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You and Yours - Transcript 成人论坛 Radio 4 |
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TX: 14.01.08 - Gordon Brown on Care PRESENTER: PETER WHITE |
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Downloaded from www.bbc.co.uk/radio4 THE ATTACHED TRANSCRIPT WAS TYPED FROM A RECORDING AND NOT COPIED FROM AN ORIGINAL SCRIPT. BECAUSE OF THE RISK OF MISHEARING AND THE DIFFICULTY IN SOME CASES OF IDENTIFYING INDIVIDUAL SPEAKERS, THE 成人论坛 CANNOT VOUCH FOR ITS COMPLETE ACCURACY. WHITE First today the Prime Minister, Gordon Brown, has told You and Yours that for decades carers have been let down in this country and that he is personally overseeing new government policy which could see changes to the controversial carers allowance. His comments come as part of our month long season of features about the state of social care in the UK, You and Yours is launching, in conjunction with the London School of Economics, an online care calculator which includes a care questionnaire, the results of which could help shape government policy. Well Carolyn Atkinson is with me, tell us more about the background to all this. ATKINSON Well Gordon Brown is getting very involved in this issue. It's no big secret that carers are the backbone of the social care system and that's whether they're paid or whether they're unpaid and he is definitely taking a lead on this, not least because he must realise that this is a very big problem and that it's going to get worse not better because we're all living longer and we will need more care. When he was Chancellor Gordon Brown launched a new deal for carers and then when he got the top job he formed a standing commission for carers. Well we caught up with the Prime Minister at a citizens jury on carers, attended by about a hundred people, in Leeds, that was the culmination of months of consultations with carers before the government unveiled its new 10 year national strategy, which is due out in the early summer. BROWN I count it a real privilege to be able to talk about something that really concerns me but to talk about caring and what concerns not just you here but concerns the whole country. And the first thing I want to do is to pay tribute to all the carers in the whole of the United Kingdom. There are six million people who care for relatives or friends or neighbours, there are people caring for people in - with particular conditions that are difficult, that need very specialist care indeed. And everyone of you, who is a carer, is a hero. We've got to be frank - we have not always recognised as we should both the needs of carers and those who are cared for and we have to do better in the future. ATKINSON Also there was the care minister Ivan Lewis, more from him in a moment, and the health secretary Alan Johnson, who not only admitted there should be more joined up thinking between health and social care but he also saw similarities between the pensions crisis and the current precarious state of adult social care provision. JOHNSON When I was at the Department of Work and Pensions we were at the early days of finding a vision for pensions, recognising that we could not continue with the status quo and that we needed a radical rethink and a political consensus around how we move forward. I get a sense of deja vu, it's exactly the same position here with adult social care and I think it's very important that we move forward together and look at radical solutions involving carers and everyone involved in adult social care. ATKINSON Social care funding is often described as one of the biggest unresolved issues of our time and the government has said that care is now one of its top priorities. BROWN I know that when politicians come and have sessions to talk about things there's a tendency to think that we're here, we make a speech and then we go away. I'm genuinely here to listen and we will take into account everything that you say. I'm hoping to come round the tables and talk to all of you so that we can learn from what your experiences are what you have to tell us. Thank you very much. CARER Upping the carers allowance would be the one thing to do because that would make a difference to the carer straightaway. CARER My point is with my daughter she has twin boys and they both have cerebral palsy but she can only claim for one of those children. They're five year old - just turned five now. When they grow out of an ordinary pushchair and they needed a new pushchair and she asked for help I think the government offered her £150 it was but the actual pushchair was costing around £3,000. BROWN Yeah, I'm sorry, yeah, I'm just taking a note of these things so that we can look at them. Any other points? CARER The medical profession - there's a huge need for updating their training. With dementia 50% of cases are not diagnosed and part of the updating is how do you interact with carers. BROWN Yeah so it's really two issues here - diagnosis of conditions and therefore to be able to give the best possible treatment. And the second thing - is there an understanding in the health service of the needs of carers themselves and those who are being cared for. And it's partly respect and recognition for the things that carers are doing and an understanding of the pressures that you're under. CARER ... were telling me before that she would really like to work but she provides informal care for a friend's children and is unable to take on work because she'd be penalised strongly or denied work. CARER I help with my friend's children but I also help with me mum. I've got - so I'm in three families in effect. So I sort of get penalised because I can't go to work full-time but I've got my children in school, school holidays. BROWN If you - if you had