HC Deb 04 March 2004 vol 418 cc1071-80

Queen's recommendation having been signified—

1.32 pm
The Parliamentary Under-Secretary of State for Health (Dr. Stephen Ladyman)

I beg to move, That, for the purposes of any Act resulting from the Carers (Equal Opportunities) Bill, it is expedient to authorise the payment out of money provided by Parliament of any increase attributable to the Act in the sums payable out of money so provided by virtue of any other Act. The motion relates to a Private Member's Bill promoted by my hon. Friend the Member for Aberavon (Dr Francis). As the House will be aware, although the Government agree with the general intention underlying the Bill— that carers be supported to ensure their own health and well-being through assessment and access to better information—it is our opinion that the provisions as currently drafted would not necessarily deliver that outcome.

Our concerns include instances where the Bill, as it stands, appears to seek to duplicate existing legislation and where we are unable to see what it will actually mean on the ground for councils or carers. I appreciate that my hon. Friend's intention in the Bill is to support the Government's objective to support carers by creating conditions that will help to combat carers' experiences of social exclusion, promote carers' health and well-being, provide better information and ensure that they are offered a carers assessment. Those overarching aims mirror those set out in the Government's national strategy for carers, published in 1999. It is important to note that the strategy remains a document representative of the needs and wishes of carers. In addition, the Bill would foster better joint working between local councils and other public bodies such as the national health service, to deliver a more coherent service for carers— an area in which I acknowledge that things have not moved as fast as we would have liked.

Let me make it clear to the House. This is a private Member's Bill and as such has no funds attached to it. The proposals set out in the Bill, including any amendments, will have to big covered by existing resources, but the fact that there is a money resolution shows that there may be costs associated with the Bill's provisions and that we need an opportunity to debate them. I should also make it clear, however, that the Government believe that, subject to amendments, the Bill will not place an onerous burden on councils.

The Bill mainly places duties on councils to consider carers and to include them in their normal processes, including their dealings with the health service. Overall, it is about culture change— reinforcing the approaches developed in earlier legislation— and could be described as the "think carers" Bill.

First, I shall deal with the parts of the Bill where we believe we can work with my hon. Friend the Member for Aberavon to deliver tangible benefits to carers. I shall then turn my attention to those aspects of the Bill that, as they stand, either require us to be needlessly prescriptive to councils or duplicate existing duties—

Madam Deputy Speaker (Sylvia Heal)

Order. I hope that the Minister is not going to go into the merits of the Bill itself rather than talking about the money resolution.

Dr. Ladyman

No, Madam Deputy Speaker, I intended—

Tony Baldry (Banbury) (Con)

Has the Minister seen the cost benefit analysis of the Bill produced by Carers UK? If so, is there anything in that analysis with which he disagrees?

Dr. Ladyman

I am not aware that I have seen that particular analysis, although I have seen much of the data that it contains. I certainly agree with the general principle of Carers UK—that looking after carers is an extremely cost-effective way of delivering care to those in need.

I was about to say, Madam Deputy Speaker, that I intended only to identify the issues that would enable me to make the case that by the end of its Committee stage the Bill will not place an onerous burden on the Exchequer.

An amended clause I will ensure that assessment is undertaken in a manner that understands and explores the possibility that carers should be able to participate in life beyond their caring duties and think beyond what they need to continue to care. We all recognise that there is plenty of best practice information and guidance about what constitutes an effective carers assessment for people working with carers of both adults and disabled children. However, we believe that it is appropriate that we have a means to ensure that the few who do not routinely inform carers of their rights to an assessment follow the practice of the majority who do.

The introduction of the duty to inform in clause 3 will ensure that, for example, during the process of a community care assessment, professionals will have a duty to inform carers that they may have the right to request an assessment of their needs. The right to the assessment exists under the Carers (Recognition and Services) Act 1995 and the Carers and Disabled Children Act 2000, and the clause would merely ensure that carers were made aware of that right. Evidence suggests that that will not significantly increase the number of requests for carers assessments. It is realistic to expect that the majority of carers providing regular and substantial care are already known to social services. It is important to emphasise that we believe that any small increases in the number of carers assessments is likely to be gradual and in line with our stated policy objective of improving performance on carers assessments.

