I do not agree at all. These cuts are far too swingeing, and there is nowhere else for my local authority, Salford, to go. After 20% cuts, the £100 million loss of funding that we have sustained cannot be found with any amount of innovative thinking. Ministers are now at the point of kidding themselves. I am sure that the Minister, like all his predecessors, goes round the country and is shown all kinds of examples of innovation, but innovation without funding will not work.
The eligibility issue interacts with the cap on care costs. The vast majority of older people will fail to benefit from the £72,000 cap on care costs; it will help only those with the most complex needs. As has been said, but we need to keep repeating it, a cap set at £72,000 ignores Andrew Dilnot’s warning that it would work only if it were set at a much lower level and if the underfunding of social care were addressed. It is clear from the Government’s own impact assessments that the number of people whose costs will be capped are a tiny minority. It is estimated that just over one in 200 people
aged over 65 will be helped in 2016 and that fewer than one in 200 will be by 2026. It is an incredibly sad reflection of this Government’s ambition that they will have spent the whole of a five-year Parliament—in fact, longer than a five-year Parliament—introducing measures on the long-term funding of social care that eventually help only one in 200 people. My right hon. Friend the Member for Salford and Eccles talked about being ambitious; this is not ambition.
On the support needs of carers, I will repeat some of the things that we heard from the right hon. Member for Banbury (Sir Tony Baldry). Full-time carers are more than twice as likely to be in poor health as people without caring responsibilities. I point out to the Minister that this Bill does not do enough to support those full-time carers. The Government have said that carers are the first line of prevention in that properly identifying and supporting them prevents the escalation of demand on statutory services. Given the A and E crisis, we need that prevention. However, identification of carers is not happening and the Bill does not do enough to change that. Macmillan Cancer Support, which has been carrying out surveys on this, tells us that 70% of carers of people with cancer come into contact with health professionals, who are the people who should be identifying them and signposting them for information and advice. Only 5% of that group of carers receive a carers assessment, and only one in three of those surveyed by Macmillan had even heard of a carers assessment. It is meaningless to suggest to people that they have a right to something they have never heard of and are not going to get.
In Salford, we have a project run by the Carers Trust centre to identify carers within the primary care system. I want to pay tribute to the work that the centre does and to mention its manager, Dawn O’Rooke, who is leaving this month after several years of work in this field. Over the years, the project has established a network of links within GP practices to identify carers. Last year, GPs made only 300 referrals to the carers centre, yet we have 23,000 carers in Salford, over 5,000 of whom will be caring at the heaviest levels. The Carers Trust tells us that, nationally, GP practices are identifying only about 3% of carers, but it should be 10% or more. Health bodies must be required—this Bill is the place to do it—to take on the task of identifying carers and referring them for advice and support, because carers are mainly seen in health settings and not by local authorities. The figures I gave about people losing packages mean that 1,000 fewer people in Salford will be seen by, or go anywhere near, the local authority because the person they care for is not getting a care package.
The Minister is aware of my private Member’s Bill, the Social Care (Local Sufficiency) and Identification of Carers Bill, which had clauses to tackle that issue. I am happy to show them to him again and explain how he could go about tackling the issue in his Bill. The clauses would ensure that NHS bodies have procedures in place to identify carers and ensure they receive information and advice. The Government’s own care and support White Paper stated that there is
“still an unacceptable variation in access to tailored support for carers”
and that NHS organisations should
“work with their local authority partners...to agree plans and budgets”.
The right hon. Member for Banbury made that point. Why are there not more robust measures in the Care Bill to make sure that this happens? As things stand, it will not happen. The NHS has been going through an agony of reorganisation and is now going through an agony of finding efficiency savings, and its staff do not have the time, unless they are directed to the right procedures, to take this task on.
As has rightly been said, clause 2, with its requirements for local authorities to provide preventive services, makes no explicit mention of the NHS, and the only duty on NHS bodies is one of co-operation. Anyone who has tried to work in local authorities on co-operation with health bodies, as I did years ago, knows that it does not go anywhere when there is no budget and no duty. Without effective procedures and systems within health bodies, the identification and signposting of carers will stay as it is now—patchy and inconsistent. It is questionable whether cash-strapped local authorities will be able to assess the needs of large numbers of carers alongside giving information and advice to self-funders and doing a lot more assessments. They will not be able to do that in any way that makes it a worthwhile exercise for carers, and carers will not bother with it if it is not doing anything for them. Indeed, the Joint Committee on the draft Bill received many comments via its web forum from people who said that local authority assessments are of little practical help in their caring role.
GPs and other health professionals are best placed to help carers when they start caring, which is when they most urgently need help and advice. During carers week here, I met carers who told me about a whole variety of things that they needed help with but nobody helped them. Nobody told them that there were schemes to help them with the cost of parking at the hospital. One mother had to buy a hospital bed and nobody told her where to find one; she was looking for one on eBay. She had no advice and support on that whatsoever. GPs deal with dementia patients, stroke patients and patients with cancer. The GP and primary health care team is best placed to establish whether there is an unpaid family carer or whether they live in another town or city. The GP can then refer them to sources of advice and support and, if they are local, give them regular health checks. A new duty on the NHS professionals is the only thing that would make it easier for social care and health services to work together to support carers. I believe that that is wanted by Members in all parts of the House.
Given everything that we are talking about, carers are clearly being placed under ever greater strains. It is essential that the Bill is used to ensure that carers are identified and signposted towards the support they need. It is clear from all the statistics that unpaid carers are the most vital providers of care in this country. I urge Ministers not to miss this chance to improve the support that we give them.
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