Dr Neil Shastri-Hurst

It is always a pleasure to serve under your chairmanship, Mrs Barker. I congratulate the hon. Member for Mid Sussex (Alison Bennett) on securing the debate and all hon. and right hon. Members on their very thoughtful and, at times, moving contributions. As we heard during the debate, across the United Kingdom 5.8 million people provide unpaid care. Those carers collect prescriptions, organise appointments and help with all aspects of personal care, and many do so either before or after they have done a full working day. For millions of families up and down the country, this has become part and parcel of ordinary life, but we should never underestimate the toll it takes over time. Of those 5.8 million carers, 1.7 million provide at least 50 hours of care each week—more than a full-time working week—and they often do it alongside employment or while raising a family or managing their own personal health needs. Of course, caring responsibilities rarely fit neatly within the timetable that defines our normal week. Likewise, the way that care, and the need for it, presents itself is often varied and complex. For some, it can come with little forewarning; they may need it after a sudden accident, such as a catastrophic spinal injury. For others, it comes much more incrementally, over a period of time: needing help with shopping becomes needing help with medication, or an occasional visit becomes a daily necessity. Eventually, it can feel as though it is becoming all consuming. Clearly, individuals must adapt because someone they love needs that help. However, our services must adapt, too. Too often we assume rather than asking whether the person who is undertaking the care is able to manage, and whether they have been shown what to do or how to use the necessary equipment and so forth. It is worth remembering that a relative’s presence is not in itself a care plan, and nor should their willingness to help be taken as proof that they do not need any support themselves. We have heard a plethora of examples of what happens when those questions are ignored. One can only imagine the frustration encountered by so many carers who are forced to describe their circumstances, often repeatedly, only for nothing to happen. That risks leaving the carer carrying entirely the same burden and responsibility as they had beforehand, but with less confidence that if they ask in the future it will make an iota of difference, and consequently, potentially, with declining physical and mental wellbeing. Others are forced to cut back on essentials just to make ends meet. These individuals deserve a clear plan from the Government. Carers frequently find themselves putting the needs of those they care for above their own. As we have heard, employment can become more challenging, which often leads people to reduce their hours in order to make caring manageable, which of course has a knock-on impact on their income. Some are ultimately forced to leave work, which brings further financial pressures and often makes returning to the workplace much harder. As a society, we should be helping people preserve their working life wherever possible. Work provides not only financial freedom, but an environment where carers are recognised for achievements beyond their incredibly commendable responsibilities as carers. We must remember, too, that many older carers are managing their own fragility, and that younger carers are often in education and their own childhoods can be affected. Support must reflect people’s different circumstances rather than assuming that every family can manage in entirely the same way. Alan Milburn’s interim review identified around 300,000 informal carers aged between 16 and 24. It described young carers as “one of the least visible groups in the NEET conversation and one of the most systematically miscounted.” A young person who misses college, declines an apprenticeship interview or struggles to attend a job or university may be managing responsibilities that somebody has simply not asked about. In those circumstances, it cannot be right that their commitment to a loved one should cost them opportunities. The previous Conservative Government took action through the 2018 carers action plan, the carers innovation fund and support for statutory carer’s leave. I welcome this Government’s publication of the unpaid carers action plan in July. The task now is to ensure that those commitments actually reach the people the plan is intended to help. With that in mind, I have three specific questions for the Minister. First, with NHS England to be abolished by April 2027, who will have ownership of the actions in the unpaid carers plan thereafter? Secondly, NHS England currently has powers to support service integration between local authorities and the NHS and for the functions of the better care fund, a major source of funding and resourcing for unpaid carers. The BCF in its current form requires the NHS and local authorities to pool budgets for the purpose of service integration, as there is a requirement to use section 75 agreements. That means that to pool budgets, the BCF must involve local authorities. The impact assessment for the Health Bill sets out that, following the abolition of NHS England, that function will be conferred on the Secretary of State. In addition, what is currently a mandatory requirement on the use of section 75 will change to a discretionary power. In short, the Secretary of State will retain the power to require pooled budgets should they wish, but that will not be the default position, as is currently the case. Does the Minister share the concerns of carers’ charities that this change may lead to significant cuts for schemes that support unpaid carers? Thirdly, the Prime Minister set out in his conference speech the bare bones of a plan for a national care service. The Government have of course proposed to fund that through reforms to the triple lock. However, those reforms will, self-evidently, not be sufficient to fund and deliver such a service. Notwithstanding the statement in the main Chamber earlier today, the details of the funding still appear to be somewhat lacking. Much more detail of what the Government are proposing is needed. Do the Government intend to set out further details of how the national care service will be funded, and will the Minister rule out increased borrowing or tax rises to fund it? The Conservatives look forward to working constructively on this issue. It is an important issue that we all face in our inbox every day, but for too long, across the political spectrum, we have kicked it down the track and not got a grip of it. In that spirit, we look forward to the ongoing cross-party talks on the issue. Ultimately, the marker of success must be whether carers can obtain the help that they need, are able to access respite breaks when they need them, and can look after their own health and wellbeing at the same time. That of course requires proper policy consideration, not just headline announcements, and I hope the Minister is able to provide greater clarity on that front today.