HL Deb 23 February 1994 vol 552 cc627-9

2.44 p.m.

Lord Stallard asked Her Majesty's Government:

What steps they are taking to ensure that local authorities uphold their duty to consult carers as part of the community care assessment procedure.

The Parliamentary Under-Secretary of State, Department of Health (Baroness Cumberlege)

My Lords, as a matter of good practice our guidance has made it clear that we expect carers to be fully involved in assessments. We have in place extensive programmes to monitor and support the community care reforms in order to enable them to be effectively implemented.

Lord Stallard

My Lords, I am grateful to the Minister for that Answer— as far as it goes. However, does she agree with the carers' associations, such as the Carers' National Association and the Alzheimer's Disease Society, that carers have very few, if any, statutory rights under the National Health Service and Community Care Act? Is she aware that despite the community care reforms many local authorities still do not consult— or are failing to consult— carers and carers' organisations about the assessment process, and that they are certainly not making the necessary provisions to allow carers to carry on caring for as long as possible? Therefore, will the Minister agree to try to persuade the Government to take a careful look at carers' needs to have some statutory rights in the assessment process as well as the provision of services that would enable them to continue caring for as long as they can?

Baroness Cumberlege

My Lords, although there are no statutory rights, the Government have made it clear that they expect carers to be involved in care plans and assessments, working with all the statutory authorities involved. We have repeatedly encouraged local authorities to ensure that there are written care plans so that carers know what is proposed and can influence the services that are provided.

Lord Ashley of Stoke

My Lords, the Minister is always helpful, but is she aware that the Carers' National Association has said that many carers are now worse off than before because of government cuts? They do not benefit from the arrangements that the Minister mentioned simply because they do not know about them. Therefore, could not the Government finance a scheme to ensure that all carers are fully aware of their entitlements?

Baroness Cumberlege

My Lords, there are no cuts in terms of the resources that are being put into community care. In fact, by the end of next year £ 1.2 billion of extra money will have been put into this operation specifically for social services and health authorities to work together to improve services. I was in touch with the Carers' National Association this morning and the director told me that she felt that in some places the involvement of carers had improved although in others it had not. The picture that is coming over clearly to us is that that is patchy, but one might expect that since the reforms have been in place for only 10 months.

Baroness Jay of Paddington

My Lords, this is the second day in succession that your Lordships have heard questions raising serious concerns about the operation of the new community care arrangements. Does the Minister now agree that it would be a very good idea to implement a nationwide review of the arrangements which, as she says, will be one year old in April, with particular reference to the idea of introducing national standards for community care, as was proposed by the British Medical Association and the major voluntary organisations, which I believe include special protection for carers?

Baroness Cumberlege

My Lords, a great deal of monitoring is going on. In September, the Social Services Inspectorate and the regional health authorities monitored all 109 local authorities. There are 14 special studies now to be carried out by the Social Services Inspectorate and the National Health Service Management Executive. A report has been commissioned from KPMG on information for users and carers. The National Users' and Carers' Group has been established by my honourable friend the Parliamentary Under-Secretary of State who is particularly responsible for community services. So, a great deal is going on. I am not an advocate of national standards because I think that every area of England is different. There are different strengths in different communities and we have to draw on those. I think that, on the whole, local decisions are better decisions.

Lord Stallard

My Lords, can the Minister go a stage further and tell us how, in the absence of those statutory rights for carers, we can now proceed to convince those local authorities which are obviously not going to commit themselves to making that provision for carers, that they have to do so?

Baroness Cumberlege

My Lords, it is a question of persuasion, monitoring and withholding funds when certain provisions which we expect to be adhered to are not adhered to. The national association, with the support of the local authorities, is running a campaign in May to heighten awareness of local authorities. I understand that that is an initiative which they welcome.