks, because they got to the nub of the debate. What is important is that today’s debate has raised the issues that are important to all of us. We all want to support carers. Like my hon. Friend the Member for Bury North (Mr Nuttall), I remember my mum acting as a carer for my granddad and her father, Charlie, who had cancer. She dedicated many hours to looking after him and other family members came and helped. I understand from first-hand experience how important it is that we give as much support to carers as possible.
The most important thing about today’s debate, which the hon. Member for Washington and Sunderland West made clear as she summed up, is that we have gone through the issues that we hope will be addressed by the Government. They have produced a draft Bill and presumably legislation will come before the House in the not-too-distant future. All the issues that have been debated today, including the contents of the private Member’s Bill, can be debated during the passage of the Government Bill. Amendments can be made at the Committee and Report stages of that Bill, and far more time than we have been allowed today will be available to scrutinise those measures. We all hope that, at the end of all of that, we will have a measure that we can all agree upon, if that is possible, and that gives the best possible support to the carers who need it. The important thing is not whether this specific Bill gets through to the next stage, but what the overall outcome is. That will be determined by the Government’s draft Bill, and that is where it is best left.
I will move on to discuss the specific issues. It is important to look back at the history. The hon. Member for Worsley and Eccles South (Barbara Keeley), who presented the Bill, said when I intervened on her—
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I apologise if I get this wrong—that the Bill is about putting reporting responsibilities on local authorities. It goes far beyond that, however. Clause 1 introduces a
“duty to ensure sufficient social care support”.
That goes far beyond the reporting of that support.
As my hon. Friend the Member for Bury North said in dealing with an intervention, the Bill comes after more than a decade of the hon. Lady’s party being in government, and she is now calling for more to be done. It was only in 2008—I seem to remember that the hon. Lady was a Minister at that time, although I could be wrong about that as well—that her Government published an update to the carers strategy that was introduced in 1999. The update stated:
“By March 2011, we will have invested over £1.7 billion for councils to use to support carers in a range of ways through the annual Carers Grant. This includes £25 million a year announced as part of the New Deal for Carers for emergency break provision.
We have also committed a further £22 million to cover the costs of the establishment of information services via a helpline and a training programme for carers and information service, and £3.4 million to directly support young carers through extended Family Pathfinders and support for whole-family working.
We are now investing over £255 million on new commitments as part of this strategy.”
It seems to me that the hon. Lady is asking in the Bill for things that her Government claimed were already happening. Perhaps she will explain why her Government did not do what she seeks.
Barbara Keeley: It is quite clear from all the excellent contributions to the debate that Members understand that this is not just about allocating budgets. It is about having the right processes and about people taking their duties seriously. We can throw any amount of money at carers’ breaks or anything else, but if carers are not identified, if GPs ignore the fact that people are carers or if young carers are not taken seriously at school and are bullied and intimidated, it does not make any difference how much money is sloshing about. That is why the specific reporting and other duties in the Bill are so important. The Bill is mostly about having processes and procedures in place and ensuring that health and other professionals take them seriously.
Philip Davies: I could not agree more. I totally and utterly endorse what the hon. Lady says. Joking aside, it is refreshing to hear an Opposition Member say that it is not just spending money but getting results that is important. All too often, spending money was all it was about under the previous Government. It was about input rather than output. I am delighted that she wants to concentrate on output, as I do.
I contend that much of what the hon. Lady seeks to do in the Bill is already happening in one form or another. She might argue that it is not happening as well as it should, and I am sure that it could always be better. She may well argue that it is happening better in some parts of the country than others, and I suspect that will always be true whether or not there is legislation. When she referred to the lack of support for carers at universities, I pointed out the excellent work that Bradford university does to support carers. I believe that the same work is done at Leeds university. I have certainly seen a document from that university about the support that it wants to give to students who are carers. I argue that much of
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what she wants is happening anyway in various places, and there is certainly nothing to prevent them from happening even without the Bill. I am sure that if all of us, including the Minister and the hon. Lady, contacted universities, showed them best practice from other universities and urged them to follow suit, their vice-chancellors would be happy to do so without the need for further legislation. There are other, more imaginative and perhaps quicker ways of achieving her aims than going through the rigmarole of passing the Bill.
