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Do Carers Fit Cameron’s Big Society?

Whilst you’ve been treated to a few guest bloggers, I’ve been doing some thinking. This could be dangerous but please stay with me!!!

Cameron’s Big Society is all about redefining the relationship between individuals, communities and Government/the State. But what does, or should, this mean in relation to carers?

I actually think carers don’t fit Cameron’s view of current society. His view is that Government is too involved; does too much in people’s lives; and has extinguished the do-it-yourself (or ourselves) attitude. We have become reliant on the government.

David Cameron on GMTV

David Cameron announced a Big Society plan

How many carers feel that they are reliant on Government? Or that Government in the form of social and health services are too involved? Or that carers don’t very often do it for themselves?

No, it seems that carers fit the society that Cameron wants to create. Individuals, families, friends and neighbours taking responsibility for the care of each other. Carers are not people passing the buck to the State, they are people doing it for themselves.

But that’s not the end of the story. There are fundamental questions that follow from this:

  • Should Government be more involved – what is or should be their responsibility?
  • Carers are taking responsibility, but is it their responsibility to do so in the first place?

Legally speaking, Government does have responsibilities regarding people requiring care and support, but there is not a law saying that people have to provide care.

From this, you could say that carers are doing what Government should be. You can see this feeling contained within some of the campaign messages that we/carers/carers’ organisations use: carers save the Government £87bn from the care they provide; carers only get paid £53.90 (Carer’s Allowance for which you have to care at least 35 hours p/w) which is well below the legal minimum wage.

But these two messages raise two questions:

Are we saying that people should not be providing any care and the Government provide it all? Are we saying that people should be paid to care for spouses, parents, children or siblings rather than expecting families to provide some element of care for each other because they want to?

I don’t think many people believe that the Government should provide all care, with many wanting to be the one who cares for their wife/husband/father/mother etc. And I think many would say that families should be there for one another, and not need to be paid to do so.

So, there should be responsibilities on both individuals and Government. What should those be and what does that mean in terms of policy? That’s for the next blog.

Take care,

Gordon

August 12, 2010 Posted by | Big Society, Carers Strategy, Conservatives, David Cameron | , , , , , , , , , , | 11 Comments

Carers and the Big Society

Note: This post is from our guest blogger Tony Baldry MP who is Co-Chair of the All Party Parliamentary Group for Carers. Tony Baldry MP made a speech at the meeting of The Princess Royal Trust for Carers held in the House of Commons on Wednesday, 28th July 2010.
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Last week, the Prime Minister repeated his commitment to the Big Society making it clear that its’ success will depend “on the daily decisions of millions of people – on them giving their time, effort, even money, to causes around them”. My whole political life has been predated on this same principle.

However, I am concerned at a potential and unintended conflict between the Coalition Government’s very understandable desire on the one hand to promote the Big Society and the need to cut the budget deficit.

In my constituency in Banbury we have the North and West Oxfordshire Carers’ Centre, member of The Princess Royal Trust for Carers and has been successfully running now for nearly two decades.

Such has been the dedication and commitment of the volunteers that the centre has won the Queen’s Award – one of very few such awards in Oxfordshire. The Banbury Carers’ Centre like the Oxford and South Oxfordshire Carers’ Centres are comprised of a mixture of experienced volunteers and some paid staff, enjoying the financial support of the local community.

They help train carers. They provide outreach services for carers. They provide a place where carers and different types of carers can come and meet, share experiences, unwind and support each other.

As we all know, carers come in many kinds from young carers to very elderly spouses still looking after a much loved husband or wife.

In undertaking this valuable work, for many years the Banbury Carers’ Centre has received funds from Oxfordshire County Council to deliver specific agreed services to carers. The reasons the County Council was procuring these services from Carers’ Centres are exactly the reasons set out by the Prime Minister in support of “the Big Society”; Carers’ Centres and their volunteers are exactly the people who are making a difference, are in contact with other carers and are in the best position to understand, articulate and meet carers’ needs. They are full of people who come together and work together to affect social change and to improve life for carers.

As far as I am aware there has never been a suggestion that the Banbury Carers’ Centre or the other Oxfordshire carers’ centres have failed to meet the objectives with which they have agreed with the County Council. However, the Council has to make savings in their budget.

They are proposing withdrawing their funding from the carers’ centres in Oxfordshire and replacing that service by a telephone call centre, almost certainly run from outside of the county to which carers will be able to call.

Part of the justification of this move, in addition to the need to save money, is an assertion that it will help them reach more carers. However, there doesn’t appear to have been any or any real discussion with the existing Carers’ Centres as to the number of carers that they are already reaching.

I would suggest the issue here is that many people who are carers simply don’t recognise themselves as being carers and if they don’t recognise themselves as being carers, they are not likely to ring a carers’ telephone hotline.

