HC Deb 08 February 1999 vol 325 cc21-33 3.30 pm
The Minister of State, Home Office (Mr. Paul Boateng)

With permission, Madam Speaker, I should like to make a statement about the publication today of the Government's national strategy for carers. You will be aware that some details of our proposals are now in the public domain. It was our intention to publish an answer to a question this morning but, due to an administrative error, that did not prove possible. No discourtesy was intended to the House, and I have written to my hon. Friend the Member for Colne Valley (Kali Mountford).

The Prime Minister, on 10 June 1998, announced plans for a national strategy for carers, which he asked me to lead. The Government believe, as the Prime Minister himself said last June, that carers play a vital role in the community and also in supporting families. The national health service and social services could never hope to provide what carers contribute to the care of the sick and the vulnerable. The Government are determined to see that carers get the support that they need.

The Prime Minister said that the national strategy should bring together existing initiatives into a single package for the first time. We have done more than that. As I shall explain, we are announcing today a substantial new policy package for carers.

The work on the national strategy for carers has involved a large number of organisations—not only Government Departments and people from the NHS and local authorities, but individual carers, representatives of carers' organisations, and representatives of more specialised voluntary organisations which, for example, help people with mental health problems. We are grateful to all those who joined working groups and to those who attended a major consultative conference on the strategy held last November. I was glad to welcome to that conference hon. Members from both sides of the House, as well as Members of the House of Lords.

The policies of a large number of Government Departments impact on carers. The document published today involves all of them. We held, for the first time, two meetings of a ministerial group specifically established to consider carers' issues.

People who provide care for relatives or friends who are disabled, vulnerable or frail can devote large parts of their own lives to looking after others. Many of them are also in paid work. The majority of carers are women. All of them need some help and support. Our national strategy for carers describes what we have been doing, and what we are going to do. Carers will have better information; they will be better supported; they will be cared for better themselves.

Two thirds of carers of working age are in paid employment. For many of them, combining work with caring can be difficult. The Government's family-friendly employment strategy will help them. We will give carers the right to time off to deal with a family emergency. For example, a carer might need time to take his or her elderly parent to hospital, following a fall. The Second Reading of the necessary legislation, the Employment Relations Bill, is scheduled for tomorrow.

We have also considered carers who cannot combine paid work with caring. Many carers of working age would like to do so. Even more would like to be able to return to work when their caring responsibilities come to an end. We will consider the scope for extending the new deal to help carers to return to work. We will publicise the benefits—to employers, as well as to carers—of flexible, carer-friendly employment policies. We will consider our own position as a major employer and make sure that we set the highest standards for carers working in the public sector.

Carers also need support from the statutory services. That does not mean social services alone—all services need to provide carers with information and to involve them in the planning of services. Only in that way can services be more responsive to carers' needs.

The national health service has an important role in that respect. It must help carers to maintain their own health: half of all carers in a recent study said they had suffered from a physical injury since they began to care; and half said that they had been treated for stress-related illnesses. The Government's national priorities guidance to health and local authorities will require those authorities to help carers to maintain their health and emotional well-being.

The national health service must also provide information to help carers to care. They need to know about the health needs, treatment and medication of the person for whom they care. Of course, that can be done only with the consent of the patient, but sometimes doctors do not ask or explore that option. It is vital that patients' agreement be sought, and we believe that doctors should always do so.

We have already announced an extra £750 million for local authorities over the next three years to help them to promote independence, especially through greater partnership with the health service on prevention and rehabilitation. People who need care and their carers will benefit from that.

We are going further, by providing from within the comprehensive spending review plans £140 million of additional funding for England over the next three years specifically to help carers. It will be a ring-fenced special grant that will go to local authorities to extend the range of services that they provide to give carers a break from their caring responsibilities. The research evidence shows that carers who have a break are better able to cope and that their own health suffers less. The new special grant will total £20 million in 1999–2000, £50 million in 2000–2001, and £70 million in 2001–2002.

We also intend, when parliamentary time allows, to introduce new legislation to extend the powers that local authorities have to address carers' needs directly. At the moment, the focus of most of the legislation is on the person needing care. We want carers to have more control over the form and timing of the services that they need as carers. That is especially true of services designed to give them a break from caring.