Much of what the hon. Lady seeks is covered in the Government’s draft Bill and White Paper. I take the point made by my hon. Friend the Member for Banbury (Sir Tony Baldry) that the hon. Lady introduced her Bill before any of that was known, so she was absolutely right to do that, but we are where we are. Given that the Government have adopted in the White Paper much of what she wants, we can safely leave the Minister to carry on. We all accept that he is a capable and decent person, and he has given the House assurances today that will have reassured us all about how he intends to proceed. He has said that he wants to involve the hon. Lady in the discussions about the Government’s draft Bill before it proceeds, and I am sure she knows that he means that. We can rely on the Government to introduce the best aspects of her Bill, so we do not need to proceed with it.
My hon. Friend the Member for Bury North made the point, which the Minister reiterated, that some of the duties that the hon. Lady’s Bill would place on local authorities, although well meant and with a positive element to them, could take money away from the front-line resources that we want to go to people who need them. It could instead have to be spent on further reporting, strategies, documents and other things that could eat up a considerable amount of local authorities’ money before we know it. I am not sure whether that approach is desirable. As I said, there might be some desirable ends, but overall it is more likely to take money from carers than to give them support.
Barbara Keeley: Do the hon. Gentleman and his colleague, the hon. Member for Bury North (Mr Nuttall), have a view on the billions of pounds that could remain in the economy if people do not give up work to become carers? If local authorities draw up the local sufficiency picture, it will help carers to stay in work. If carers stay in work, they are earning money, they are not on benefits and they pay tax and national insurance. Does the hon. Gentleman not see that there is a balance to be struck? I am sure that the sufficiency reporting duty will in no way match the billions of pounds that would be lost if 1 million carers give up work to care.
Philip Davies:
The hon. Lady makes a fair point although I cannot speak for my hon. Friend the Member for Bury North. If he had not been cut short we might have learned his view of the sufficiency measures, but perhaps we will hear it at a later date. I do not want to get bogged down or I will be criticised for trying to talk out a Bill that I have no intention of talking out. On this occasion—one for the record books—I endorse what the Government are doing. I wish the Minister well in developing the strategy, and I hope that we get the outcome we seek. In all honesty, however, we can do that without the Bill, and if the hon. Member for
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Worsley and Eccles South had known the Government’s plans at the time of the ballot for the private Members’ Bills she might have chosen a different issue. As she must acknowledge, the Government are doing much to go down the route she has advocated today.
2.16 pm
Heidi Alexander (Lewisham East) (Lab): I am grateful to the hon. Member for Shipley (Philip Davies) for keeping his remarks brief and giving me the opportunity to contribute to the debate. I was determined to remain in the Chamber until the bitter end, and I think it will be bitter because the Government are clearly determined to kill off a Bill that could make a significant difference to the lives of carers, particularly young carers. It would also make a difference to the way in which local authorities understand the nature of the social care problem—the social care crisis—with which they are having to deal.
I congratulate my hon. Friend the Member for Worsley and Eccles South (Barbara Keeley) on promoting this Bill. She is a long-standing and effective campaigner on these issues, and I was delighted when she asked me to co-sponsor the Bill, which I believed would give hon. Members the opportunity to talk about the social care crisis, and take steps to improve the lives of carers.
Let us be under no illusion: there is a crisis in social care. I say that for two main reasons. The first is a personal reason linked to my family’s experiences, and the second is that when I was a local authority councillor I saw the huge pressures that council budgets were under from increasing demand for social care, particularly for elderly people and adults living with disabilities.
My experience of the crisis in care relates to my nan, who sadly passed away last year. She was a working-class woman who had worked hard all her life and had to sell her home to fund care at the end of her life. She was from suffering from Alzheimer’s and was frail in her later years, and all her life savings were effectively used up to pay for her care. She had to sell her house, and when she passed away her estate was the £23,000 that people are allowed to keep after they have paid the costs of their care. It upset me to think that my nan, who had worked hard all her life, had to use her life savings in such a way and was not able to pass them on to her family. I do not begrudge the use of that money for the excellent care she received, but it is an issue faced by families across the country.
I mentioned my experience of local government, where I saw the huge pressure put on local authority budgets by the rising demand—it rose virtually every day. The Local Government Association recently produced research showing that councils currently spend about 40% of their budgets on social care, but that is expected to increase in the next seven to eight years. In 2019-20, 60% of councils’ money will be spent on social care— £2 in every £3 they spend. The problem is therefore huge. Any steps that the House can take to encourage local authorities better to understand services, demand and how best to meet needs in the local area are incredibly important.