We need a collective effort to help carers voluntarily register themselves as carers so that they are recognised as being carers by GPs or by schools if they are young carers. This requires a sustained campaign in GPs surgeries, in the schools, and in the media to make people ask the question “are you a carer?”

I suspect that for many years GPs haven’t been asking the question of whether someone is a carer, because there has been very little that they could do to support them. However, now that PCTs have funds to support respite care, GPs are in a position to refer carers for respite care and short holiday breaks and for that reason alone, one would hope that every GP practice would know which of their registered patients are also carers.

I think the reality is that for many years central government has used local government to support a whole range of social interventions. Money for carers’ breaks is given in part to PCTs and given in part to local Councils. However, if local government is obliged to save money, they understandably start by reducing funding for those organisations for which they have no immediate responsibility.

However, there are a very large number of active citizens undertaking constructive voluntary work within our community who to a certain extent depend on some funding from local government. An alternative, of course is to allow organisations such as the Banbury Carers’ Centre to bid direct to central government to provide carers’ services.

Here we appear to be bedevilled that Oxfordshire County Council has decided to bundle up all its carers’ contracts into a single contract, thus bringing it within the parameters of the EU procurement directives and requiring compulsory tendering. This makes it much more difficult for local voluntary organisations to bid and appears to run completely counter to the desire for localism and the Big Society.

I think we all have to accept that these are particularly difficult and unusual times. No peace time government has had to tackle a similar financial deficit. We need to develop the Big Society. We need to see how we can best reconcile these two policy objectives. However, to start with we have to recognise and acknowledge that there are some real tensions that need to be worked through.

Tony Baldry MP
House of Commons

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July 28, 2010 Posted by | Budget, Carers Strategy, Conservatives, Liberal Democrats | , , , , , , , , , , | 8 Comments

Government’s White Paper on Restructuring NHS in England

Thankfully, the birthday card I got at work yesterday included some humourous messages from colleagues giving me comic relief from the Government’s White Paper on restructuring the NHS in England. The White Paper is obviously important, but it’s just not the most fun read in the world.

In a nutshell, the proposals are:
• GPs will commission the vast majority of all health services for patients and carers meaning Primary Care Trusts (PCTs) will vanish. A NHS Commissioning Board will oversee GP commissioning.
• There will be a new Public Health Service with local Directors of Public Health being appointed jointly with local authorities, who will have new Health and Wellbeing Boards to replace Health Overview & Scrutiny committees.
• Patients should have a choice of providers – so not just NHS organisations
• More information should be shared with patients and carers and decisions taken jointly with health professionals – no decision about me without me

I don’t think the question should be whether GPs being responsible for commissioning is a perfect structure (it really isn’t) but whether it is better than the alternatives. Not everybody seems convinced of that either.

However, proposals for more patient and carer involvement and a new performance framework that focuses on outcomes for patients rather than processes should be welcomed.

This focus on the duties of health services is timely given Barbara Keeley MP’s Bill in Parliament today proposing that all health services should be required to identify patients who are carers or have a care, and consider the carers’ needs. The Bill would also require schools to have a policy to identify young carers – something which we have campaigned on.

There is little chance that Barbara Keeley’s Bill will become law unless the Government support it. So, we should ask our MPs to to support this Bill and ask them to write to Paul Burstow MP (Minister for Care Services) asking him to take the Bill forward.

The Bill has received support from MPs in the Conservative (Tony Baldry MP), Liberal Democrat (Annette Brooke MP) and Labour parties (Diana Johnson MP + others), plus Caroline Lucas MP of the Green Party. The NHS has a history of neglecting carers and it is imperative that carers are not further forgotten during and after any restructuring. This Bill could ensure that doesn’t happen.

Take Care
Gordon

July 14, 2010 Posted by | Carers Strategy, Health, Uncategorized | , , , , , , , , | 5 Comments

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.

Big BenBurstow 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

July 6, 2010 Posted by | Budget, Carers Strategy, Young carers | , , , , , , , , , , | 4 Comments

Budget and benefits: what’s happening with the pledges on carers?

Waking up from the hangover of England’s World Cup campaign? Here’s what you missed.

coins arranged as a question mark

Cuts could still happen at the local level

Budget and benefits

All benefits, except pensions, will rise in line with the Consumer Price Index measure of inflation, which excludes most housing costs, rather than Retain Price Index. CPI is usually about 1% lower meaning benefits will rise slower in future.

There will be a new medical test for Disability Living Allowance from 2012 and Iain Duncan Smith MP has subsequently said that  people who are able to work should do community work to keep benefits.

Will social care escape funding cuts?

