Tag Archives: social care

One of the political messages which did get through in the July General Election – thanks to Ed Davey – was the vital importance, but also the chronic neglect, of carers. There are an estimated 1 in 5 of the population who care, unpaid, for sick or disabled loved ones: a vast invisible army without whom society would literally fall apart. Ed was able to use his own direct experience as a carer, and that of his upbringing, to highlight some of the problems – which are growing as the population ages and as fiscal pressures grow. 

Having got the issue on the agenda, what do we say and do about it? First, we need to sweep away some of the complexity and topical red herrings like the mooted, but now abandoned, ‘cap’ on social care costs.  A key starting point is the distinction between the 1.5 million care workers who are the professional backbone of adult social care (that is, care outside the NHS) and the estimated 10 million unpaid carers who are estimated to be the equivalent of 4 million paid care workers. The care workers are usually very badly paid, have minimal career progression and often have stressful working conditions which is why 10% of vacancies are unfilled and why recruitment depends very heavily on immigration from Asia and Africa. 

The unpaid carers are more numerous and less visible. Any conscientious MP or councillor will know however of the horror stories and heroics amongst carers: bereaved or abandoned children caring for other children to stay out of care homes; parents struggling to manage children with complex needs requiring 24-hour attention; elderly couples with waning powers and strength trying to help each other to manage a home and combat loneliness;  or the daughter (usually) of a frail or disabled parent trying to manage children, part-time job and mum.  Local councils provide some domiciliary support subject to means tests and -rising- thresholds of physical need which, itself, needs – scarce – social worker assessment. Almost 80% of carers receive no support. 

Carers’ needs are not just financial or physical. Caring imposes heavy emotional demands. My limited experience caring for my late wife when terminally ill was demanding enough and I was lucky to have a supportive family and friends and reasonable finances.  My wife was brave, lucid and engaged unlike the growing numbers of elderly, dementia sufferers who tax the emotional reserves of their carers. Many carers have had to give up careers and leisure, are isolated and lonely and worried stiff about money. The most useful support is often respite: time out for exercise, shopping, meeting people. But day respite care, let alone holidays, is patchy at best.

Helping carers usually involves money- for more, high quality, professional carers to support those struggling at home; more, better funded respite centres; more generous carers’ allowances; more generous eligibility tests for support. And that means more money channelled through cash strapped local government. Eyes inevitably roll at the mention of money. But support for carers is not a financial black hole; it keeps the frail elderly out of hospital and in the community; children out of care homes and specialist institutions. It keeps families together and the elderly from expensive institutional care. 

But for those of us who don’t subscribe to the tree theory of money there are difficult choices and trade-offs to be made. That is the context of the review of public spending being undertaken by the Labour government. The care sector – and local government, which is responsible for most of it – is facing austerity piled on austerity and is in competition for funds with the courts, prisons, defence, public sector workers and much else. Clearly taxes must rise but no one expects the tax increases to be remotely adequate to meet the current pressure on public services. It is important therefore to get priorities right.