As has already been said in the debate, when people reach a crisis point in their lives—perhaps they are caring for a loved one—they often turn to their local town hall for help and advice. If they have moderate means, they could face the problem of funding their
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own care. There is a woeful lack of information and advice for self-funders—people who pay for their own care package. That is the current situation. People do not understand what costs they must cover. They do not know whether they will have to pay for the next three or five years.
What happens when the money runs out? That was my family’s experience, and it happens in 25% of care self-funding cases. The cost to local authorities of people falling back on to the state is about £1 billion every year, but that is anticipated to rise. Local authorities, in planning how they will deal with such enormous costs, need to understand the demand and need, and the services that are provided, in their local area. In that way, they will not only be able to plan better, but to give appropriate and quality advice to individual carers and their families who come to them for support.
There is a current demand, but another question is whether the Government will proceed with the funding for the Dilnot proposals—we still do not know. Press reports in the summer suggested that they would like to proceed with Dilnot, but where will the money come from? Dilnot is not the whole answer. It covers social care costs, but it does not cover “hotel” costs—accommodation costs that can be significant for individuals who enter residential care.
All politicians need to level with the public about the scale of the challenge and what people are likely to have to pay for in their later life. If people know that they must sell their home to pay for their care or a proportion of it, they can start to plan, but there is currently complete uncertainty. Dilnot is heralded as the fantastic answer to the social care crisis: it might be part of the answer, but it is not all of it.
Local authorities need to be able to provide that high-quality advice to people who come to them for help and support. I recently met Partnership UK, which is one of the few companies in this country to provide an insurance product for elderly people and those moving into later life and who want to insure themselves against the costs of their care. Partnership UK informs me that in 2009-10, 53,000 people who were going into care homes were self-funders. Of those, only 14,000 had received financial advice and only 7,000 had received financial advice from a properly qualified person. That situation cannot be allowed to continue. Local authorities have a role in signposting people to relevant places and organisations where they can get independent, high-quality advice.
I have spoken about why the Bill is important in improving local authorities’ understanding of the social care needs and demands of their local population. Before I finish, I will say something briefly on the importance of the Bill for the early identification of young carers.
During the summer recess, I was fortunate to visit Carers Lewisham, which does fantastic work with a range of carers in Lewisham, south-east London. It works with about 500 young carers who are referred to it by schools in Lewisham. When I met young people at Carers Lewisham, what struck me was the enormous support they give each other. There is not just support from the adults to help understand the system; there is
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also support on a human level, reassuring each other that they are not the only individuals facing the very difficult challenge of caring for their loved ones.
In Lewisham, this works quite well. Schools refer young people to Carers Lewisham and they receive good, high-quality support. However, it is not like that everywhere and the issue is too important for it to be a postcode lottery dependent on whether there is a great head teacher in the school, or a great local organisation or great ways of local working. It would be hugely positive if we could underpin the excellent work that is happening at the moment through this Bill. It would not undermine the excellent work that is currently done, as the Minister suggested it would. It would make a positive contribution to the lives of young carers.
The duties in the Bill that would require parts of the NHS to identify carers are also critical. Carers in Lewisham told me that they face a constant battle to get the support they need from various different parts of the public sector—the council or different parts of the NHS. They spoke about the lack of join-up between hospitals, GPs and councils. If we have the duty to identify carers, hopefully that will foster better working between those different parts of the public sector. A survey conducted during carers week found that two in five carers put off having medical treatment because of the pressures of caring for loved ones. Paying attention to the health of carers, as well as the individuals they care for, is important, and the Bill would do a lot to improve that.
This is an excellent Bill. Sadly, it is obvious that the Government are determined to defeat it. It would have made a small difference to part of the big jigsaw that needs to be solved in the social care crisis. It would have provided immediate, effective steps in getting support in place for carers. Sadly, it is obvious, from the position that the Government have set out, that these provisions will not go through immediately. I hope the Minister lives up to his word and works with my hon. Friend the Member for Worsley and Eccles South to find other ways for the provisions to find their way on to the statute book.
2.28 pm
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.
