National Carers Week
The final item of business is a members' business debate on motion S1M-1976, in the name of Karen Whitefield, on national carers week, from 11 to 17 June.
Motion debated,
That the Parliament pledges its support to National Carers' Week from 11 to 17 June 2001; acknowledges the huge contribution which carers make to society as the mainstay of care in the community; welcomes the publication of the report from the Scottish Carers' Legislation Working Group and the ongoing consultation by the Scottish Executive on proposals for carers' legislation; notes with concern the findings in the Carers' National Association Scotland research document You can take him home now on carers' experience of hospital discharge, and urges the Scottish Executive to consider the findings of that document during the formulation of its next Programme for Government and to work with health boards and organisations throughout Scotland to implement the recommendations made in the report and the research document.
I welcome the opportunity, following national carers week, to highlight the valuable role played by carers.
Throughout Scotland, carers are providing practical and emotional support to friends and family who are unable to care for themselves. They represent an army of unpaid and often unrecognised health workers without whom our modern health service could not function properly and without whom care in the community would be no more than a meaningless title.
In the main, carers seek little other than the most basic forms of recognition and support. They offer their time and energy for the love of those for whom they care rather than for any financial gain. It is incumbent upon the Parliament to ensure that they are supported in their commitment to those for whom they care.
Scottish Executive statistics suggest that there are around 626,000 carers in Scotland, more than 95,000 of whom care for more than 50 hours a week. They must be seen in the context of a holistic care-in-the-community service. They do not merely complement NHS and local authority services; they are an essential part of them.
I welcome the significant shift in policy and legislation in support of carers over the past few years. The Carers (Recognition and Services) Act 1995 and the national and Scottish carers strategies illustrate the extent to which carers' needs have been recognised. I also welcome the Scottish Executive's consultation on proposals for new legislation to help carers. The process, which ends on 6 July, will ensure that the voices of carers and the cared-for are clearly heard and that their positive and negative experiences are used to shape future legislation and service provision. The Scottish Executive's commitment to designate £10 million a year for local authority carers services and to invest £500,000 in voluntary sector initiatives to support carers begins to put some meat on the legislative bones.
We all know that true care in the community is not a cheap option, but it is the best option. Wherever possible, caring for friends and relatives in the community must be preferable to institutional and residential solutions. That is why we must be prepared to resource our carers properly and to ensure that they have access to assessment, information and support services.
The recently published report by Carers National Association Scotland and Crossroads, called "You Can Take Him Home Now", highlights some of the current system's successes and failures. The document states that although 66 per cent of those questioned said that they had been consulted about hospital discharge plans, 43 per cent felt that those arranging discharge did not take their concerns into consideration or give any credence to their ideas or suggestions. More positively, 58 per cent of carers in the survey had been assessed, which is far preferable to the UK figure of 50 per cent.
Some carers' comments in the document are positive, particularly one who said that their experience had been good, because they had been kept informed of what was happening and had received a lot of help from the community rehab team. That should be compared with the experience of a person who was discharged at night and not allowed to use a wheelchair. There were no porters in the hospital. A 72-year-old had to leave their daughter sitting on the stairs while they found their own way to a car to fetch it nearer to the hospital. That happened in Glasgow.
Although we have a long way to go, we have clearly made considerable progress. That is being fully translated into policy. CNA Scotland commissioned "You Can Take Him Home Now" because it wanted to make a positive contribution to the debate. The report provides some constructive suggestions about how services could be improved. Although I do not intend to detail each suggestion today, I recommend the document to all members as it represents a constructive set of responses to carers' difficulties.
However, it is fair to say that the recommendations made by carers tend to centre on the need for improved communication among all agencies, carers and those who are being cared for and the need for more responsive services for carers. Picking out a few of the policy recommendations in the document, I highlight to the minister the need to ensure that the interests and needs of carers register fully in the emerging delayed discharge learning network.
I highlight also the recommendation to characterise individual carers as key partners in the provision of care, according them an appropriate level of authority in discharge arrangements. The report also identifies the problems that are faced by carers and those for whom they care in getting to and from hospital, which are brought to life in a couple of harrowing quotations in the document.
