Shadow Health Minister’s response to Queen’s Speech focuses on carers and Care Act

“The Government’s programme falls short in a number of areas, including the provision of support to carers. There is nothing in the Gracious Speech to improve support for carers or to ensure that local authorities have the resources necessary to implement the duties that the Government placed on them in the Care Act 2014. The 2011 census shows that the number of carers increased by 11% over the previous 10 years, and the steepest rise was in those caring for 50 hours or more each week. The number of older carers is also increasing. Age UK has found that one in seven people over 80 now provides unpaid care to family and friends. In the last seven years, that number has increased by 40%, and now includes 417,00 people in their 80s.

Failure to address the needs of older carers will mean that many will find it difficult to cope with their caring responsibilities. Caroline Abrahams of Age UK stated that “as public funding falls further and further behind the growing demand for care we worry that very old people are being expected to fill the gap. They can’t do it all on their own and we shouldn’t take advantage of their determination to do right by those they love.”

It is wrong to presume that when budgets for adult social care are cut unpaid carers will fill the gaps, and current pressures are bringing carers closer to breaking point.

Earlier this month, Carers UK released the findings of its annual “State of Caring” report, which highlights the difficulties of providing quality services for carers against a backdrop of continued local authority cuts. It states that “the spirit of the Care Act 2014 and the Children and Families Act 2014 have not become a reality for all and carers are struggling to get the support from health and care services that they need to care, work and have a life outside caring. The survey shows evidence of public services creaking under pressure charging is up, the right services are harder to find and vital support is cut or under threat, leaving many carers anxious about the future and their ability to continue to care.”

I have raised the impact of funding cuts on the care sector in a number of debates, because social care is too easy a target for cuts. Ministers have been prepared to slash local authority budgets, leading to cuts of £4.6 billion in adult social care since 2010. The Local Government Association has estimated that the implementation of the national living wage—as the Government call it—will this year cost an additional £330 million for home care and residential care providers. In Salford, for example, the 2% social care precept—that is all the provision that the Government are making this year—will raise £1.6 million, but the cost of implementing the national minimum wage will be £2.7 million. It is easy to imagine that gap multiplied up and down the country.

Despite what Ministers say during debates and questions, there is no extra funding from the better care fund for social care this year, and only £105 million next year. Pleas were rightly made by the directors of adult social services and the Local Government Association for the Chancellor to bring forward £700 million from later years of the better care fund, to address those immediate financial pressures. Failure to do that could lead to care providers failing or walking away from publicly funded care, and that could have serious consequences for vulnerable people who rely on care services. It is unfair to think—as seems to be the view—that unpaid family carers will be able to pick up the pieces if care providers fail because of cost pressures.

Unpaid carers are already under increasing pressure because of the impact of Government policies, and one third of carers told Carers UK that they have experienced a change in the amount of care and support that they receive. Almost 60% of those reporting a change say that the amount of care and support they receive has been reduced because of cost or availability, and in some cases those cuts have been significant. One carer reported: “The social worker who assessed my wife said all direct payments in the borough were being reduced. We discussed the needs and were advised we would be informed of any change. Without warning or notification the budget was cut by 30% immediately.”

Given those facts, it is not surprising that 54% of carers surveyed felt that their quality of life will get worse over this year, despite the Care Act 2014.

The 2014 Act was supposed to entitle all carers to a timely assessment of their needs, yet one in three carers who have had an assessment in the past year had to wait six months or longer. Worryingly, nearly 40% of carers caring for someone at the end of life also had to wait six months or more for an assessment. There is no time at the end of life to be considering what a carer needs “in six months’ time”, and I urge the Minister to press Health Ministers to respond to the independent review of “Choice in end of life care”, which was published more than a year ago, and to consider a new review that would extend choice at the end of life to children and young people.

Almost a quarter of carers had to request an assessment for themselves over the last year, instead of having one offered to them as the law requires. Even when carers receive an assessment, many feel that it does not address their needs. Almost 70% of carers felt that their need to have regular breaks from caring was not considered, and 74% of working-age carers did not feel that the support needed to juggle care with work was considered sufficiently. It appears to some carers that assessment is just a listening exercise that provides no real help. As one carer reported: “All assessment areas were considered by my assessor but due to cuts there was no support they could practically offer me. I was listened to but there was no positive outcome.”

Along with the emotional stress and physical exhaustion that can occur from providing care without enough support, many carers are finding that it has a real impact on their finances. Of the carers struggling to make ends meet, nearly half surveyed are cutting back on essentials such as food and heating. Others are borrowing money, and more than a third are using up their savings. That is clearly not sustainable in the long term.

I urge Ministers to ensure that carers have the financial support they need. Carers also need access to services to help them in their caring role, and the health and social care system should have a duty to identify carers and take meaningful action to promote their health and wellbeing. Assessments should be accessible to carers, and they should be more than a tick-box or listening exercise. They should lead to carers being provided with tangible support.

The Gracious Speech did not provide any assurance that the Government will address the funding problems that local authorities face in providing social care, which I have outlined. The move to full business rate retention by local authorities will not address the chronic underfunding of social care. As with the social care precept, the proposed financial arrangement for local government fails to consider need, and could create further inequalities in funding for social care. I am concerned that those areas where most funding is needed will be those that gain the least from business rate retention. Unless the Government outline significant changes for carers in their upcoming carers strategy, it is likely that we will continue to see higher costs for carers, and lower levels of support for them or the person they care for”…

On the issue of the success or failure of the Care Act (and on the question of adequate funding) , Rescare also brings to your attention an article by Mithran Samuel which appeared online  in Community Care on 1st April. Entitled “One year on, what has the Care Act achieved?“, its subheading ran as follows “While councils project optimism about the legislation’s impact, cuts to care packages, problems meeting advocacy duties and social work shortages are sources of concern”, and in its conclusion predicts  “a difficult second year for the Care Act”.  Well worth reading.