National vs. local: What’s best for carers?

We held our first ever event at a Liberal Democract conference today. It was a joint meeting with the College of Occupational Therapists and proposed greater support for carers and occupational therapists if we are to help people live healthier longer and for people who receive care to live a more independent life.

Sandra Gidley MP (Health Minister) and Paul Burstow MP (Chief Whip and Chairman of All Party Parliamentary Group for Older People) were there with a few other invited guests. It was agreed that greater identification of carers was crucial and that GPs had a large role to play in this. Evidence was given where GP surgeries that have contact with their local Carers Centre identify many more carers than those with less or no contact. We hope that our recently published guide for GPs will increase GPs’ support for carers.

The Green Paper was also discussed with general disappointment at its lack of detail and depth and this was repeated at a meeting I attended with the whole Lib Dem health team and other health organisations. The Lib Dem position on social care is being reviewed but currently could be described as broadly supporting the Scottish model where everybody receives a contribution to their care costs regardless of income, but some may have to top up this contribution with their own funds.

Their policy would inject a further £2bn into social care funding but I think they are looking at finances to see where they could get this £2bn from, given current Government deficits. I spoke to Greg Mulholland MP at the end who agreed to do a web chat about social care when Parliament returns so we’ll keep you posted about that.

Both meetings also discussed the need for commissioners to listen to their communities, service users, carers and professionals about the range of services that are needed. This gave me a perfect opportunity to plug a new guide on Commissioning for Carers that we helped write, which I duly grabbed.

However, the big story at the conference was the speech given by Norman Lamb MP, shadow Secretary of State for Health. He announced that they would scrap Strategic Health Authorities and improve local autonomy of health bodies. I got to discuss this issue of local control with the Lib Dem health team in the context of Primary Care Trusts (your local NHS body) and providing breaks for carers.

My previous blogs have detailed that the Government announced in a National Carers’ Strategy that they would give PCTs £150m to provide breaks for carers. Then it turns out that the Government were just giving PCTs £150m to spend on whatever they wanted, would not tell PCTs how much each was getting of the £150m nor ask them to report on how they spent it. So the Government makes the proclamation then washes its hands of delivering what they announced.

The Government have defended this saying that local NHS bodies know their local areas best, so it should be up to them how to spend the money with local people holding them to account. However, PCTs boards are not elected and it is very hard to hold people to account when you do not know how much they have received or what they have spent it on. You cannot have accountability without transparency.

We are currently stuck in no mans land where national government abdicates responsibility to those who we have no control over. We either move to a system where national politicians take more control and responsibility for delivery, or where local bodies are more accountable to local people who are given greater support to getting involved. The Lib Dems prefer the second option, do you?

Take Care


September 21, 2009 - Posted by | Liberal Democrats, Party Conferences | , , , , ,


  1. Unless the whole aspect of Social Care is clearly defined by Statute , wherein responsibilities for all parties , including carers , are laid down , no way should any control be given to individual LA’s.

    Social Care is the clear responsibility of society as a whole …. just like the NHS …. would any reader suggest that treatment under one local hospital should be any different to another ?

    In addition , as Social Care is the responsibility of society , funding for such must be society’s responsibility , namely general taxation , just like the NHS. Classic example of which is when a carer is hospitalised … the caree would receive a bill for alternative ” care ” in the absence of the carer … how do 24 \ 7 carers cope if they need urgent hospital treatment ? Take their caree with them ?

    No , the biggest lie of all is to say that we , the taxpayer , should not fund Social Care …. any system of self funding is wide open to a post code lottery , with the poorest , as per usual , fighting for scraps from the table !

    Comment by Paul | September 21, 2009 | Reply

  2. Surely the Care Quality Commission has the responsibility of monitoring what PCTs and LAs do with the money central government allocates them even though its not “ring-fenced”?
    In Scotland the Care Commission monitor this.


    Comment by ians1 | September 21, 2009 | Reply

    • Hi Ian,

      Unfortunately the performance monitoring regarding services for carers is pretty weak. In England, there are 3 tiers of ‘Vital Signs’ that Primary Care Trusts are judged on. Carers are in the third level which means that PCTs are only performance monitored on this issue if they choose to be. However, we are planning to discuss monitoring services for carers in the NHS with the Care Quality Commission.

      Regarding the specific money, there are no expectations on PCTs to report what they have done with it to anybody. Officially, nobody knows exactly how much each PCT was given of the national share (although we have produced estimates) making it impossible for an official body to hold them to account for how it was spent. However, we do think that there is a role for local authority health scrutiny committees (comprising of councillors) to ask questions of PCTs, which they can do and can be effective. Anybody can suggest what topics should be considered so I think finding a local councillor who could help is a way forward.

      Thanks Ian

      Comment by Gordon | September 22, 2009 | Reply

  3. Since P C Ts do not administer benefits and have a history of “robbing Peter to pay Paul” why not give this £150.000.000 direct to the needy in benefits?

    Comment by webglynne | September 23, 2009 | Reply

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