I shall not speak today about young carers, as tomorrow's members' business will concentrate on that subject. That debate has been secured by Donald Gorrie. Today, I merely put on record my continuing commitment to ensuring that young carers' needs are properly assessed. The first step towards relieving young carers of their onerous caring responsibilities is to ascertain the level of care they provide. Only then can a proper programme of support be provided to give them some relief and respite.
Following national carers week, it is appropriate that we congratulate those who give their time to care for someone else. More often than not, carers do not seek accolades or financial gain. They do the job because—as the word carer suggests—they care for someone. They seek a system that works for them rather than against them; a system that recognises and responds to their needs; above all, a system that listens to carers. Such a system should not be beyond our abilities and I firmly believe that we are heading in the right direction.
The Scottish Parliament and the Scottish ministers are truly committed to supporting carers and will continue to provide the resources and legislative framework that are needed to deliver on that commitment. The problems and needs of Scottish carers have never been given greater recognition than they are being given by the Parliament. We must ensure that the good will that exists and increased resources are translated into meaningful and responsive support services for our carers. I hope and believe that, in carrying out that task, the Parliament can speak with one voice.
I congratulate Karen Whitefield on bringing this important issue before the Parliament and enabling members to participate in this debate. Like her, I found "You Can Take Him Home Now" fascinating and harrowing. It reminded me of earlier days, when the phrase was, "Does he/she take sugar?" The philosophy is the same, and it is that which we must remove from our approach to those who give their time and effort to care for people.
I add my congratulations to the vast army of workers in the Carers National Association Scotland and the voluntary arm of Crossroads, who have done much to keep us all on our toes in the Scottish Parliament and—as the minister knows—in another Parliament where he and I worked previously and debated the subject. All members will have knowledge of carers, either in our role as elected representatives to whom people bring their problems or as members of families or communities in which caring is significant. I suspect that the experience for most of us is a combination of those roles, as all of us need help from carers at various stages in our lives.
Carers defy definition, as they come in all shapes and sizes and from all classes and age groups. As Karen Whitefield said, Donald Gorrie will speak in another debate tomorrow about young carers, in which I know my colleague, Irene McGugan, wishes to speak. I remember, from my experience as a teacher, youngsters who were carers at home and who had little time for their own academic development.
We applaud carers, but they deserve our action. As Karen Whitefield said, we should remind ourselves how much money they save society. Without carers, full-time residential or nursing care would be an absolute requirement. Without straying too far into that sphere, I point out that we know that that is not a happy situation.
Because I know that many members wish to speak in this debate, I will be brief, but I have a few points to make to the minister.
The provision of respite is critical to our carers, as they are doing a full-time job. They need breaks from the often harrowing circumstances in which they work. There should be an allocation of regular respite provision and the flexibility to allow carers to choose and plan ahead. This matter lies in the hands of the Scottish Parliament as it would be dealt with as part of the allocation of funds to our local authorities. We should consider carers' contributions to respite care, bearing in mind that many of them have limited resources.
I know that benefits are a reserved matter, but dealing with the various issues relating to benefits is one of carers' most complex tasks. Attendance allowance, disability living allowance, carers allowance, pension rights, the carers premium, invalid care allowance and so on are all inextricably linked, which can be confusing to people who are already exhausted by their work.
One of Scotland's failures is that we have not retained central advice centres with guaranteed home visits to carers, which can assist them through the complexities of their situation. That should be taken into consideration.
Support for voluntary organisations, who do much to support carers or those who are being cared for, is important. There are additional pressures on our voluntary organisations as the statutory authorities cannot afford much of the work that they would like to do.
I hope that those brief points will be taken on board by the Executive.
I congratulate Karen Whitefield on securing this worthwhile debate.
I was one of the young carers who have been mentioned, although I did not think of myself as that. When I was in my teens and my father occasionally went away from home on business, I coped because of the strength of the community in which I lived with my parents. The local nuns were invaluable and people such as my neighbours and the local health care professional rallied around. One of the problems with which we must deal today is that our society is selfish and inward looking. We look after ourselves rather than look out for our neighbours. When I was a boy, people looked out for their neighbours and I still see that happening in country districts and small communities. The Scottish Parliament needs to pay some attention to that issue because, as Margaret Ewing rightly said, a huge load is being carried on behalf of society by carers of all kinds. Some struggle to hold down a job, others might have young children or other relatives and neighbours who are poorly and need support. Such people are the unsung heroes of our society.
