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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

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

Crunch time for MPs to commit to carers

HRH The Princess Royal and Care Services Minister Phil Hope

HRH THe Princess Royal joined MPs from the three main parties at the roundtable event

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

Under Lib Dem plans carers would be able to receive a personal budget and choose what to spend it on

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.

Take care,

Gordon

March 10, 2010 Posted by | Building Society to Care roundtable | , , , , , | 3 Comments

NHS Operating Framework fails even to mention Carers Strategy: Time for Plan B

It’s never easy judging success, just witness the surprising winner of this year’s BBC Sports Personality of the Year Award. Now-a-days, it’s not what you put in or maybe even the way you do it, it’s the result that matters. And you cannot hide from results.

This year, the focus of my work has been trying to lobby Government regarding Primary Care Trusts’ (PCTs) use of the £50m allocated to provide breaks for carers. The desired outcome was to make the NHS Operating Framework for 2010/11 more explicit in its guidance to PCTs regarding supporting carers. This was our goal.

plan b in fridge magnet letters

Carers cannot afford to be the loser again

To do this, we thought we needed to show that PCTs are not using the money as intended. So, we asked the local carers’ organisations of The Princess Royal Trust for Carers and Crossroads Care networks to tell us what was happening in their local area. It was clear there was confusion and sometimes a denial about the money and thus support for carers was not being increased.

We told Government, but they did not seem convinced…

So we asked our local networks to get their PCT to fill in a questionnaire giving financial details. Responses were not forthcoming so we then decided to submit the questionnaire under the Freedom of Information Act. During Carers Week, MPs questioned Government using our information and we wrote to the Chief Executive of the NHS, but both remained unmoved.

In September, we got widespread media coverage of our preliminary results showing PCTs were not using the money to increase support for carers. Then at the Party Conference, we spoke to Andy Burnham who said he wanted to speak when he got back from Conference.

While waiting, we published our report showing that only 23% of the £50m was used to increase support for carers. National TV, radio, newspapers and websites covered the story and it was the focus of a Health debate in the House of Commons.

Surely, they would listen now?

The meeting with Phil Hope was encouraging and two days before the Framework would be published, Burnham in a Commons debate said he was considering strengthening the Framework in relation to carers. The day it was due, I was glued to the Department of Health website. It popped up and I stuck “carers” into the search.

I was gutted and colleagues couldn’t believe it.

The Operating Framework does not even mention the Carers Strategy or that an allocation has been given to provide breaks. In my eyes, and those of others, it is not more explicit than last year’s. That was our goal and it is results that matter. We have a responsibility and in this we failed. I am sorry…

So now plan B. We will lobby commissioners, Strategic Health Authorities, Oversight & Scrutiny Committees, the Care Quality Commission, local authorities – anybody who will help us persuade PCTs to increase support for carers. The desired result? More than 23% of this year’s £100m is used to increase support for carers. Carers cannot afford to be the loser again.

Take care

Gordon

December 23, 2009 Posted by | Health | , , , , , | 1 Comment

Big Care Debate = Big Government Confusion

By nature, I’m an optimistic kind of person that likes to believe the best in people. Sometimes, it works out for the best, but you can also be left shaking your head in disbelief. Which is what I’m doing regarding disability benefits and the Green Paper. To the many carers who have commented on this, I apologise.

The links below show that the Secretary of State and a Minister in the Lords appeared to be avoiding ruling out rolling a number of benefits into social care budgets. This is despite Phil Hope MP and senior civil servants telling people (including me) directly that it was only Attendance Allowance that was being considered.

Now, they may only be seriously considering AA, but mixed messages on such a sensitive subject are alarming. They give the impression of a power struggle between government departments. They are a huge distraction from what should be a once in a generation chance to transform social care.

Arguably, the government should have separated out discussion about benefits from the Green Paper, to avoid the rest of the proposals (some of which we think are really good) getting lost. But now that benefits are included, ministers should be crystal clear about the scope of the discussion they want to have. The Green Paper seems to say it’s just AA being considered. If they are really thinking about rolling DLA and even Carers Allowance into social services budgets as well, we need to know. They can rest assured that carers will not be shy about giving their opinions on that.

www.theyworkforyou.com/debates

www.theyworkforyou.com/lords

Take care,

Gordon

PS. You can now read Phil Hope’s responses to carers from our online Q&A

October 16, 2009 Posted by | Social Care | , , , , | 6 Comments

The Labour Conference and the Big Care Debate

The final Labour Conference before the election; would the tone be going out with all guns blazing a la Butch Cassidy and the Sundance Kid or one mired by infighting and every man for himself? In the ornate lobby of The Grand Hotel, it felt more like the Titanic with people denying the reality of a sinking ship.