Paul Burstow MP, Minister for Care Services, advised that no grants for adult social care would be cut in 2010/11. The Carers Grant remains unring-fenced although each local authority has an amount identified within its’ budget as its’ share of the £256m national Carers’ Grant from the Dept of Health. £20m will be reinvested in respite for disabled children from what would have been invested in the now scrapped Child Trust funds for disabled children, and this will be ongoing annually.

However, because these grants are not ring-fenced local authorities could use some of the funds to cover shortfalls in other areas of their funding where there have been cuts. So cuts could still happen at the local level but it would be madness to cut support for carers – see an earlier post. Sir David Nicholson, CEO NHS England, has recognised this whilst saying that the NHS should use its funding to cover shortfalls in social care.

What’s happening with the pledges on carers?

The previous Minister for Care Services, Phil Hope, requested that Strategic Health Authorities scrutinise what PCTs are doing to support carers. The new Minister, Paul Burstow MP, is currently analysing information from SHAs.

Burstow has also said that in future he will:

  • encourage the NHS to do more to identify and respond to carers’ needs earlier to prevent ill-health
  • improve information, advice and support to help carers stay in or get back to work if they are able and willing
  • refresh the Carers’ Strategy as it only taken partial steps to improve support for carers

However, the recently revised NHS Operating Framework for 2010/11 does not increase carers as a priority for the NHS, but does ask PCTs to publish how they are implementing the Dementia Strategy. Why can’t they do this for the Carers’ Strategy?

So there should be a lot for MPs to talk about during their debate on carers on 1st July. Kick off is 14:30 in Westminster Hall. Let’s hope there’s something to cheer about.

Take care

Gordon

June 28, 2010 Posted by | Budget, Carers Strategy | , , , , , , , , | 4 Comments

Carers Can Wait No Longer for Government Plans

Paul Burstow, new Carers Minister, at our roundtable event earlier this year

On health and social care, what’s in store for us?

It’s the waiting that’s the worst. So say civil servants, local authorities and the NHS as they wait to find out exactly what the Government plans are. Carers are maybe more used to waiting.

They wait months for a hoist that will help lift a disabled husband out of bed. They wait for information and basic training to care for a daughter dying of cancer. They wait for a break from caring 24/7 for elderly parents who live with them.

Words are spoken and strategies published but for too many, the waiting continues.

I don’t think anybody should underestimate the scale of what new Government ministers have to learn and comprehend in a very short space of time. There are also lots of competing priorities to order but next week is Carers Week and it is time for carers to wait no longer.

I met Paul Burstow MP (new Minister for social care) on Monday. He told me that they made a firm pledge to increase access to respite care and they would deliver on it. Carers now need to know how this will be achieved and when.

I also met the new Labour shadow Minister for social care – Barbara Keeley MP. She has consistently campaigned for carers locally and in Parliament and worked on carers’ issues before entering Parliament. I also met her fellow shadow Minister for Health, Diana Johnson MP who has supported local carers and carers’ organisations.

The appointments of Burstow and Keeley are positive but this will not mean that all the policy changes carers need will happen instantly – or at all. But, I do believe we have two people who regularly meet, listen to and understand carers. The election is passed, new ministers are appointed and the waiting must end – it’s time for change.

Take Care,

Gordon

June 11, 2010 Posted by | breaks for carers, Carers Strategy, Conservatives, David Cameron, General Election, Liberal Democrats | , , , , , | 2 Comments

Carers Cannot Suffer Financial Cuts

Carers are already doing their bit

Long summer nights tend to bring out the wistful, romantic in me. What a wonderful world is on repeat in my head and I embellish my mood of serenity.

Then on the 21st/22nd June, the earth begins tilting away from the sun meaning shorter days and longer nights. It seems appropriate that the emergency budget outlining future spending plans will happen on 22nd June. The first day of the darker nights.

Our pre-election demand was that the £256m non-ringfenced grant given to English local authorities to support carers cannot be cut. And this was spared from the £6bn savings for this year announced a couple of weeks ago.

But, the financial cuts experienced by local authorities in other areas means that they will have to pull money from some areas to cover other losses. We are already hearing reports of our local Carers’ Centres and Crossroads Care organisations having funding withdrawn or greatly reduced.

I am wholly convinced that we all should “do our bit” – some of us will pay higher taxes and other programmes may lose out. But, what is clear is that carers are already doing their bit. If you take what little support they get away, they will fall over due to physical and emotional collapse.

And if this was to happen, there would actually be a bigger cost to this country.

Our latest report produces evidence that supporting carers is not only morally right but actually leads to better outcomes for people they are supporting and saves money in the long term. We show that by supporting carers, there will be:

  1. Less hospitalisation of stroke patients saving £3500+ per patient, per annum.
  2. Delayed entry into residential care of person needing care by over 500 day
  3. Improved hospital discharge processes that means freeing up beds

Money has to be saved but government and local authorities must look elsewhere because put simply, this country cannot afford to not support carers.

