Equal Opportunities Committee, 01 Dec 2009

Meeting date: Tuesday, December 1, 2009

Official Report 189KB pdf

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Carers

Under item 3, we will take evidence on the development of the Scottish Government's carers strategy. The committee has held two round-table discussions on the issues that face unpaid carers and instigated a debate in the chamber on the issue earlier in the year.

I welcome to the committee the Minister for Public Health and Sport, Shona Robison; and Moira Oliphant, the team leader of the Scottish Government's community care division. Minister, would you like to make an opening statement?

Thank you, convener. I am pleased to be giving evidence to the committee today on the carers strategy for Scotland, including evidence on young carers. I very much welcome the committee's interest in this area. I have always said that the care 21 group's report was a landmark report and that we must build on its recommendations so that there is better support for carers and their caring role. Despite the economic situation, I believe that we can, in partnership with the Convention of Scottish Local Authorities and others, provide a robust strategy that will offer lasting changes. Indeed, there is an imperative to do so, given the increasing numbers of older carers and our changing demography, which I am sure we will touch on today. That means that we have to set out a clear vision and establish short, medium and longer-term objectives, and that we must concentrate our efforts on where change can be achieved.

On young carers, the priorities are that they are children and young people first and foremost. That means that they must be relieved from inappropriate caring and allowed to flourish as children and young people.

On the more than 657,000 unpaid carers in Scotland, we are seeking to move forward on a number of fronts regarding identification and support. It is imperative that there are key linkages with other policy developments such as the reshaping care agenda and the equalities strategy so that we can maximise outcomes for carers. The dementia strategy will also dovetail well with the carers strategy.

The strategy will be published during the first half of 2010.

That was a helpful opening statement.

Obviously, the strategy is for carers and unpaid carers. Where does the priority lie, however? What sort of proposals do you have to separate those two groups?

The priorities have been identified by carers themselves, who are involved in all the work that is being done on the carers strategy. I touched on some of those priorities in my opening statement. A lot of work has been done on the identification of young carers, which is clearly an issue, particularly in relation to the role of schools. Earlier this year, I announced some work that we are doing with the Princess Royal Trust for Carers to identify young carers in primary schools. We also believe that additional support for learning provides some useful opportunities, and that will feature in the work that we are doing on the strategy.

It is important that the needs of carers, including young carers, are assessed. What transpires after that in terms of support is also important. Clearly, respite is key. Shortly, we will be able to reveal the progress that has been made by local authorities on increased respite for carers.

Those are not issues that will come as any revelation to committee members, as they have been identified by carers for a long time, through the care 21 report and before that. The strategy, therefore, involves what we can do to move those long-standing issues forward through an examination of the progress that has been made and the progress that still needs to be made.

As you may be aware, the strategy will contain a lift-out section—that is how we describe it, but the phrase might not do it justice—on young carers. That will be a stand-alone section that will set out exactly what our intentions are for young carers. This is probably the first time that that has been done. As well as, hopefully, pointing the way for young carers who need to get support, it will give a clear indication to service providers of what is expected of them.

There is, rightly, an emphasis on young carers. At the other end of the spectrum, however, elderly carers have specific needs.

Absolutely. One of the strong elements emerging from the reshaping services agenda on the needs of older people generally is that older people tend to be cared for by other older people, such as their partners or neighbours. That will form an important strand in our response to the issue that you raise. If care is to continue to be provided through those informal networks—which we need it to be—people need to be supported in doing that, and we should not take that for granted. Clearly, older carers have particular health needs that we must recognise. I can reassure you that that is very much at the core of our thinking on how we reshape services. It is not good enough simply to tinker at the margins of that; we must deliver a complete overhaul of how we deliver care through health and social care services. Within that, support for informal carers will have to be key.

There is an older carer population who are the parents of adults in their 40s and 50s with learning difficulties. They need to have peace of mind about what will happen to their children when they pass on. We are working with Enable Scotland and others to raise the profile of that group of people and more closely integrate services for people with disabilities and services for the elderly. We have also asked Enable to produce a think-piece paper for us on housing options, which will feed into the strategy development.