At a meeting with Labour Ministers Phil Hope, Gillian Merron and Mike O’Brien, we were asked to imagine a world in which we had to deal with a Conservative Government. The Tories would listen and respond to us less we were told.

Phil Hope and Andy Burnham (Minister for Care Services & Secretary of State for Health) also spoke at a Big Care Debate event where it was repeated again that moving finances for Disability Living Allowance into social care budgets will not happen. However, it is clear that because of the ambiguity (see previous blog) in the Green Paper, the Big Care Debate has turned into a series of denials on a single part of the proposals.

Actual debate on other issues does not seem to be widespread, which is harming the chances of changing the social care system for the better. Millions of lives are affected by our social care system and millions more will be, but we as a general population are not engaging with this debate. Is it because we do not care, or is it because of a lack of knowledge?

I accept that whole family assessments does not make sexy news, but for families with multiple care needs this could be key to getting the support that is best for everybody and not just an individual (Phil Hope was very interested in this idea by the way). Perhaps most people have not considered whether there should be a single national assessment process or variable local ones, but surely this is highly relevant in a world where people move around more. Some may not know that you have to pay for social care and others may believe that they will never need it, but we should still be debating whether we should all pay regardless of whether we use social care or not.

Labour say the Tories won’t listen, but what are they meant to be listening to? I guess that is up to us all.

One thing we do want Labour to listen to is that PCTs are not using the £50m allocated to provide breaks for carers for that purpose. This is partly because of a lack of information given to PCTs by the Government. Secretary of State for Health Andy Burnham has said that he will listen and we are to set something up after the conference. However, listening is only one part, we want action. You can help by signing the carers breaks petition

Take Care

Gordon

September 28, 2009 Posted by | Labour, Party Conferences | , , , , , | 8 Comments

Disability benefits: Where does the Care and Support Green Paper stand?

So going back to the meeting that I was discussing in my previous blog, I will expand on what they were saying about moving the finance that funds disability benefits into the budget that funds social care.

Phil Hope wanted to be clear that it was only Attendance Allowance (AA) and not Disability Living Allowance (DLA) that was included in the proposal, and seemed a little mystified that people may have thought otherwise.

Of course, the reason why was that the Green Paper was not explicit (my italics below):

“We think we should consider integrating some elements of disability benefits, for example Attendance Allowance, to create a new offer for individuals with care and support needs.” (p 15)

“There might be a case for integrating some disability benefits such as Attendance Allowance into the care and support system.” (p 103)

It was explained that the reasoning for this proposal is related to resources. Attendance Allowance is a non-means tested benefit meaning rich and poor get it alike and their proposal is to use the money that funds Attendance Allowance to target social care support for those of less means. It is what they described as a “trade-off” (see previous blog, I fear this term could become ubiquitous jargon) where some lose and others win; a universal cash benefit is lost to enable greater free social care support for those eligible.

A colleague asked whether all of the money used to fund AA would be transferred to social care budgets, or whether a saving would be made by only transferring some of it. The reply was that all of the money would be transferred.

There appears two main objections: Firstly, at the same time as the Government says it wants to give individuals more choice and control, they take away a cash benefit free to use as the individual thinks best so that government/local authorities can disburse as a personal budget or direct service. So does this restrict individual choice and control?

Secondly, the Green Paper says that while people currently receiving AA will continue to receive the same level of support after any change, the same could not be said for those after the change who would have been eligible for AA. This is clearly linked to the “trade-off” described above.

Our briefing contains more details on this and there is a survey as well. There are also discussion forums running on this and other Green Paper issues.

Take Care, and in the spirit of my last blog’s sign off, Take Part

Gordon

September 11, 2009 Posted by | Social Care | , , , , | 11 Comments

Social care reform must value carers contribution

If you hear me saying “I’m going green” you may think I have fallen in line with my girlfriend’s environmental leanings. However, until the Government’s consultation ends on 13th November, it means that I’m off to a meeting about the Green Paper on reforming social care. Today was my first “going green” day.

Minister for Care Services, Phil Hope and Director General of Social Care, David Behan led a meeting to discuss the various proposals in the Green Paper. After a brief summary of the Green Paper they asked for questions. I am usually polite and don’t make a Usain Bolt like dash for the microphone but in this instance it was within arms reach so how could I not?

On page 114 of the Green Paper, it is suggested that in a Comprehensive Model, where everybody aged 65+ has to make a financial contribution, couples could be asked to pay less. The Green Paper gives two reasons for this:

• The costs to a couple having to use savings to pay two contributions could be very high
• Couples often provide mutual care and support, therefore saving the social care system money

I am not convinced by the first reason given that it is increasingly common for both adults to be working, but I do see the logic of the second. It is fair that we value in-kind contributions that carers give to the system by reducing the financial contribution we ask them to pay.

