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Caring Responsibilities

Volume 529: debated on Wednesday 15 June 2011

I am pleased to have the opportunity to debate this subject under your chairmanship, Mr Streeter.

This is carers week. It is a time for us to praise carers, to have our photographs taken and to issue press releases to our local newspapers to show how much we care for the carers. In fact, however, it is a worrying time for carers, and the first aspect of that is the budget cuts.

The Government have made a great deal of their injection of £2 billion a year of extra money by 2014-15 to support social care. The Minister of State, Department of Health, the hon. Member for Sutton and Cheam (Paul Burstow), said that this

“means councils can meet cost pressures and maintain services”

However, an Association of Directors of Adult Social Services survey found that 98% of English councils showed overall budget reductions, even when taking account of the additional £1 billion for 2011-12.

Age UK says that spending cuts are projected to reduce spending on older people’s care by £300 million over four years, and that real spending on their care will be £250 million less in 2014 than it was in 2004. That is despite the fact that, during that time, we will have seen a rise of two thirds in the number of people over 85, one of the biggest groups that need care.

In 2005, half of our councils provided support to people who were assessed as having moderate needs. In 2011, however, that figure had fallen to 18%. To qualify for adaptations that could help them to manage better without care, people are assessed largely on the same basis. One example is showers that enable people to bathe without assistance. In the overwhelming majority of council areas, people now have to demonstrate critical or substantial need. Many constituents have asked for help with such things as shower adaptations but have been refused because they do not meet that need. One constituent has told me that, as a result, she can take a bath only if her daughter is there to help, yet she lives some miles away. If she had a shower, she feels that she could use it on her own, without having to call on her daughter for assistance. Not only would that improve her well-being and self-esteem, but it would clearly reduce the need for care. Use of these levels of eligibility for the person who needs the care places a greater burden on friend and family carers, who have to fill the gaps.

I argue that the cuts are short-sighted and could end up being more expensive. For example, if the carers’ help is compromised by having to take on an extra burden of care, or if the ill or disabled suffer accidents—perhaps because they do not have adequate adaptations—it will cost us a great deal more. We know that an older person having a fall is more likely to require expensive hospital care, or that a fall can act as a trigger for needing long-term residential care. Such accidents can often precipitate events that might not have happened for a long time, if at all. It is in that context that I argue that the cuts could be short-sighted.

In April, my hon. Friend the Member for Islington South and Finsbury (Emily Thornberry) carried out a survey of 61 councils; 27 were Conservative, 29 were Labour, four were Lib Dem. It showed that 88% of councils were increasing charges for social care services; that 16% were raising eligibility criteria, which as I said had already been increased; that 54% were making cuts in the voluntary service; and that almost two thirds were closing care homes or day centres. The Government’s response is often to say that it is primarily for local authorities, under the localism agenda, to decide how to spend the money. I bring to this debate a cautionary tale from north of the border.

Four years ago, the Scottish Government discovered localism, although they did not call it that. In 2007, they entered into a concordat with local government that included the removal of most ring-fenced funds and what I would describe as the velvet embrace of a four-year council tax freeze. Adult social care is not statutory. As a result, it often suffers in budgetary crises. Supporting People funding, which is primarily low level and preventive in scope, has been used since its introduction in 2003 for such things as supporting people in sheltered housing, and helping to meet part of the cost of care packages for people with learning and physical disabilities who have been moved out of institutional care—something that we all agree with—into their own homes.

The end of ring-fencing has led to a reduction in low-level support, the money being used to meet more immediately urgent needs. However, it has proved extremely difficult to track exactly where the funding is being used. The removal of the ring fence has made it hard to be absolutely certain that the money is not being used as it once was, other than through some of the outcomes.

Home care hours have been cut substantially in my city over the last four years. Many people now receive short visits—perhaps 15 minutes at the beginning and end of the day. However, the beginning and end of that day will be whenever the care services deem them to be, and people may be put to bed at 8 pm because it suits the care service. As a result, many families are having to plug the gap. That takes no account of considering such things as paying for care services. Visits can be very brief indeed.

A further difficulty in tracking what is happening is the increasing individualisation of decisions on care. A professional decision that someone needs fewer care hours can be hard to monitor, as individuals do not know what is happening to others and do not necessarily know that there is anything to challenge.

A family who I visited at the weekend have had their care hours cut from 50 to 42 a week. The husband, who is 74, has suffered severe strokes and needs constant care. His family have seen no change in circumstances other than their observation that they are worse, not better. His main carer is his 71-year-old wife; but having been fit and healthy and having worked to age 65, she is now beginning to suffer health problems, and recently suffered a slight stroke from which she has now recovered. No overnight care is provided outwith the family, and the wife often gets little sleep, with other family members regularly having to stay the night to give her an overnight break. The payments that the family receive to pay for care have reduced from £560 per week to £475 per week, based on the argument that their need was less. The family suspect that it is do with funding cuts. It would be more straightforward if local authorities were to say so, rather than suggesting that a professional decision had been made.

Others might touch on this later, but concern has been expressed about what has happened to the money for respite care that was made available by the previous Government. Many of the organisations involved have complained that it was not clear where the money had gone or whether it had been used for the purposes for which it had been granted. Further money has been given. The Prime Minister spoke about it again today. However, the main question is whether the money is being used for the purposes for which it was given. Although a hands-off localist policy makes it possible for Governments, devolved or not, to disclaim responsibility for what is happening, they remain, none the less, the largest funder of local services. A policy of successive council tax freezes tips the financial balance further towards central Government.

Cutting support for the elderly and disabled is described as the cruellest cut of all. Is my hon. Friend concerned that the Prime Minister described Birmingham city council as “excellent” when it had been branded in the High Court as acting unlawfully in taking away care from 4,100 people in substantial need? Does she not agree that the council should continue to support organisations such as Elders with Attitude because they bring people out of their homes and stimulate them mentally and physically so that they lead a good life and do not become dependent on the national health service or have to go into a care home?