I cannot say much more than Margaret Ewing did about the technical support that carers require, but as a former community pharmacist—I know that the minister was expecting me to mention that—I used to see carers regularly, as did my staff. If a carer required a domiciliary visit from one of my pharmacists to help them manage someone's medicine, we would do that. Busy doctors do not have the time to do that, but we were able to. Going to the homes of carers brought home the reality of their duty.
Recently, I spoke to a respite group in Aberdeen with which I am happy to be associated. I said that it is important not to organise respite by menu, as people have differing requirements, and that it is essential to organise time in which carers can go out and shop and have a little bit of life for themselves. That gives people strength to carry on and cope. People become isolated from their own lives and their own people.
I believe strongly—I know that others in my party think the same—that people are best cared for in their community, close to their friends and close to the places they know, even if that means only a view over a church tower, down to the beach or into the park. It is vital that people—particularly older people, whose friends are not so mobile— keep in touch with their friends and that they have the opportunity to be visited by their friends.
Caring is a 24-hour job in many cases. We owe it to carers to set up systems that give them the support and help they need—and a little bit of life for themselves. Those who are being cared for often feel a great burden because they are restricting the lifestyle of their family. Caring signifies strongly that love and care are still vital parts of our society. They are the motivations that drive people. I do not wish to hear people say, "I do it because of duty." That is nonsense. People do it because they care and want to do it.
When I consider our society, I hope that our young people will realise as they develop that, in time, not only will they need help, but their parents might not be the hale and hearty people who today give them a fiver when they need one and run them to the football club, but may in turn want a little bit back. I have five children, so I suppose I have covered myself reasonably well. I tell them to consider always that parents and older members of the family provide for their future and that when they are in their future they should not forget that their parents and older family members will have a need for them.
I stress the requirement for the Executive to examine the hospital discharge system closely. I call on the minister to do his best in that respect. It is important that I do not get constituents telling me, "I run a respite home, but I don't get the right fees and I will have to close the door." Respite care homes are a vital support for our carers. I ask the minister to examine how local authorities deal with the support of respite care homes to ensure that carers do not lack support for just a few pounds. They save our health service and community care services a fortune that is not quantifiable.
Several members wish to speak. It would be helpful if members would keep their speeches to four minutes.
As other members have said, there is to be a debate on young carers tomorrow. I want in this debate to indicate my commitment and that of other Liberal Democrats to caring and to congratulate Karen Whitefield on securing the debate.
One of the refreshing aspects of the Parliament is that although one occasionally gets depressed about things, we also get debates such as this in which there is really strong personal commitment and personal knowledge of the issues.
Probably the most harrowing morning that I have spent in the two years in which the Parliament has existed was in a town in central Scotland when the Princess Royal Trust for Carers organised for me to spend a whole morning listening to carers with a full range of commitments. Almost every combination was covered. I realised the commitment and pressure that some such people carry. I have enormous admiration for them.
Such an experience puts in context the odd problem that we MSPs have with particularly difficult constituents, or with trying to be in three places at once—or even occasional difficulty with our party whips. Carers have real problems, not the sort of problems that we face. They cope with those problems amazingly well. However, they have a lot of difficulties that society could put right and deal with much better.
Others have mentioned respite care. One of the people who spoke to me had a child who, at the age of 11, got a debilitating disease. The parents had continued faithfully to look after that child and had asked for a bit of respite care. They were offered some respite care—six years later. From when the child was 11 until when they were 17, they got no respite care at all. That is not the condition of a civilised society.
Greater funds must be made available, either centrally or locally, for respite care. More effort and funding should be made available for teaching and encouraging medical, social work and educational people to understand the needs of carers and to deal with them better. Part of the job of those people is to recognise the stress borne by the carers and to do something about it.
