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Carers

The hon. Gentleman is right. There is a huge challenge ahead in terms of how we finance social care provision, and it is particularly acute given the changing demographics. I hope that he will agree with what I am about to say about changing the system to ensure that much greater resources could be directed to carers. Two Under-Secretaries from two Departments are present, so let me deal with them one at a time. I shall start with the Department of Health. Let us consider the example that I gave of the refuse collector from Farnham. When his wife became disabled, he would have had to grapple with three levels of bureaucracy in the social service system. The first is the carer’s needs assessment. For that, he would have to provide 140 different pieces of information spread over 40 pages and three different forms. Secondly, his wife would have to undergo possibly five different assessments. She would have to: go through a contact centre to ascertain whether she was eligible; do a fair access to community services assessment followed by a community care assessment, and she might have to undergo a specialist assessment for physiotherapy or occupational therapy. She then might have to do a further assessment, which is named—somewhat ironically—the ““single assessment process””. If we examine the questions that both must answer, two thirds of the questions that he has to answer are already asked of her. Councils throughout the country would like to reduce the bureaucracy of the assessment process but legislation requires much of the assessing, thus making reduction difficult. The third layer of bureaucracy is perhaps the worst because it is hidden. It is the bureaucracy that providers of social care must tolerate. It comprises: reports to get star ratings from the Commission for Social Care Inspection; 26 performance assessment frameworks, including key thresholds; delivery and improvement standards reports for the Audit Commission; best value performance indicator reports; comprehensive performance assessment reports, and, for the Department of Health, the referrals, assessments and packages of care reports. All that bureaucracy comes at a huge price of £2 billion. That money is used in the assessment and commissioning process, not in delivering the services that carers and disabled people need.