That is clear example of what is happening up and down the country not only for older people who need care but for older carers themselves, who have very specific needs. Half of the 6 million people who are providing unpaid care in the UK are aged over 50. In England in 2010, nearly 1 million people aged 65 and over were providing unpaid care to a partner, a family member, who might be younger than them, or some other person. The largest number were aged between 65 and 74, but there were nearly 50,000 people over the age of 85 who were giving substantial amounts of care. A quarter of all carers aged 75 and over provided 50 or more hours of unpaid care per week. Carers over retirement age are a particularly vulnerable group because they tend to have health issues themselves. Such people say that they really have no retirement or that they have not been able to enjoy the retirement that they had expected.

I congratulate the hon. Lady on securing this debate. She refers to the age of carers. The survey to which she alluded earlier indicated that about half of all carers are in poor health. We often use the expression “a time bomb”, and it can be a cliché, but here we have a living example of a literal time bomb. If 50% of carers are in poor health themselves, we will, within a few short years, have a double whammy of a problem to deal with—the people who are being cared for and the carers themselves.

I thank the hon. Gentleman for that contribution. That is exactly the point that I was trying to make. The carers face not only health problems, but financial difficulties. Carers over retirement age do not receive a carer’s allowance even though they incur additional costs. They could use additional funds to buy some respite time that they might not otherwise get. They often become cut-off and isolated because they are not able to get out of the house to enjoy the sorts of social activities that enable people to live healthier and more fruitful lives.

Furthermore, there is an anomaly that needs to be resolved. Those on a low income who are over retirement age claim carer’s allowance, but they do not get paid it. Instead, they get access to a carer’s premium in pension credit. We have about 250,000 carers in that category. It is very confusing because they are claiming a benefit that they do not receive in order to get access to a completely different benefit. Hopefully, that is something that the current Government, with their zeal for simplifying the benefit system, will move very quickly to address.

As we debate this subject in Westminster Hall, the main Chamber is considering the Welfare Reform Bill on Report. Many colleagues who would have liked to be here are taking part in that debate. They know how important the Bill is to carers as well as to other people. The proposed changes to benefits are a big worry for carers. At present, carer’s allowance can be claimed if the person being cared for qualifies for either the middle or higher rate component of the disability living allowance. The successor benefit, the personal independence payment, will only have two bands of the daily living component, which is the equivalent of the care component. What is still not clear is how eligibility will work under the new benefit. Will it apply only if the cared-for person receives the new higher rate? How many people will lose eligibility for carer’s allowance as a result of these changes? In the Bill Committee, the Minister was unable to give us an answer to that question. However, Disability Alliance has calculated that to achieve even £1 billion of cuts to DLA—the Government’s forward projections expect there to be a £2 billion saving overall—there could be a risk to 643,000 people who currently receive the lowest rate and to a further 100,000 people on the middle or higher rate.

We are told by the Government that we cannot assume that everyone who currently gets the lower rate of DLA will lose out in the benefit changes because the new test will be very different to the old one, which leaves a question mark over an undetermined number of people. We cannot assume that all the losers in the new personal independence payment regime will be people who do not have a corresponding link to the carer’s allowance.

I congratulate my hon. Friend on securing this timely and important debate. There is no doubt that the proposed cuts to the employment and support allowance and the DLA will have a devastating impact on thousands of families right across the country. One such couple, Mr and Mrs McCann, wrote to me expressing their own concerns. They both had to take part-time jobs because of caring responsibilities for their daughter, resulting in a 50% reduction in their combined salaries. They do not qualify for carer’s allowance because they have an income of more than £100 a week. They rely on their top-up element for their child tax credit and the DLA that their daughter receives. Does my hon. Friend think that it is fair that this family should have to face the brunt of the cuts and even further hardship?

I certainly do not think that that is fair. I also fear that for some families, not necessarily for my hon. Friend’s constituents, it can be the crisis point that makes it impossible for them to continue with their caring responsibilities. If the family cannot continue to care, the cost to society of institutional care will be very much higher than that of properly supported family care.

There is also a small group of carers who currently receive income support. They are not necessarily in the same household as the person for whom they care, but their caring responsibilities mean that they are unable to be in work—or at least to be in very much work. Around 250,000 people are in that category. They will transfer from income support to universal credit, and, as currently drafted, there is no earnings disregard on that for carers. At the moment, a carer in receipt of income support has a £20 a week earnings disregard, which enables them to do some part-time work as well as their caring responsibilities and still have some financial benefit. An amendment to the Bill on Report was not accepted by the Government, but I hope that they will think again on that point.

There could also be people with caring responsibilities who would fall foul of the proposed benefits cap. A single parent with three or more children living in a relatively high-rent area who also cares for a parent living somewhere else could be affected. The Government have made much of the fact that people receiving DLA will not be affected by a benefits cap, which is good. However, there are people who are carrying out an important caring function who might, in certain circumstances, be covered by the cap. I ask the Government to consider exempting them.

Important changes are also proposed in relation to the money that is given to families with disabled children. Disability additions under universal credit will continue to be given in similar ways to the additions and premiums that are given within the current benefit system. However, the current lower rate of benefit is being halved. We are told that the higher rate is being increased—by £1 a week—but many families who have children receiving the lower rate of payment will have their payment halved. The reason being given for that is that it brings the disability additions for children into line with the disability additions for adults. However, I have a question, one that I have asked previously in relation to these reforms. Why do such alignments always have to be downward? Why is it only deemed to be fair if we equalise downwards—not even meeting in the middle, but equalising downwards—in this way? Given the considerable additional costs that we know families with disabled children have, this change seems to be another particularly harsh one and it will worsen the position of many families.