The minister could look into the fact—although it is probably not for his department—that Citizens Advice Scotland has offices in hospitals in one or two places, which manage a lot of very good advice. That could be replicated elsewhere. There could also be advice centres for carers and for people who are wrestling with the benefits system. Although the benefits system is a UK issue, helping people to wrestle successfully with it is the sort of thing that we could do. I think that we could offer far better advice services.
I think that this is an excellent subject and I hope that we can get the Executive to put allocating the modest amounts of money that would be involved very high up its list priorities for the future.
I echo other members' thanks to Karen Whitefield for securing this debate, which is timely, given that last week was national carers week. It is vital that we continue to recognise the work of carers, because, at some time or another, caring will affect every one of us. I am glad that we are highlighting the issue today. The work of carers in our communities is crucial in providing a decent quality of life for those who need it most. It is important that those in government, at local and national level, do everything that they can to provide support for carers.
The Scottish household survey tells us that 12 per cent of Scottish households contain one or more people in need of regular help or care because they are sick, disabled or elderly. Providing care for those people often falls on relatives, friends or voluntary organisations. However, who cares for the carers?
There are almost 6 million carers in the United Kingdom. They range from children looking after a disabled parent or other siblings—we will hear more about them in tomorrow's members' business debate—to elderly people looking after partners or friends. It is often a 24-hour-a-day, seven-days-a-week occupation, with little respite. As politicians, we are all aware of regulations such as the working time directive, which helps to ensure that employers do not expect their staff to work excessive hours. No such regulations exist for carers, who often have no choice but to be at the home of the person being cared for all day, every day.
More needs to be done by those in government to help, and I am pleased that the minister is listening to this debate and will respond to the comments that have been made. I hope that the current consultation exercise will strengthen the law to help carers, particularly in relation to respite. Having spoken to carers in my constituency, I know that that is a key issue.
Last year, the Executive announced that it would provide resources to fund thousands of additional hours of respite care. That was a step in the right direction, but we should also consider providing more information and training for carers—Margaret Ewing touched on that in her speech. Professional assistance would benefit carers and those in need of care, as it would provide better standards of care.
When I trained and worked as a nurse, I was taught how to care for people who needed care: I was taught how to feed, how to toilet and how to provide all the basic elements of care. However, who provides such training to carers? We cannot always assume that people who are put in the position of having to be a carer will have those skills. We need to be sure that we are providing carers with proper training and expertise, so that they can perform the duties that they desperately wish to perform for their loved ones to the best of their ability.
We also need to consider the financial aspect. Statistics show that, in less affluent areas, more people need regular help from carers. According to the Scottish household survey, 17 per cent of people in disadvantaged council estates need regular care, compared to an overall figure of 12 per cent. Such statistics show that financial assistance for carers is a key issue that the Executive ought to investigate.
I hope that, in formulating its policy on carers, the Scottish Executive will take note of the concerns that have been raised in this debate. I am pleased that various groups are involved in the consultation. I know that carers groups in Rutherglen and Cambuslang are pleased that the consultation exercise is taking place. I hope that it will lead to the provision of even greater support to those in our society who need help most.
I want to make a rather personal contribution. My mother died relatively recently—when I saw the submission by the Carers National Association, I thought that it should have been entitled "You can take her home now".
In November last year my mother underwent a serious operation. Six of the CNA's nine findings tallied with the experience of my father and my family. At the age of 79, my mother was discharged within five days of a major operation, to be cared for by my father, aged 86. He jokingly called himself the oldest carer in Scotland, but he probably was not. David Davidson spoke about support networks. In my mother's case, the family had to rally round, as there was no one else to help.
A major cause of concern is patients being discharged too early. My mother certainly was, which led to her being readmitted to hospital within seven days with breathing difficulties. That also happened a second time. I am not saying that all her treatment was bad, but early discharge is a problem that the survey highlights.
The survey also states:
"40% per cent of carers said the person they cared for was not given enough support on returning home".
