The Games are nearly over and the politics begin – but who are carers’ parliamentary champions now?
The sun may be shining but make no mistake – the summer is over. This week saw the expected Cabinet shuffle. No surprise to anyone really that Andrew Lansley moved on – his bruising over the Health and Social Care Act meant his time had come. We were taking bets in the office on who his successor might be, but no-one predicted the outcome . Jeremy Hunt, I’m sure he would admit himself, has not at any time in his career been notably visible at the helm of campaigns to improve either health or care.
He has been brought in to persuade us all that the health reforms are all good and will work a treat. Where I am sitting, what I see now is local health professionals and managers, as well as carers, patients and the organisations which support them, entirely unclear how large chunks of this is going to work. Carers Trust and carers’ organisations have spent years working with PCTs so that they begin to understand carers and the kind of support needed, and much of that may now be lost in the transition from one set of decision makers to another. Or alternatively, we may find that little changes except logos, offices and headed paper, with the huge superstructure of the NHS Commissioning Board providing even more bureaucracy than was there before.
So a tall order indeed. Good luck, Mr Hunt. I think you may need it.
In other reshuffle news, here in carer policy land we’re all a bit sad to see Paul Burstow return to the back benches . He was of course, fully involved with the health reforms I’ve just spent half a blog criticising, so he too will have to reflect in five years’ time whether it was all worth it. However what you can say is that no Health Minister, probably ever, has pushed carers’ issues as far as he has in terms of recognition. We now have a draft Care and Support Bill with carers written all over it – not perfect, but you can’t miss the carer theme. He personally took the initiative to put pressure on PCTs to spend money on carers and was supportive of Carers Trust and our campaigns on this. It hasn’t solved everything, and it was never going to in such a short time, but it has made an impact. We’ll miss his role as government champion for carers. I hope Norman Lamb will take a leaf out of his book, in this respect at least.
And finally, today we have the second reading debate on the Social Care (Local Sufficiency) and Identification of Carers Bill. Barbara Keeley MP – an incredible advocate for carers – has used her Private Members Bill slot to promote the ways in which carers can be supported and increase the duties on a range of organisations to identify carers. Watch this space for an update on the debate early next week. Good luck Barbara, and thank you – we’re all behind you.
The Government has made an immediate response to our ‘NHS Not Making the Break for Carers’ report by prioritising carers in the NHS Operating Framework for 2012/13. The Operating Framework is the set of requests given to the NHS by the Department of Health every year, guiding their priorities.
Following our report, the Government has said that carers is one of only three areas that have been designated as requiring “particular attention”. Think of all the illnesses, diseases, long-term conditions and medical issues the NHS is concerned with, and then consider what it means that carers are up there as the most important priority.
Of course, the reason that the NHS needs to pay “particular attention” is because they have not been doing enough to support carers, despite additional money and Government requests to do so. This Operating Framework is a sign that Health Ministers Paul Burstow and Andrew Lansley are losing their patience having been quite clear what they expected from the NHS in terms of supporting carers.
What they didn’t expect was that most Primary Care Trusts (PCTs – local NHS bodies) would not publish plans and budgets to support carers despite being asked to; and that some would continue not to invest a single pound in services to support carers, despite receiving additional money for this.
So for 2012/13, PCTs need to agree plans and budgets with local authorities and local carers’ charities. These plans should identify how much of the total is being spent on breaks and indicate the number of breaks that should be available from that funding. Importantly, PCTs have to publish these details on their websites by 30th September 2012 at the latest.
But we can’t wait until then to act. Carers and carers’ charities need to be contacting their local PCT now to find out how they will be improving on what they were doing this year. PCTs by ranking in terms of spending on services for carers and ask the non-Executive Directors of your PCT what they will do to improve that.
The NHS has a duty to those people who have often sacrificed so much to care for people, and they also have a duty of care to their patients who are otherwise being cared for by their friends and family. Our message should echo that of the Government’s; the NHS can no longer avoid their duty to carers.
You cannot change the quality of care in this country without respecting carers and improving the support they receive. This was the simple message delivered to the three political parties at yesterday’s conference on carers. The response we were seeking was what each party would pledge to do for carers in the next Parliament…
Care Services Minister Phil Hope focussed more on what the Government had done in this Parliament to increase support for carers, and there have been improvements: £25m training and employment support for carers; recent £1m investment in young carers’ services; new credit scheme to help carers build up pensions; and a national helpline and website for carers.
But the big moment came when he put himself on the line in response to our report “No Breaks for Carers” on PCTs not supporting carers – “I will personally hold PCTs to account for the carers’ money they will receive but do not spend on carers and will keep going until they do spend the money on carers” (read the full story here).
It’s not often that politicians make a personal pledge like this. Eyes darted around the room to see reactions.
Shadow Health Minister Stephen O’Brien did not give detail but pinpointed two issues that he wants to tackle: carers losing Carer’s Allowance when earning over £100p/w and when they begin receiving a State Pension. O’Brien restated that the Conservatives would retain Attendance Allowance and Disability Living Allowance and that indeed his parent’s in law rely on AA. He also said that the Conservatives would announce a policy to improve care in the home to accompany their residential care policy, and that they wanted to extend flexible working for carers.
Liberal Democrat Chief Whip Paul Burstow expanded on his party’s pledge to commit £500m p/a to carers. Carers would be able to receive a personal budget, for example of £510, and could choose what to spend it on. Lib Dems would act upon the Work & Pensions Commons Select Committee report (August 2008) which recommended increasing Carer’s Allowance.
Burstow also agreed with a carer who spoke later that carers must be a higher priority for the NHS – not a Tier 3 lowest priority giving the NHS the option to support carers or not; carers have to be a “must do” for the NHS. He finished by praising his local Sutton Carers’ Centre which he said had “educated him” about wide range of carers’ needs and issues.
Two carers spoke and gave their recommendations which included making GPs improve their identification of carers, and the RCGP representative agreed they would continue to raise the profile of carers amongst GPs. Tory MP carers campaigner in Parliament, Tony Baldry, suggested that a voluntary register of carers would prompt all professionals to ask if people had caring roles and then people could have an annual review to ensure they were receiving support.
What found universal agreement was an approach that saw everybody in health and social care informing, advising and supporting carers as part of their role. This responsibility cannot be passed to a few appointed individuals within organisations or there will still be too many carers ignored, isolated and in danger of failing health themselves.
We presented questions from carers, including a one asking the MPs if they would like to be a carer for the day. The MPs declined, which goes to show how much harder we have to work to improve the lives of carers.