We need to see older people as a resource. Some older people will have good health into their later years and, under the reshaping care agenda, we need to find out what the capacity could be for older people to work within communities to support carers who are less able to carry out their caring responsibilities.

Could you be a little more precise about when the final carers strategy will be published? It is eagerly awaited by everybody who will be affected, but there seems to have been a little bit of slippage.

I appreciate that, but we want to get it right, and we are working through a number of areas. The strategy will be comprehensive. We are considering all the areas that carers are concerned about, and progress has been made in many of them. A lot of in-depth discussions about key elements are still going on. I want the issues to be properly thrashed out so that the right conclusions are reached.

The strategy will be published as soon as possible; it will certainly not slip beyond the first half of 2010. If it would help, I can keep the committee updated on what is happening. I can give it a heads-up on when we think we can launch the strategy and ensure that it has the date as early as possible.

That would be appreciated. We can then have the date firmly in our sights.

How is the work of the steering groups and the sub-groups feeding into the strategy?

Moira Oliphant can probably tell members a bit more about that, as she has been closer to that work. The carers organisations have been working extremely hard, and the sub-groups have done a lot of consideration of quite complex issues. On the face of it, certain issues seem easy to resolve but, when one gets into considering consequences—there may be unintended consequences—they are sometimes not quite as easy to resolve as they seemed at first. In that context, I appreciate the work that the organisations are putting in.

I invite Moira Oliphant to say a little bit about the structure that holds everything together.

There are two steering groups: one for carers generally and one for young carers. There is a good representation mix on both groups. COSLA is, of course, represented on both, and all the national carers organisations are represented. The Association of Directors of Social Work and Alzheimer Scotland are represented on the group for carers generally, and the Association of Directors of Education in Scotland and Children 1st are represented on the young carers group. The groups have been up and running since February or March and have met several times. A lot of good discussions about the priorities in developing the strategy are taking place in them. There is a lot of interesting discussion that gives a good flavour of the issues to be taken forward, and all the people on the groups have very good backgrounds. Both groups recently considered an outline for the carers in general and young carers components of the strategy, and they have supported the way in which we are progressing the proposals.

There is also a carers reference group, which consists of 10 carers from different parts of Scotland, including rural, remote and urban areas. Those carers represent different caring experiences. That group has met three times, and one carer on it is a member of the main carers steering group. She can therefore take the views of the carers reference group to that steering group.

The carers reference group has been very good. Every individual caring experience is unique, but there is nonetheless a commonality of issues—for example, transitions at certain points in the caring journey, the quality and scope of carer assessments, respite and short breaks, and access to carer training. A lot of good, vigorous discussion that has taken place in the carers reference group has gone to the main carers steering group. The carers reference group will continue to meet until the strategy is published and will act as a good sounding board and scrutineer of the proposals. We propose that carers' stories be incorporated in the strategy. The carers reference group will be used for that.

On the young carers side, a sub-group on transitions considers the transitions of 16 and 17-year-olds from school to training and employment. We link into Skills Development Scotland and hope to make contact very soon with the further and higher education sectors to find out how carers at those ages can be supported in transitions to further and higher education, training opportunities and employment. It is recognised that young carers can face particular hurdles and barriers along the way.

On the carers in general side, there is a sub-group on carer training. We have just received the results of three pilots on carer training. The sub-group links into wider workforce development of the paid workforce and considers how better synergies between carer training and training in the wider paid workforce can be achieved. Again, that work links into the reshaping care agenda, as there is a lot of on-going work in that agenda on the paid workforce and the recognition and embedding of carers' issues within their training.

Through those work streams, we are having meetings with the regulatory bodies such as the Scottish Social Services Council to see what we can do about entry-level training and continuous professional development. Of course, we recognise that training places and courses are fully occupied, but we are considering how we can embed such issues more generally.

A group is also considering the personalisation agenda. It recognises that personalisation represents an approach to carers' issues, from carer identification in the first place—whether that is self-identification or identification of carers, including young carers, by organisations—right through to the provision of services to support carers in their caring role.

I hope that that gives members a flavour of what is happening.

How many times have the steering groups met since February or March?