My father had none. All he had was his family. Two of his children were in Edinburgh—my brother and I—and the others were scattered throughout Scotland. Apart from the general practitioner, there was no one else to help. When the family asked whether my mother would be bathed by the district nurse, we were told that district nurses did not do that any more. My father and other members of the family ended up doing it. That is the sort of care that was provided. I merely provide an example of what is happening. In our family, this went on for only a short time, but for many people it is a long-term problem. At the age of 86, my father had to climb stairs to take meals to my mother, because there was no one else to do it until the family arrived.
I want to highlight the situation of unpaid and elderly carers, such as my father, who are probably not included in the statistics and have realised that they are carers only since people started to carry out surveys into this question. They thought that they were just looking after people whom they loved.
My colleague Margaret Ewing and other members have highlighted two of the policy recommendations that have been made. It is proposed that we monitor the implementation of the joint future group's recommendations on free short-term care and assess benefits to older people with carers. Many people provide free personal care at the point of delivery, just as my father did. We should make invalid care allowance a proper wage. I am not talking about my father's situation, but about that of long-term carers. They should be paid properly for the work that they do, which saves the state millions of pounds.
My second point relates to respite care facilities. My father's respite was his family. However, when I asked the Executive in a written question about respite facilities for people caring for sufferers from conditions such as Alzheimer's, I was given the usual answer: that the relevant information is not held centrally. I do not blame the coalition Executive for that, but it is time that there was an audit so that we can find out what respite facilities are available. That would enable us to ensure that we develop and provide funding for them, in recognition of the work that carers do.
One of the most telling phrases that Karen Whitefield used was "heading in the right direction". I agree that we are heading in the right direction but, as other members have said, we still have a long way to go.
Many of the points that I wanted to make have already been made, but I draw the minister's attention to the issue of technology. It seems odd that, in this day and age, Raigmore hospital in Inverness should be involved in a scheme called the electronic communication initiative—ECI. That is a pilot study in which the hospital notifies general practitioners about the needs of their patients when discharged from hospital. I find it incredible that, in 2001, with access to the world wide web, we are still running pilot studies on acute hospitals talking to GPs.
Nevertheless, I welcome that pilot study and I hope that it will be rolled out across Scotland quickly, because many GPs in the Highlands have informed me that they and their staff spend a long time on the telephone trying to find out why a patient was discharged, what their needs are and what drugs and help they are supposed to have. Meanwhile, the carer is sitting in the surgery, wondering what they are supposed to do. We are heading in the right direction but we recognise that we have a long way to go.
Margaret Ewing mentioned social security benefits. Recently, a carer's daughter was taken into hospital; the carer told me that not only had her daughter lost her independent living fund—I am not too familiar with such benefits—but that, when she was discharged, she was unable to get that benefit back because she was not purchasing enough care. In addition, she was not allowed to attend her day care centre because of her medication. That was a learning curve for me. I discovered that the energies that should have been spent on caring were spent on bureaucracy and administration.
Such situations also arise for elderly people. If an elderly patient is in hospital for a certain period of time but then goes home, they lose benefits and have to go through that bureaucratic system again. They also go to the end of the queue for home care assessments and benefits, which were all in place before they went into hospital.
Malcolm Chisholm, the Deputy Minister for Health and Community Care, is chair of the care development group and, on the theme of heading in the right direction, I look forward not just to the group's definition of personal care but to the minister's commitment to the recommendation of both Sir Stewart Sutherland and the Health and Community Care Committee that there should be a single budget, a single point of entry and a single management system for people who leave hospital and who are cared for.
Most members talked about carers, but I would also like to speak about respite care. The idea seems to be that when respite care is set up, everything is all right. However, many carers worry about whether the respite care is appropriate or up to standard. Respite care must be appropriate.
The debate brought to my mind a recent case from Kingussie that Fergus Ewing will know well. A carer's husband is in hospital and, therefore, in care. However, the carer spends most of her day visiting him. She has a 40-mile journey each way, with a further bus journey. That journey leaves the carer more concerned and traumatised.
The carers strategy, which the Executive produced in November 1999, promised that an national health service helpline would be set up in spring 2000 to provide information and access to social services and support for carers. I ask the minister to confirm that that helpline has been set up. I hope that it has; perhaps I have missed it.