more flexible working arrangements it might be better but you are dealing with three different families, so it's very - it's bound to .... CARER [Indistinct words] It's hard. ATKINSON You're taking a very personal interest in carers and the whole strategy obviously which you were behind, just from what you - the conversations you've been having today what's most worrying to you about what carers are saying? BROWN I've taken an interest in this because I've seen in everywhere I go around the country the magnificent contribution that carers make and over a long period of time - over decades - we haven't done enough as a country of course to recognise our carers, to value what they do and to give carers the support that they deserve, not just to be good carers but to have a life sometimes of their own where they can feel that we are supportive and on their side. So we're looking at everything from respite care, which gives carers better opportunities, to training of carers, we're looking at the carers allowance of course itself, we're looking at the particular issues faced by young carers, by elderly carers but particularly people caring for people with dementia. We're looking at the problems of double carers - people who care for both young and old. In fact I've just met someone who you might describe as a triple carer because she's caring for young, old and the children of a neighbour. So what you find as you go round the country is people are in lots of different situations and perhaps the benefits system and all the different services that are on offer have got to recognise first of all that people need services tailored to their needs, more personal, and also recognise the changing nature of the care needs in the country. ATKINSON One of the things they were picking up on was the carers allowance and this feeling that it's unfair, it's low - it's £1.39 an hour, some people are saying, if you do more than 35 hours a week. BROWN Someone was saying to me, one of the groups, the carers allowance is one part of this and you've got to look at the benefit system as a whole as well. And some people are in a difficult position because there is not proper recognition in the benefit system of certain things that they do and therefore it's not simply a review of finance but finance will be part of the review. ATKINSON On Radio 4 we're doing a care season - Care in the UK - and a lot of the information that the listeners are telling us is going to be fed into your national consultation on the future of social care funding. What do you want to hear from our listeners? BROWN Well I welcome the fact that so many people are contributing through the work of the programme and the excellent programmes that you do. I also think it's really important we hear the whole range of concerns that people have. From your listeners I think we will hear information that will influence what we do because we've got to take into account not just the situation as it is at the moment but what people think is going to happen in a few years time when there are more elderly people, when people's aspirations are rightly higher, when people have a greater desire to live in their own homes and not in institutional care and therefore we've got to have a system again that is more personal and responsive. ATKINSON Tracey Brady, you've been in this meeting today and the Prime Minister was listening to what you're saying and we heard you earlier talking about your particular issues. We've just spoken to the Prime Minister and he's picked up on what you've said, how does that make you feel? BRADY Good that he's listening and to think that he's singled out something I've said, you know you're thinking I'm just one of these little people, it won't be just me that are looking after three or four - we'll just have to see if they do come through. WHITE Tracey Brady in Leeds ending Carolyn's report. Well today on You and Yours we're launching an online device called a care calculator, together with a care questionnaire. The results of this could influence this government policy that we've been hearing about. There's also a care map. It's been developed by the London School of Economics and two of the leading experts on social care policy - Professor Martin Knapp and Dr Jose Luis Fernandez are with us, we'll talk to them in a moment. But first Carolyn took the opportunity to show Ivan Lewis how the calculator works. ATKINSON Ivan Lewis, care minister, you're trying the care calculator, you're on step four and you have to choose one of the follow imaginary situations to discover how much care people might get on average in England at the moment. So which what one are you going for? LEWIS Okay I'm going to go to the one which says that the person's been diagnosed with early onset Alzheimer's Disease. ATKINSON And then you choose an age. LEWIS And let's choose you do own your own home. Age - let's say - let's say 65. ATKINSON Okay, so now we're scrolling through and we're going to get the answer. LEWIS In terms of home care, less than 5% of people would receive home care support, that percentage would receive two to eight hours of support per week. And it's unlikely that the local authority will provide financial support because the person has savings over £21,000. ATKINSON And so what's your reaction to that - are you surprised or is that about what you would expect? LEWIS I'm not surprised because in a sense we know that this is one of the consequences of the means tested system. ATKINSON Now the care calculator is aimed at people who perhaps know nothing about the social care system altogether, what's your sort of - you've only just seen it for a few seconds - what's your view on it? LEWIS Well I think the care calculator's excellent, I think it'll raise awareness and it