§ RIGHTS OF PERSON PROVIDING CONSTANT ATTENDANCE FOR RELATIVE
§ (1) A person who has given up employment to provide constant attendance for a relative at home shall, for the purposes of the National Insurance Acts, retain employed status while so doing, and shall be entitled to receive unemployment benefit upon ceasing to provide such attendance and upon registering as available for full-time employment.—[Mr. Brocklebank-Fowler.]
§ Brought up, and read the First time.
§ 11.30 p.m.
§ Mr. Christopher Brocklebank-Fowler (King's Lynn)
I beg to move, That the Clause be read a Second time.
The purpose of this new Clause is to debate the special situation of those who nurse elderly people at home. The Government, by introducing constant attendance allowance, have shown their recognition of and concern for sickness at home, and I am sure that in due course, as the administrative staff becomes available, it will be possible for the Government to liberalise the application of that provision, but even this is not enough to protect many people from genuine hardship.
I quote from a letter from a constituent about whom I have been in 1472 correspondence with my hon. Friend. She writes:Three years ago last October I had to give up my position as shop assistant to look after my aged father of 82 after a fall. He lived until 10th February, 1971, which meant I was off work for two years and five months, during which time the social security paid me an allowance for looking after him, which continued until last October, when I was able to return to my previous employment for three months, but as the vacancy was only temporary I had to leave on 15th January. I could not claim unemployment pay as I had been getting a non-employed stamp while I was at home. As my father's money, consisting of £1,535, was made over to me during my employment, my social security was cut from £5.80 to £2.85 per week. Although £1,050 of this money is invested until January, 1975 I only have the interest from this loan twice a year. As you will realise, the money I am receiving is not sufficient to cover my weekly expenses, so I am having to draw on my savings, and as I am only just 50 years old this means that for 10 years I shall have to continue drawing on my savings, as it seems impossible to get employment in my particular job at my age. I have written for several jobs and have not even had a reply. I am wondering if there is ever an exception to the rule that non-employed stamps cannot count towards unemployment benefit, as I was forced to give up my job to look after my father, thus saving the country the cost of two and a half years in hospital, as he could not be left alone.This, clearly, is a case of a responsible person who has been self-supporting and who voluntarily gave up her employment for perfectly understandable family reasons to be at home to look after an elderly relative. That kind of action is surely not only in the interests of the 1473 family but in the interests of the nation as a whole. The sadness is that people like that are severely disadvantaged by taking this voluntary action.
My purpose in moving this Clause is to give hon. Members on both sides an opportunity to debate this very important human problem, and I am sorry to see only the hon. Member for Rotherham (Mr. O'Malley) on the benches opposite. It may be that my proposals are technically unworkable. That is because my knowledge of these matters is limited. However, a large number of people currently are suffering. They suffer from the effects of interrupted careers, the loss of employed status and the right to unemployment benefit, the inability very often to pay their insurance contributions, and the consequential loss of their pensions.
They may also lose modest inheritances before qualifying for assistance in the form of social security benefits. Not only is the State actually benefiting from their service to the nation. It goes further and says, "Because you have some money, you must wait until you have spent it all before we can give you any assistance."
I contend that this attitude on the part of successive Governments is not justifiable. We are considering the possibility of paying between £2,000 and £4,000 to people who terminate their employment in the docks. If the dockers are a special case for the purpose of Exchequer aid, surely the people of whom I am speaking are also special cases.
These are people who remain silently at home, without a strong union to back them, serving their families and the nation. They are devoted public servants, and they deserve the recognition of this House and of this Government in helping them to cope. Is not it time society recognised the contribution that they make to reducing the burden on hospitals and on the tax payer? If my right hon. Friend the Secretary of State hopes to encourage families to look after the elderly and infirm at home in order to release geriatric beds in our hospitals, he will have to make more adequate financial provision for them.
What studies have been made of the cost-effectiveness of encouraging the accommodation of geriatrics at home? What would be the additional annual 1474 cost to the State if all existing patients at home were to demand accommodation in hospital beds, as they are entitled? Is not this a factor to be taken into account in considering what assistance could be given to the people to whom I refer?
The Government must act quickly to lessen the hardship suffered by the many people like my constituent who are only doing their duty. Even if my hon. Friend the Under-Secretary is not able to accept the technical provisions of my Clause, I hope that he will recognise the problem for what it is and tell us that the Government understand the situation in which many quiet and simple people who get on with their jobs without the support of a trade union may be given assistance at home.
§ Mr. O'Malley
Before the hon. Gentleman sits down, perhaps he will deal with this point. I listened to his proposition with a great deal of sympathy. But may I point out to him that his speech revealed an anti-trade union attitude? It may be that he did not mean it. But a simple person meeting this kind of problem is just as likely to be a member of a trade union as not. There is no reason why the hon. Gentleman, especially in today's climate, should gratuitously make that kind of remark when from this side of the House we are listening to him with a great deal of sympathy.