I do not know the exact number of times off the top of my head, but it must have been four or five. There is a meeting every two months. We keep to that; no meeting has been delayed. The steering groups and the carers reference group last met in the past two weeks.

Carers' stories or case studies are a good way of highlighting issues. Will the strategy include stories across the board? Will elderly carers' case studies as well as those of young carers be included in it?

Very much so. It is hoped that the strategy will include diverse carers' stories. It is clear that it cannot be crowded out with carers' stories, but stories that show different types of caring experience would bring it to life in some sense. People whose minds we need to change can be drawn into a caring story.

That would be an effective way of highlighting the issues.

Before I ask the question that I was going to ask, I would like to follow up on what has been said. We welcome all the consultations and meetings that have taken place, and we particularly look forward to the launch of the strategy, but there is concern about whether we are talking about a strategy or an action plan. Will there be a list of actions? Have any clear actions been taken this year, for instance, that enable better outcomes for carers? What has actually happened? An action plan is important; there should not be just another document. How can the Government ensure that local authorities and the national health service implement the actions?

There will, of course, be an implementation plan for the strategy. How the various elements of any strategy are to be implemented must filter through. Whether we are talking about an action plan or an implementation plan, it is clear that actions will flow from the strategy, and how aims will be achieved and who will achieve them will have to be decided. I can confirm that.

In the meantime, quite a lot has been happening on the concordat commitments on increased respite weeks. As I said, we will get information about that fairly soon. On the health side, the carers information strategies, which I signed off, are there for people to see. Each health board has a link to its strategy on its website. I will receive reports soon from health boards on what they have achieved through those strategies. I am happy to share that information with the committee when I get it. We have not been standing still while we await the strategy. However, the strategy will lay out where we go from here in the short, medium and long term in supporting unpaid carers. The new element will be the clarity for all public service providers. They have all been doing their bit, but the strategy will bring cohesion for the next period. In the meantime, a lot has been going on in local authorities and health boards.

I am always keen to know that actions have been taken and are being monitored. That is what we should target.

How will the carers strategy address concerns about the low uptake of direct payments, which we know is a concern to carers?

That is a fairly complicated issue at the moment, so Moira Oliphant might say a bit more about it. Some local authorities have been providing direct payments, but there is a question about the legal underpinning of that. The issue is the interpretation of the legislation—the 1968 act, I think.

It is the Social Work (Scotland) Act 1968.

There is a question about whether there is a legal underpinning for carers to receive direct payments because of the term that is used in that act. It talks about those who are in—what is the term that is used?

In need.

Yes. No one here would question whether carers could be identified as being in need, but the strict definition of that term in the 1968 act is causing concern. There will be an opportunity to consider that through the proposed self-directed support bill, which we intend to introduce next year. I am keen to consider the opportunities to clarify the legal basis. I take the simple view that carers should have access to direct payments in their own right. Those are obviously distinct from direct payments for the service user. For service users, we are talking about large packages of care but, for carers, a direct payment might relate to quality-of-life issues, or practical things that can make the caring role a bit easier. I have said for a long time that I believe that there should be no impediment to carers receiving such payments. The summary is that work is in progress and the legal issues have to be resolved. I ask Moira Oliphant whether she wants to add anything.

The self-directed support strategy, which will include direct payments and which will be put out for consultation early next year, will flag up the issues vis-à-vis carers. A lot of work is being undertaken on the possibilities for providing direct payments to carers in their own right. We recognise that carers' needs are different from those of the cared for, albeit that the two are closely intertwined. As the minister said, when carers have had direct payments, those payments have had benefits for the carers' quality of life and have helped to sustain them in their caring role. The payments are often for small initiatives, such as driving lessons to help with transport for the cared-for person. That can improve a carer's quality of life and make things easier. I have heard of somebody having blackout blinds installed so that the cared-for person did not get up through the night, which helped tremendously. There are many issues that we are teasing out with lawyers. There will be proposals on that in the self-directed support strategy, which we will issue before the carers strategy.

In previous round-table discussions, the committee has been told about the low take-up of carer assessments. Will the strategy address that problem?