Clause 4 will also place a duty on authorities to consider requests from social services to develop services for carers and their families in a more holistic manner. The emphasis on whole systems and joint working means that it is vital that councils have the ability to draw on the powers and expertise of other parts of the health and social care system. Carers are a heterogeneous group; their needs reflect not only the varied people they care for but their own diversity.

Most people accept that partnership working between health and social services is crucial in the planning and provision of services for those who want to continue to live independently in the community. Indeed, working collaboratively is routine in most places, and the clause will help to ensure that the role of carers is recognised in the partnership. We estimate that any costs to local government of implementing those clauses would be very small, and would be funded from existing resource allocations.

The parts of the Bill that cause us concern were well documented in the Second Reading debate on 6 February. They relate to obligations that have the potential not only to place new financial burdens on councils but to limit their ability to respond to local circumstances. For example, the uncertain scope of clause 1(1), which does not make it clear what social services would actually be required to do if they were under this duty, and the provision of the regulation-making power in clause 1(3) both have unpredictable cost implications. Clause 2 would have us dictate to councils the form and content of their community plans, and it would require a consultation and review process, which would have direct costs to councils.

Finally, with regard to clause 5, my Department considers that, in substance, that duty already exists under section 22 of the National Health Service Act 1977 and that it will impose no additional costs on authorities. As a consequence, we will table an amendment to remove it from the Bill.

It is appropriate to address the issue of existing resources because the cost of the Bill must be met from those funds. The House will be aware that we increased the national resources for personal social services by 20 per cent. in real terms between 1996–97 and 2002–03. That is an average real-terms increase of 3 per cent. per annum, and we will continue to increase resources until 2005–06 by an average of about 6 per cent. per annum in real terms. I would be in dereliction of my duty as a Minister if I did not point out that that compares with an average increase of 0.1 per cent. per annum under the previous Government.

Next year, total social services resources for adults are set to increase by 8.2 per cent., or £ 775 million. That increase includes a 6.8 per cent. rise in formula spending shares, as well as extra resources that have been provided to local authorities to enable them to expand community-based social care services. That will both improve services for carers and raise the skills and quality of the social care work force. That will ensure that support for carers is provided by appropriate and high quality services.

In addition, resources for children's social services have increased from almost £3.7 billion in 2003–04 to slightly more than £4 billion in 2004–05. That provides for an overall increase in total resources of some 8.7 per cent. In addition, every council will receive additional resources for children's social services as a result of the Government's decision to provide councils with an additional £100 million.

Specifically with regard to supporting carers, the carers grant came from the commitment in the strategy to provide funding to ensure that carers had access to short breaks. Subsequently, and in response to requests from carers, the conditions have become more flexible to increase choice and control, improve the responsiveness, quality and accessibility of services and increase holiday and leisure options. It is a tangible sign of our ongoing commitment to carers that the grant has increased annually since it started. It is worth £100 million this year and is set to rise to £125 million in 2004–05 and £185 million by 2006.

Hon. Members may be concerned by the removal of the ring fence around the carers grant next year. The money will still be paid as targeted grant with the intention that at least that amount of money should be spent on carers. That means that the Government are reducing the prescriptive nature of grant provision in response to councils' requests. The removal of the ring fence allows councils to provide appropriate and responsive services to address the needs of local carers. Just to make sure that councils are in no doubt, however, that will be measured by the development of a new carers performance, indicator.

In the light of that significant increase in funding for councils and the support expressed to my hon. Friend the Member for Aberavon by the Local Government Association and the Association of Directors of Social Services, the Bill has, with amendments, the potential to support that group of people to whom we owe such a lot, without imposing additional costs during a time of fiscal restraint. Councils must recognise the crucial role that carers play in enabling individuals to remain independent in the community for as long as they want. However, it must also be appreciated that that often comes at a price for the carer in terms of their health, well-being, self-esteem and employment prospects. I hope that councils will: understand and recognise the drive behind the Bill.

The Bill will need work if it is ultimately to receive Government support. My hon. Friend the Member for Aberavon and I are both committed to doing that work, and the determination is there to ensure that the seeds of change sown by earlier legislation will develop our public services for the benefit of carers and those for whom they care.