There is a cumulative effect to all of these changes. There are benefit changes of several kinds that might kick in for the same household, together with changes in the support provided by local authorities for services such as home care. The cumulative effect of all these changes will be very harmful indeed to families who have someone who needs a certain level of care. There will also be a particular effect on the carers themselves, those people who we are only too pleased to praise in this one week of the year. We have to put our money where our mouth is on this subject.

To conclude, I have a number of specific questions for the Minister. What assessment have the Government made of the impact on carers of the estimated £1 billion of cuts to social care services in the current financial year? What arrangements do the Government have in place to monitor what is happening at local level, so that they can fulfil their pledges to improve support for carers? The changes in benefits, such as the change from DLA to PIP and the move to universal credit, could lead to thousands of carers losing carer’s allowance, so is the Department of Health assessing the impact of those changes to families and indeed to services if families can no longer afford to provide care? Will the Minister seek to ensure that carers do not lose out in the welfare law reform proposals? At the moment, we are being told that some of these things will be ironed out, potentially in detailed regulations. So, whatever happens with the Welfare Reform Bill today, detailed regulations could still be needed and I want to know what the Minister will do to raise this issue with her colleagues in the Department for Work and Pensions. Also, do the Government intend to accept the Law Commission’s recommendations set out in its recent report on carers? Finally, how should the forthcoming reform of the funding of social care take account of carers’ contributions?

I thank everyone for their attention to this subject today and I look forward to hearing the Minister’s response in due course.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Sitting suspended for a Division in the House.

On resuming—

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

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

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

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

It is a pleasure to serve under your chairmanship, Mr Streeter—let us hope that we do not have too many more interruptions.

There cannot have been a more worrying time to have caring responsibilities, given the abuses at Winterbourne View; there must be a real worry that such things are happening in other care homes or hospitals. There are real worries about the future of Southern Cross, which is still very uncertain. There are also the issues that we are discussing, including the cuts to council budgets, which are resulting in the downgrading or loss of packages of care services. Carers have a range of worries and fears, some of which I want to cover, because these are serious problems for many families and it is right that we are debating them today. I congratulate my hon. Friend the Member for Edinburgh East (Sheila Gilmore) on securing the debate and on the excellent way in which she opened it.

It is 10 years since I started to meet carers in the course of research that I undertook for the Princess Royal Trust for Carers. In that work, I met many hundreds of carers, who opened my eyes to the issues with which they live day in, day out. Some time after I entered Parliament in 2005, I introduced the Carers (Identification and Support) Bill—not all Members were here when I said that I will send a copy to the Under-Secretary of State for Health, the hon. Member for Guildford (Anne Milton), and to the hon. Member for Banbury (Tony Baldry) because he seems to support the ideas behind it very much.

This year, the theme for carers week is, “The true face of carers”, and its aim is to highlight what life is like for carers and the challenges they face. New research for carers week shows that 80% of carers are now worried about the consequences of cuts to services. As has been mentioned, the survey of social service directors showed that adult social care services face cuts of £1 billion. The Minister has been asked this question, but I would like to emphasise the point: what assessment have the Government made of the impact on carers of the estimated £1 billion in cuts to social care services? I have some detail on impacts being felt in Greater Manchester.

Whatever we think about it, many councils are having to struggle with the Government’s swingeing front-loaded cuts, amounting to 27% over four years—that is the figure in the Budget. Many have found themselves having to cut grants to voluntary organisations, which is having an impact, and many are increasing or removing caps on care charges. As we have heard, the survey undertaken by my hon. Friend the Member for Islington South and Finsbury (Emily Thornberry) showed that 88% of the councils that responded were increasing charges for social care and 54% were cutting support to the voluntary sector. It is a double whammy—cuts in support and increases in charges.

Like everyone else, carers are hit by increases in the cost of living, which we must also take into account. Fuel costs and VAT affect them in the same way as they affect other people. Most carers are financially worse off than other people, because many have had to cut down on or give up work so that they can care.

For this debate, I asked local organisations in Greater Manchester to tell me exactly how cuts or fears about cuts are affecting carers. A staff member at the Bury, Salford and east Lancashire branch of Parkinson’s UK told me of her experience. She said that there had been a big increase

“in calls from people who are living on very tight budgets with no chance of increasing the family income due to disability and caring responsibilities, distressed because they can’t afford day to day living costs.”

The calls that she receives are about the knock-on effects of lack of money—stress, not eating well, relationship difficulties or breakdown, anxiety and depression. They can lead to illness worsening, and if a carer becomes ill and cannot cope, it can lead to hospital admission. She also said something that ties in with points made earlier in the debate:

“More people with Parkinson’s disease are being turned down for”—

allowances such as—

“disability living allowance and attendance allowance. There is no sense to who gets the benefit and who gets turned down…The distress this causes families is huge because they feel that they are begging. I can only imagine that families who don’t have support miss out completely. The benefit is meant to pay towards the extra costs of having a disability, the fact that genuine people are being turned down means that carers”—

would end up—

“having to do even more.”

My hon. Friend the Member for Edinburgh East raised carers’ eligibility for benefit, which I think is and will become the key issue due to the Government’s programme of cuts and the uncertainty. The Minister has already been asked the question, but will she tell us in this debate what the impact will be if those carers who lose their carer’s allowance decide that they can no longer afford to care? The responsibility for caring will then fall to the local council and the state.

I do not think of my constituency as different from anyone else’s, so I am sure that the hon. Lady will agree that young carers clearly play an important role. Those who are 16 years old and under do not qualify for any financial assistance, but their role is critical for the family, parents and those they look after. Does she feel that the coalition Government should address the importance of young carers?

I very much agree. I have a point to make later about that topic, because the staff who work on the young carers project in my constituency have said that they are very concerned about carers losing their education maintenance allowance. That is the one support that the state gave young carers and it is going, which is a worry.