That is a big issue for carers organisations, and understandably so. It is fair to say that the provision is patchy—I suppose that that is the summary. We certainly want to consider ways of making carer assessments and the right to request an assessment more systematic. We are exploring how we might do that. Assessments are a key issue, for several reasons. The first is that the process identifies a person as a carer, whether or not there is then a requirement for services. In some cases, a requirement for services might not be the outcome, although it will be in others. However, the recognition of someone as a carer is hugely important for their interaction with the health service and to ensure monitoring of their health through the process. It is also important for reasons of information provision. The identification of someone as a carer allows them to receive information on what is going on in their area and to take advantage of that. The assessment is a key element and we are considering ways in which we can improve it.

The take-up of carer assessments has been poor and patchy and we know that they are not always promoted. In some circumstances, there might be a sense that an assessment is not effective. However, we also know that some carers benefit from the assessments if they are carried out properly and in an empathetic way and if they truly assess the carer's situation, including issues such as a life outside caring and whether they want access to employment. Some carers have reported that simply the process of undertaking a carer assessment is almost cathartic, because they feel that they have been listened to and supported. We are working on the issue. The strategy will promote the uptake of good-quality carer assessments. We will also work on training for the paid workforce, so that the value of a carer assessment is recognised.

There are local approaches. In parts of Glasgow, self-assessments are carried out, which we are considering. Some carers are not taken with the word "assessment" because they think that something will be done to them, rather than that they will be seen as a partner in care. They are not keen on the terminology because they think that there will be heavy social work involvement, which they might not want. We are considering small changes that could make a big difference. We have discussed producing a practical guide to carer assessment, because the available information is more about the policy than the practice. That could help, too.

You mentioned taking account of carers' employment needs, which was an issue that arose in our round-table sessions. There seems to be nothing in the guidance that says that social workers should take account of carers' employment or education needs. Will that be addressed?

Shona Robison touched on the more general point that many carers are concerned that an assessment does not necessarily lead to services. Will there be a concept of a right to a level of service that follows from an assessment, or will a certain service level still not be guaranteed by an assessment? As Shona Robison said, an assessment might find that services are not required, although in many cases services will be flagged up as necessary.

Before I come on to that, and in case this goes out of my head, I will mention the good work that has been done to support carers through the Jobcentre Plus initiative, which helps carers with back-to-work interviews, job-search training and other employment support.

There has been a long-running debate on whether the right to assessment should lead to a right to services. That would be very difficult to achieve given the way in which local authorities provide their services. We have been exploring the idea of respite entitlement. Work is continuing on that, and I am due to get a report soon. I spoke earlier about things that might seem simple to do at the outset, but that are actually complex. I would put respite entitlement in that category. I want to avoid taking action that has unintended consequences, for instance by displacing support from one set of carers to another. I am concerned that we do not do that. In taking any steps to bolster people's rights to services, whether it is respite entitlement or something else, we must be careful that the response from service providers is not just to take from one and give to another. That does not take us forward.

We have been growing the capacity and availability of respite provision through the concordat. There will be information on that soon. That will hopefully show some success, and carers should be getting more respite in the way that they want and when they want it. There is still a lot of work to be done on that but, by increasing capacity, we are moving towards meeting people's needs according to their assessments.

That is where we are at now; the debates will continue.

In evidence, concern has been expressed about variation among local authorities. Do you regard that as being to an extent inevitable? Can anything be done to address it? You have referred to an entitlement approach, and others have suggested minimum standards. Could more be done to specify a more defined outcome on carers under single outcome agreements, or under the traditional method of allocated resources? Is there any way in which you can address the problem of unacceptable variation, while acknowledging that there will always be some variation?

There will be variation because of the different populations that local authorities serve: we have been doing work to support carers who live in rural areas, for example. Even with those variations, we might ask what priority local authorities or health boards give to support for informal carers. Our job is to ensure that that support is a higher priority, and we can do that in a number of ways. Over the years, we have worked to strengthen the rights of carers, although carers might argue that it has not been enough. The concordat commitment on respite was an attempt not just to deliver 10,000 extra weeks of respite, but to give more priority to carers in terms of the resourcing that local authorities provide. It will hopefully flow from that that carers are generally given higher priority.