2.29 pm
Jacob Rees-Mogg (North East Somerset) (Con):
The question before us is not so much quis custodiet ipsos custodes, as Juvenal put it—who guards the guards themselves?—but who cares for the carers themselves? The hon. Member for Worsley and Eccles South (Barbara Keeley) introduced the Bill with amazing foresight, because the very next day Her Majesty’s Government took a lot of what she was proposing and put it in their own White Paper and draft Bill. That is an almost
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visionary achievement by a Back Bencher, unknown in the history of the House, and she should be commended for it.
Let me say what a pleasure it is to welcome the Minister to his place, but what a loss he will be to us in the European Committee debates, where I enjoyed discussing trade with him. However, many people regard him highly in the new role that he has undertaken.
Let me turn to the Bill. Everyone is concerned about carers. In my constituency there is a fantastic carers centre—
2.30 pm
The debate stood adjourned (Standing Order No. 11(2)).
Ordered, That the debate be resumed on Friday 1 March.
Business without Debate
Winter Fuel Allowance Payments (Off Gas Grid Claimants) Bill
Motion made, That the Bill be read be now read a Second time.
Bill to be read a Second time on Friday 1 March.
Town and Country Planning (Control of Advertisements) (England) Regulations 2007 (Amendment) Bill
Motion made, That the Bill be read be now read a Second time.
Bill to be read a Second time on Friday 19 October.
Bank of England (Appointment of Governor) Bill
Resumption of adjourned debate on Question (13 July), That the Bill be now read a Second time.
Bill to be read a Second time on Friday 14 September.
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Criminal Injuries Compensation Scheme
Motion made, and Question proposed, That this House do now adjourn.—(Mr Evennett.)
2.31 pm
Kelvin Hopkins (Luton North) (Lab): I am grateful for the opportunity to raise concerns about the criminal injuries compensation scheme as proposed by the Government. The scheme is due to be considered formally in Committee on Monday, but the concerns are serious enough to be properly aired in the Chamber today. They received a full airing in the other place on 25 July, and I believe that the Lords were wrong to approve the proposals. Significantly, the Minister in the Lords was the only speaker to support the proposals. The previous Government had the good sense to withdraw a similar proposal and I urge the current Administration to do likewise.
I am also grateful for information received from the Union of Shop, Distributive and Allied Workers and the Communication Workers Union, both of which have members who are particularly affected by the proposals. I make no apologies for taking up the cause on behalf of the trade unions and the thousands of employees they represent. The Association of Personal Injury Lawyers has also provided information, for which I am grateful too. I should add that one of my trade union memberships is with the CWU.
Let me return to the origins of the scheme. In a House of Lords debate in December 1962 on the “Report of the Working Party on Compensation for Victims of Crimes of Violence”, the then Lord Chancellor, Lord Dilhorne, told peers:
“For the innocent victims of such crimes we all feel sympathy, but we feel that sympathy alone is not enough.”—[Official Report, House of Lords, 5 December 1962; Vol. 245, c. 305.]
That principle should be maintained. In 1964, the Criminal Injuries Compensation Board was established, later becoming the Criminal Injuries Compensation Authority—the CICA—which administers the criminal injuries compensation scheme.
In October 2010, the then Lord Chancellor, the right hon. and learned Member for Rushcliffe (Mr Clarke), told the House that the scheme was underfunded. As a result, the Ministry of Justice launched a consultation, “Getting it right for victims and witnesses”, which has resulted in the current proposals, which exclude innocent victims of crime from the scheme, denying them financial compensation. Before that, in 2009, the right hon. Member for Epsom and Ewell (Chris Grayling), now the new Lord Chancellor, showed his caring side, saying:
“And law abiding, decent people are asking—who’s looking after me? Well, my message to them is that a Conservative Government will start looking after you.”
Withdrawing the proposals will enable the Lord Chancellor to match those words with deeds. To withdraw compensation from these innocent victims of crime goes against the very purpose of criminal injuries compensation and ignores the view held by successive Governments for decades that victims of violent crime deserve more than just words.
The scheme uses a tariff system that is split into 25 bands. The Ministry of Justice has proposed removing the first five bands—which currently include all claims valued under £2,500—from the new scheme. According
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to the Criminal Injuries Compensation Authority annual report for 2010-11, 48% of all payments made by the CICS fell into bands one to five. That represents 17,700 victims a year on average. By way of example, under the new scheme someone who has suffered a minor disfigurement of the face will no longer be entitled to any compensation, and someone who suffers temporary partial deafness will also be denied compensation.
