Baby steps for carers

The Government called it their ‘Next Steps for the Carers’ Strategy’. Carers will want to know whether these are just baby steps or worse something akin to Paula Abdul’s “Take two steps forward, and you take two steps back’.

The biggest leap forward in the Strategy was actually announced a week before; £400m would be given to the NHS to spend on supporting carers which I spoke about in my last blog. This leaves the extra investment in training GPs to support carers as the headline maker. Government have said £6m will be made available for this over the four years of this strategy.

Many carers will angrily feel that they should get the money and not GPs, and others will think that we should not spend money on training GPs to do something they should already do. The Government feels that this money can get GPs to identify and refer carers for support much earlier than they are currently doing, if at all. Hopefully, this should mean that more carers will get support, and earlier too.

There are many Carers’ Centres and Crossroads Care schemes who do training and work with GPs and it does result in more carers getting better support and more help from GPs. The NHS has to realise that the £400m they will receive should be used to support the extra carers that GPs should be identifying and referring for support.

Other announcements are unlikely to get any carers dancing in the streets – even to a Paula Abdul song…

• Skills for Care and Skills for Health will publish a learning and training framework so professionals better understand needs of carers
• Will develop an e-learning module to improve school support for carers
• Government will promote the benefits of providing flexible working
• Seek to improve access to support for carers suffering mental and emotional strain

Governments are often criticised for over promising and under delivering. So far, I’m not sure that they could be accused of the former and time will tell regarding the delivery. It all hangs on that £6m for GPs and £400m for the NHS. If they don’t bring about the changes needed, carers will not think the Government will have done much in the four years to 2015.

Take care

Gordon

“NHS, give us our money”

There is a scene in ‘Yes, Prime Minister’ when Humphrey the civil servant shows how changing the way things are phrased can either lead somebody into thinking that national service is what we need to instil discipline or that national service is like giving guns to thugs and showing how to use them.

I see the same tricks being used when it comes to local government making decisions. It’s either local people having control in their own communities or something that leads to postcode lotteries where people living across the street can get treated differently.

Would you want a bureaucrat stuck in a London office deciding what happens in your rural community or would you like a dedicated public servant who has spent years working in different communities and has gathered information about what works best from all over the country and internationally? The two can be the same.

Most people I have spoken with favour local people deciding what happens in their local communities but don’t want postcode lotteries. Most seem to want policy based on evidence and learning from what has been tried and tested, but abhor the employment of any ‘bureaucrat’ to do this.

So what do people think about the Government’s decision to give the NHS £400m over four years without ring-fencing to supporting carers? They probably think that Labour tried this with £150m over 2 years and our research showed that only 25% of it was used to increase support for carers. So what’s different this time? Hopefully a couple of things which will help.

• Primary Care Trusts (and then GP commissioning consortia from 2012/13) will know how much of the annual £100m their share is, allowing local people to know exactly how much they have received to spend on carers.
• PCTs will be monitored on their performance regarding support for carers

These didn’t happen before and I hope that they will lead to more than 25% of the £400m being used to increase support for carers, but certainly not all of it will. Some will say that Government shouldn’t announce £400m for carers when the NHS can spend the money on anything it chooses. I understand this, but I can also understand that there would be an outcry if Paul Burstow said that he as Minister for Care Services was not going to do anything to support carers – that it is a matter for local government.

We look to national government because that is who we elect to govern for us. And yet we then want local control but without the variation that inevitably brings. Our opinion on this probably changes according to the particular issue; it depends on where you are sitting at the time. One thing I know is that where carers are sitting at the moment is a place full of overburden, isolation and turmoil, which makes the right call unequivocal: “NHS, give us our money.”

Pitching for Carers at the Party Conferences

Gordon Conochie making a pitch to the dragons urging more investment in NHS for carers support

The Princess Royal Trust for Carers is part of a group of charities that work together to keep health issues high up the political agenda. Within the large group, we join into triumvirates to hold debates at each party of conference and we went with the Royal College of GPs (RCGP) and Breakthrough Breast Cancer.