Take care

Gordon

June 7, 2010 Posted by | Social Care | , , , , , , , | 7 Comments

Consensus on social care? Not yet…

This week we have seen social care everywhere in the news.

Our Chief Exec, Carole Cochrane, attended the much publicised care conference today, called by Secretary of State for Health, Andy Burnham, and attended by Lib Dem Shadow Health Minister, Norman Lamb, but boycotted by Conservative Shadow Health Minister, Andrew Lansley.

With all the major charities represented, the conference sounds like it was a much more sensible and thoughtful discussion than some of the stand up rows the politicians have been having recently.

Andrew Lansley in front of a poster of David Cameron

The Tories have specifically ruled out a compulsory levy

The view of the majority of those represented at the conference is likely to add further fuel to the flames, however, because there appears to have been a consensus that some kind of universal (read: compulsory) insurance system was the best solution, or perhaps the least worst option would be more accurate.

This won’t go down well with the Conservatives who are favouring an opt-in solution and have specifically ruled out a compulsory levy, particularly one that you pay in inheritance tax after you die (the so-called “death tax”).

Neither option is perfect. People don’t really like compulsory systems – most of us keep our fingers crossed that we’ll never need to give or receive care, despite the overwhelming evidence to the contrary. Optional systems give more choice, but are much more expensive to buy into, because the risks are spread across a smaller group.

Our view is that whichever option is chosen (and let’s hope that, whoever wins this argument and the election, we do at least get one of these options in place, however imperfect), most care will continue to be provided by unpaid family carers.

Today’s conference agreed with us that, whichever option is chosen, as well as being able to pay to participate, the unpaid caring that you provide should also count, in lieu of a cash contribution. After all, people who care full time for years simply don’t have the same opportunities to build up income and savings.

It’s time that the political parties stopped focusing all of their energies on criticising each other’s ideas and instead came up with a decent offer to the UK’s six million carers.

Our sources tell us that one of the parties might be going to do just that on Monday…watch this space.

Take care,

Alex

Alex Fox, Director of Policy and Communications at The Princess Royal Trust for Carers, is standing in for Gordon on his blog this week.

Alex has written an article in Society Guardian this week on the “need for a clear emphasis on unpaid carers”.

February 19, 2010 Posted by | General Election | , , , , , , | Leave a comment

Social care must be a priority in the General Election

a road sign that reads "changed priorities ahead".

We must make social care a priority at the ballot box

Devolution in Scotland has caused some in England to look enviously northwards and ask why is it that they’re getting stuff that people in England are not.

I was at a Mark Thomas comedy gig the other night where a radical suggestion was for eye tests to be free, until I pointed out that they already are in Scotland. Then of course, there is ‘free’ personal care in Scotland, which isn’t actually free but people aged 65+ do receive contributions towards nursing/residential care costs or care at home.

What is not reported is that to fund these policies, the Scottish Government has to find savings in other areas – they have to re-order their priorities.

The Lib Dems announced a re-ordering of their priorities this week, which has meant a focus on fair taxes, extra investment in schools and improving transport and energy production. A loser in this re-ordering has been their commitment to provide a Scottish style system of personal care funding, which has been put on hold until it “becomes affordable again”.

The Conservative Party have also made some policy announcements publishing their draft health manifesto (does this mean it could change?) this week:

– £10 million a year funding beyond 2011 to support hospices in their work with children

– preserve disability living allowance and attendance allowance and allow a single budget for individuals combining health and social care funding

– provide separate public health funding to local authorities, which will be accountable for–and paid according to–how successful they are in improving their local communities’ health.

It also included their previously announced social care policy of people paying £8000 on retirement to receive free residential care, but there’s no announcement yet on their domiciliary care policy…

Politics is all about choices; the choices politicians make and the choices the electorate makes. There may be some issues on which you agree with one party, but on a different issue it is another party you agree with. So we have to make a choice about what our priorities are when voting.

Politicians know this so focus on issues that they think voters care about. “It’s the economy, stupid” is meant to illustrate that the economy is the priority for voters. British politicians often believe the NHS is, while Blair and now the Lib Dems think education is a priority for voters.

What is clear is that for social care to be considered a priority by politicians, we must first make it a priority in how we vote. Folks, it is time to consider our priorities.

Take care,

Gordon

PS. There are Parliamentary outreach events on 26th January in Birmingham, Manchester and Norwich advising how people can effectively engage with Parliament, and understand its inner workings. If you’re interested you can find the details here.

January 14, 2010 Posted by | General Election | , , , , | 6 Comments