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Carers: National Strategy

Volume 836: debated on Tuesday 12 March 2024


Asked by

To ask His Majesty’s Government whether they plan to develop a national strategy for carers to take account of the needs of unpaid carers.

My Lords, I beg leave to ask the Question standing in my name on the Order Paper and draw attention to my interests as set out in the register.

My Lords, we have set out our strategic approach for supporting unpaid carers in People at the Heart of Care, published in 2021. The enormous contribution made by unpaid carers is reflected throughout Next Steps to Put People at the Heart of Care, published in 2023. Ministerial colleagues indicated last year their intention to meet annually, in the run-up to Carers Week, to share ongoing work to support unpaid carers and identify opportunities to work together to achieve more.

My Lords, I thank the Minister for his response. I never have any difficulty getting agreement that carers are vital to our health and social care system and should be supported, but I doubt if the 5,000 carers just surveyed by Carers UK about a national strategy will be very pleased with his Answer. They emphasise how vital this kind of step change is if they are to be able to continue caring while safeguarding their own health and finances. What they, I and all those who work with carers want is a national strategy that covers all relevant departments and is led by the Prime Minister, as the last one was in 2008 by the then Prime Minister, Gordon Brown. This Government promised a national strategy in 2015. Why are carers still waiting?

I pay tribute to the noble Baroness for the work that she has done and her lifetime service to carers and to the voluntary service. We are fortunate to have her in this place. We will continue to work together across government to support unpaid carers. Ministerial colleagues and senior leaders from the Department for Work and Pensions, the Department for Business and Trade, the Department for Education and the Department of Health and Social Care, as well as NHS England, met last year to share ongoing activity and identify opportunities to achieve more. Ministers indicated their commitment to meeting on an annual basis, most likely in the lead- up to Carers Week. We recognise the importance of continuing to improve data and evidence and will note the results of the APPG/Carers UK survey, in addition to other sources once available.

My Lords, the Minister has talked about a strategic approach and meetings. What exactly are the Government doing to address the disproportionate risk of poverty among carers? Where is the strategic approach on that? Things are getting worse, not better.

This Government are fully committed to the 10-year vision for adult social care set out in the People at the Heart of Care White Paper. The Government have made available up to £8.6 billion of additional funding over this financial year and next to support adult social care and discharge.

My Lords, the support received by carers varies according to where they live. Does the department have access to how many unpaid carers there are and where they live? Does it hold information about the ages of carers and those whom they are caring for? If not, why not?

My Lords, the noble Baroness makes an important point. She is right that we need to know where carers are. People at the Heart of Care, published in 2021, addresses the identification of unpaid carers by increasing the use of markers in NHS electronic health records and by simplifying current approaches to data collection and registration. In many communities up and down the country, that works very well, but clearly there is more to be done in other communities.

My Lords, the Minister will recognise that anyone at any time can have a major care role thrust upon them unexpectedly which can transform their lives completely. When the committee that several of us sat on took evidence from unpaid carers, one of the things that astonished us was that carers felt so devalued. When they took the person whom they were responsible for to hospital, they were not even allowed into the consulting room with a doctor because their status was not considered sufficient to allow them in; it was only the patient who could go in. These carers said to us, “What is the country doing to support unpaid carers?”

The noble Lord is right, and indeed I have experienced that position myself. If you take a loved one to hospital or to the doctor’s, and the doctor’s surgery has been used to seeing the patient over many years, they look at the carer and think, “Who is this person?” Their records do not reflect things, and that is simply not good enough. Registering a power of attorney with the GP is one way of doing that, but we are a long way from having it in place. It is incumbent on GP practices to get up to speed. When they have patients on their records, there should be a clear segment in the computer system so that if a patient turns up with a carer the practice knows who the carer is and makes them welcome.

My Lords, there are some deep concerns—I have seen a number of things on television recently—about actual children acting as carers for their parents, when I think the normal assumption is that carers look after elderly people or those who are particularly disabled. Does my noble friend agree that we need to be particularly careful to identify situations where children are carrying out those functions, and assist them as much as possible?

My noble friend is absolutely right and raises an important point. The Department for Education’s new data on young carers, collected through the school census published last year, is an important step towards improving their visibility in the school system, allowing schools to better identify and support their young carers. That will also provide an annual data collection to establish long-term trends. We will consider the findings from the census to inform the next steps.

My Lords, on International Women’s Day last week, Carers UK stressed that older women aged 75 to 79 are providing the most unpaid care—50 hours per week—and that there has been an alarming increase since 2011 in women aged over 85 providing unpaid care. These are not the women who come under the Government’s award of one week’s unpaid carer’s leave from work, and neither will they be first in line for the small amounts of respite care funding that GPs have been allocated. How are the Government addressing this situation, and what specific actions will be taken to help to alleviate the terrible burden of care these women face?

The noble Baroness raises a very important point and, as I have already mentioned, the Government have conducted a census looking at the data to identify those carers. Various groups of carers all have different needs. My noble friend just mentioned child carers, and the noble Baroness just mentioned carers of working age; employers have to be sympathetic and understand.

Also, it is challenging for those aged over 85. As I alluded to in my previous answer, GP practices have to be able to identify people in that age range so that they can work with social services and the local authority to make sure that they are supported.

The Archbishops’ Commission on Reimagining Care, based on conversations with many unpaid carers, recommended that there should be a “New Deal” for carers including restorative breaks, financial support and support from employers, including paid leave and the right to request flexibility. Does the Minister agree that any future national care strategy should consider the need for unpaid carers to have flexibility in their paid work?

The right reverend Prelate raises an important point, and we welcomed the report he referred to. The Department for Business and Trade is bringing in a new leave entitlement of one week, available to all employees, including those working in adult social care, providing care for a dependant. This is on top of existing statutory holidays. The Carer’s Leave Act 2023 and flexible working regulations will come into force on 6 April. Under the Act, eligible employees will be entitled to one week of unpaid leave per year. This is just the start. The right reverend Prelate is absolutely right: good employers should recognise when employees need time off, because it will happen to the employers at some stage in their lives.

My Lords, I will pursue the point on the healthcare needs of unpaid carers and how the NHS treats them. The Government’s White Paper on adult social care reform had a range of measures including voluntarily used markers to identify unpaid carers in NHS health records. That was about their own health needs, not about supporting the health needs of those whom they were caring for. What progress has been made in this vital area?

As People at the Heart of Care put it in 2021, we set out a strategic approach to empowering unpaid carers, and in October 2023 the Department of Health and Social Care launched an accelerating reform fund. It provides almost £43 million over 2023-24 to support innovation in adult social care and services for unpaid carers. This takes forward our commitment to invest £25 million to bolster the care services that support unpaid carers.