1.44 pm
Mr. Paul Goodman (Wycombe) (Con)

The official Opposition support the Bill, and the Minister will remember that we backed it on Second Reading. It offers the prospect of equal opportunities and real help for carers, and I congratulate the hon. Member for Aberavon (Dr. Francis) and his Bill team, which includes my hon. Friend the Member for Banbury (Tony Baldry), on introducing it. If we support the ends of the Bill, it follows that we must support the means. Therefore the Minister will not be astonished to hear that we do not propose to oppose the money resolution—indeed, we expect it to be unopposed.

Naturally, we want to probe the Minister a little further about some of the details that he announced, and I shall begin with a point raised by my hon. Friend the Member for Banbury. Carers UK supports the Bill and believes that it would bring few costs and several benefits. It cites the benefits as reduced health costs, increased work participation rates, reduced state benefits and increased revenue from tax and national insurance.

On costs, Carers UK argues that clause 1, which lays upon local authorities a duty to promote equality of opportunity for carers, would not be burdensome. It cites provisions in the draft Disability Discrimination Bill, which lays a similar duty on public bodies in relation to people with disabilities, as being more costly.

Clause 2 seeks to ensure that provision for carers is written into community strategies, and Carers UK states that that would not add substantially to the costs of drawing up those strategies.

Clause 3 is perhaps the nub of the Bill. It would require local authorities to inform carers that they have the right to an assessment of need, and it would not add substantially to local authorities' costs. On that issue, Carers UK cites evidence gleaned from the Scottish Executive—that duty is already written into the law in Scotland—and the Minister appeared to agree with that point when he spoke on Second Reading.

We recognise that the Minister does not appear to have read the Carers UK documents, but he will have noted the points. Perhaps he can tell us whether Carers UK is broadly right to argue that the Bill will bring few costs and several benefits and that the money resolution, which we believe will be passed today, will not bring substantial costs to the Exchequer.

Being relatively new to money resolutions, I have examined the money resolution carefully. It states: That, for the purposes of any Act resulting from the Carers (Equal Opportunities) Bill, it is expedient to authorise the payment out of money provided by Parliament of any increase attributable to the Act in the sums payable out of money so provided by virtue of any other Act. I thought, perhaps wrongly, that I saw the Minister smile slightly as he read out those words, which might, to those of us who are new to money resolutions, appear somewhat obscure. The Minister then said that money would come from existing resource allocation. I confess that I am still unsure which particular budget or budgets he expects funds that may be paid out in pursuit of the ends of the Bill to come from. Perhaps he can clear up that matter for me when he replies. He might also wish to spell out whether local government will be fully compensated for what he described as the "very small" costs it is likely to incur.

Finally, the Minister will recall saying on Second Reading: I am delighted that the hon. Member for Wycombe (Mr. Goodman) committed the official Opposition to supporting the Bill, at least in principle. We will need to work together to improve it, and I shall say a little more about that in a moment. My hon. Friend the Member for Aberavon, the Committee and the Government will need the help of the official Opposition to ensure that what emerges from Committee is a Bill that we can all support." — [Official Report, 6 February 2004; Vol. 417, c. 1070.] During that debate—the Minister has echoed this point today—he was broadly satisfied by clause 4 and perhaps clause 3, but he had considerable reservations about clauses 1, 2 and 5; in other words, he had reservations about three of the five clauses. It therefore seems reasonable to suspect that he proposes to table substantial amendments to the Bill; in essence, he approves of the principle of the Bill, but he intends to demolish several sections of its main architecture.

Madam Deputy Speaker

Order. I remind the hon. Gentleman, as I did earlier, that we are debating the money resolution rather than the content or merit of the Bill.

Mr. Goodman

Indeed so, Madam Deputy Speaker. I merely wished to express the hope that we might have early sight of any amendments that the Minister might table.

1.50 pm
Dr. Hywel Francis (Aberavon) (Lab)

I am delighted to acknowledge the support of my hon. Friend the Minister for the principles underpinning the Bill and I welcome the money resolution. I also acknowledge the strong support from the hon. Member for Wycombe (Mr. Goodman) on behalf of the official Opposition. We all know of the immense contribution that unpaid carers make, which was estimated recently at £57 billion. The Bill and the money resolution are modest acknowledgments of the labour of love of 7 million carers.