Mr David Hamilton (Midlothian) (Lab): I congratulate my hon. Friend on bringing this matter to our attention. I should like to declare an interest as someone who has a scar right across his face. The wound was inflicted without provocation and the person was convicted for it. I believe that it would be an outrage to take away the possibility of compensation from anyone who was entitled to it.
Kelvin Hopkins: I thank my hon. Friend for that helpful intervention.
It is unacceptable to say these injuries are not life-changing, as the Minister in the Lords did. Many victims say that they are. They suffer flashbacks, nightmares and panic attacks, for example. Moreover, many of the awards in tariffs 1 to 5 are for permanent physical disabilities such as corneal abrasions, speech impairment, or a “continuing significant disability” to a finger—very important for those who do manual work such as filling shelves or delivering letters. Nor are the awards “penny-pinching” amounts, as the Minister claimed. That just shows how out of touch the Government are. To a shop worker on the minimum wage who has to take weeks off work because of a fractured hand, £2,000 compensation is a substantial amount that would help to pay the debts accumulated during the period off work.
As well as removing the first five bands, the Government propose to slash compensation for claims between £2,500 and £11,000 in bands 6 to 12 by up to 60%. Those seven tariff bands represent 42% of criminal injury compensation payments under the CICS. Injuries covered by those bands can include the loss of a finger, two collapsed lungs or the partial loss of an ear, and they account for 13,000 cases a year. The Lords Minister stated that shop workers would still be able to claim for mental trauma of six weeks or more, but that is incorrect. To qualify for the level 6 tariff, a person requires diagnosis by a psychiatrist, which does not occur for several months, until courses of anti-depressants have been tried.
Over the past five years, 23,000 postal workers have been attacked by dogs. On average, 12 postal workers are attacked by dogs every day, amounting to about 5,000 being injured every year in dog attacks. Many are never able to return to their job, owing to the physical and psychological effects of the attack. Many are scarred and receive facial disfigurement for life. Many have lost fingers through dog bite amputations and many others have sustained dog bite injuries leading to painful lacerations and puncture wounds, nerve, ligament and tendon damage, fractures, serious infections, disability and disablement. I was bitten by a dog while delivering leaflets during the last general election campaign. I was not seriously injured—I required only a plaster and an anti-tetanus injection—but it was a disturbing experience.
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That group of workers who suffer the disproportionate majority of violent dog attacks now needs the support of the law, the enforcing authorities, the judges and the courts in dealing with the problem. It also needs the support of the scheme, which in many cases is the only remaining avenue for obtaining personal injury compensation. Many postal and BT workers have suffered personal injury through violent crimes, as defined by the Dangerous Dogs Act 1991, caused by irresponsible, reckless and negligent dog owners who are usually uninsured and often do not have the financial means to pay any compensation and cannot therefore be obliged in law to do so. I understand that this is known to lawyers as the doctrine of the man of straw.
The injuries to postal workers may be physical or mental, or both, and in some cases they have resulted in near death. However, the proposals remove the right to claim for injuries resulting from an animal attack. As a result, postal workers will have nowhere to go for effective compensation. Dog owners are unlikely to have third-party insurance, and may have no assets from which to recover a civil litigation claim or pay a criminal compensation order. The current scheme is the last resort for victims of dog attacks, and it will be removed under the proposals. All of the public will lose the prospect of compensation for dog bites, not just postal workers.
No one asks to be a victim of crime. Reducing, or removing altogether, the amount of compensation available to those people will send a clear message that the state does not view their injuries as serious or important. The Government propose to retain awards at their present level for injuries resulting from sexual offences and physical abuse, but that accounts for only about 8% of victims of all crimes who will be unaffected by the changes.
The Government misrepresent the current cost of the scheme. In the consultation, it was claimed that the scheme was not sustainable, and that it had historic liabilities of nearly £400 million. The Minister inflated that figure to £532 million by including possible claims yet to be lodged with the authority—presumably for crimes not yet committed, which seems odd, to say the least. However, examination of the authority’s accounts shows a stable and sustainable scheme, and that view is supported by the impact assessment.
Closer analysis shows that the average annual cost to the Ministry of Justice of existing tariffs is £192 million. It has varied very little, between £171 million and £214 million over the past four years. The cost for 2012-13 is estimated at £181 million under the current scheme rules. Even if I supported the Government’s deluded economic policy, I would have to point out that reducing the scheme’s budget by £50 million will do relatively little to reduce the Government deficit. It is a small sum in the scheme of things.