I commend Karen Whitefield for her commitment to carers and for helping to raise awareness of caring and carers' needs. I hope that we can continue to head in the right direction.
Karen Whitefield is to be congratulated for introducing for debate an issue of such major concern to us all. I have found the debate interesting and, at times, moving. I am thinking of the contributions from David Davidson and Christine Grahame, who described their own experiences.
Mary Scanlon and I are not ashamed to say that we have worked together on many issues, including that of carers. In Badenoch and Strathspey, there is no place in which those who suffer from dementia, for example, can be cared for. That means that carers must travel long distances to Inverness or Nairn and those journeys take up a large part of carers' lives. They do not grudge the travelling, but the practical difficulties of travelling anywhere by public transport from Badenoch and Strathspey are very difficult indeed. I know that the minister will be sympathetic to such points, which is why it is useful to have debates of this nature.
One of the few advantages that I may have over other members in the chamber is that I fought a number of losing election campaigns that gave me a great deal of time to acquaint myself with my constituents to be. One of them now cares for her mother, who lives in a remote part of Lochaber. From one of my unsuccessful campaigns, I knew the lady to be an active member of the community—she was a schoolteacher. I went to visit that lady in her home, but she had gone from a life in which every day was full of work and social activity balanced in the busy life of a schoolteacher, to a life in which, because she is looking after her mother who has dementia, she has only about an hour a week when she is out of her house. Carers who look after elderly people with dementia are particularly isolated. They do not have the conversation and they have to deal with the sadness as well. I hope the minister will take that point on board.
In a letter on behalf of another constituent, I ascertained from the minister's predecessor that the £10 million a year contribution to which Karen Whitefield made reference in her opening remarks has been earmarked. In a letter of December 1999, Iain Gray said to me that, if that money proved to be insufficient, the issue would be reconsidered. There is no doubt that the provision of services to carers is a priority area. Other areas, such as the escalating costs of certain buildings, cannot be so described.
Domiciliary care is another area that has not been mentioned. One of the few decisions that the Highland Council could perhaps be criticised for was its decision to withdraw, to a certain extent, the provision of domiciliary care and basic care for housework and shopping in Inverness. That caused great hardship. Some people came to people like me and Mary Scanlon to complain. Others had advocates who consulted us. However, I worry about the larger number of people who did not complain and did not have advocates because they were too proud or did not want to make a fuss. I would like to see a statutory obligation—as I understand it, no such obligation exists at the moment—to provide domiciliary care.
Since we are talking about respite care, we must also mention people with special needs. There is an establishment in my constituency called Badaguish that provides excellent care for children with special needs and gives them access to virtually all types of outdoor activity. For example, a young child who was blind first heard the sound of running water by putting her ear to the burn in Badaguish.
Badaguish is situated within the future Cairngorm national park. The aims of the national park are wide enough to allow the provision of respite care to allow people with special needs to have the same opportunities as other people who do not have a disability. I hope that the Deputy Minister for Health and Community Care will see his remit as encroaching on to that of Allan Wilson.
On Saturday, I shall participate in an event called the Caledonian challenge, which hopes to raise quite a lot of money through the 1,280 people who will participate. The charity is called the Scottish Community Foundation and I believe that this year's target is £1 million. I know that the Scottish Community Foundation is interested to hear from members who feel that they have a worthy constituency charity or community project that the foundation could help from the £1 million that it is hoped will be raised. I am sure that David Fox-Pitt, the terrific fellow who is the organiser of the event, would be delighted to hear of any applications that members feel are worthy of support.
I congratulate Karen Whitefield on securing this important debate. I welcome the opportunity to acknowledge the immense contribution that carers make to society and to making care in the community a reality.
At the beginning of her speech Karen Whitefield mentioned various initiatives such as the strategy on carers; the £10 million that has been given to local authorities, which we are monitoring; and the £0.5 million for voluntary sector initiatives to support carers. She also referred to the current consultation on new legislation for carers and Janis Hughes spoke about that in detail in her speech. I am glad that carers were centrally involved in the formulation of that consultation document. I look forward to reading the responses in the near future.