As we have heard, Carers UK has undertaken a cost-benefit analysis of the Bill and I hope to make use of that analysis in Committee. I will certainly share with the Minister the papers that have been provided. While it is difficult to quantify precisely the costs and benefits of the Bill, it is beyond dispute that our objective is to reduce health costs, spending on state benefits, and the costs associated with economic inactivity. It follows that we aim to increase work participation rates, which will mean increased revenue from tax and national insurance.

Most important, our aim is to improve carers' health and general well-being. Only carers will be able to measure the true value of the proposed legislation, with its objective of enhancing the lives of carers beyond their caring duties. That is why it has strong cross-party support, as indicated by the fact that early-day motion 602 now has the support of more than 100 Members. It has also received strong support from the Minister for Health and Social Services in the National Assembly for Wales and from outside this House, as we have already heard, from carers, carers' organisations, local authorities, employers and trade unions. For all those reasons, hon. Members on both sides of the House have asked me to welcome the money resolution warmly today.

1.52 pm
Mr. Paul Burstow (Sutton and Cheam) (LD)

I, too, welcome the money resolution. I listened to the Minister with interest, and I wish to congratulate the hon. Member for Aberavon (Dr. Francis) on his work in bringing the Bill this far. I also congratulate people outside the House on the detailed work that they have done on the cost benefit analysis that has informed today's debate and, perhaps more important, will inform debate in Committee.

There is no doubt that carers not only make a huge difference to the quality of life of those for whom they care, but provide economic benefits to the country as a whole in the savings to the NHS. The hon. Gentleman mentioned the figure of £57 billion. The Minister mentioned several of the clauses of the Bill and the concerns that arise about their financial impact. For example, he mentioned clause I, which I also examined on Second Reading. That clause is drawn so as to focus solely on social services departments, but the Bill would confer a duty similar, if not identical, to those that already exist in race relations legislation and those that are planned for future disability legislation. The regulatory impact assessment for the disability legislation made it clear that substantial burdens would not arise out of a more general duty on public bodies to deal with matters pertaining to promotion of equality for people with disabilities, so it is hard to understand how there could be a greater cost arising from applying a narrower duty in respect of carers. I hope that in Committee it will be possible for the Minister to elaborate on how his Department reached the conclusion that it should be concerned about the financial consequences of clause 1.

It is worth stressing that substantial economic benefits will flow from the Bill, if it is successful, not least because—according to the Policy Research Institute—we shall need an additional 2.5 million members of the work force, less than a quarter of which requirement will be met by school and college leavers. In other words, we must attract back to the work force people who, for one reason or another, are not economically active. That means that we must find ways in which we can make it easier for carers to return to work by removing barriers in their way. The Bill is a vital ingredient in achieving that aim.

The Minister also mentioned clause 3, which provides a duty to inform. It is an important keystone provision, because it is the right to know about one's entitlement to an assessment that unlocks so many of the services that carers need. I hope that before the Bill passes into Committee, the Minister will place in the Library a copy of the Department's assessment of its financial impact, so that we can properly scrutinise it as part of our deliberations. I hope that he will also circulate that information to those Members who are fortunate enough to be selected as members of the Committee, so that we can ask the appropriate questions.

In undertaking the assessment, did the Department separate out the costs that would arise directly as a consequence of the Bill and those that would arise as a consequence of the Bill's making people aware of statutory rights that they already have and for which money resolutions have already been passed? In effect, Parliament has already said that money should be available to fulfil the assessment requirements in previous legislation and the service implications that flow from them. It would be useful if the Minister could confirm that point.

I endorse the comments of the hon. Member for Wycombe (Mr. Goodman) when he said that we need early sight of any amendments that the Government will table to the Bill, so that we can have a genuine and informed debate about whether they would help to improve the measure or would gut it of its central purpose. The Department published national priorities guidance in 1998 that required general practitioners to identify carers by April 2000. As I said on Second Reading, that target was reset in 2002, and the Minister kindly undertook to write to me on the issue after the debate. He did so, but unfortunately in his desire to respond as quickly as possible he was unable to give me the specific figures that I sought. I hope that he will now be able to provide those figures.

The money resolution should be passed. This is an important Bill, which will change things for the better for carers, their families, those for whom they care and the wider society.