To return to the testimony from Parkinson’s UK, the final points were about more carers contacting the staff member to ask for help finding respite because they are struggling to cope; financially, they cannot now afford a break, a treat or a holiday. I am glad that the hon. Member for Banbury raised that point. The staff member said:

“I know of one carer who has had to take on a part time cleaning job in the early evening because money is so tight. She puts her husband to bed before she leaves”—

for work—

“at 4pm so that he is safer and so she won’t worry that he will fall while she is out.”

I think that we would agree that we would rail at care agencies that put a person to bed at 6 or 8 o’clock, yet this carer has to put her husband to bed at 4 o’clock because that is the only way that she can do the cleaning job that she has to do.

I also had some input from a branch of Age Concern in Greater Manchester about how cuts to grants are affecting its dementia support service, which is important because it is another line of support. Cuts to grants of 40% over the next three years are affecting its capacity to deliver individual and group support. That goes against objectives 5 and 7 of the national dementia strategy. The staff member told me:

“Carer support groups have had to close. These are groups where carers can get a break, have a chat to other carers and get advice and information from staff. These groups help to maintain morale and prevent carers from becoming socially isolated.”

Even though there are personal budgets, which will come in in Greater Manchester, carers of people with dementia often find it hard to mix in other social groups because of the “different” behaviour of the person with dementia. Carers have described the groups as a “lifeline” and something “to look forward to”. The fact that they are being cut back is important.

The proactive support to carers of phoning them every few weeks is another aspect of Age Concern’s work that is being cut. The staff member said:

“We now have to wait for them to contact us for time-limited intervention. We know that many older people are proud and longsuffering and will often suffer in silence rather than ask for help.”

Before the cuts, branches of Age Concern in Greater Manchester ran special events for carers such as a carers day each year, parties and trips. The reduction in funding means that it can no longer offer the extras that it knows give people a better quality of life. I am very concerned to hear that carers in my area in Greater Manchester are starting to suffer.

I want to return to the two sides to the debate—values and choices. We are fortunate in Salford because, due to the way in which the cuts and the organisational turmoil in the NHS are being managed, we are not suffering as much as other areas. There are choices. Labour-run Salford city council is now one of only 15% of local councils still providing support to people with moderate care needs, as well as to those with substantial or critical needs. We are fortunate to have an excellent carers’ centre run by the Princess Royal Trust for Carers. Salford has tried to ensure that carers continue to be supported through these difficult times. As I mentioned earlier, however much the council and our local NHS bodies support carers and try to maintain what they are providing, the national changes and cuts affect our carers.

The young carers project will be affected when the young carers lose their education maintenance allowance. The centre manager told me of two other concerns: the changes to benefits and disabled people being called in to take work capability assessments. The extra worry of having to take them and of having benefits curtailed are starting to affect carers.

The centre manager also said that a major concern for her organisation was that although the carers’ centre was very well established, the service has to go out to tender through the joint commissioning process next year. She said:

“We are aware of a number of carers’ services which have gone out to tender in other areas, and bids have come in from organizations and agencies which have no experience, knowledge or expertise in carers and carer issues, including organizations from abroad.”

What reassurance can the Minister give to staff of the carers’ centre that an established, trusted and effective organisation such as theirs will not be undercut in the tendering process by organisations with no local knowledge and no experience or expertise with carers or in carers’ issues? Our carers in Salford would lose out if they lost the valuable support that they get from their carers’ centre.

The Government’s economic policies are damaging support to carers. Government cuts to local council budgets have gone too far, too fast. Councils pleaded not to have their budget cuts front-loaded. We have lost £1 billion from adult care services at a time of rising need, and we have lost billions in grants to the voluntary sector, but the worst thing is that we are only a few months into the first year of cuts, and we can already see the impact on carers. Carers are fearful about the cuts and distressed that they cannot manage financially. People with serious conditions such as Parkinson’s are being turned down for attendance allowance and made to feel like beggars if they appeal. Young carers are losing their education maintenance allowance. Carers are now unable to afford a break or holiday. It is shameful that a carer should have to take a part-time cleaning job and put her husband to bed at 4 pm.

That is not a record of which the coalition Government can be proud, and it is so early in this Parliament. I hope that carers week gives Ministers time to rethink the impact of the cuts that they are making.

Colleagues, three Members have sought to catch my eye, and we have 19 minutes before winding-up speeches begin, so can we regulate ourselves to about six or seven minutes each?

Thank you, Mr Streeter. It is a pleasure to serve under your chairmanship this afternoon. First and most importantly, I congratulate the hon. Member for Edinburgh East (Sheila Gilmore) on securing this debate. It is the most timely debate that we could imagine, given that this is carers week. The hon. Members for Stretford and Urmston (Kate Green) and for South Thanet (Laura Sandys) and I were asked by Carers UK to act this week as carers’ ambassadors in our constituencies and elsewhere to promote some of Carers UK’s key messages.

On the true face of carers, the reality is that there are so many different faces, stories and anecdotes. As we have heard, there are 175,000 young carers. There are carers in work or grappling with the prospect of staying in work while managing their caring responsibilities—I will say a little about that in a moment—as well as elderly carers. We receive many different stories in our e-mails and postbags every week.

Let us celebrate carers week. It is about celebrating the invaluable work that carers do and showing our appreciation of those who give up their time, sometimes at a cost to their own health and financial well-being. That message has come loud and clear from many Members in this debate, and I echo it. I will focus my remarks on some of the personal experiences that constituents relay to us.

We as a society unquestionably rely on carers to provide a service, and there are clear benefits to people caring for their loved ones: not only do they make them more comfortable, but they reduce pressures on health and social services. I was privileged this week to launch a carers week event in my constituency. It involved the book “Dywedwch ‘’Dwi’n iawn’…a’i Olygu”—the hon. Member for Newport East (Jessica Morden) might be able to understand that—or “Say ‘I’m Fine’…and Mean It”. It is a good book that promotes some of the services available in my constituency and more widely. It was produced by Ceredigion council and a local project called Mind Your Heart to give carers advice on maintaining their physical and mental health. It is an excellent project. I agree with the hon. Member for Banbury (Tony Baldry) that the voluntary sector has done and is doing much, although that is being impinged on by the scale of the decisions made here and, in the context of my constituency, in the Welsh Assembly.