The national strategy will also help some specific groups of carers. First, we are announcing today that there will be a reduction in council tax for some disabled people. Those who live in accommodation that is valued at band A and that has an extra room which they need because of their disability, or enough floor space to allow them to move around in a wheelchair, will receive a reduction in council tax similar to what is given now for the other bands. That change will be made from 1 April 2000. It is long overdue and it is only fair.

Secondly, we have particular concerns about young carers. The Government are taking extensive action to offer new help to children and young people and we are placing particular emphasis on supporting the most disadvantaged children and their families. Children who have to provide personal care to a parent may not even realise they are carers, but their attendance at school can suffer; they can also have difficulty doing their homework; and they often have no time for leisure, for play, or to meet their friends.

The Government will promote awareness of the needs of young carers. We shall encourage schools to make sure that there is someone to support them. That need not be a teacher—it could be someone else with the right skills and the time to develop special expertise. Children who are carers might need help to contact professionals in the health service, the social services, or a local project worker specifically for young carers. They need help and they need someone who is there for them.

There is also a group of children who need more care than other children of the same age. Their parents are especially in need of help and support: for example, they might feel unable to spend enough time with the rest of their family. We are increasing the help and support we provide to parents of a disabled child. We have already announced new objectives for children's services, which require local and health authorities to work together to meet the needs of disabled children.

Social services will get an extra £375 million to help them to meet the needs of vulnerable children. We are also introducing new children's nursing teams, in memory of Diana, Princess of Wales, to support those children who have life-threatening health problems. Those will cost £2 million a year initially, and we are establishing 10 teams around the country.

Many carers need help and support in the neighbourhoods where they live. In general, we believe that this is best provided by voluntary organisations. They are doing some wonderful work which, in the course of preparing the strategy, I was privileged to travel around the country and see at first hand. Many hon. Members on both sides of the House will be aware of that work in their constituencies. Carers' centres are but one example. They already exist in a number of areas and we want to make sure that all carers have access to a support service near where they live. The national strategy report also describes how we intend to make sure that carers get a high-quality service from such carers' centres.

The national strategy for carers contains a great deal of information about carers and their needs, but we lack information in some cases. That is why we will introduce a new question about carers in the 2001 census. The results of that new question will tell us, for example, how many carers are in each local authority area. The information will allow local authorities to plan much better how to provide services for carers in order to meet their needs.

The Government believe that what carers do should be properly recognised and supported. We—the Government—and the whole country should take pride in carers. The Government are determined to make sure that carers can feel proud of what they do and of a society that recognises the debt of gratitude that we all owe them for doing it.

Mr. Philip Hammond (Runnymede and Weybridge)

I thank the hon. Gentleman for his statement and for his courtesy in letting me have a copy of it in good time. The Opposition welcome any additional support for carers—the great silent army that, quite literally, props up our social care system. We believe that the family is the best mechanism for delivering support to the elderly, the disabled and the frail wherever that is a practical reality.

To support those family carers who give of their time so selflessly is not only a moral obligation on society but the most basic form of economic common sense. Care in the family, where that is possible, is often the best solution for a vulnerable person and for society as a whole. However, we recognise that those benefits have too often been at the expense of the carers. We welcome the tone of the hon. Gentleman's statement, but as so often, there is a gap between the rhetoric and the reality. Much of the statement is a recycling of announcements that have already been made, and still more of it consists of an announcement of further consultation.

Carers come in all shapes and sizes and we cannot generalise about them. However, we know that the majority are women, many of whom are married. The Government's tax and benefits policies have hit single-earner couples—who already bear a disproportionate share of the tax burden—particularly hard. Should the Government not consider the advantages of transferable tax allowances to ease the burden on those couples where one partner voluntarily gives up the opportunity to earn in order to take on a caring responsibility?

Many carers are pensioners and still more are seeking to make pension arrangements for their retirement while continuing their caring responsibility. The Government have announced a further consultation on second pensions for carers that might lead to carers being £50 or so better off in 2050. At the same time, the Government have hit all pensioners with their £5 billion pension tax and the poorest small savers—of which 300,000 are pensioners-through their mean-minded abolition of dividend tax credits for non-taxpayers.

It is a case of jam tomorrow and nothing today. Which generation of carers is the Government's policy supposed to help? What can the hon. Gentleman say to carers who are 40, 50 or 60 today and have made inadequate provision for their retirement?

