I am delighted to have secured this debate to discuss an issue that affects not only many of my constituents but people across the country. I am confident that few Members will not have been approached by carers or carers’ organisations in their constituencies highlighting the problems that they face.

I should like to acknowledge the care workers and care staff working in the UK, and the voluntary organisations that provide a valuable service to the national health service. This morning, however, I should like to focus on carers who look after a relative, friend or partner who, because of age, illness or a physical or learning disability, needs support and cannot manage without help-in other words, people who provide care through sheer necessity and not through a contract of employment.

The latest figures show that there are nearly 5.7 million carers in the UK, which is approximately one in seven of the adult population. The 1999 general household survey revealed that that number is increasing. For example, in 1999 there were 620,000 adult carers in Scotland compared with 500,000 only four years previously. The survey also showed that the number of carers providing support for more than 20 hours a week has increased by 13 per cent. since 1990. There are approximately 185,000 adults in Scotland at the heavy end of caring.

It must be recognised that providing care ranges from occasional help such as helping with shopping to providing continuous care. It is estimated that approximately 60 per cent. of carers who look after someone in their home provide personal care such as bathing, washing, dressing and toileting. A similar percentage of carers provide physical help such as getting in and out of bed, walking and getting up and down stairs. Approximately 27 per cent. of carers take responsibility for administering medicines, 60 per cent. look after someone with a physical disability, 7 per cent. look after someone with a mental disability and 15 per cent. provide care for someone who is both mentally and physically disabled.

The invaluable contribution made by carers should be properly recognised and supported. They contribute a great deal to society and save the NHS billions of pounds each year, yet they make untold sacrifices and often feel unsupported and isolated. The tasks involved can lead to physical and mental exhaustion and stress, which can affect the health of the carer and have a knock-on effect on the person being cared for.

Figures show that the peak age for becoming a carer is between 45 and 64. Carers in that age group can feel socially excluded as many give up paid employment and a career to care for someone, and that can lead to financial hardship.

As one 56-year-old carer said:

“I sacrificed my career to care for my parents. I deserve some recognition for what is now my employment.”

Another carer said:

“I love my daughter dearly, but I have paid the price of caring. Now I would like to have a life too and follow some of my own dreams.”

Young carers also experience stress and isolation as their schooling is often affected. Many of them are unable to enjoy the social activities that their peers take for granted. Worst of all, many carers feel demoralised by the lack of status that their role brings.

The general household survey also uncovered some disturbing facts about the additional help provided, or at least available, for carers. Some 53 per cent. of carers who live in the same household as those they care for said that they were the sole carer. Some 75 per cent. of those receiving care from someone who lives in the same household had no regular visits from professionals such as doctors, district nurses or social workers. The proportion of households that receive visits from health professionals is declining and that increases pressure on the carer.

The Government have already made bold moves to address those difficulties. They are increasing the recognition that carers receive, and easing the burden on their lives. The Employment Relations Act 1999 ensured that, for the first time, those who combined caring with employment would have the right to unpaid time off to deal with difficult caring situations, such as arranging residential care. The 1999 Act encompassed a range of domestic situations, including those involving unmarried partners, and carers who have responsibility for people living outside the family home.

In October 2000 my right hon. Friend the Secretary of State for Work and Pensions announced an extra £191 million aid package for carers; 300,000 of them could benefit from that in the next three years. Those measures led to the Government’s consultation on the invalid care allowance, which was widely welcomed. The consultation period ended yesterday, and I look forward to hearing the recommendations that follow it.

The Government’s proposal to allow carers who are over 65 years old to claim invalid care allowance for the first time is particularly welcome. ICA not only provides financial help, but confers recognition to the role that carers play. Benefit provisions for carers aim to maintain the income of those who give up the opportunity of full-time work to provide someone with regular and substantial care. It follows that those who have reached pensionable age do not sacrifice the opportunity of full-time employment, but as Age Concern rightly pointed out:

“many older carers are angry that they receive no financial support in recognition of the important role they play.”

Extending ICA would help to secure equal treatment for all carers, and ensure that conditions of entitlement were uniform. I hope that the widely welcomed proposals to extend ICA to those over 65 years old will be introduced as soon as possible. There are strong arguments to suggest that the ICA should not remain an income replacement benefit, but should be extended to cover the additional costs that carers incur through their duties. There is a strong case for waiving the overlapping benefits rule.

Benefits for those who need care are often reduced or taken away altogether. A disabled person who lives alone but needs help from someone outside the caring profession is entitled to the severe disability premium, but once the carer is in receipt of ICA, the premium is scrapped. The person who is cared for is often unaware of that rule, and ultimately loses control of how his or her care is administered.

The premium allows the disabled person a degree of flexibility, but that independence is eroded once the premium is withdrawn. Carer UK and many carers have told me that that is a continuing problem. The severely disabled often face the dilemma of deciding which benefit they should claim. I hope that the Government look into the matter.

The consultation proposes to allow the carer to receive ICA for eight weeks after the death of the person receiving care. That will make a huge difference to the carer, and will help them not only to cope with the loss of a friend or relative, but to adapt to a new domestic and financial situation. I commend the Government’s recommendation and hope that it is implemented soon.