The outcome of a Wales-wide survey of carers—we heard the UK figures from the hon. Member for Worsley and Eccles South (Barbara Keeley)—revealed the extent of their concern and worry. As many as 71% of carers have suffered health problems as a result of caring, 64% have had to give up their career ambitions and aspirations since taking on their caring roles and 63% of carers were surprised at how hard it is to be a carer. Sometimes, at comparatively short notice—even very short notice, such as after a car accident—carers suddenly discover that they must undertake a life-changing role. Some 43% of carers have a disability, condition or illness themselves. I met an 88-year-old constituent on Sunday evening who had cared for his wife, also in her 80s, for many years. Carers week is an opportunity to highlight such issues and concerns, given the inevitable decisions on the deficit that the Government must take.

The title of this debate, commendably, refers to the effect of spending reductions on families. I will address that, but it is important to recognise that some decisions and prospective decisions made by Government could be good news for carers. However, there is a great deal of work to be done. The Government are embarked on a consultation on proposals to extend the right to request flexible working. I introduced a ten-minute rule Bill earlier this year to extend the definition of carers within current flexible working regulations and provide for so-called day one rights, allowing carers to request flexible working from when they start a job, rather than after waiting six months. I launched a lottery-funded project in my constituency with Crossroads Care and various local chambers to assist carers and boost their confidence in returning to the labour market where their circumstances permit it. The challenge of finding the confidence to return to the labour market after caring should not be understated.

We have had good news that the Government plan to introduce a right for all workers to request flexible working, which is to be welcomed as a big step forward. The Government have recognised that many successful modem businesses acknowledge the importance of respecting that their staff will have other responsibilities and that the best way to ensure that they remain motivated and reach their potential is to give them the flexibility that they need. It is a big issue. More than 150,000 people in Wales who are in paid employment have unpaid caring responsibilities. However, the Government have been less forthcoming on day one rights. There is a perception that it is somehow unfair for people who have just been appointed to a job to request flexible working. I contend that people should have the right to request flexible working at the outset. Many of us share the view that if carers wish to work, they should be given as much support as possible, but there is a barrier.

I have one minute, so I will rattle through my next points. I agree with colleagues about the concerns expressed by the hon. Member for Banbury, and consistently by Labour Members, on the arrangements for carer’s allowance, changes to disability living allowance and the uncertainty involved. As the hon. Member for Edinburgh East said, clarity is lacking on those matters. I also agree with the principle that if we embark on major changes, there must be a process for monitoring, evaluating and reporting back on them. Work on the awareness of benefits is fundamental as well.

To return to my original point, a quote from a carer in my constituency illustrates why carers week is so important in highlighting cases. A lady in my constituency who will remain anonymous cares for her disabled son. She says:

“I note the activities locally for carers week in Ceredigion, in which you are involved. I cannot attend such activities, as I am trapped at home looking after my son. When I do have time without him (when he is at school) I am at work trying to retrieve our family’s financial affairs from the effects of my son’s disability and trying to keep some semblance of a life for myself apart from my son. Disabled people and their carers are very often voiceless for these reasons. This sounds dramatic, but it is a very small divide between coping and not coping. And the implications of not coping are horrific.”

That is why this debate is important, why carers week is important and why it is crucial for all of us to continue to press the case for carers’ rights.

It is a pleasure to serve under your chairmanship, Mr Streeter, for the first time in a Westminster Hall debate. I echo the tributes to my hon. Friend the Member for Edinburgh East (Sheila Gilmore), whom I congratulate on securing this important debate on the effects of spending reductions on families with caring responsibilities, not least because of the important changes being made in the House of Commons in the Welfare Reform Bill.

I want to confine my remarks to a couple of issues, because of the shortage of time. A survey of more than 2,000 carers was recently carried out for carers week. It shows that 80% of unpaid carers are worried about cuts to services and that about 50% are unsure how they will be able to cope without the vital support that they currently receive. For the record and for anyone who is not involved directly as a carer, it is worth stating that three out of every five people will be an unpaid carer at some point during their lives. To respond to the point made by the hon. Member for Banbury (Tony Baldry), those unpaid carers save the economy a huge sum. It is difficult to quantify it, but it may be more than the total NHS budget—£103 billion each year.

We have done some research in County Durham. I am proud to speak up for the vulnerable, the disabled and for carers. My county alone has 61,000 carers and the estimated moneys saved to the public purse by the very important work that these unpaid carers carry out are £1 billion a year. We should not be dismissive of their needs and requirements. Each carer who works for nothing saves the Government, the taxpayer and the Exchequer the cost of a care worker, which is about £18,000 a year.

My own constituency of Easington is characterised by long-term ill health. As the hon. Member for East Londonderry (Mr Campbell) has mentioned, many carers, particularly in my area, are themselves victims of ill health. That was highlighted by a recent report by Carers UK. The legacy of coal mining and heavy industry has left many thousands of people debilitated in later life by long-term disabilities and in need of care, which is often provided not by the state, but by close family members.

I shall speak briefly about a number of issues. In particular, I want to draw Members’ attention towards, and place on the record, the effects being felt by some of my constituents as a result of the transport costs they now face due to local government cuts, and towards respite care, which has been mentioned. I also want to ask the Minister a couple of questions—I hope that she will answer them—about carer’s allowance and the provisions in the Welfare Reform Bill.