The hon. Gentleman has recycled earlier announcements of £750 million for promoting independence and £375 million for vulnerable children. The rhetoric from the Dispatch Box about the improved co-operation between health and social services, the legal duties of partnerships, and the demolition of Berlin walls sounds impressive, but health authorities and social services departments, certainly in London and the south-east, are experiencing squeezed budgets—the hon. Gentleman's rhetoric will ring hollow there. With the best will in the world, the grand vision cannot be realised in areas where the resources available are under concerted attack by the Government.

The ring-fenced special grant for respite care is welcome. The chance of a break from their responsibilities is probably the need most often cited by carers, but in many areas, social services departments and health authorities are already cutting back on the support that they are able to give to the voluntary sector. So long as budgets are under such pressure, how can the Minister ensure that the ring-fenced grant does not merely substitute for existing funding, often via voluntary organisations that currently provide respite care?

I have a couple of specific questions, and I should be grateful to the hon. Gentleman for responses to them. I particularly welcome his reference to young carers. Many young carers projects are doing excellent work throughout the country but are precariously funded. Local authorities facing difficulties of their own are often unable to fund worthwhile voluntary organisations. For example, the joint finance funding that supports the Sheffield young carers project will run out in March 2000 and the national lottery grant that supports the project will run out in September 2000. There will be no more joint finance for that project because the Government have abolished joint finance from next year.

What assurance will the Minister give the Sheffield young carers project about the security of its funding for the future? Will the Minister identify where the additional funding that he has announced today for the ring-fenced grant will come from? How much will come from sums that have already been announced within other spending totals, and how much is new money?

We welcome the emphasis that the Minister placed on carer-friendly employment policies. Do the Government have concrete proposals specifically dealing with carers to encourage such policies on the part of employers, public and private; or will the hon. Gentleman rely on exhortation?

There was no mention in the statement of training for carers, which the hon. Gentleman will agree is important. I should be grateful for his comments on support for training for carers.

We welcome the focus that the statement places on the needs of carers. We support the principles that the hon. Gentleman has outlined, but in many cases and for many people, what he has announced today gives back with one hand what the Government have already taken away with the other. How will the fine words translate through the mechanisms of budgets, health authorities and social services departments into benefits for carers?

Mr. Boateng

I welcome the hon. Gentleman's response in so far as it went, but it did not go far enough and sounded increasingly churlish towards the end. He referred to a gap between rhetoric and reality. There is a gap—it is the Conservatives' gap and it lasted 18 long years. We are now filling that gap by making changes to carers' lives and delivering what they are entitled to expect by way of society's recognition of the debt of gratitude that it owes them.

That means a new emphasis by the NHS on training, and the NHS will be taking that on board. Much of what we can do to help carers is practical, sensible and long overdue. One example, which the hon. Gentleman ought to recognise, is the problem of back pain for carers which could be overcome if they were better trained in lifting. At the moment, that is not done. My hon. Friend the Under-Secretary of State for Health will ensure, as he takes the strategy forward, that it is done.

The hon. Member for Runnymede and Weybridge (Mr. Hammond) asked about money. We are only too happy as a Government to take pride in the fact that, next year, spending on social services will increase by £503 million. That is new money, which would not have been provided if that lot on the Conservative Benches had been in power. In addition, we announced today £140 million of new money for practical policies to support carers. That is why the Carers National Association has described this strategy and this Government's approach as a momentous leap for carers. That leap came with Labour; carers would have got nowhere under the Tories.

Mr. Tom Clarke (Coatbridge and Chryston)

Is my hon. Friend aware that nothing said from the Opposition Benches can detract from the excellence and warmth of his statement, which I think will appeal to millions of carers in Britain? Has departmental consultation included the Scottish Office, the Welsh Office and our colleagues in Northern Ireland? May I remind him that a section of the Disabled Persons (Services, Representation and Consultation) Act 1986 deals with carers? The previous Government had 11 years to implement it, but did not. I hope that my hon. Friend will consider it helpful in coinciding with and encouraging the main thrust of his excellent statement.

Mr. Boateng

I thank my right hon. Friend for his kind words of welcome. He brings enormous expertise to this area, not least from his period as our spokesperson on disability matters. He will be glad to know that we are in close contact with right hon. and hon. Friends in the Scottish Office, the Welsh Office and the Northern Ireland Office, all of whom have contributed to the development of the national strategy. I have no doubt that they will bear in mind his points when matters are advanced in the devolved Parliament in Scotland and the Assemblies in Wales and Northern Ireland.