Historical liabilities have been reduced to 73 cases, estimated at less than £150 million, most of which the authority says should be cleared by 2014. Almost all these cases involve children who were seriously injured before the tariff scheme commenced in 1996, and whose ongoing needs could not be established until they reached adulthood. Neither is the CICA lax in exercising its responsibilities, with over half of claims refused. In 2011-12, of 58,000 applicants, over 30,000 claims—52%—were disallowed.There is therefore no immediate financial
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imperative to make these drastic cuts, which will impact so seriously on some of our most vulnerable people who most need support.
To add insult to injury, under the new scheme victims will be asked to pay up to £50 up front to obtain their initial medical evidence. Making victims pay this amount when they may be off work or still emotionally and mentally scarred from their attack could prevent genuinely injured victims from bringing a claim. Victims of violent crime who are eligible for compensation under the new scheme and who are unable to work owing to their injuries will also suffer as a result of changes to the scheme. These victims will be worse off because of changes in the arrangements for future loss of earnings, which will now pay only statutory sick pay, which is currently £85.85 a week. If someone were to work a 37-hour week on a minimum wage of £6.08 an hour— £225 per week—before they were injured, they could be worse off by £139.15 a week, which could result in serious financial hardship.
Changes to the scheme also fail to take into account the current employment market. The new scheme states that to be eligible for a loss-of-earnings payment, the victim will have to have been in
“regular paid work for a period of at least three years immediately before the date of the incident giving rise to the injury”.
The scheme offers exemptions if the person had a good reason for not having been in regular paid work—for example, because of age, care responsibilities or full-time education. In the current climate, however, it would not be unusual for someone to have been moving between temporary jobs, or to have had a period of unemployment in any three-year period. The new scheme will prevent someone from receiving a loss-of-earnings payment under such circumstances, even if they are now in regular paid work.
The changes to loss-of-earnings provisions will affect not only those who have been injured but relatives eligible for dependency payments after the loss of a loved one. The dependency payments, which are awarded to someone financially or physically dependent on the deceased, will be reduced as a result of these changes, and may not be enough to support the dependant.
Some of the most vulnerable people in our society are, of course, children, yet this new scheme will do nothing to protect children who are victims of certain violent crimes. The Department for Environment, Food and Rural Affairs has recently consulted on the possibility of extending section 3 of the Dangerous Dogs Act 1991 to make it a criminal offence in England for an owner of a dog to allow it to be out of control on private property, such as on the owner’s own property. That consultation closed on 15 June, and no response has yet been published. At the same time, the Ministry of Justice has proposed removing the right of compensation from those attacked by animals, unless the animal was
“used deliberately to inflict an injury on that person”.
This would create a scenario in which a child who has been mauled by a dog will be denied compensation, even though a criminal offence may have occurred—if the Dangerous Dogs Act 1991 is extended—and the child will have sustained life-changing injuries.
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While the Government are retaining all awards for sexual offences, the decision no longer to cover the cost of private medical care may prevent a victim of child abuse from receiving counselling and support quickly. While these services are available on the NHS, private funding would prevent any delays, and prompt treatment can be vital in such circumstances.
It is the Government’s intention to cut the lower standards to provide better protection and support for the most seriously injured victims. There is, however, no evidence that this has actually happened. Even those with the most serious injuries will suffer as a result of these changes. The Government should show common sense and compassion and withdraw these proposals.
2.43 pm
The Parliamentary Under-Secretary of State for Justice (Mrs Helen Grant): This has been a short but interesting debate, and I congratulate the hon. Member for Luton North (Kelvin Hopkins) on securing it. I have listened very carefully indeed to everything he has said.
Support for victims and witnesses of crime is a priority for this Government. That is why, for example, we have provided Victim Support with £114 million in grant funding spread over three years, enabling it to invest in long-term service provision. The victim and witness general fund provides £5 million a year in grant funding to voluntary sector organisations supporting the most seriously affected, vulnerable and persistently targeted victims.