There is a difficulty around whether that should be explicitly mentioned in single outcome agreements. The relevant organisations would probably say that because they represent specific groups of people there is a problem if there is no specific reference to them in the concordat. Under that approach, however, everything would be mentioned in single outcome agreements, and strategic agreements would cease to be. Local authorities' view, and our view, is that what sits below the single outcome agreement is just as important. I refer to local authorities' provision for their carers strategies—some councils have carers plans—and the work that is done on joint agreements with local health boards around outcomes for carers. Those are the areas that we want to scrutinise in order to ensure that local authorities and health boards are clear about the outcomes that they are to deliver for carers. If there are things that we can do through the strategy to make that more systematic and to give carers tools that they can use in their negotiations, we will do them.

Many carers report that, despite the fact that they are already under stress, they have to use up some of their valuable time—either through the assessment process or outside it—in trying to find out what services are available to them. There are often services available, perhaps from organisations that deal with specific conditions, but the professionals might not be aware of those organisations. People tend to find out by default, rather than through a systematic process, about the support that such organisations offer.

We hope that the development of a web zone by NHS 24 to give information to identified carers will provide support. There are other initiatives that can provide support to carers, such as telecare—there is a major telecare conference today in Glasgow, at which the Cabinet Secretary for Health and Wellbeing is speaking. The evaluation report on the City of Edinburgh Council's reablement service, which was published last week, described the outcomes that are generated, at least in the shorter term, for people with complex needs, and took into account the run-on implications for carers. Many things help to support carers, so it is a matter of working systematically and ensuring that provision is, as far as possible, rolled out Scotland wide, with good practice being promoted under the carers strategy, particularly in the young carers strand.

Does the Scottish Government still have plans to hold a debate on unpaid carers?

Yes—I am happy to have such a debate. The judgment is about whether that should happen before or after publication of the carers strategy. My instincts say that it would be better to hold it after the strategy is published, so that there is something concrete to form the backdrop to the debate, although I am keen to hear members' views on that. If members feel that that is the best way to proceed, I can certainly give a commitment to have that debate in Government time.

I think that committee members were expecting a debate earlier, rather than later. There is an argument that such a debate should inform the strategy, rather than the strategy being discussed once it is published.

I am happy to do things that way if that is what people want. My sense is that everybody knows where the problems are, through the committee's work and development of the strategy. We have already listed where the biggest challenges are and where we need to move things forward. Would a debate in advance of the strategy's publication shine any more light on those or would we end up talking about the same things, albeit in more detail? There is certainly an argument that, once the strategy is published, we could have a debate on what it will mean for carers and service providers, particularly on Marlyn Glen's point about how it will translate into an action plan, how it will be implemented and who will do what by when. However, I will be guided by members—I am pretty open to either suggestion.

We will consider our future work programme and decide what is best. There are arguments on both sides. We covered many points in a small way in the hour-long debate that we had. We could have filled twice that time talking about the issues, getting into some of the nitty-gritty and examining good practice and flexible working. Equally, there is an argument that, once the strategy is published, consulting our stakeholders and getting feedback on it could inform the debate. There is a balance to be struck and the committee will come to a decision when it considers its work programme. If it is agreeable to you, we will let you know what we think would be best.

Okay. I am happy to take that on board.

Good morning, minister. I draw your attention to the Equality Bill that is going through Westminster, part of which clarifies the law on protection against discrimination by association, on which there have recently been high-profile cases in England. What is the bill's likely impact on the Scottish Government's approach to unpaid carers?

A lot of work is going on at the moment to determine what impact the Equality Bill will have. We have made a commitment to consult. The obvious impacts that spring to mind concern health services on which there are age restrictions, such as screening services. My understanding is that the conclusion on that may be that we can have age-restricted screening programmes as long as there is medical evidence to back up the restrictions. However, the issues are complex and the Equality Bill's provisions on services will be a challenge for organisations that are listed in the bill, whomever they deliver to, because they will have to ensure that their services comply with its provisions on age discrimination and the other types of discrimination. A lot of work is going on to determine what the precise impact will be in practice. We have co-operated closely with the United Kingdom Government on that. I think that the consultation is due to go out.