§ Mr. Brocklebank-Fowler
I am grateful for that intervention not only to point out, with some sadness, that the hon. Member for Rotherham is the only hon. Member representing the Opposition on a matter of grave national importance, but to say that the country is getting sick and tired of the fact that those who are the best organised and strongest and shout the loudest often are more successful in obtaining Government support than the quiet sort of person to whom I am referring—indeed, some of them may be trade unionists; I make no complaint of that—who, nevertheless, by their demeanour and sense of responsibility towards society, deserve greater recognition. I apologise to no one for having drawn the comparison today between those in full-time, relatively well-paid employment who seek to qualify for terminal payments of substantial proportions and those who quietly remain at home looking after 1475 the sick, the infirm, and the elderly without hope of reward at all.
§ Mrs. Elaine Kellett-Bowman (Lancaster)
I rise to support strongly the case so eloquently put by my hon. Friend the Member for King's Lynn (Mr. Brocklebank-Fowler). Like him, I am saddened that there is only one hon. Member on the Opposition benches who has the interest to remain and to support the cause of those who take the trouble to keep their elderly relatives at home.
In recent months I have had the honour of chairing a sub-committee of the National Council for the Single Woman and her Dependants. I have heard well-documented case after case of woman after woman with a good job and promising career before her who has thrown it all up to work at home and look after either elderly parents or relatives. Often, as my hon. Friend said, she has used her savings in trying to make her parents' or relatives' last months more comfortable, and when they have died she has been left with not only no job but sometimes no home and, as my hon. Friend also said, a reduced pension.
We cannot, within the scope of the new Clause, hope to bring the relief to these women to which I have always believed they are entitled by their service and sacrifice, but I very much hope the Minister will give us a positive assurance that justice will be done to these women at the earliest possible legislative moment.
§ Dr. Stuttaford
It gives me enormous pleasure to speak tonight in support of another East Anglian radical. I feel that my hon. Friend the Member for King's Lynn (Mr. Brocklebank-Fowler) has raised a very important point. As another East Anglian has told us, my hon. Friend the Member for Lancaster (Mrs. Kellett-Bowman), who comes from East Anglia—
§ Dr. Stuttaford
My hon. Friend, who lives in East Anglia, has said it is a question of the single woman and her dependants. This forgotten army of women have given up everything to go back to their homes to look after some member of their families who can no longer lock 1476 after themselves. It is done as a social service not only to the family but to the community. Were it not for these women—regrettably, it is nearly always single women—who are prepared to stay at home and do the menial chores which the aged and the sick need carrying out for them, the State would have to pay hospital, doctors' and district nursing fees.
The least we can do for these people is to see that in future they do not suffer financially as they do today. They suffer because they give up jobs to come back to their homes and then find it very difficult a year or so later to get back in the groove into which they previously fitted. Often they cannot get back to the type of employment they enjoyed previously. It is unreasonable to expect them to go straight back. We should do our best to see that the financial hardships they undergo, because they have returned home to look after aged relatives, are recognised and recompensed.
§ 11.45 p.m.
§ Mr. McCrindle
I congratulate my hon. Friend the Member for King's Lynn (Mr. Brocklebank-Fowler) on having focused attention on one of those forgotten social problems which we discuss far too seldom in this House.
I should like to focus my contribution on a rather wider base than the single woman looking after her relative. I confess that she is the person about whom we should be thinking most this evening, but I want the House to turn its attention for a moment to the man whose wife may become a terminal patient and who, with complete disregard for his own future in business or in terms of promotion in his job, decides that he will spend as much of the last few months as possible with his wife and so he gives up his job to look after her. If he does that, no consideration is given to him. Not only does he lose his place in the employment race, but he receives no benefit in terms of social service.
My hon. Friend's new Clause would look after the man after he had returned to work, or was ready to return to work, but it would not pay him social benefit during the period that he nursed his wife, and I believe that that is something to which we should also be paying attention this evening.
1477 I urge the Minister to bear in mind this terminal patient type of situation as well as the rather more widespread case of the woman looking after the elderly relative.
§ Mr. Dean
I am sure that the House is grateful to my hon. Friend the Member for King's Lynn (Mr. Brocklebank-Fowler) for raising this very important subject for those people—usually women, but, as my hon. Friend the Member for Billericay (Mr. McGrindle) said, not always women—who give devoted care and attention to elderly relatives at home, very often at considerable personal sacrifice.
May I remind the House of what the Government are doing now and what they hope to do in the future to assist this group of people in the splendid work which they do for their families. I propose to deal first with the disabled. In introducing the new Clause my hon. Friend mentioned the attendance allowance. About half of the 80,000 allowances now in payment are paid to people over 60, and they often go to households where a younger woman is looking after her elderly parents. Equally, with the extension of the allowance which is provided for in the Bill, which will be available to those who need attention by day or by night, there will be another large group of elderly people who will benefit.