We are spending £2.75 million on individuals bereaved by murder and manslaughter in 2012-13, while in line with our coalition commitment—I am personally proud and pleased to announce this—we have put rape support centres on a secure financial footing, with 65 centres around the country receiving total grant funding of nearly £3 million a year until 2014. Over the past year we have funded the establishment of four new centres, and a further five will open in March 2013. Last but certainly not least, we aim to raise up to an additional £50 million from offenders, which is a very significant sum. It is to be spent on services for victims, along with the existing central Government spend of £66 million. I shall return to that in a moment.
The proper protection and support of those who have suffered at the hands of criminals is a fundamental and essential part of our civilised justice system. We are determined to provide the best possible support for the most seriously affected, vulnerable and persistently targeted victims of crime, helping them to cope with and recover from what are often terrible experiences. However, because of the financial climate, we cannot be blind to the question of which policies are feasible and which are not.
As the hon. Gentleman said, the criminal injuries compensation scheme is demand-led, and the cost to the Government is more than £200 million each year. Historically, the scheme has been underfunded. Funding allocated at the beginning of the year has often needed to be topped up at the end of the year to enable the Criminal Injuries Compensation Authority, which administers the scheme, to continue to make payments for claims as and when they fall due. Last year the authority was provided with additional funding, and a total of £449 million in criminal injuries compensation payments was made, the largest ever in a single year.
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Despite that cash injection, total liabilities currently stand at around £532 million. That includes an estimate of the claims for which payments are likely to fall due in the future but which have not yet been lodged with the authority; it also takes account of the remaining rump of pre-tariff cases. With new liabilities arising at a rate of about £200 million a year under the current scheme, that is simply not sustainable in the present economic climate. The scheme must be put on a sensible, sustainable footing so that timely payments can continue to be made.
Against that background, it made excellent sense for the Government to look carefully at the scheme and consider certain reforms. We concluded that the scheme needed to focus resources on the victims who are most seriously affected by injuries that they suffer as a result of deliberate violent crime committed in England, Wales and Scotland. We believe that the provision of support services for victims at the point of need is a much better use of money than providing small amounts of compensation, in some cases long after the incident involved, for relatively minor injuries. For that reason we are removing payments for less serious injuries such as sprains and fractures.
However, we concluded that, as well as protecting injury payments to victims with the most serious injuries, it was right and proper to protect tariff payments to the bereaved, to all rape victims and victims of other sexual assaults, and to those—including victims of domestic violence and children—who are subjected to a repeated pattern of abuse. We have also retained the vast majority of special expenses payments, with the exception of payments for private health care. Those are fair and sensible policy decisions.
Some Members may have seen one or two briefings about our reforms, including papers produced on behalf of postal workers and shop workers. While I am more than happy to acknowledge the valuable, indeed essential, role that many of those people perform, sometimes in the face of challenging circumstances, the Government do not believe that a compelling case has been made for maintaining payments for minor injuries, which is what has been asked of us. As with other applications to the scheme, if postal or shop workers’ injuries are sufficiently
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serious, they will be eligible. As I said earlier, our aim is for additional services to be funded by offenders, which will provide better support for those with minor injuries.
Another key part of our reform package results from our view that payments should be made only to blameless victims who co-operate fully with the justice process. Those with unspent convictions will not be able to claim if they have been sentenced to a community order or imprisonment, and those with other unspent convictions will be able to receive an award only in exceptional circumstances.
The hon. Gentleman made important points about loss of earnings. We believe that our proposals are the fairest way to achieve the necessary reforms and to create a sustainable system. I also wish to clarify the position on dog attacks, which he also raised. The purpose of the scheme is to compensate for injury caused by deliberate violent crime, and there are other avenues that people can pursue, including civil remedies, in relation to these incidents.
We envisage that the cumulative effect of our reforms will help deliver savings of an estimated £50 million per year to the taxpayer. That does not mean that we are reducing the overall spend on victims—our aim is to keep overall spend on victims the same. That is to be achieved by offsetting the £50 million reduction in the criminal injuries compensation scheme with a similar amount raised from the offenders for victims’ services.
The Government’s intention is that the new scheme will be implemented around the end of September. For that to happen, it requires the approval of both Houses. There was a debate in the Lords on 25 July and there will be a debate in this House next week, on Monday 10 September. On that occasion, I will go into more detail than I have today about the changes to the scheme and I will also be seeking the House’s approval for our statutory scheme which will compensate victims of future overseas terrorism. In conclusion, the draft criminal injuries compensation scheme represents a coherent and fair way of focusing payments on those most seriously affected by their injuries, within an affordable budget.