will make aware. I mean I think one of the difficulties is that most people understand that the NHS is free at the point of use, irrespective of ability to pay. But very many people don't realise that the social care system has always been means tested. So I think the care calculator will help people to understand that, think through the consequences to think about the caring circumstances they may find themselves in. WHITE So thumbs up from the care minister for the care calculator. Professor Martin Knapp, if I can come to you first, you're going to be looking at the results of what you get from the calculator, just explain what it does and why it's so important? KNAPP Well as the minister just said it gives you an opportunity to try out what - to find out what the current system offers to people in terms of the services they might get and what they might be expected to pay for those services. There are a range of different options - hypothetical options - Ivan Lewis chose the option somebody with early onset Alzheimer's and there are others - somebody with a diagnosis of breast cancer, with motor neurone disease and so on. So you can choose one of those options as an illustration and then the care calculator will ask you to say what your personal circumstances are - your age, your living circumstances, your income, your savings, do you own your own home - because those factors, those characteristics, will determine what you'll be expected to pay under the current arrangements. And then you click on the next page and that will then tell you what somebody with those circumstances would currently be receiving, in terms of services, not in terms of entitlements but a description of what is currently happening. WHITE Right, because that's important isn't it about entitlements because I mean this is so difficult - individual cases are different, longevity is difficult to gauge, you don't know what illnesses people are going to get. So in a way this is to give you a marker really. KNAPP Yes, I mean national policy sets the framework but local authorities have a huge role to play in deciding what gets delivered and what is funded locally and then individual people will also have their preferences for what they would want to receive. So it's a negotiation between those different elements. WHITE Dr Fernandez, you did the data - the number crunching - I think, what did you feed in? FERNANDEZ Well what we needed was information which linked people's circumstances, both in terms of the levels of dependency problems, needs that they might have and their levels of resources to the levels of support that they might be receiving. And so what we did was collect information from general surveys about the general population, such as the general household survey, or the family resources survey. We also used models that have been developed by colleagues at the London School of Economics looking at the likely cost in the future of social care services. And then that gave us an idea of the picture out there, of who is that is receiving services, how many services they are receiving. WHITE And we are talking about England aren't we, we need to make it clear that it only covers England because that's where the information is. FERNANDEZ Absolutely. The data that we were able to gather relates to England and therefore our results are representative for the general picture in England. WHITE Can I put to Professor Knapp because there's another important - there is the map as well, isn't there, and there's quite a lot of geographical variation in what happens around the place. What's the significance of the map? KNAPP Well the map on the website will give you links to local services, so I clicked on Kent where I live and it will tell you about the Centre for Independent Living, about direct payments which are money that individuals can get to buy their own services and the social services contact directly. So I think it gives you an opportunity to then see what the further sources of information are in each of the localities across the UK. WHITE Right. Dr Fernandez how easy is it to use, particularly for those who don't regard themselves as kind of whizz kids as far as computers and working online is concerned? FERNANDEZ Well hopefully this would be very easy to use and that was part of the idea. I think there is a lot of misconceptions about social care and what this is trying to do is to provide an easy and simplified, to some extent, picture of what's happening out there. And the tool, in a sense, reflects that aim and is as simple as we could make it. WHITE Can we just, Martin Knapp, ask about the third element, which is the questionnaire, the care questionnaire, what will that basically give you - what information - and what will you get? KNAPP Well we are researchers, we love data, we love information and what we've asked people to do is to fill in a questionnaire, after they've gone to the care calculator and just understood what people are currently getting, we're asking people what they think about that and in particular what they think about the future financing of social care. And as you heard earlier in the programme from the Prime Minister and the two ministers there's a lot of discussion now about the future funding of long term care for older people and disabled people. WHITE Well we will watch its progress with great interest. Professor Martin Knapp and Dr Jose Luis Fernandez thank you both very much indeed. You can find these live on the Care in the UK website, you can also find more details on our social care season and download podcasts of this and every other item throughout the month and don't forget the message boards are there to hopefully stimulate discussion as well. 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