Carers’ promise

Council director Andrew Cozens argues that it
is time the government delivered on its promise to carers.

The carers’ lobby has friends in high places.
No less than Prime Minister Tony Blair and leader of the opposition
Iain Duncan Smith are endorsing National Carers Week 2002, and
Princess Anne heads one of the major carers’ organisations in this
country. So why have neither Conservative nor Labour governments
fully endorsed carers’ legislation, and why won’t they fund it
properly? Also, why has the National Assembly for Wales,
apparently, done more than Westminster?

The
economic case for supporting carers seems strong. New figures from
Carers UK suggest that the unpaid contribution of carers to the
economy in the UK equates in value to the total cost of running the
NHS. This £57bn estimate is the replacement cost of all carers
if they withdrew tomorrow. It would never happen, but it underlines
how seriously policy makers should take carers’ needs. However,
this economic case does not seem to have the same weight in
Treasury circles as the case for investment in children that is
shown in the admirable Sure Start and Children’s Fund
programmes.

Social
services departments have, until recently, felt uncomfortable about
the wholesale endorsement of the carers’ lobby. Concepts of caring
and carers do not fit well with the social model of disability,
because they reinforce ideas of dependence and lack of choice, and
diminish the care given by disabled people themselves as parents
and carers. With anti-discriminatory legislation, and practice and
services that are user-directed and which offer real choices, there
can be a reduced reliance on carers. But for those who are carers,
there must be recognition and support too.

If
social services are not adequately funded to provide the
flexibility and choice that disabled people want and to support
carers, both lose out. Cuts in services make more demands on carers
at the time when the support they receive is at best
limited.

Supporting carers as policy is,
not surprisingly, popular across the political divide. It fits well
with reasserting the responsibilities of families and individuals
and reducing demand on state-funded services. Translating this
support into tangible rights or benefits has proved more difficult
and has been left, so far, to backbench MPs.

The
first piece of legislation was the Carers (Recognition and
Services) Act 1995 introduced by Labour MP Malcolm Wicks. This gave
carers providing a regular and substantial amount of care a right
to an assessment, in addition to the assessment of the person they
cared for. However, if the person being cared for refused an
assessment, then the carer could not have their needs
assessed.

Local
authorities received no additional funding to undertake the carers’
assessments or to provide more services. As a result the number of
assessments undertaken by authorities under the 1995 act continues
to be low, as a proportion of all carers.

The
incoming Labour government’s national strategy for carers
recognised this problem and introduced a specific carers’ grant in
England, targeted mainly at additional breaks for carers. This was
warmly welcomed at the time and has, without question, led to a
dramatic increase in the number of breaks for carers.

There
was also a sea change in the attitude of social services
departments to the case for carers’ rights. Experience and research
had shown that carers’ demands were modest. They wanted to carry on
caring; to do so they needed information, recognition, support, a
break, and a safety net to fall back on. All departments now have
plans for support to carers, a condition of the carers’
grant.

Hopes
were high that the strategy would be reinforced by a government
bill to consolidate the rights of carers to assessments and
services in their own right, backed up by more funding to make it
happen. But, like its predecessor, the Carers and Disabled
Children’s Act 2000 was introduced by a backbench MP (now Lord
Pendry). It built on the 1995 act by:

–
Giving carers a right to an assessment in their own right, even if
the cared for person refused an assessment themselves. This is the
one mandatory duty on local authorities.

–
Allowing councils to give services to carers to help them care,
separate from those provided to the cared for person (providing
they were not of an intimate or personal nature), and to charge for
them – a discretionary power for local authorities.

–
Giving local authorities a power (not a duty) to provide direct
payments to carers (for services for them); to parent carers for
services to disabled children; and to 16 and 17-year-old disabled
young people for their own services.

–
Giving local authorities a power (not a duty) to offer vouchers for
short-term breaks.

All
parties welcomed the act as an important step forward. But it was
tempered by concern that its impact would be substantially reduced
by a failure to provide additional funds – beyond the targeted
carers grant – for local authorities to carry out new assessments
and provide new services for carers, extend direct payment
arrangements, and introduce voucher schemes. Both the Association
of Directors of Social Services and the Local Government
Association warned that cash-strapped departments would not
undertake new discretionary roles without funding for the new
responsibilities, on the basis that if the government really meant
it they would fund it.

To
gauge the impact of the act and whether the ADSS and LGA’s
predictions were too pessimistic, earlier this year I undertook a
survey for the ADSS of departments’ work on implementing the
act.¹ Responses were received from 110 of the 163
councils surveyed.

The
findings were stark. Only 20 had found new resources to implement
the act, other than the carers’ grant. Only 26 planned to do so
this year. Virtually all councils said the lack of resources
inhibited implementation. Most had put in place new arrangements to
assess carers in their own right, but progress on new specific
services to carers, or innovative ways of delivering them envisaged
by the guidance on the act was very patchy.

When
lobbied in February 2001, John Hutton, then health minister with
responsibility for carers, responded to the ADSS and LGA calls for
new funding for the act by pointing to the carers’ grant and an
earmarked element of the Quality Protects grant. He also said that
the only duty on councils was to carry out assessments of carers.
The carers’ grant allowed some limited expenditure in support of
carers where the cared-for person refused services.

Subsequently, the Labour Party
included a commitment in its manifesto for the 2001 election to
look at a fund for implementing the act. We believe this is being
considered in the current comprehensive spending review, and that a
precedent has now been set for this funding. The Welsh assembly has
already made a three-year commitment from 2002-3 through the
revenue support grant, reaching £2.6m in 2004, to meet the
costs associated with delivering carers assessments.

Carers, backed by their
organisations and the ADSS, are calling for this manifesto promise
to be met. We estimate that £40m is needed to fund the
infrastructure that gives the act a chance to achieve its
objectives. Money is needed to carry out more assessments and to
bring in new, imaginative services to carers in their own right.
This must be provided transparently and in good faith. Our survey
shows that departments have an open mind about whether it should
come in a specific grant or, for example, in the manner of the
children’s fund. We are happy to demonstrate how it will make a
difference for carers.

Andrew Cozens is director of social
care and health, Leicester Council, and junior vice president and
lead director on carers for the Association of Directors of Social
Services.

References

¹ Andrew Cozens,
Findings of the ADSS Survey on the Implementation of the Carers
and Disabled Children Act 2000, ADSS, April 2002