Mr. Paul Burstow (Sutton and Cheam)

I thank the Minister for his courtesy in allowing us to look at the statement and the strategy before his announcement. We very much share the view that carers play a vital role which, for too long, has been given inadequate and insufficient attention. Much good practice in the national strategy needs to become the norm. Gathering it together in this one place and highlighting the gaps is a very welcome initiative, which we on the Liberal Democrat Benches certainly support.

We must consider not just the fact that carers save the nation £3 billion, but that they bring an extra quality of life to the loved ones whom they look after and support. Does the Minister therefore accept that the strategy's success hinges on the many thousands of people who are carers but remain uncounted and unsupported? How will the strategy address those hidden carers, about whom the agencies do not yet know? As many as eight out of 10 carers have not yet been assessed by social services departments. How will the Government ensure that such assessment proceeds apace, given that, on Treasury figures, social services departments will be £100 million short in their core budgets in the coming year? How can support and assessment go forward on that basis? I would be interested to hear the Minister say how.

Millions of pounds of benefits to which carers are entitled go unclaimed each year. Will the Minister therefore look again at how, through partnership with local government, about which the Government often talk, and through local authority mailing and the Benefits Agency, we can ensure increased take-up of council tax carers discount, which is going unclaimed in very large amounts?

The tax and benefits system penalises carers, and the rules for invalid care allowance do not recognise the extra and on-going costs of caring. The strategy says nothing about reform of the invalid care allowance. When will Ministers outline much needed and long overdue reforms to that benefit, turning it into a genuine carer's benefit?

Will the Minister accept that the Government have raised expectations today? They should raise expectations that there will be new initiatives to support carers—they are long overdue. However, today's statement, at its most generous, gives carers an extra 15p a week. I hope that the Minister will recognise that 15p a week may be being oversold today, and that the Government are underfunding carers' needs.

Mr. Boateng

Call me partisan, but it would have been nice to receive at least a word of recognition and thanks from the hon. Gentleman for the £496,000 of new money that we are giving his local authority to meet the needs of carers—money that it would not have had before.

However, the hon. Gentleman makes some serious points. We do regard the collection of information about carers' needs as a priority. Some 60 per cent. of carers have no contact with other agencies as carers. Many do not recognise themselves as carers. We must find new ways of reaching out to them, to ensure that they get their due. We are introducing a census question to give us a better handle on where carers are and what their needs are. That is a small, practical measure; why was it not taken years and years ago?

We do not intend to leave it at that. We intend the NHS and social services to work alongside the voluntary sector and with the private sector to present these issues, especially on carers and employment. We envisage that a promotional campaign on carers and employment, led by the Under—Secretary of State for Education and Employment, my hon. Friend the Member for Barking (Ms Hodge), will make an important contribution to the initiative.

We are therefore not only making available new money, which is not, as the hon. Member for Sutton and Cheam (Mr. Burstow) would suggest, inadequate, but ensuring that a raft of policies is put in place to meet carers' needs; even more important, we are ensuring that, as new policies are developed in this and other areas, carers' needs are at the heart of what we do, in addition to the needs of patients and users.

Mrs. Gwyneth Dunwoody (Crewe and Nantwich)

Is my hon. Friend aware that this is the first attempt in a targeted and vigorous manner to reverse years of neglect of carers, and, as such, it will be warmly welcomed by those who find themselves in that position? Tonight, many people will be very grateful to him and the Government for what he is trying to do. Will he, however, ensure that he does not follow a wholly unacceptable Tory practice? Will he pay careful attention to those carers who currently receive voluntary support, if it is available, but who may need much more professional help? Will he promise me that he will look at how things are working?

Mr. Boateng

I am much obliged to my hon. Friend. Of course she is right. We must ensure that we have the sort of professional interventions that are necessary to meet carers' needs, and we must recognise the value of partnership between the voluntary sector and the statutory sector. It is a question of ensuring that each contributes that which it is best equipped to give, and we shall ensure that that is done. We have also learnt from the voluntary sector that there exists, in the wider community, a degree of commitment to and wisdom about the practical needs of carers which we need to make better use of in the statutory sector. I promise my hon. Friend that this Government—her Government, our Government—intend to do so.

