The Number 10 Experience

Note: The following blog post has been written by Moira Fraser, Director of Policy at The Princess Royal Trust for Carers

“The Prime Minister requests the pleasure of your company…” came the invitation. What an opportunity to get carers Number 10issues noticed right at the top. So on Wednesday morning, determined to give it my best shot, I walked up Downing Street, said good morning to the policeman and  rang the brass doorbell. The door swung open ominously….

Around twenty charities were  invited to give their views on NHS reform. Some big household names, some tiny – a real mix, but few others with a real carer focus. Lansley opened the debate, later joined by Cameron and Clegg.

The Coalition Government is clearly in trouble with its health reforms, and I have to say I can’t see what’s in it for carers. They say it’s not about privatisation, but unless more thought goes in, the competition it will allow will end up with a focus on price rather than quality. You can’t provide decent carer’s services on tuppence ha’penny. It also means charities end up competing against each other – exactly what we want to avoid. And changing the boundaries of health consortia and making these different from local authorities will make it a lot more difficult to join up all the different services which are needed to support young carers and families with complex needs.

About an hour into the meeting, I took my chance.  I caught Andrew Lansley’s eye – he looked at me and nodded. Gulp. In what felt like slow motion, Cameron and Clegg turned and looked at me. Carers have been absent from the debate so far, I said, and you need to remember our vital role. With some notable exceptions, GPs often forget all about carers  and carers organisations. We need joined up working, and services which work together to support families  to make sure vulnerable people don’t  fall through the cracks. The Bill needs to help this happen, not hinder this.

They nodded and asked more about GP practices working with the voluntary sector. The GP present agreed that primary care sometimes forgets anyone else exists. They agreed the Bill needs changes to give more indication of how local arrangements should work but didn’t agree that consortia boundaries will make things difficult. As he left, the Prime Minister, said we will all need to work to make health and wellbeing boards effective, “to do things like making sure carers get the right kind of support”.

I think there are real problems with the Bill. I think there is a massive risk of carers being forgotten about in decision making processes. There may be opportunities for the voluntary sector, but if it comes down to price we will all lose out. I said my piece. They said they were listening. But did they hear?

April 15, 2011 - Posted by | Carers movement, Carers Strategy, David Cameron, Social Care | , ,


  1. It’s really good news that you were invited to Number 10 and I’m glad to hear you were able to comment to the top people about how important the role of the carer is in the long term future of Health and Social Care.

    However, I do think that the changes do bring the opportunity to introduce a true market into the care sector. People don’t just buy goods and services on price, otherwise we would all be driving the cheapest car and there would only be budget supermarkets. I think that just like other markets such as food shopping there is a role for the small independent providers, specialists and a whole range of bigger chains, providing different levels of service, but all offering something that people are looking for – there are the Lidl’s and Aldi’s, through to Tesco’s, Sainsbury’s and Morrisons, through to higher end – Waitrose and upwards to Harrods.

    One of the main things about personalisation was giving people choice of how their care was provided and it’s important that the market develops to give people those choices. One of the problems at the moment is trying to get everybody in the care sector to think differently. Council’s need to continue working on preventing the need for care in the first place rather than just just squeezing price and continuing to look for ways to control and shape the care marketplace. Give people their personal budgets and the information they need to be able to choose their care and the market should shape itself.

    Providers also need to be educated or to start thinking differently about how to market and run their businesses, as the majority of them still have the mindset of chasing council block contracts as it’s easy to win the business. Council’s are putting the squeeze on these, often in an unrealistic way. I heard of one very large council wanting to contract care at £10 an hour. If you think about it, it’s impossible to run a business if that’s your main source of income as take out the minimum wage from that (£5.93) and that leaves just over £4 to pay for carer expenses, uniforms, equipment, consumables such as gloves and aprons, training, back office overheads, etc – it’s just not going to promote any quality of service at all.

    I know and realise it is a challenging and worrying time for everybody, but now really is the time to change the system rather than trying to put another plaster on it, as it won’t be able to support all our needs in the future if we keep running it the way we are.

    Comment by Rob Osborne | April 15, 2011 | Reply

  2. Gordon & PRT thanks for being there. I was beginning to think we were forgotten again and I could not see a way in.
    The Governments focus with GP’s is worrying they only see us for 7minutes now and again and they have no idea about the remaining 23 hours and 53minutes in every 24 hours, day by day, year after year. Its Carers, Nurses, Carers voluntary agencies,friends & neighbours who deal with the rest. They need to be represented at that Consortiums top table.
    We also want high quality hospital treatment & primary care locally to us and also appropriate carer support services. My first choice is local. If the Local Hospital is on the verge of bankruptcy and not giving appropriate quality treatment then thats what the Government should sort out, not wait until people die or have miserable deaths.
    For power to be in the hands of GP’s the people who are the highest paid as it is. It is all extremely worrying. Yes change is needed but test it out across differant postcodes before you roll it out across the country.

    Comment by Daphne Sanderson | April 15, 2011 | Reply

  3. Why is it NO ONE EVER INVITES ORDINARY PEOPLE LIKE CARERS to these functions,are they afraid we will eat them. I ahve been a CARER fulltime for 25 years and in the begining there was NO HELP – NO ONE WHO LISTENED AND NO ONE WHO CARED ENOUGH TO INVOLVE US (ME).
    Its still the same to day with this Con/Dem goverment who have consigned CARERS to the politcal wilderness,the only thing thet are really interested in is the CUTS PROGRAM margaret thatcher tried to start.
    Maybe next time someone might consider inviting some CARERS like me,we would certainly give the primrminister and his cohorts something to think about

    Comment by Taras Kurylak | April 16, 2011 | Reply

    • Hi Taras – I kow carers often feel sidelined – The Princess Royal Trust for Carers is holding two events next month with ministers, MPs and other events so carers can put their points across directly. The Number 10 event was about NHS provision of services, so we were there because carers centres often provide services on behalf of the NHS, so the event was talking about that – how the new legislation can help us to run services. However there were carers there – I was sitting next to Orin Lewis from the African Caribbean Leukaemia Trust, whose son died after a long battle with cancer and other conditions. They’re working with the NHS to increase the number of bone marrow and organ donors from ther African Caribbean community. There were also a number of people who have conditions or disabilities, and also others whose caring role or health problem wasn’t explicitly mentioned.

      Comment by Moira Fraser | April 18, 2011 | Reply

    • hi taras exallent comment about real life carers i look after my wife who has a brain injury i am sure its going to kill me and yet the powers that be still seem to ignore our plight it is criminal the way we our treated my sincere and best wishes richard

      Comment by richard stephens | May 25, 2011 | Reply

  4. I have been invited to events many times to speak up for Carers and I would love to have gone.As I feel over the years I have learnt very much about situations that caring has put on many people’s lives.

    Yet each time I get the invitation nobody realises that I have no one to leave my daughter with and because she does not have a high disability will not go to a centre. Maybe next year I will be able to go as I am fighting for change for my daughter’s life and mine.

    Comment by Simone Farrugia Meiszner | June 19, 2011 | Reply

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