A constituent who came to see me recently is a full-time carer for her husband. She has one day a week of respite care. Her husband attends a day-care centre in Grampian House, in Peterlee in my constituency, once a week for four and a half hours. That is the only break she has. It is an excellent facility and I pay tribute to its care staff. I have visited it myself and a close relative of mine is in there. They do tremendous work in terms of physiotherapy and rehabilitation. However, from September, due to the front-loading of cuts of £67 million this year to my local authority of Durham county council, transport to the centre will be cut. It will cost my constituent £72 for specialist transport, which means that she will not be able to take her break and take advantage of the respite care.

The issue of transport has been raised by many of my constituents. They understand that cuts to social care by local authorities are due almost entirely to the swingeing, front-loaded cuts that the Government have imposed. Councils are struggling to cope with massive funding reductions from central Government.

People are also aware of the impact that the Government’s £18 billion package of cuts to the benefits system will have on carers in particular. The Government accuse Labour of rejecting welfare reform, but I am proud to say that we stand firm on the principle that the most vulnerable should not be paying that £18 billion when some of the richest in society—most notably, the bankers and the banking sector—contribute only between £2 billion and £5 billion to the cost of the deficit.

I shall conclude my remarks, because time is short. Another big issue that has been raised is that of ring-fencing moneys for social services, with a distinctive sum identified for carers’ services—the carer’s grant. Although it was not ring-fenced under the previous Government, councils at least knew how much money they were receiving for that purpose. The Minister has responsibility for public health and I would like to congratulate my own soon-to-disappear primary care trust, County Durham PCT, on clearly ring-fencing, identifying and spending its allocation from the Department of Health on the provision of respite care for people with disabilities and their carers.

How will the Government fulfil their pledges to improve the support for carers in the face of massive cuts to local government? How will the Government ensure that the proposed reforms, outlined in the Welfare Reform Bill, do not result in carers losing their carer’s allowance? The Government could give two promises that would give confidence to those who are most vulnerable and most in need. First, budget cuts should not result in carers losing the services that they rely on. Secondly, carers should not lose out under changes to the benefits system.

Thank you, Mr Streeter, for the opportunity to contribute to this vital debate, and I congratulate my hon. Friend the Member for Edinburgh East (Sheila Gilmore) on securing it. I will not rehearse the arguments that we have already heard, because time is short.

As a carer for my 86-year-old father, who was born deaf, I have a deep personal understanding of the issues and challenges that many carers face. I am deeply concerned that the decisions taken by this Government will massively compound the financial and emotional pressures that carers face. Others have discussed the national policy changes, but I would like to talk quickly about issues that affect my constituents.

Both of the two cases that I wish to address relate to services provided by Lancashire county council as the social care provider in my constituency. The Derby day centre is a fantastic facility in Ormskirk. The staff are committed to providing high-quality care and support to people who use the centre. It offers a wide range of facilities to meet the needs of the individual, whether they have dementia or a physical disability. I have visited the centre many times and I am always impressed by it.

In a shock move, however, Lancashire county council has announced that it is increasing the daily cost from £5 a day to £30.75. That is not a small increase, but an increase of nearly 500%. I wonder how that fits with the mantra of not affecting front-line services. The council says that, this year, it will not charge users more than £30 a week extra. However, next year that will also increase so that people will not pay more than £60 extra. It is clear that, before long, anyone attending or wanting to attend the centre will have to pay the full cost of using it. Today, my office received a call from a centre user’s family who were angered by the scale of the increases. For them, the cost will rise from £40 a month to £160 a month for two days a week at the centre. That is just one issue in Ormskirk. There are many cases in which the elderly or disabled are being impacted by Lancashire county council decisions. The dial-a-ride service, for example, has been almost decimated. Some families will grumble about the cost but will be able to pay. Others will not be able to meet the costs and the council will help. However, a great number of families in the middle will be sitting at home wondering whether, financially, they can afford to continue to use the centre and, conversely, whether, emotionally, they can afford not to.

The second case is a group of mums who told me of their concern about funding for Aiming Higher for Disabled Children. That programme finished at the end of March and since then no short breaks or activities have been available for families, even for a day or a few short hours. The county council has said that it will consult parents on how the scheme will work but, in the meantime, there are no services—zilch, nothing. No support is being offered whatsoever, and that is a huge burden. I understand that the summer holidays are coming up and that interim arrangements will be made, but that still does not address the proper concerns that exist. In 2010-11, the funding for Aiming Higher was £4 million. Officers are now telling us that only £3.5 million will be available for two years. That is a reduction of a half. Does the county council believe that half the need for the scheme will evaporate while it is considering its budget cuts, or is it dumping the care, responsibility and the cost of children with disabilities back on to hard-pressed parents?

I will end my remarks because I have to cut them short. I am really, really sad that when the local newspaper asked me about the matter, I said, “Well, this is now the typical Conservative attitude. They know the price of everything and the value of nothing.” I find it gut-wrenching that the elderly and the most vulnerable will have to live with the consequences of the Government’s decisions. We keep hearing that we are all in this together. Families with caring responsibilities in West Lancashire are now realising that some people are in this more than others. How can the Minister justify this, and look carers and their families in the face?

It is a pleasure to serve under your chairmanship, Mr Streeter. The debate could clearly have gone on for twice or perhaps three times as long. A feature of it has been the number of people who wanted to speak and have not been able to. My hon. Friend the Member for Newport East (Jessica Morden) wanted to speak, as did my hon. Friend the Member for Birmingham, Erdington (Jack Dromey). My hon. Friend the Member for Glasgow Central (Anas Sarwar) had also prepared something, and my right hon. Friend the Member for Croydon North (Malcolm Wicks) had told me that he wanted to make a contribution. The fact that many people have shown an interest in the matter demonstrates its huge importance.