Margaret and Fergus Ewing referred to the need for extra respite care. I remind members of the extra 22,000 weeks that were announced in October, for which a sum building to £11 million in year 3 has been allocated.
Mary Scanlon asked about the NHS helpline. I can assure her that it was extended in April 2000 to provide information for carers on local and national sources of advice and support. Donald Gorrie also referred to information and made an interesting suggestion on a possible role for the CABx. I am not aware of such a role in relation to carers but I know that, in Mr Gorrie's former Westminster constituency, there are welfare rights people in certain general practitioners' surgeries. I would like to acknowledge Karen Whitefield's role in helping to bring about an initiative in Airdrie involving the CAB and Macmillan nurses.
The main issue that I would like to refer to is the report entitled "You Can Take Him Home Now". Karen Whitefield gave a very balanced account of that report. It is clear from the survey that some carers feel that they and their relatives are not receiving a level of service that meets their needs and that improvements could be made in hospital discharge arrangements. In particular, the survey suggests that many carers feel that their relatives were discharged before they were ready and had to be readmitted shortly thereafter. Christine Grahame highlighted that point.
The reasons for readmission are many and complex. Inevitably, there will be occasions when readmission will happen, especially when the patients concerned are older people. However, what the NHS must do is to work with social care agencies to minimise inappropriate discharge and provide optimum home care as necessary. I know that much work has already been carried out by the health and social care sectors to improve the experience for patients and carers.
To take last winter as an example, disruption to successful service delivery and to patients was minimised by the implementation of robust planning arrangements. The spread of rapid response teams across Scotland enabled people who would previously have been admitted to hospital to be cared for in their homes. The rapid response team approach also provided support after discharge for patients in their homes for an agreed period to assist in their recovery and allow them to regain their confidence.
These teams of professionals, working together with patients and carers, provide assessment, intensive rehabilitation and home care packages; they facilitate the smoothest and timeliest possible discharge; and they ensure patient and carer choice. The Executive is committed to the expansion of rapid response teams throughout Scotland.
Of course the issues for carers and patients are wider than discharge arrangements. Properly planned continuing support is paramount. Joint planning based on individually assessed needs is the only safe and sensible way to proceed and is the best way to arrive at a successful and sustainable transfer from hospital care. That is why "Our National Health: A plan for action, a plan for change" unequivocally underlines our commitment to improving and integrating planning and decision making so that patient care, in and out of hospital, is organised and provided on a seamless basis. There will be a step change in that process from next April, with health boards and local authorities coming together to jointly resource and manage all services for older people. I am sure that Mary Scanlon will welcome that.
Clearly, money is an important issue. We have invested £24 million this year and next, which will rise to £48 million in 2003-04, to develop key services such as rapid response teams, more intensive home care services, more short breaks and the shopping and domiciliary maintenance services to which Fergus Ewing referred. Those measures will make a difference, as will the totally free home care for four weeks following discharge, which we announced recently and for which £2.4 million has been allocated.
Additional work is being taken forward by the chief medical officer's group on the health care of older people. It is looking at all stages of the older patient's journey of care through the NHS, from home into hospital, intensive care if necessary, discharge and back home again. The objective is to identify problem areas and seek solutions, so that older people can have the smoothest possible journey through the system. At its meeting next month, the group will be examining delayed discharges. The Carers National Association Scotland is represented on the expert group, and has already provided it with a copy of the supplementary report for Scotland. I am sure that the group will find that to be a helpful contribution, as will the emerging delayed discharge learning network.
Carers undoubtedly help to hold the complex web of health and social care together. It is fitting that this week we have two debates on care. I look forward to the debate tomorrow on young carers, and I concur with Karen Whitefield's remarks on it. As an acknowledgement of the importance that we attach to carers, the First Minister held a reception last week at Edinburgh Castle, at which I was pleased to meet a large number of carers. I was also privileged to meet a number of remarkable carers last night at Douglas House in Edinburgh, which is a residential and respite facility for children with severe disabilities.
I will consider the policy recommendations in the report "You Can Take Him Home Now" to ensure that the concerns of carers are comprehensively considered as we develop and implement our policy initiatives.
Meeting closed at 17:22.