My hon. Friend's remarks were addressed very largely to the caring relatives themselves and the cash position in which they often find themselves, and perhaps I may briefly remind the House of the position. First, supplementary benefit is available, without the usual requirement of registration for work, for those daughters who stay at home to provide care and attention for their parents, provided it is medically confirmed that the parents need this care. And where supplementary benefit is awarded to a daughter who has given up work in these circumstances, consideration is given to the cost of the non-employed contribution, and in assessing the elderly parents' ability on their resources to provide for the daughter a margin of £2 above the normal supplementary benefit level is allowed as well as any standing commitments, such as mortgage and insurance payments, before it is considered that the elderly parents 1478 can provide for the daughter, even it partly by free board or lodging.
My hon. Friend asked what information we had, and I can tell him that the latest figures, those relating to November, 1971, are that about 14,200 women recipients of supplementary benefit are in the category of being responsible for caring for elderly dependent relatives at home. The majority of them are single women, although there are some divorced and separated women amongst them.
Hitherto successive Governments have felt it right to look on the matter on the supplementary benefit basis rather than in the context of the National Insurance scheme. It has been felt that the National Insurance scheme is designed to provide some protection against the main events which cause loss or cessation of earnings in circumstances which affect the claimant personally and over which he or she has no control, such as sickness, unemployment and retirement on grounds of age.
Nevertheless, there is, perhaps, wider cover than my hon. Friend may have realised within the National Insurance scheme itself and for unemployment benefit. It could be made available in a number of circumstances. There are the main qualifying conditions, namely, 26 Class 1 contributions must have been actually paid and50 Class 1 contributions must have been paid or credited in the relevant contribution year. Reduced benefits are payable if at least 26 Class 1 contributions have been paid or credited in the relevant year. This means that if a woman gives up her employment for a period of three months or less her entitlement to unemployment benefit will not be affected if she pays the non-employed contributions. If she gives up employment for six months or less she will still be entitled to unemployment benefit, although it will be at a reduced rate. At the time she wishes to claim unemployment benefit she can still be covered for full benefit through the contributions she paid before giving up work.
For example, a woman whose card runs from March to March who gave up work in March, 1972, would continue to have full cover for benefit until August, 1973. The period after which all rights to benefit end varies between 11 and 23 1479 months depending upon the date unemployment ceases in relation to the date the contribution year ends. There are special rules which help people who lose their title to benefit to requalify for full benefit quickly. I mention those points to show that there is some cover now within the National Insurance scheme for the sort of woman my hon. Friend is understandably concerned to help.
In addition, the Government are anxious to stimulate the development of a whole range of services for the disabled which could be of particular help for elderly people. It is hoped that in time it will be possible for them to be provided with tailor-made services to suit the individual needs of themselves and of relatives who may be caring for them. This is a long-term development to which the social service departments of the local authorities are lending themselves with considerable enthusiasm. When these services are developed we hope that it will be possible to give more support for those families who now bear the burden of caring for dependent relatives with little or no outside practical help.
The increasing use of places in residential homes to provide short periods of care to give a family a well-earned break is another important aspect of the matter; the spread of special holiday schemes and day care facilities; and the steady improvement in home help and meals on wheels services. All these can play an important part in helping hard-pressed relations without necessarily requiring them to lose their independence or their financial basis of independence which an outside job brings.
Not only local authorities are doing a useful job in developing these services. Voluntary organisations are responding to the growing needs in these spheres. I assure my hon. Friend that this is not a forgotten army, nor is it a forgotten social problem. It is one in which we are anxious to develop further the selective policies which we have already begun. But we freely recognise that much more needs to be done. We intend to go on making progress.
We need to know more about the extent of the problem and the type of help which would be most appropriate. I was asked what studies we were doing. We 1480 are carrying out a study now. An analysis is being made from the results of the 1971 Census to establish the extent to which matters in this field may have changed in recent years, and to show in greater detail than is known now the occupations, economic activity and hours of work of single women living in households with one or both parents. It will necessarily be some time before the results of this work are available. These will be of great value to us in defining more clearly the problems of the households concerned.
I hope that my hon. Friend the Member for King's Lynn, having introduced this valuable subject, in which I know he takes a keen interest, and having had the assurance that we have taken steps in the matter, and that we firmly intend to take further steps, will feel that a valuable purpose has been served by drawing attention to this important human problem, and seek to withdraw the Clause.
§ Mr. O'Malley
The House will be grateful to the hon. Member for King's Lynn (Mr. Brocklebank-Fowler) for bringing this important subject before it. Everyone listened to him with great sympathy when he quoted the example of the woman moving towards middle age who gave up her job to look after an elderly father in his eighties. The Under-secretary tried to deal with the Amendment sympathetically, but this is a problem which remains basically unsolved in 1972.
