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Plenary, 25 Nov 1999

25 Nov 1999 · S1 · Plenary

Item of business

Carers Strategy

Simpson, Dr Richard Lab Ochil Watch on SPTV

I must begin by declaring that I still act as a medical adviser to foster carers in the former Central Region, now Falkirk, Stirling and Clackmannanshire.

There is little doubt that much caring in families and among neighbours goes unacknowledged. The way families, neighbours and friends step in quietly and without any fuss when a crisis occurs never ceases to amaze me. We should all acknowledge that help.

I remember one of my patients, a stroke victim, whose friend came in every morning before going to work to shave him and to have a chat with him. That was almost worth more than many of the therapeutic efforts that the team was undertaking. I also remember the families in my practice who, in the 1970s, volunteered to provide respite care at short notice for families with profoundly disabled children. That scheme is now incorporated within statutory provision, moving from a voluntary capacity to a statutory capacity, which is excellent.

I welcome the Scottish Executive's strategy for

carers and wish to address three points that are raised in the document.

First, the inclusion in the 2001 census of a question on carers will undoubtedly help us to understand the wealth of caring in society—and make us proud of it. I welcome the minister's statement that the new G-Pass GP data system can be employed in that respect—I think that it is flexible enough to do that.

Secondly, I emphasise the need for patient consent to the provision of information to carers by the primary care team. Only after careful consideration should information be divulged without that consent. The one exception to that rule is when the medical information about the family of a looked-after child would be crucial to the care of that child. While current General Medical Council regulations prevent doctors from releasing that information to carers, I am discussing with interested parties the possibility of a bill to ensure that the rights of the child are paramount in this area.

The need for information about the help that is available from the NHS is also important. I welcome the patients project, which is developing a strategy for effective communication. The extension of the NHS Helpline, to which the minister referred, should be linked closely to the development of the NHS Direct service and the proposals for NHS Direct must be linked to the continuing development of out-of-hours services. The services must be linked up to provide a comprehensive service to carers.

Thirdly, the provision of aids and adaptations remains a vexed problem at the interface of health and social services, which must be streamlined with the rapid implementation of best practice, both for joint assessment and for joint provision. The care and repair provision also has problems: the different pots of money for different categories of housing must be combined to ensure one-stop provision. It is, quite frankly, obscene that money can remain in one agency's budget while an unmet demand remains with another agency in the same area. I can give the minister detailed examples from my constituency, if that would be helpful.

We must also address the vital issues that face foster carers. The UK standards have been published. We must value and support our foster carers if we are to create the best parenting for looked-after children—previously known as children in care. Research from John Trisiliotis shows that too many foster carers are leaving the system. I believe that we must move rapidly to a salaried service.

In the meantime, in keeping with the new proposals for pensions for carers in general, we should apply immediately pension rights to the fees and expenses of foster carers. Ten per cent of foster carers who left the service did so because of a lack of respite—one returns repeatedly to this issue—and the minister has recognised that by providing new money, which is fundamental to the provision of respite care.

Finally, we must recognise that family structures are changing. The homophobic regulation that prevents households with two adults of the same gender from offering foster care is, frankly, no longer appropriate and should be removed. We know that good outcomes for children's mental health depends on the quality of the relationship between the adults who care for them— irrespective of gender—and not on the structure of the household.

I welcome the Executive's caring strategy as an excellent first step.

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Plenary, 25 Nov 1999

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