Sir Nicholas Lyell (North-East Bedfordshire)

Will the hon. Gentleman accept that we on the Opposition Benches strongly welcome all genuine extra support for carers, and that in so far as his statement provides it, we welcome it? However, before history is rewritten, will the hon. Gentleman be kind enough to write to me to confirm the many billions of pounds of extra money every year that were provided by the previous Government over 18 years? I remember vividly when I was a junior Minister with responsibilities for social security that by 1987 the sum had risen to an extra £6 billion a year for disabled people and their carers.

Will the hon. Gentleman confirm also that, taking the latest local authority settlement, Bedfordshire county council, for example, must find an extra £10 million worth of cuts before it begins because of the money moved away from counties such as Bedfordshire? What will the hon. Gentleman say to carers such as members of the Biggleswade carers society, who are deeply anxious, and rightly so, that there should be extra care with respite support? How often per year, per three years or per five can they expect some practical help from this extra money, which seems to come to less than £10 a year for a carer?

Mr. Boateng

The right hon. and learned Gentleman seems to be suffering from a degree of amnesia in this area. It must be said in fairness that right hon. and hon. Members on the Opposition Benches singularly failed when they had the stewardship of our nation's affairs to give carers the focus that they are now being given. The right hon. and learned Gentleman must at least own up to that. I hope that he will point out to the good folk of Biggleswade in his constituency that they will benefit from an additional £836,000 that they would never have received had he continued to sit on the Treasury Bench—and for that they should be thankful.

Mr. Malcolm Wicks (Croydon, North)

This is an historic day for Britain's carers. It is a special and important day for 6 million people who provide care worth more than £30 billion. Does my hon. Friend agree with me that when he meets carers he is struck by their extraordinary sense of responsibility and duty and by the fact that for that they often pay a price in terms of extraordinary stress, poverty in old age and sometimes physical or mental breakdown?

Given that the great thing about the document produced by the team so ably led by my hon. Friend is its cross-departmental nature, will he nevertheless give heed to the work of Florence Nightingale, who once observed that reports are not self-implementing? Although there are good things in the report that are very specific, much of the rest of the document properly relies on aspirations, good practice and the rest.

Will my hon. Friend therefore consider, not necessarily today, how we can monitor this great comprehensive strategy so that this Parliament and carers can be certain, as Opposition Members have said perfectly properly, that good rhetoric is matched by good practice, as I expect it to be?

Mr. Boateng

The whole House always listens closely to my hon. Friend on matters relating to carers, knowing full well his enormous contribution, in the form of private Members' legislation and subsequently, to their welfare. He makes an important point about the contribution of the entire ministerial team across government to the development of this strategy. I pay tribute to the members of that team and to their officials for the contribution that they have made.

I have no doubt that my hon. Friend the Under-Secretary of State for Health, who will be carrying forward the strategy, will want to ensure that the commitment and drive are continued. There is no doubt about the commitment of my right hon. Friend the Prime Minister to carers' needs and concerns. My hon. Friend need have no fear; Florence Nightingale is an example to us all and the wick in her lamp will not be allowed to burn itself—[Laughter.] Well, it is a try. It will not be allowed to burn itself out. If it seems that it might, I have no doubt that my hon. Friend will be there to keep it alight.

Mrs. Angela Browning (Tiverton and Honiton)

Will the Minister recognise that, although he is right to say that a proper assessment of need throughout the country should be undertaken, in some parts of the country that process has already been taking place? Many carers have been at meetings, filled in forms and identified their needs.

Will the hon. Gentleman ensure that the resources that he has announced today are not sapped by yet more forms designed to ascertain what I am sure many social services departments already know but fail to deliver? Will he recognise that one of the greatest pressures on carers is applied if the needs of the people for whom they are caring are not appropriately met? Around the country, social services departments are making those people pay for services that they previously received free of charge. That will be a terrible pressure on the people who look after them.

Mr. Boateng

The hon. Lady speaks with a great depth of knowledge and is respected in all parts of the House for her contribution to caring and carers. I am grateful for her remarks.

We must make sure that we get right the mechanisms for consultation with carers. That has not always been done as well as it ought to be. Part of our strategy for getting health and social services to work that much better together is to make sure, for instance, that the work being done in relation to health improvement plans and the role of primary care groups and GPs is informed by carers' needs, concerns and opinions.