We decided that our debates would replicate the format of Dragon’s Den with each organisation making a pitch to a panel asking for money to improve what the NHS achieves. The panel at each conference would be made up of a Minister (or shadow), a journalist, a NHS representative and a patient or carer. They would interrogate us, followed by questions from the audience and then they would decide how many chocolate gold coins each organisation would get.

The RCGP wanted more money to lengthen GP training from 3 years to 5 years that would help their awareness of the huge variety of conditions and prepare them for GP commissioning. Breakthrough wanted funding so that every area used digital mammography rather than having to process film, which would make the process much quicker. We wanted money to support carers at the point of discharge to prepare them for what caring responsibilities they would shortly take on.

We narrowly lost to the RCGP at the Lib Dem conference but audience members told us that we were robbed. I agreed. However, we did get the backing of the dragons at the Labour and Conservative conferences including the support of Diana Johnson MP and Simon Burns MP, Shadow and Minister of Health respectively. We did get a wee bit of help from Dr Claire Gerada, incoming RCGP chair who gave their pitch, announced that the dragons should give us their vote at the Conservative conference.

The debates at each conference were very well attended (overflowing at Tories) and the feedback from delegates was very positive, including NHS and local authority reps. Denis Campbell (Guardian and Observer journalist), chaired the Conservative party and concluded that the treatment of carers was a national scandal. Hopefully another ally there.

I’ll let you know exactly what the politicians were saying in the next blog, but just thought you might find this interesting.

Gordon

MPs Debate How to Support Carers

Burstow vs Keeley, Round 1

On 1st July, MPs debated how to support carers have a life of their own in Parliament giving us the first opportunity to see Paul Burstow MP and Barbara Keeley MP, Minister and Shadow Minister for Care Services respectively, debate the issue.

Burstow began by highlighting the huge benefit that being in contact with social services can make to carers: a DH survey of 35,000 carers in contact with social services found that only 13% said they did not have the time to do anything they enjoyed whereas a Carers Week survey of 3200 carers, many of whom may not have been in contact with social services, found 76% did not think they had a life outside of caring.

From this the first of his three priorities is for more carers to be identified and for GPs to play a large role in this. His other two are to improve joint working between health, social care, and the voluntary sector, and secondly to extend the use of direct payments/personal budgets.

On cancelling Caring with Confidence (CwC), he advised that the course materials were good but they weren’t getting value for money from delivery. So, he will give the materials freely to Carers’ Centres and other providers of the programme while reinvesting the money in training for GPs on carers’ issues and other support for carers which will be announced soon.

He also advised that the DH would shortly publish an audit of Primary Care Trust support for carers, which is welcome news. Keeley replied that money for carers must be ringfenced as history has proved it is the best way to ensure that money goes where Government (& Parliament) intends… If only her previous colleagues had learnt this lesson.

Keeley expanded on this by arguing that with GPs taking on a larger role in commissioning local services and schools becoming independent of local authorities, it would be even harder to ensure that a strategic view of the needs of carers was taken in every area.

To address this, she plans to reintroduce her Carers ( Identification and Support) Private Members Bill of 2007. This would require health bodies to identify patients who are carers or have a carer and that health services took the carers’ needs into account. It would also have require schools to have a policy to identify young carers.

Responding to the CwC cancellation, Keeley pointed out that there will still be costs of actually running the course and training GPs should come out of NHS core budgets. Tony Baldry MP (Chairman of the All Party Parliamentary Group for Carers) commented that carers will still need to be trained to help manage their caring role. He also asked the Minister to look at the Work & Pensions Select Committee’s report on carers which recommended a costs of caring payment of approximately £25-£50 p/w could be given to all carers in intensive caring roles, even if receiving the State Pension.

Other MPs spoke of the need to increase benefits for carers pointing out that proposed benefit changes will see Carer’s Allowance rise slower than before and potentially fewer carers receiving it due to fewer people they are caring for getting Disability Living Allowance (DLA is requisite for the carer to get Carer’s Allowance). Many spoke of the particular need to support young carers and it was good to hear that so many had visited their local Carers’ Centre and young carers’ services and been impressed by their work.

So, seconds out, we await round two. I’m quite looking forward to it.

Click here for the transcript of the full debate

Take Care

Gordon