Health Bill [HL]

Your Lordships will not be surprised that I rise to speak in support of the amendments about carers—that is, Amendments 16, 20 and 31. Not including carers in this matter is a missed opportunity. That is strange for this Government, who have an exemplary record as far as carers are concerned, which I acknowledge. I declare an interest as vice-president of Carers UK and president of Eurocarers. In those roles, I am well aware that what this Government have done for carers is the envy of the world. We have only to look at the national strategy, the Standing Commission on Carers, Acts of Parliament and the kind of regulations and encouragements which the noble Earl, Lord Howe, has already mentioned to us. It is a missed opportunity if we do not mention them specifically in this regard. One of the problems with which the Minister may be wrestling is the dual role that carers play, because they first of all are patients of the NHS in their own right and have rights in that respect. We should remember that three-quarters of all carers—there are 6 million of them, as I do not need to remind your Lordships—report that their own health, physical, emotional or mental, is adversely affected by the caring role. So they have great needs as patients. However, they then have a second role as suppliers of care. Healthcare does not take place in a vacuum; nor does it take place in hospitals or surgeries, as we might be forgiven for thinking if we listen to some of the debates in your Lordships' House. Healthcare takes place largely in your own home, provided by yourself and your family and to the value of £87 billion, which is very nearly the cost of another health service. So carers play sometimes confusing roles which are often even in conflict. I make no apology for reminding Members of the Committee of the case that I quoted at Second Reading of the woman who had bowel cancer several years ago. The NHS provides her with excellent follow-up care, which requires her to have a colonoscopy every year. As someone who has that treatment, I know that it lays you out for a couple of days. This woman cannot take that opportunity because she cannot find anyone to care for her husband while she has the treatment. We need to take very careful account of those kinds of conflicts when we consider carers. Not including them in consultation denies them an opportunity to consider their role, not only as patients in terms of what they need but in terms of what they can contribute. I hope that the Minister will acknowledge that they cannot just be regarded as being in that catch-all term, ““the public””. It is logical, consistent and desirable to include carers and I hope that the Minister will do so. I support what the noble Earl, Lord Howe, said about specialist services. I speak in my role as chair of the Specialised Healthcare Alliance. These services may not be known to many people in healthcare but they constitute 10 per cent of what the health service provides and, as the noble Earl reminded us, often serve people in very great need. We have to think about specialised services as well in this context.