1.58 pm
Tony Baldry (Banbury) (Con)

As one of those who spoke on Second Reading, I wish to make a few observations. I hope that the Minister will not misunderstand me when I say that his body language today was rather different from his body language on Second Reading. I can only assume that he has received some minutes from the Chief Secretary to the Treasury saying, "While the Government support the Bill in principle and you can say kind words about it, you must make jolly sure that no extra burdens result from it." The Minister nods in assent.

There is nothing more frustrating for the House, and especially for Ministers, than private Members' Bills suffering death by a 1,000 cuts, in Committee or on Report, with the Whips putting up compliant Back Benchers to talk a Bill out or make other difficulties for it. Another problem that may arise is that a Bill gets through but the implementation date is delayed.

All that I ask of the Minister— he is genuinely an extremely reasonable man—is that he talks to the Bill's promoter before the Standing Committee on Wednesday to find out whether it would be possible to reach a compromise and agreement on the amendments that the Government want—

Madam Deputy Speaker

Order. I must reiterate the remarks that I made earlier. We are debating the money resolution.

Tony Baldry

But, Madam Deputy Speaker, I suggest that the way in which the Minister moved the money resolution and the language that he used laid the ground for a course of action that we have all seen before. Having heard the way it which he laid the ground today, I am trying to suggest that it might be for the greatest happiness of the greatest number if there could be some discussion before next week's Standing Committee to determine whether it would be possible to find agreement to enable the Bill to move forward meaningfully. A lot of people will be extremely disappointed if it is not possible to pass the Bill as a measure that will make a genuine improvement in the situation for carers in this country.

2.1 pm

Dr. Ladyman

With the leave of the House, Madam Deputy Speaker, I shall respond briefly to the debate.

Several hon. Members asked whether the Government think that the Bill, as drafted, would substantially increase costs to the Exchequer, but to a lesser extent than the amount that we would gain from its benefits. I absolutely and totally accept that there are huge benefits to be gained for society as a whole if the Bill succeeds in its purpose of making it easier for carers to care and get back to work. They would thus pay more taxes, and fewer benefits would have to be paid, and they would be more content and able to continue in their caring role.

I stress that the Bill is a private Member's Bill and, as such, a budget is not associated with it. If we were considering a Government Bill, there would be detailed assessments of costs and we would have a detailed money resolution so that the House knew exactly how much it would cost. However, if a private Member's Bill is to succeed it must be tightly defined, tightly written and specific. We must all understand exactly what such a Bill means. My worry about the Bill—clause 1 is a good example of this—is that its current wording does not make it clear exactly what councils would be expected to do. We know what hon. Members and the people who drafted it want it to do and we know what carers want it to do. Our job, as a Parliament, is to ensure that the Bill says what we want it to do.

Dr. Francis

May I invite my hon. Friend to sit with me and redraft clause 1(1)? I am sure that we would arrive at a good and effective compromise.

Dr. Ladyman

My hon. Friend is absolutely right. He and I have already been working together closely on amendments that will be tabled in my name. My officials and I have been working closely with other Departments and Carers UK to ensure that, as the hon. Member for Banbury (Tony Baldry) said, the finally amended Bill does what we want it to. The amended Bill will be unambiguous, so we shall be able to determine precisely the costs that it will impose. If the amendments are agreed in Committee, I have no doubt that the whole House will want to back the Bill on Third Reading and that the Government will be able to back it. We will then all see clearly what it will achieve, it will be welcomed by carers, and it will be all the better for the work that we shall put in.

I give hon. Members the assurance that the Government are committed to getting the Bill right. We are not trying to emasculate it in any way whatsoever. We are tabling fairly extensive amendments to specific clauses, which I shall try to make available as soon as possible. However, as the hon. Member for Banbury suggested, it will be necessary to convince other Government Departments, Carers UK and carers generally of the merits of what we are trying to do. That takes time, but the work is being done. With that assurance, I hope that hon. Members will agree to the money resolution and that we can get the Bill into Committee to do the extensive work required so that we end up with a Bill that will really do a heck of a lot of good for carers.

Question put and agreed to.


That, for the purposes of any Act resulting from the Carers (Equal Opportunities) Bill, it is expedient to authorise the payment out of money provided by Parliament of any increase attributable to the Act in the sums payable out of money so provided by virtue of any other Act.