I congratulate my hon. Friend the Member for Edinburgh East (Sheila Gilmore) on securing the debate. It is very easy to come out with a number of platitudes about carers, but carers want to hear what we will do to help them. Carers probably save this country more in money than is spent on the national health service. By 2017, it is likely that the UK will reach a tipping point, as the number of older people needing care will exceed the number of people of working age with families. There will be a crisis and we need to ensure that we are up to dealing with it. We must be able to support those people on whom we rely entirely. As has been said, if anyone is demonstrating the Prime Minister’s big society, it is carers up and down the country, so we need to look after them.

Where is the good news? There is some good news, which has come from the Law Commission. It has published a report that has largely received broad support from social care groups. A number of proposals are well thought out and will be well received, for example, rather than the carer needing to request an assessment, the local authority will have a duty to provide one. In addition, those assessments should be made for people who provide some care, rather than being restricted to those providing substantial care. Both those proposals are sensible. The third proposal is to ensure that a national system of eligibility assessments will provide some consistency across the country and allow people to move from one local authority to another without there being a huge time lag, which causes great distress to families. That will allow some portability of care.

The Under-Secretary’s brother Minister who is responsible for care, the Minister of State, Department of Health, the hon. Member for Sutton and Cheam (Paul Burstow), has so far welcomed the Law Commission’s report. In his pre-coalition past, he expressed support for many of the ideas it recommends. However, many of the issues will not come within the Department of Health’s ambit, but within that of the Department for Communities and Local Government. Given that the Secretary of State for Communities and Local Government has indicated that he wants to conduct a review of local authority duties, there is some concern that he may be resistant to a new duty being put on local authorities to ensure that carers are assessed as well as the person needing care. I hope that that is not the case and that people are speaking strongly in his ear, so that the Law Commission’s recommendations can be implemented in full because they are to carers’ advantage.

The other piece of good news may be the Dilnot inquiry. I met Mr Dilnot again today. He is very generous with his time and is meeting a broad range of people. The meeting he had with me and my right hon. Friend the Member for Wentworth and Dearne (John Healey) was the first of eight meetings that he is holding today. Of course, we all agree that we need to make fundamental changes, that the status quo will not do and that we must have a fundamentally reformed care system. The Opposition believe that there should be high-quality care for those who need it and that care needs to be funded in a fair way, with proper accountability for those who deliver it.

We repeat the Leader of the Opposition’s invitation, which was made on Tuesday 7 June. We welcome cross-party talks and we would like them to happen as soon as possible. We will come with an open mind because we want to be able to work together for the best way forward. I understand that the Prime Minister has welcomed that approach, but we still have an empty diary and we want to be able to get on with it. If the failures of the past are repeated, we will not be forgiven by those who use the care system or their families. It is important to remember that, even with co-operation and a fair wind, we are unlikely to see any of Dilnot’s suggestions implemented until 2014-15. The current problem for carers is what is happening now to the social care system and their support .

I am afraid that that takes me to the end of the good news and into the bad news. As has been said very eloquently by my hon. Friends, social care cuts are clearly having a fundamental impact on the lives of carers. I was going to congratulate the Minister of State, Department of Health, the hon. Member for Sutton and Cheam on finally taking his fingers out of his ears, stopping singing, “La la la la la,” and accepting that the cuts to social care will affect front-line services. That is inevitable; there is no other option. Given that social care is top-tier councils’ biggest area of discretionary spending, we simply cannot have 27% cuts to local authorities without there being cuts to social care. It just does not work. Unfortunately, the Government have ignored the advice of the Association of Directors of Adult Social Services and the Local Government Group, who know what they are talking about.

Although no centralised assessment of the impact of the cuts to local government on social care was carried out, several people have done the Government’s job for them. A wealth of evidence has been provided by ADASS, the BBC and my own survey. As has been mentioned, my survey of the directors of social care received 61 replies from councils and shows some very worrying results. I am pleased that the Minister of State, has complimented my survey as being robust, accurate and, indeed, more reliable than that done by the BBC. However, he needs to look at the impact of it and what it means. We will do the survey again next year and the year after, and I am afraid that we will not get good news.

ADASS has shown this year that the shortfall to adult social care spending is £1 billion. The Government have done their best not to affect adult social care, but next year they have to cut again and the year after they have to cut yet again. If things are bad now, as has been so eloquently reported by my hon. Friends, where are we going? Do the Government have any idea of the impact of these cuts on carers? This has already been asked, but I repeat: how many of those who no longer meet councils’ very narrow eligibility criteria will need to rely on the informal care provided by their families? Do the Government know how many carers will have to go without support from their local authorities and will, as a result, be forced to give up work to meet their new obligations?

I was particularly pleased to hear what the hon. Member for Banbury (Tony Baldry) said about respite care—I support him in that. The Government are right—our Government was right—to ensure that money is put aside for respite care. The difficulty is that the mechanics do not work. Primary care trusts have been given that money. It is not ring-fenced. It is not clearly labelled. There is no accountability. The Department of Health is very unclear about which PCTs have spent it, in what way, how much they have worked with local authorities, or how much they have worked with carers—there is no overall picture. Frankly, is that not the sort of thing that the Government should do? It is not just a question of handing out the money. Surely there needs to be some form of accountability.

The Princess Royal Trust for Carers has been doing its best to conduct an audit of that, just as I am doing an audit of local authorities and the impact of the cuts on social care, but surely that should be a job for Government. Surely the Princess Royal Trust for Carers has things to do other than conduct an audit of whether the money given by the Department of Health to PCTs for respite care for carers is actually being spent on carers. That is part of the knock-on effect of the chaos that has been created through the proposed partial abolition of PCTs in the Health and Social Care Bill. What action will the Government take if PCTs do not work with local authorities and carers of organisations to publish plans and budgets?