I wish that the last part of the speech of the hon. Member for King's Lynn had not been permeated by what I think was clearly an unconscious reaction, a feeling of dislike, towards members of the trade unions. [Hon. Members: "No."] Conservative Members may sound horrified, but that shone through the speech. Plenty of trade unionists are quiet, sensible people, but they tend to become not so quiet and to become angry if they are driven to it by the policies of a Government that look no further forward than the end of their noses.
By moving the new Clause the hon. Gentleman has done the House and the single people in question, often single women, a service. The hon. Member for Billericay (Mr. McCrindle) raised another very important aspect of the subject, with 1481 which the whole House should have a great deal of sympathy. New Clause 8, which was not selected, attempted to deal in another way with the problem of the terminal patient. I should have thought that was the type of problem case which could be more easily helped than the general case of the single woman, for example, looking after her elderly father. Perhaps the Government could deal with that in another place. Will they consider that before the Bill receives the Royal Assent?
§ 12 midnight.
§ The Under-Secretary of State tried to answer sympathetically, but there are a number of other matters which could be helpful. First, the hon. Gentleman mentioned the importance of local authority social services. I have heard of a number of cases in the last two or three years where people of the kind mentioned by the hon. Member for King's Lynn have needed a holiday, a week or a fortnight away. In my area we have one of the best local authority social services departments in the country and often it is able to deal with such requests. However, I hope that the hon. Gentleman will go back to his Department, fully recognising the problems which arise because of the shortage of geriatric beds, and will examine the possibility of a regional hospital board national policy to provide a small number of geriatric beds, particularly throughout the holiday season but also throughout the year, so that these people could be given some assistance. There is no reason why hon. Members should have to be approached on this kind of case as often as they are. Perhaps the hon. Gentleman's Department could help.
§ The Under-Secretary of State pointed out that some payments were made to the disabled and that the Supplementary Benefits Commission could and did make some provision. The hon Gentleman said that there were more than 14,000 women who were helped in looking after elderly relatives. He also pointed out that some provision exists within the national insurance system for people who are involved in relatively short-term care of people, involving taking time off work and perhaps giving up their jobs. But, as all hon. Members realise, that is no solution. We are faced with the perennial 1482 problem of how far to stretch the contributory principle. It can be pushed to the point where the whole thing becomes absurd.
§ There are two ways in which the problem could be resolved: first, through the national insurance system, although there are problems about the nature of the contributory system; secondly, through other changes in the overall tax benefit structure, which could result in benefits of a kind which the Chancellor of the Exchequer envisaged during his Budget speech. We look forward to a further examination at a later stage by a Select Committee of the House and then in a debate of the whole House.
§ However the problem is to be solved, whether through the national insurance system being stretched even further or through a new look at the tax benefit structure, solved it must be. I hope, with the hon. Member for King's Lynn, that we shall shortly find a solution. It must be remembered that these women—more women than men are involved—are saving a great deal of public money by keeping people out of hospital beds, and they deserve well of the community. The system which we have inherited does not cope with their needs, and we must do something soon to solve the problem once and for all. We are grateful to the hon. Member for King's Lynn for moving the Clause.
§ Mr. Brocklebank-Fowler
I am grateful to everyone who has spoken, particularly those who have illustrated other aspects of the problem that I was not able to cover. I am grateful also to my hon. Friend the Under-Secretary of State for answering my question and saying that we have 14,200 people in this category, most of whom will be suffering difficulties of one kind or the other as a result of the service they give voluntarily in the home.
I have noted with interest the increasing range of facilities available to them to assist them in their task. Notwithstanding that, I think it important that the House should note that the most priceless thing they lose is their independence and their status. These are not people to whom the nation should be satisfied to dole out little handouts to keep them out of trouble. These are people who make in their own right a contribution 1483 to the livelihood of the nation, a contribution which my hon. Friend has recognised in speech after speech in noting the importance of having the sick accommodated at home in order to release hospital beds for other, perhaps even more deserving people.
Perhaps in the review and in the creative thinking which is taking place in the Department, my right hon Friend would consider the possibility of giving an auxiliary status to these people and employing them even on a salary basis within the National Health Service so that they can, in one way or another, retain their employed status so that when their task—sadly often because of the death of the patient—is finished they can go out into the labour market owing no one anything and being independent people in the world.
What these people need and what they deserve, and what I hope the House will strive to see that they gain, is their dignity. They deserve it and I think that successive Governments have perhaps not paid enough attention to the problem. Nevertheless, armed with the reassurance of my hon. Friend that the Department is actively looking at the various alternative ways of solving this very important human problem, I beg to ask leave to withdraw the Motion.
§ Motion and Clause, by leave withdrawn.