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Primary Health Care (Carers)

: I am grateful to my hon. Friend for that intervention. Having started the job, we must finish it. There is one opportunity to do that on which I might elicit her support. Having announced at the end of June that we will set out a vision for family health services fit for the 21st century, we are now going into a period of consultation, which will help us to draw up that White Paper. Our desire is to ensure that health care outside hospitals is delivered to high standards and in a way that people want. That must take into account the needs of carers. My hon. Friend's point about the need for a national definition is one that can be usefully considered as part of that consultation. It is especially true for people with long-term conditions who are being cared for in the community, where carers often play important roles. We have made it clear that we want as many people as possible to contribute to that discussion because our aim is to listen to and learn from the public and people who comes across such issues in their daily lives. To undertake that consultation, we are setting up an extensive public engagement programme, which will start in the autumn. It will include national, regional and local events. I will write to the team in the Department that is working on the project to ensure that the points that my hon. Friend made are taken into account when that consultation process is being designed, rather than when it is underway. I turn quickly to a couple of the other points that my hon. Friend made. She made a point about the systems being used in GP surgeries to track the number of carers. That was considered. We decided that it was hard to specify one direction because of the diversity in systems and practices in GP practices. Most importantly, we are moving from processes to outcomes—a focus on all patients. That must include carers. As my hon. Friend said, they have better outcomes. I also take my hon. Friend's point about how only three points out of 1,050 in the GMS contracts relate to carers. I stress that carers are individuals in their own right, so other parts of the contract will apply to them in addition to the carer-specific issues. Although the quality and outcomes framework cannot be altered locally, it is worth stressing that PCTs can commission extra services from any or all of the GP practices if they choose. Those services are called locally enhanced services. They are negotiated locally and funded from the PCT's main allocation. They are outside national negotiations and agreements, and the only proscription is that they are additional services. That is possibly another area for us to explore. My hon. Friend also made the point about setting a date for a campaign to raise awareness among GPs about carers needs. Although I cannot commit to that specifically, I shall write to the Department of Health team working on the White Paper consultation. I may also write to the carers organisations with which I work in my portfolio to alert them to the debate and to flag up the point that, as the White Paper consultation gets under way, they may need to think about these issues. My hon. Friend mentioned a useful point about expert patients. I have met some of them, and their stories are extraordinarily powerful. We must consider how such programmes can be introduced more widely. I should underline the importance of the White Paper consultation. It is vital that the consultation is broad, and that experts such as my hon. Friend have the chance to input into it. I am reminded of the time when the mother of a very disabled man in his 20s spoke at an event that I was speaking at in Birmingham. She pointed out that carers consultation events often start at 10 am, finish at 4 pm, and have no facility for the cared-for person to attend, no paid expenses, no close parking and no messaging service. That will not be helpful if we are genuinely to take into account the views of carers. I am determined that we shall not make that mistake with the White Paper consultation.