I am not sure about that, actually.

We will confirm that for the committee. As I understand matters, the consultation is due to go out. [Interruption.] It is due to close.

At our most recent carers steering group meeting, one group member made it clear that they thought that, if the Equality Bill is passed, it should be profiled within the strategy and that we should consider the implications of its protection against discrimination by association for enhancing the role of carers within the workforce so that their role can be fully valued and recognised without such discrimination, which was the issue in the Coleman case that was brought before the courts.

We understand that the general consultation on the bill will close in January, but we will also consult on the socioeconomic duty within the timeframe of the bill, so there are two elements.

It is clear that the bill will have a significant impact. Public services will have to be clear that, if they discriminate, they would have to have medical evidence and so on to back that up. That is undoubtedly a challenge for the way in which we deliver our programmes in the health service, but that is being looked at.

You said that the consultation will close in January. Do you have a rough timescale for when you expect to liaise with Westminster on the issues?

Work is well under way on the impact of the bill on health and community care services. It could have a profound effect. There will be similar issues north and south of the border about how services will have to respond, so it makes sense to have some synergy. If the committee wants more detail on that, I am sure that we can provide it.

On whether we have looked specifically at unpaid carers, I do not think that officials have yet talked in detail about specific client groups. The focus of attention has been on considering how we ensure that, where services are delivered to specific groups and not to others, there is a good reason for that and we can justify it on medical grounds. Screening services are an obvious example. However, if the committee would like more detail on that, I can certainly provide it.

That would be helpful.

There was the socioeconomic consultation, which is now closed—

Is it? Sorry.

Thereafter, I suppose the stakeholders will be consulted on their views on the bill. Of course, the bill is going through Westminster, so we will see how that progresses. It would be good to know how you see those things fitting in, because although they are not mentioned specifically, such issues certainly impact to a large extent on the Equality Bill.

In January 2009, the Scottish Government allocated about £13 million to support carers, which comprised £4 million for 10,000 additional respite weeks and £9 million to support NHS initiatives on information, training and so on. What progress has been made with that work? Do you remain confident that we can deliver the 10,000 additional respite weeks by 2010-11?

If we take into account not just the carers information strategies and the 10,000 extra weeks, but the resources that we allocated for specific young carers initiatives, I think that the total for the additional spend is some £13.8 million. The £4 million for the 10,000 extra weeks of respite is in addition to the resources that are wrapped up within the concordat, so it was, if you like, a supplement to seal the deal.

As I said earlier, the information has been gathered, but a process to consider and validate the data on the 10,000 extra weeks is under way. The data will be issued as soon as the process is complete, and I am pretty confident that the provision of 10,000 extra weeks is on target. I have always said, however, that that is not the end of the story. I would never sit in a room full of carers and say, "Well, that's the deal done. I hope you're all happy", because I would get short shrift.

I always describe that as a signal, which I hope will be used to prioritise carers in the respite provision from local authorities and in the carer information strategies that health boards have had to produce. Health boards have had to tell me how they will give more priority to carers and what that will mean practically—for example, measures such as carer training or information. The money is well spent, but it is not the end of the story. Much more has to be done.

In addition, local authorities spend their own resources—I am trying to find the figure—on services for carers. I think they spent £117 million in—

They spent £117 million in 2007-08. That is the latest figure.

That spending was up from £100 million in the previous year. That shows that, even beyond the 10,000 extra weeks in the concordat, local authorities are spending a higher percentage of their resource on carers. We want that to happen, because the work is all about giving carers higher priority.

Will we see any of the feedback so that we can learn lessons that will inform the strategy as it develops?

I am happy to provide the committee with the feedback.

Thank you.

As Willie Coffey said, £9 million over three years has been allocated to NHS boards' carer information strategies. We are examining carefully the progress reports on activity in 2008-09 to see what progress has been made in accordance with the minimum standards that were set out for the delivery of the carer information strategies.

It is important to pick up on the good practice that is being generated and promoted to provide positive outcomes for carers. To that end, in February we will hold an event to bring together national health service boards to share practice and pick up from one another what is happening in each area. That event should be worth while. We also encourage NHS boards to place their progress reports on their websites.