The hon. Lady is right. We need to improve consultation. We shall make sure that the additional resources being brought to bear on the problem are spent wisely and effectively, and that the spending is properly monitored. That is why I set great store by the new accreditation scheme mentioned in the national strategy. It will involve the voluntary sector in accrediting carers centres to make sure that the public get value for money. That is extremely important. I accept entirely the hon. Lady's point about the importance of consultation and the need to make sure that carers are central to it.

Mr. Tam Dalyell (Linlithgow)

I welcome what was said about young carers. Some of us, at our surgeries, are simply appalled by the pressures put on youngsters of 12, 13 or 14 who have to undertake caring duties, often for single-parent families, that make the mind boggle. What is meant in the statement by the words: We shall encourage schools to make sure that there is someone to support them. That need not be a teacher—it could be someone else"? Have there been discussions with the teaching unions about that?

The statement goes on: Children who are carers may need help to contact professionals in the health service, the social services, or a local project". What will be done to help local authorities in this matter?

Mr. Boateng

My hon. Friend is right to highlight the special needs of young carers. We want to make sure that we do not impose a straitjacket on the way in which a school determines that those needs should best be met. Someone in the school office, with an administrative grasp and overview, may be better placed than a teacher to see the entire picture and to make sure that the form master or mistress is aware of the young carer's needs. That concern may initially need to be addressed centrally.

The Under-Secretary of State for Education and Employment, my hon. Friend the Member for Barking (Ms Hodge), and my right hon. Friend the Minister for Public Health have particularly in mind a role for the school nurse and for the school, as part of its wider liaison with the NHS, to pick up the special health needs of young carers.

Of all the individuals and groups whom I have met during the preparation of the strategy, none have impressed more than young carers—eight-year-olds and sometimes even younger children who take responsibility day in, day out for the care of a parent. The least that we can do is to ensure that they get support in doing that.

Mr. Elfyn Llwyd (Meirionnydd Nant Conwy)

The document is most welcome and plugs an important policy gap. Following on from the previous question, would it not be better if there were a slightly more rigid approach to assistance for young carers via the school? Leaving it to individual schools may not be adequate. For example, there are many schools without school nurses. The circumstances are so varied. Would not central monitoring be preferable, to look at each situation as it develops?

Mr. Boateng

My hon. Friend the Under-Secretary of State for Education and Employment is certainly concerned to ensure that the guidance and the guidelines that we put out to schools refer to the needs of young carers. We are currently consulting—not only as part of the Green Paper process, but directly in relation to this strategy—the unions and others about the form that that guidance should take.

The flexibility within the school community is important, and I am sure that the hon. Gentleman wants us to bear that in mind, but we need to ensure that schools get a handle on the problem. There may be, in the fulness of time, room for the inspectorate—and, indeed, for the local authority—to engage in that process; but, first, it is vital that we get out guidance that meets the needs of those young people. They are not being met at the moment—we recognise that—but all concerned are determined to change that.

Mr. Vernon Coaker (Gedling)

Across the country there will have been a sigh of relief among carers in respect of the statement, which supports them in their most valuable work. Will my hon. Friend ensure that the work of the voluntary sector—and groups such as the Gedling Take-a-Break Carer group and the Alzheimer's Disease Society, which work alongside groups with statutory entitlements—is supported? The invaluable work that those organisations do to support carers and those in need of care cannot be underestimated. We need to ensure that their valuable contribution is fully recognised in any proposals.

Mr. Boateng

I had the opportunity to meet representatives of the voluntary sector in my hon. Friend's constituency when I was in Gedling a couple of weeks ago. I was struck by the strength of local infrastructure, in relation not only to caring but to a wide range of initiatives that required better and closer partnerships between the statutory and the voluntary sectors.

We need to build on the experience of these organisations—not only the Alzheimer's Disease Society, which my hon. Friend mentioned, and the Parkinson's Disease Society, but Crossroads, the Carers National Association and the Princess Royal Trust for Carers. Those organisations were doing such work long before it became fashionable and when carers' needs were by no means centre stage, as they are now. They have developed expertise and they bring to this area something that, in my view, only the voluntary sector can bring. We have to make sure that they receive the recognition and support that is their due; my colleagues on the Front Bench and I will be doing just that.

Mrs. Virginia Bottomley (South-West Surrey)

I, for one, want to welcome a statement on carers. Recognition of carers and their interests is essential, and for the Government to play to their strengths and to be involved in promotion and publicity in this area is a step forward in itself.