I welcome the proposal to change the name of the invalid care allowance to carers allowance. That will direct the focus away from those cared for and toward the carer, thus increasing awareness, recognition and the status of the role.

Some organisations have called for an increase in ICA. The Scottish Carers Alliance, among others, has called for ICA to be set at the level of the basic state pension. The Government recently indicated that the estimated cost of increasing ICA to that level would be £650 million in 2001-02. However, to be entitled to ICA, someone would have to be caring for more than 35 hours per week. Some carers work less than that, but others considerably more. For the sake of argument, let us assume that the 5.7 million carers in the United Kingdom average a 35-hour week. The minimum wage is now £4.10 per hour. If carers were paid an hourly rate for their work, it would cost the country a staggering £42.5 billion per year. The most recent official figure is £34 billion but that dates from 1993. The introduction of the minimum wage legislation alone does not account for the increase–we must keep in mind the increase in the number of carers during that time.

As things stand, most carers earn approximately £1 per hour. Considering that ICA is intended as replacement income for those who give up or are unable to take up, full-time work the current rate is far from adequate. Carers’ organisations commended the Government for raising the earning limit from £50 to £72, which will then rise in line with the lower earnings limit. That figure has not changed since April 1993, and the new level will make some difference to those who need to combine care with employment.

Some carers are hidden carers. They may not even know that they are carers and, because they are not known to relevant authorities, they may not be aware of the help to which they are entitled. In Anniesland, the Princess Royal trust has pioneered a number of methodologies in partnership with local GPs and pharmacists in order to identify hidden carers. For example, GPs have written to their patients asking them whether they care for someone; pharmacists have been placing surveys in all prescription bags and health centres have been conducting surveys. In order to publicise the benefits and the help available to carers, it is important that those hidden carers are identified. The holistic approach taken in Anniesland has been very successful, and I would welcome a move by the Department to pilot such schemes nationwide. Although the Scottish Parliament has responsibility for many matters relating to health provision in Scotland, I feel that in this area in particular, examples of good practice can be monitored and adopted for the benefit of the whole country.

The Carers and Disabled Children Act 2000 gave carers the right to an assessment by their local authority to determine whether they were able to provide the required level of care. Those assessments can make an enormous difference to both carers and those in need of care. However, many carers complain that it is often extremely difficult to get that assessment and carers’ organisations have told me that the social services, health authorities and other relevant organisations are often unaware of their obligations. I urge the Government to ensure that those professionals are aware of the need for assessments and are equipped to carry them out.

Carers have brought to my attention the poor standard of information and support that is often all that is available when someone in need of care is discharged from hospital. In many cases, someone leaving hospital will require care for the first time and carers often find that they are left without instructions or information on where to turn for help. GPs also need to play their part in identifying and supporting carers, and that requires Government support. Surveys conducted among GPs found that many perceived that they would not be able to meet the carers’ needs. However, carers often have relatively modest needs such as needing information or being directed towards sources of help.

Research also reveals that up to 50 per cent. of carers have suffered a physical injury while caring, such as a strained back. A similar percentage of carers said that they had been treated for stress-related illnesses since they began caring.

Many GPs recognise that they can prevent the health of carers from deteriorating by supporting them. That, in turn, reduces the strain on primary care resources. The NHS plan puts forward prevention as one of the five key challenges that face the NHS, and ensuring that carers receive support will be crucial if the NHS is to meet that challenge.

At the weekend, my mother’s kitchen caught fire. She is almost 81, and I suddenly became aware that I was now her carer. The house was gutted and my mother was taken to hospital. She was, I am glad to say, all right. I was not at home at the time, but my wife took the call and we took my mother to my house. My mother has great difficulty in walking. The toilets in my house are upstairs, as are the bedrooms and the kitchen and living area are downstairs. My mother could not climb the stairs. She is an old lady who needs to go to the toilet regularly, and I had to carry her upstairs four times so that she could go to the toilet and then back downstairs to watch the television where she was comfortable.

Although I have a slight knowledge of what to do, it took me eight hours to get help from the local council’s social work and housing departments. Can Members imagine what it would be like for someone who had no such knowledge? Clear and concise guidance is needed, including emergency and advice numbers. I hope that the Government will consider looking into ways in which carers’ rights and the responsibility of local bodies can be publicised. Carers are often unaware that they can get additional assistance such as respite care, adaptations to the home, equipment for the disabled and meals on wheels. The 1999 general household survey found that only 22 per cent. Of carers reported that the person for whom they cared received home help. Only 8 per cent. of those who are cared for received meals on wheels. Most shocking of all, perhaps, was the fact that almost 50 per cent. of carers reported that they had not taken a break of at least two days since they started caring.

I have raised a number of issues relating to the problems that carers face. I would like the Minister to answer some questions. What can be done about the unequal and confusing benefit system? What more can her Department do to ensure that carers are properly identified and supported? What additional help will be given to young carers? Will the Department look at ways of advertising the importance of caring, so that carers are more aware of the help to which they are entitled and so that key professionals are also aware of the problems that carers face?

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