It is interesting that the budget is increasing. Will it increase beyond 2011?

Are you talking about the spending of £117 million and £100 million?

I am talking about the budgets for the respite weeks and the carer information strategies.

I clarify for interest that £117 million and £100 million were actual spends, which are tracked through the returns that local authorities make.

As for the resources of £4 million, £9 million and £800,000 or so that we have allocated, we are working with health boards to try to embed carer information strategies in how they go about their business. As with everything else in the health service, we want eventually to reach the point at which such strategies are part of their normal business rather than a special initiative for boards to undertake and an outcome for which resources are allocated. We want boards to make such strategies part of their core business.

We have made a commitment on respite weeks for the comprehensive spending review period until 2011. As with everything else, we will have to debate such matters in relation to the next comprehensive spending review. The backdrop of financial constraints is difficult for all services. Within that, we need to build on the work that has already been done—we do not want to lose any momentum. The carers strategy will add momentum. I hope that, even within the tight financial constraints that we face, we will be able to give as much priority as possible to unpaid carers.

How is the Scottish Government monitoring the funding that has been allocated to the Princess Royal Trust for Carers, which you have mentioned? What impact has that funding had?

We have a good working relationship with the Princess Royal Trust for Carers. I assure you that the resources that we give it are well spent—its approach is to wring out every pound to get a better deal for carers. Moira Oliphant will describe the monitoring arrangements.

Over the past two or three years, various pots of funding have gone to the Princess Royal Trust for Carers. There is a combination of core and project funding. For example, the trust carried out a mapping exercise of young carers services to see what dedicated young carers services are available in all parts of Scotland. That exercise was done well. We received a presentation on it from PZA Consulting, which carried out the work on behalf of the PRTC and other carers organisations.

The trust was given funding to roll out carer training pilots in Lothian and Highland, and in connection with black and minority ethnic carers. A couple of weeks ago in Perth, there was a presentation of the independently evaluated results of those pilots. It seems that there have been extremely good outcomes for the carers who participated. We received the independent evaluations in advance so that we could see what carer training had been rolled out. Input from carers on their experiences and what they thought about carer training was part of the evaluations.

This year we have given the Princess Royal Trust for Carers £200,000 for three young carer initiatives: to identify young carers in primary schools; to employ a mental health and emotional wellbeing development officer; and to look at transitions from school to training and employment among 16 and 17-year-olds, in recognition of the fact that many young carers prefer such support to going through jobcentres.

We always get evaluations of the PRTC's work and we monitor the results carefully. Like other national carer organisations, it is working flat out to support development of the strategy.

I am sure that we all know that most carers exist in straitened financial circumstances, especially because the carers allowance is the lowest of the earnings replacement allowances. I was grateful for your statement in the members' business debate on the subject in June that you had written to the Secretary of State for Work and Pensions about the carers allowance, to ensure that the Scottish Government's views were fed into the UK Government's work on the carers benefits system. In light of "Shaping the future of care together" and the impact that that may have on the attendance allowance, what input has the Scottish Government managed to have into the work of the Department for Work and Pensions on the carers allowance?

We made the representations on the carers allowance to which I referred. Forty-six thousand carers in Scotland claim that allowance. The controversial point is that the carers allowance can be reduced if other benefits are received. We understand why that is a long-standing bugbear of carers.

On the specific issue of the attendance allowance, the cabinet secretary wrote to the DWP and the Secretary of State for Work and Pensions to express our concern that what was proposed in the green paper had fundamental implications for Scotland. I do not think that that was appreciated at all. In essence, the UK Government was pursuing a plan for the reform of social care in England, but any changes to the benefits system would apply equally north of the border. Scottish Government officials are now engaging with DWP officials but, from the feedback that we have had, I am not sure that the DWP officials have yet quite grasped the implications for Scotland of the proposed changes to the system. I am keen to ensure that any changes do not curtail the work that we are embarking on to reshape older people's services. It would be unfortunate if we set off down a particular road and the benefits system was changed in such a way that it hindered progress in that direction of travel. We need to know what is proposed.