I declare my interests, which go back 20 years, although they do not go back 30 years to the Rev. Mary Webster. For many years, I was the late Baroness Sear's vice-chairman at the Carers National Association, and am currently a vice-president. I am president of the Isle of Wight branch, which I founded, and am closely involved in the Guildford and Waverley branch.

There is a crisis of confidence, and I ask the Minister to take one specific step. Please will he write to me setting out the detail of how the home counties, and Surrey in particular, are to cope? They have had the £6 million transitional grant for community care confiscated and their increase for health is the lowest in the country. People are living longer and many live alone. The error that they commit is to be healthy and long lived. That penalises them in the Government' s funding formula, and the anguish at present in Surrey is such as I have never previously known it.

I welcome the statement, but please will the Minister—to clarify that point—respond to me, identifying how Surrey is to cope in the light of the savage social services and health settlements?

Mr. Boateng

The new partnership grant does not represent the confiscation that the right hon. Lady suggests. That, if I may say so, is a travesty of the truth and does her little credit.

Of course I recognise the right hon. Lady's commitment and contribution, over many years, to this particular subject. I will certainly write to her. I have had the opportunity of visiting carers in Surrey and have formed a clear view of the considerable contribution that the voluntary sector makes.

I have good news for the right hon. Lady. The programme of work that we are initiating in this area has the support of those engaged in care in Surrey and elsewhere. There is no crisis of confidence in the Government's determination to put social services on a secure foundation—which they singularly lacked under the right hon. Lady's stewardship—and to take forward this initiative and agenda for carers. This important step must not be undertaken in an atmosphere of party political acrimony, so I am only too happy to write to the right hon. Lady.

Mrs. Sylvia Heal (Halesowen and Rowley Regis)

I welcome the statement and congratulate my hon. Friend, his team of Ministers and the many carers who contributed to this strategy and to the document. In addition to their caring roles, they are often called upon to participate in policy making, which they welcome and which proves to be of value.

I am particularly pleased that, at long last, the position of children and young people who are carers is being recognised. Perhaps it is right to declare an interest: immediately before coming to the House, I was employed by the Carers National Association. I am pleased that its campaigning work, along with other organisations, has at last brought about this important step.

When the census forms are completed, will young people undertaking caring roles in the family be identified? If adult carers have been the hidden army, young people have been even more disguised and lost in the system.

The Government are encouraging awareness raising by other Departments. Will the Minister ask his colleagues in the Department of Health to ensure that GPs and primary health care workers participate in the training programme? In many cases, a carer's first contact is the family doctor or the district nurse.

Mr. Boateng

My first memories of my hon. Friend were of someone who was leading the voluntary sector's work with carers, especially young carers. She is right about the need to get better at identifying young carers. We hope and believe that the census question will assist in that, but it is important also to recognise the role that GPs, health visitors and other health professionals can play in helping us to identify young carers. Young carers are more willing to approach those people and share their concerns with them, because they are not seen as judgmental or likely to raise the possibility of social service intervention, which young carers fear.

We must use health service and other professionals, and we must give young people a sense that they can identify themselves as carers without anyone being judgmental of them and their parents. Young carers have told some horrific stories. This morning at No. 10, a young carer aged nine told of being stood up in front of a class and identified as a carer, which was the last thing on earth she wanted to happen.

We must ensure that when we identify young carers we respond to them sensitively. We must encourage them to come forward to get the help that they so richly deserve.

Mr. Andrew Rowe (Faversham and Mid-Kent)

The Minister will know as well as anyone that one of the most useful things for carers is to be able to count on relatively simple but regular substitution or assistance, so that they can have some respite to go to the hairdresser's or whatever. The Minister may also be aware that there is an increasing determination among the Churches of this land to make themselves a great deal more effective in intervening to assist their communities—this strategy being based around the millennium.

Will the Minister undertake to consult the Churches at this early stage in their plans, to establish the extent to which regular, reliable, voluntary assistance can be built into those plans? By doing so, he will make available possibly as many as 5 million volunteers.

Mr. Boateng

I entirely accept what the hon. Gentleman has said. Indeed, last Friday I had the privilege of presenting our strategy to His Grace the Archbishop of Canterbury, who received a copy of our document today. We have embarked on the process. We see the Church and, indeed, other faith bodies as partners in the task. They are already doing great work, and together we can do even better.