The new carers strategy received little media coverage, launched in a week dominated by the row over detention of terror suspects.
However, publishing it last week, care services minister Ivan Lewis summed up its importance by saying: “Over the next decade elder care will be the new child care.”
Its goals are ambitious: that by 2018 carers will be recognised as expert partners in care, be able to have a life of their own, will not be forced into financial hardship by their role and will be supported to stay well, while children’s care will be improved. The strategy’s health and social care aspects cover England, while its income and employment elements reach across Great Britain.
From 2008-11, it promises £150m to expand short breaks for carers and £38m towards supporting carers into work. Annual health checks for carers, more joined-up provision between the NHS, councils and charities, and training for GPs in supporting carers will be piloted. Young carers services will receive a £6m boost.
Priorities for 2011 onwards include reviews of the benefits system for carers and the annual carers grant for English councils.
‘Turning point’ for NHS
Alex Fox, of the Princess Royal Trust for Carers, believes the emphasis on health marks a “turning point”. He points out that the £150m for short breaks will be allocated to primary care trusts, who will work with councils and publish joint plans. “The NHS has lagged behind councils in seeing carers as its business,” Fox, assistant director of policy and service development, says. “Social services have always had to pick up the pieces, so we need a system where support is shared between agencies.”
The NHS Confederation says parts of the NHS have not been good at supporting carers because of other targets. Jo Webber, deputy policy director, says: “The thrust has been towards the big hits such as reducing waiting times. Despite this, there is widespread recognition that carers are vital to the NHS. They deal with issues 24/7 and many patients would not be able to remain at home without them.” She describes the strategy as the next piece in the government’s jigsaw of personalisation, “tailoring support for carers are well as patients”.
Despite such enthusiasm, there is disappointment over the government’s failure to give carers an immediate financial lift, particularly by raising carer’s allowance from the current £50.55 a week.
Carers campaigners welcome the promise of a benefits review but say it must happen now. Carers UK chief executive Imelda Redmond warns that without it there will be a “real mismatch” between the strategy’s vision and reality.
Other questions centre around the government’s review of the carers grant. Since it was introduced in 1999, the grant has given councils over £1bn to support carers, with £224m pledged in 2008-9 and £256m in 2010-11. But there is evidence to suggest the money has not gone to the right places since ring-fencing ceased in 2004-5.
A recent Princess Royal Trust survey found that while the government increased the carers grant by 16% this year, some councils only passed on a 3% increase to carers centres, many of which are run by the trust. Others authorities made cuts of up to 10%.
Question marks against councils
Fox warns: “If councils aren’t spending their grant on carers now, how will they spend the new resources?”
Graham Betts, joint lead on carers for the Association of Directors of Adult Social Services, says it is hard to judge if councils are spending the grant as they should but says money is also spent from other streams. Betts hopes the grant review will highlight exactly how money is being spent, so improvements can be made, adding: “We are not fearful of the review.”
However, Lewis says: “If it becomes clear that local authorities are not spending money on improving carers’ quality of life, we will look at changing the way we allocate the funding.” The grant could be channelled through charities, he suggests. Another idea, from the Institute for Public Policy Research, is “top-slicing” existing carers funding to create a personal budget for carers. The strategy says the government is committed to the introduction of personal budgets for carers.
Finger on the pulse
Scrutiny over the strategy’s implementation will partly be provided by the Standing Commission on Carers, headed by learning disabilities and carers campaigner Philippa Russell who says: “We will keep our finger on the pulse of what’s happening.”
Long-term success could depend on the next – possibly Conservative – government. Shadow health minister Stephen O’Brien welcomes aspects of the strategy – such as the £150m for short breaks – but criticises the lack of “hard commitments on tax and benefits” and action to tackle the “postcode lottery in services”. But he offers no concrete proposals on what the Tories would do.
Betts wants change soon: “This is a 10-year strategy, but 10 years is a long time to wait if you are a carer struggling from day to day.”
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The 2001 census found there were 5.2m carers in England and Wales, with nearly half providing more than 20 hours care a week, and more than a million providing over 50 hours a week. In the same year, Carers UK estimated the number of carers across the UK could rise from 5.7m to 9.1m by 2037 unless services expand or the health of the nation improves.
Carer Eric Stead: I will “reserve judgement” until he sees how it works in practice
Eric Stead, 61, has been caring for the past 20 years for his wife Diane, who is also 61 and has complex disabilities. Eric, from Lancashire, gets Diane out of bed, washes and dresses her and prepares all her meals. Diane cannot go anywhere on her own, being “unsteady on her feet” and uses a wheelchair outside. She attends a day centre, and Eric would like more time for himself but does not have enough money to go “out and about”. His biggest disappointment in the strategy is that it does nothing to “meaningfully increase” the carer’s allowance, as the current weekly rate of £50.55 “gets swallowed” up by basic needs. However, Eric welcomes the pledge of more support from the NHS, as his experience has been “patchy”. He says: “When my wife has been in hospital I have often been seen as a visitor, not as the person who has to take over when she goes home, and this has really upset me.” Eric hopes the strategy will add to recognition of carers’ roles. But he is anxious that the £150m for PCTs must not go into “administration”. He also thinks the money would be better channelled through his council, where a popular fund providing short breaks is running out due to demand. Eric believes the best thing about the strategy is its pledge to see the carer as an “expert and partner” in care. But he says he will “reserve judgement” until he sees how it works in practice.