Things seem to be shifting. We have had some changes around the disability living allowance proposals, although I understand that they would still apply to people over 65 who are on DLA.

Attendance allowance is the big issue. Voluntary organisations in Scotland have expressed deep concern about a proposal to remove attendance allowance from individuals and to make it part of the package of care. In their view, attendance allowance has been a crucial resource in giving people quality of life and enabling them to manage their day-to-day lives and the lives of the people for whom they care. Any change would have profound implications for what we do in Scotland.

In addition to what the cabinet secretary wrote, a submission was made by the ministerial strategic group, which reiterated the point that any changes must take cognisance not just of Scotland but of Wales. I understand that the Welsh feel the same as us. The benefits system in Northern Ireland is a bit different. There must be discussion involving all the devolved Administrations. We will continue to make those arguments.

The University of Leeds is presently undertaking a study to develop a clearer understanding of the carers allowance claimant group. Its report will come out in about March next year. The research involves interviewing carers in Leeds, Harrogate, London and Renfrewshire—we managed to ensure that Scotland was included in the study. Letters will shortly go out to carers in Renfrewshire. As well as looking at people's take-up of carers allowance, the study will examine what they use the allowance for. The questions will also focus on the caring experience—what helps and what the barriers are. The report will, therefore, contain information on those issues, which will be helpful to us. That is all part of the wider review of welfare reform that is taking place down south. Having an in-depth study on the carers allowance claimant group will help us to understand and bring some clarity to the issues.

That will be helpful. Thank you.

The Eurocare conference will be held in Scotland in May, and the issues that we are discussing will naturally be discussed at some of the sessions. What does the Scottish Government hope to achieve at the Eurocare conference?

I hope two things. First, I hope that people outside Scotland will see the good practice that is happening here. The conference provides an opportunity to showcase the good things that are going on, and we would like to do that.

Secondly, no one has all the ideas; it is always worth seeing how other areas and countries have addressed challenges that are similar to those that we face. I will therefore look a bit further afield on the sharing of good practice and ideas that we and carers may not have considered before. Sharing ideas and listening to others' experiences will be extremely important.

Are other European countries or partners similarly developing their own care strategies and are we drawing lessons from them?

Do you know, Moira?

The national carer organisations have been taking forward planning work on the Eurocare conference. I will get in touch with them to see how that is going, because I have not heard from them for a while. We have been looking at some of the experiences in Scandinavian countries and Australia, although not in depth. We have also looked at the available international literature, especially on short breaks, from which I hope we can pick up information.

I think that I am right in saying that the Republic of Ireland is not going to move forward with a carer strategy now. We are therefore in the forefront on carer issues compared with many other countries. One of the aims of the Eurocare event is for other countries to see and for us to showcase what we do. You will hear from the national carer organisations that Scotland and the UK generally are in the lead on supporting carers. Other European countries, such as Spain, have not started yet.

To follow on from Nicola Sturgeon's answer to a parliamentary question from Elaine Smith on the H1N1 vaccine, can you tell us why unpaid carers have not been included in the first round of the vaccination programme and whether you anticipate that the monitoring of the programme will give you an opening to include them?

I am happy to be able to tell you that carers are to be included in the second phase of the H1N1 vaccination programme. Work is under way to define what a carer is. You can imagine that there are various definitions. That is being worked through, and is taking into account the views of the national carer organisations. It is expected that vaccination for carers will therefore begin in January. I know that carers will welcome that, and I hope that the definition will be sufficiently broad to include the vast majority of unpaid carers. We can certainly keep the committee informed about that, but things are moving apace. It certainly makes me happy that unpaid carers have been included. It is the right thing to do. These issues are always difficult, because we follow the evidence and the scientific advice. I am just really pleased that that is the advice that is now being given.

That is welcome.

It will be very welcome. I spoke recently at the Scottish Court Service carers conference, at which the issue of vaccination was brought up. I know that carers will be very relieved by the minister's announcement and will welcome it.

That completes our lines of questioning. Do you want to add anything, minister?

I do not think so. The discussion has been very helpful. We will follow up on the areas on which we said we would come back to you.

Thank you. We will get back to you, too, on the timing of the debate on the carers strategy.