The other piece of bad news, which has been mentioned, is welfare reform. We welcome the Government’s announcement that carer’s allowance will be outside universal credit. We also welcome the news that disability living allowance will be excluded from the overall benefit cap. However, the bad news is that, when the Government talked about introducing personal independence payments, they said that there would be a 20% cut to DLA. It is not just a 20% cut to DLA. Those people will not be springing from their beds, suddenly well. People with dependants will still be there. Not only will they, but their carers will lose their money, because carer’s allowance will be attached to DLA. There will, therefore, be a huge impact on the families of those people who are losing their DLA. Do the Government have any idea of how many carers will lose out as a result of moving DLA to the personal independence payment and the 20% cut? Are the Government aware that carer’s allowance is not excluded from the proposed benefit cap, while DLA is? I am sure that the Minister would agree that that is, at the very least, not consistent, let alone fair.

Order. It may help the hon. Lady to know that the debate ends at 4.10 pm, and I want to give the Minister some time to respond.

May I just come back to this last point? It is shocking that, at a time like this, carers suffer in the way that they do. It is a question of priorities and hard choices. As my hon. Friend the Member for Worsley and Eccles South (Barbara Keeley) so eloquently put it, it is not right that a woman has to put her husband to bed at 4 o’clock in order to do a part-time cleaning job to pull things together. It makes “We are all in it together” hollow rhetoric.

It is a pleasure to serve under your chairmanship, Mr Streeter. Time is very short. I have about seven minutes, so I say up front that I will ensure that hon. Members receive a note to answer the questions that I will not be able to address. As the hon. Member for Edinburgh East (Sheila Gilmore) knows, this is an important debate. Like her, I would like to feel that this is about more than just press releases this week. Indeed, we praise carers this week. We should praise them every single week and every single day—those we know about and those we do not.

As the hon. Lady knows, in her constituency the Scottish Government have overall responsibility for devolved budgets and I am sure that she will therefore take up some of the issues with them. I note the cautionary tale about ring-fencing—mentioned by a few other hon. Members—and also tracking funding. Local authorities, however, have a duty to provide community care to those who meet eligibility criteria. The Department has set out an eligibility framework, which is important to bear in mind.

Who cares for the carers? Somebody first said that to me a very long time ago—in fact, when I was a district nurse. Those with caring responsibilities need care themselves, so that they can maintain their own health and well-being. Although it has not been mentioned today, the figures on the physical, mental and emotional health of carers are shocking.

Care and support services from both the statutory and voluntary sectors face challenges, irrespective of funding, like never before. Demographic changes mean that most of us will either become carers or need care. Some of us already care for children with disabilities and are often lifetime carers. Others care for partners as they grow older; some for ageing parents, neighbours or friends. Carers come in all shapes and sizes, and with different needs. It is important, when government at any level tries to meet the needs of carers, to recognise that they need specialist and personalised help, which is why personalised budgets are an important step.

I will run through some of the money that is coming through, so that hon. Members can raise, with their local authorities, what is happening to it. The spending review allocated an additional £2 billion by 2014-15 to support the delivery of social care. Some of that funding is already getting through. Some £162 million went in during January, which was money transferred from NHS budgets to support care services that improve people’s health and support carers. A further £648 million will pass to local government in England in the same way. A further £1.3 billion is now supporting the transfer of funding and the commissioning of learning disabilities services from PCTs to local councils, which will help. One hon. Member raised the issue of integrating services. That is very important. It applies to several Departments, and it is also true at local authority level.

Taken together, that is the biggest ever transfer of hard cash from health to social care. That is an important development and comes on top of the £530 million for social care this year from the Department of Health, which we rolled up into the Government grant formula. The Department for Education is providing more than £800 million in the next four years for short breaks—they are absolutely critical; respite breaks are a lifeline to parents of children with disabilities—as part of the new early intervention grant.

We recognise that the current funding system needs overhauling. We cannot avoid the wider challenges that demography brings us. My hon. Friend the Member for Banbury (Tony Baldry) was 100% right about how the money is spent, and the hon. Member for Edinburgh East also mentioned monitoring. It is extremely important that we identify carers early, so that we can meet their needs early and they can continue to do what, essentially, they want to do, which is to care for those who live with them.

The Dilnot commission will report in July and will help us find new ways to modernise the funding of social care and ensure that it is more in line with the demands and expectations of the 21st century. The carers strategy, which we published in November 2010, sets out our priorities. Those priorities are important because we measure what central Government and local authorities do against them. They are: to support those with caring responsibilities to identify themselves as carers at an early stage, and involve them in designing local care provision and planning individual care packages; to enable those with caring responsibilities to fulfil their educational and employment potential, which is absolutely critical as young carers do not necessarily get to any step on any ladder as far as education and employment are concerned; to personalise support for carers, which is critical, and to support carers to maintain physical and mental wellness, because the physical burden of providing care for a friend or family member can be significant. Ideally, carers who are identified at an early stage can get the help that they need.

My hon. Friend the Member for Banbury mentioned the work that Sainsbury’s is doing. We should congratulate it. Of course, it is not a substitute for other things, but it is an important addition. Tomorrow morning, the Minister with responsibility for care services will launch a new e-learning tool for all GPs, developed in partnership with the Royal College of General Practitioners and the Princess Royal Trust for Carers. That will be an important tool in enabling GPs to do what we need them to do. The Department of Health has made a further £1.5 million funding available for other initiatives to support GPs to help carers further. Alongside the carers strategy, we published examples of how the principles of personalisation have been applied locally, emphasising the value of finding ways forward that make sense and work best locally.

I have to say to Opposition Members that the country is financially where it is because that is where we found it when we took over from the previous Government. The hon. Member for West Lancashire (Rosie Cooper) shakes her head. We cannot get away from the fact that we inherited a massive budget deficit that we are now having to tackle. Opposition Members look as if they are in denial. The hon. Lady, who is a sensible person, asked how we could look carers in the face, but how can members of the previous Government look carers in the face? We have been left with some difficult decisions. We have to ensure that every £1 of taxpayers’ money actually buys £1-worth of care, to support carers in the ways in which they need it.