Unpaid Carers

Question

Asked by

To ask His Majesty’s Government whether they are taking steps to ensure the NHS gives more support to unpaid carers.

My Lords, we recognise the vital contribution of unpaid carers and are committed to improving support through the NHS and social care. The 10-year health plan sets out how we will systematically capture data on unpaid carers, ensuring recognition and support and involving them in care planning. The plan commits to introducing a My Carer feature on the NHS app, enabling carers to manage appointments and engage with clinical teams, improving experience for carers and for those they support.

I thank my noble friend for that Answer. It is indeed good news that the 10-year plan is considering the needs of carers, but the latest survey from Carers UK shows that carers’ rights are being ignored when the person they care for is discharged from hospital. Only 14% of the carers surveyed were asked about their ability to provide care after discharge—and those rights, as some in this House will remember, were hard won for carers. Ignoring carers’ rights in this way is not only against the law but very short sighted: if carers really break down and cannot provide care, it results in the readmission of the person they look after.

I thank my noble friend for her long-standing commitment to the cause of unpaid carers and for contributing to strengthening their rights under the Health and Care Act 2022. I reassure her and the House that the Government recognise the concerns raised in the recent Carers UK report. The Hospital Discharge and Community Support Guidance states that NHS bodies and local authorities have a duty to involve parents and carers, including young carers, at the earliest opportunity in discharge planning for adults who are likely to need care and support. The Care Quality Commission is assessing local authority performance against the Care Act 2014. If the CQC identifies that a local authority has failed or is failing to involve carers in discharge planning, the Secretary of State can intervene.

My Lords, I was told in a discussion with a carer coping with the day-by-day, hour-by-hour demands of looking after someone with severe dementia that when they got a hospital appointment, the doctor spent a great deal of time looking at the screen and firing off questions to the patient. Frankly, the patient did not recognise where she was, and when the carer intervened to help, they were made to feel that their only job was to act as chauffeur to get the patient to hospital. Surely the time has come to recognise the tremendous contribution of unpaid carers in our society, and to support them, value them and help them to feel valued.

The noble Lord, as always, goes right to the heart of the issue. I reassure him that, through the 10-year plan, all the issues that he has raised are recognised. Through all the aspects, enhancing the position of carers is paramount. It cannot be right to have the situation he outlined whereby the carer’s wishes, understanding and insights are not taken seriously. The golden thread running through all the planned improvements is that the rights of carers will be recognised. Through the My Carer app, for example, no medical professional can have any excuse for not recognising the vital role that they play.

My Lords, there are over 1 million young carers in this country, many of whom are still at school. There are 15,000 school- children giving care for more than 50 hours a week, 3,000 of whom are aged between just five and nine. They are most at risk of missing school and being suspended, and at the moment, it takes three years on average before they are identified and given support. What can the Government do through primary care and children’s services to identify those children earlier and give them a better start in life?

The noble Lord’s point is well made. There is nothing more heartbreaking than when a school does not know that a child is a young carer and makes them stay for detention, for example, because they were late on account of their caring responsibilities. It cannot continue, and I am pleased to inform the House that this issue is being taken very seriously. It is crucial that young carers are known, but, most importantly, that all the relevant agencies work together at a local level to share their knowledge of the young person, very much along the lines of the family group conferencing model that is working so well in children’s social care. It is a huge issue. Many young carers, as we know, do not want to divulge that they are indeed carers because they are worried that it might result in the family being split up. There is a lot of work to do in raising confidence, but everyone working together is the way forward.

In the recent survey by Carers UK, which has already been referred to, some 51% of unpaid carers said that they need more support from the NHS—a figure that has risen in recent years. Under the Care Act 2014, it is the responsibility of local authorities to provide an assessment of carers’ needs. Can the Minister therefore say what proportion of unpaid carers have received such an assessment, what sort of support they have received and what has happened to expenditure on unpaid carer support in the last three years? If she does not have those figures to hand, can she write to me?

I thank the noble Baroness. I do not have the precise figures to hand, but the more work we do in this area, the more we are exposing what needs to be done. The fact is that the confidence of carers is quite low, and we need to make sure that all the support comes together to wrap around them. All the evidence that is gathered by the different agencies on the ground is exceptionally welcome and will inform the routes forward. I will get the precise information she has asked for to her after this discussion.

My Lords, we all know that being an unpaid carer is a profoundly challenging role that can take a serious toll on people’s physical and emotional health as they care for someone else—often, a relative, as we heard from my noble friend, or a young person. They are selfless individuals who put their own needs last. Can the Minister set out what steps the Government are taking to ensure that carers are made aware of their rights, as alluded to by the noble Baroness, Lady Pitkeathley, and the existence of the support available to them, so that it can be accessed easily? This is perhaps a question for a written reply, but have the Government given any thought to the challenge set out in the amendments to the Renters Rights’ Bill concerning access to accommodation for carers supporting a landlord or their family?

The noble Lord highlights a crucial point. We are saying all the way through that there needs to be greater coming together at a local level. NHS England is taking this exceptionally seriously, working with local authorities, GPs and ICBs, for example, to make sure that they come together. One of the most important aspects of its work—for example, the conference it is setting up—is that the voices of carers themselves are heard, that the incredible importance of their experience is recognised, and that no assumptions are made about what should be done on their behalf. It is critical that they are at the centre of all the work going forward. I will indeed write to the noble Lord on his last point.

My Lords, many of the children and other young carers, referred to in a previous question, depend on charities. Are the Government content that the balance is right between what the state offers and charitable support?

The right reverend Prelate raises a very good point. These issues are at the centre of all the discussions that are going forward to make sure we get the right balance, that everyone who has a say gets an opportunity to be heard, and that we get a much better package of support for all the unpaid carers who need it.

My Lords, does my noble friend accept that the current value of the carer’s allowance does not reflect the extraordinary value of unpaid carers’ work? Does she therefore support an urgent review of the allowance in the social care review of the noble Baroness, Lady Casey?

The noble Baroness, Lady Casey, has already started the work, and I am delighted to inform the House that one of the first meetings she had involved carers. She has opened a portal so that information can be fed in, and I know this will be one of the areas that raises a lot of interest and concern.