My question was whether they would be prepared to extend the proposal to all carers as there are lots of carers who are not caring for a partner but should be equally valued. It would appear strange if only carers with a romantic interest would qualify, although it might hasten the return of Blind Date to help match people up.

Their answer was that if this was a case that the carers’ movement wanted to make, then we should make it and the Department of Health would listen. There are various issues within the Green Paper that will affect us all but this is one of the only issues that is specific to carers and it demands our attention.

Carers provide the majority of care and support, and without them the social care system would collapse. These in-kind contributions are as important to the future sustainability of social care as any model of raising extra funding for it is. And it should be treated as such. What carers give should be valued by the State giving something back in return. It is fair, it is right and we should make sure that the Government, Parliament, councillors and even the man down the road know this.

However, we cannot win the argument alone. For carers to pay less, others will have to pay more and it is their support that we need. We need them to accept that this is a fair “trade-off” (a new Dept of Health buzzword going by today) and support our campaign on this. We have a briefing on this issue and will be running a poll on it later this month. Please take part in it and encourage others to do so. If we’re going green, then it’s time to move.

Take care, and take action

Gordon

PS. Despite my clarion call to support Queens Park (aka The Spiders) last week, they unfortunately fell to a 1-0 defeat to Berwick Rangers at the weekend. 519 hardy fans paid money to watch it.

September 3, 2009 Posted by | Care and Support Green Paper | , , | 18 Comments

Carers Question Time

Well we certainly stretched Carers Week out as much as possible. The first event (Thames Walk) was before it even started and the last media interview took place at 11pm last night. The lucky person who got to stay up late on a Sunday night for the Five Live interview was my esteemed colleague Danni Manzi. Danni heads the development of young carers support work in England and Wales for The Princess Royal Trust for Carers.

I’m going to have to take some tips from Danni who managed to remember our website address and telephone number during the interview, which was something that I failed to do with Quay Radio (Portsmouth) last Thursday.

Last Thursday was a busy one with me attending a question time type event at our Southwark Carers’ Centre. I do fear these events in case everybody realises that the carers in the audience know more than me sitting on the panel. Thankfully, I wasn’t heckled or booed and the event showed how poor the level of discourse on the real Question Time can be.

Two fellow panellists were councillors who admitted to me beforehand that had learnt so much in preparation for the event. This honesty meant that they actually listened and even agreed to meet with carers to discuss how carers’ policies could be included in their local party manifesto for council elections. Genuine working together can hopefully bring greater understanding of the pressure on both sides.

Sadly, this will have to be done without Allan Johnstone, who was enjoying his last day as Chief Executive of the centre. He will be missed but will still be working to support carers – so all is not lost. Centre managers often put huge amounts of their lives into supporting carers and I am generally in awe of what they manage to do on a shoestring.

Doing this did mean that I missed the short debate on carers in the House of Commons. However, I did manage to read the debate online.

It was good to see that Dr Andrew Murrison spoke. He was one of the MPs who dropped in to our information service last week who had never previously been involved. 

There was much focus on Primary Care Trusts (PCTs) not providing breaks for carers, which I’ve mentioned in earlier blogs. MPs Paul Burstow, Greg Mulholland and Stephen O’Brien all asked Phil Hope MP (Minister for Care Services) how the Government was tracking whether PCTs were spending the £50m given to them (£100m next year) to provide breaks for carers. Mr Hope didn’t give the wholly truthful answer of “we’re not” but chose to absolve himself of responsibility instead placing it on MPs and carers themselves:

“Part of his responsibilities as a local MP, along with those of carers, might be to ensure that the local primary care trust understands the needs of carers, does the job that it should be doing to assess people’s needs and ensures that it allocates from its budget the money that the Government have allocated to it to support carers in the area.”

I would love to find out how much Northamptonshire NHS, which covers Phil Hope’s constituency, is spending on carers.

The truth is the Ministers gave the money then washed their hands of it. Little guidance was given to PCTs and PCTs were not even told how much of the £50m each was receiving. We have been gathering information over recent months and the feedback shows that only four out of the 70 PCTs we have information on are spending all of their allocation (we worked these out) on carers’ services. The majority do not seem to be spending any of it on carers.

Anne McGuire MP also asked the Government to consider not defining Carer’s Allowance as an income replacement benefit, which would allow a carer to receive a State Pension and a Carer’s Allowance at the same time. Many carers dream of such a scenario.

Young carers also received some focus and the debate does show that there are MPs who care. However, if a new speaker does reform anything, it should be making MPs answer the questions put to them in Parliament. It’s a shame that local councillors find it easier to be open and honest than national Parliamentarians do.

Take care,

Gordon

June 15, 2009 Posted by | Carers Week 2009 | , , , | Leave a comment