Britain has a new ritual: at 8pm every Thursday we gather at our front doors, windows and balconies to clap for our carers and the incredible jobs they’re doing on the frontline. For us, it’s a symbolic attempt to recognise the contribution of our key workers in an unprecedented time of crisis. Yet for many, a round of applause in recognition is far from all they need. Our informal carers are just one cohort who have gone too long without enough support. In 2018, our report The Carers’ Covenant called for a radical new settlement between the state and informal carers, including a new Universal Carer’s Income. When this crisis is over, will we see a newfound commitment to supporting all carers – not just on the streets, but in government policy too?
Read the full Carers’ Covenant here, and the introduction below.
In a 2012 essay for Political Quarterly, Charles Clarke, the former Labour Home Secretary, coined the phrase “the too difficult box” to describe the intractable political and public policy challenges that governments conspire to ignore. (4) Climate change, welfare reform, vocational education, multinational tax avoidance, economic centralisation – it is a frustratingly big box. And given the country now appears destined to focus primarily upon renegotiating its place in the world for the next decade, it is one that may soon be even more tightly packed.
Still, chief amongst its contents is our inability to create a proper care system to complement and accompany the NHS. Neither the cross-party nature of this failure, nor the scale of the problem can be understated. Furthermore, with a rapidly ageing society – arguably the biggest change in who we are as a nation since the industrial revolution – compounding the situation, this is one public policy challenge that can surely no longer be ignored. Almost one in seven older people are today living with an unmet care need, a figure that looks set to only grow. (5) Maintaining what is already a threadbare, under-resourced, barely functioning social care system will require £18bn by 2033/34 just to stand still. (6)
In response, Members of Parliament are now beginning to work across parties to explore proposals for the future of social care. (7) The Government has promised an imminent Green Paper on social care, recognising that we need a “long-term solution to care”. (8) Former Prime Ministers reflect ruefully that they should have done more, (9) whilst some of the country’s leading newspaper columnists now regularly promote radical solutions. (10)
These developments are all undoubtedly welcome, yet equally it would be unwise for advocates of systemic change to entirely ignore the political challenge that perhaps saw social care placed in the ‘too difficult box’ in the first place. These political challenges come through very clearly in our focus groups (see chapter two) where we uncovered a stark hostility towards tax rises as a vehicle for increased care funding – and this amongst those who might reasonably expect to benefit from it too. Indeed, our focus groups left us in no doubt about why both major parties took severe political hits – Labour in 2010 and the Conservatives in 2017, respectively – when trying to finally address the issue in the full glare of a general election campaign.
Therefore, though this research began with the simple insight that individual carers were absent from a debate focused almost entirely upon the structure of the state and its funding, we now believe that a fundamental reframing of new policies away from statist solutions and towards better family and carer support may be one way through the political impasse. Furthermore, we wonder whether the long-held assumption that the UK, in contrast to other countries, culturally prefers the state to care for its relatives has survived a decade or more when eight million of us now take upon this caring role.
Of course, on a challenge of this scale it is not and never will be a binary choice between the state and carers; any feasible solution will have a mix of both. But because of this deeply held scepticism about an all-encompassing state solution – perhaps because caring is deeply personal and different in kind to other more anonymous public services – we must be sceptical of the pull to collectivise care. That being said, the expansion of market-led private provision is also problematic – in our focus groups carers were just as wary of private providers as they were of an overbearing Leviathan interfering in their lives. We must therefore look beyond the market and state to the families, communities and neighbourhoods that are already providing so much care and examine how we can better support them.
To that end this report calls for a new policy deal for Britain’s carers who serve as ‘invisible millions’ to so many of our current public policy systems. We do this for three primary reasons.
One, we estimate that there are almost eight million informal carers in the UK today – an increase of roughly 35% since 2001 – and that too many of them are at breaking point. (11) That our entire welfare, social care and health services are essentially propped up by their work, should be a cause for huge concern. Unless our carers can be supported to lead healthier, happier and more sustainable lives, the very fabric of our society is at risk of collapse.
Two, any long-term solution on social care will be dependent on the buy-in and support of informal carers, given the vital – but too often invisible – role they play in our social care system today. For reasons discussed above it may be the case that any solution on social care must also look at ‘formalising’ the role of informal carers through proper financial support approaching a wage and other support measures. But given the sorry state of support for carers at the moment this option just would not be possible – our carers would have to be in better shape than they are today to play such a role.
Three, the increase in the number of informal carers is already having and will continue to have significant economic implications. As this report shows, becoming a carer significantly affects an individual’s ability to stay active in the labour market. Therefore, whilst the carer is often the best person to provide care for reasons outlined above, we have to find a way forward that doesn’t force so many carers to leave the workplace and never return.
To those familiar with the work of feminist economists, the above will come as little surprise. As New Zealand political economist Marilyn Waring argued in her seminal work If Women Counted, because unpaid labour is not included in standard measures of economic activity, those providing unpaid labour are forgotten. (12) In the age of measurement, get measured or get forgotten. In Britain today informal carers have been forgotten and this report also aims to put that right.
The report contains four chapters:
Chapter One explores the rise of the informal care economy and asks ‘who are informal carers?’. It concludes that they are more likely to be middle-aged, female and in work, delivering a significant number of hours of care each week. They are also likely to be found in rural areas or small towns away from large metropolitan cities. We also see that whilst the majority of carers are in work, their rate of employment is significantly lower than that of the general population, suggesting that caring is affecting their ability to work.
Chapter Two explores the experience of informal carers through two focus groups in Leeds and London. We find that carers are often extremely stretched and find it hard to cope. They struggle with existing systems of support and would welcome greater financial assistance, but are also opposed to higher taxation to pay for a more comprehensive social care system – a view that could be driven by their mistrust of external involvement in their lives.
Chapter Three provides a brief overview of the support on offer to informal carers in other countries. It concludes that they have a more flexible, generous approach to supporting carers and that the UK should enact similar measures if it is not to fall further behind international standards.
Chapter Four outlines our policy agenda to improve the lives of informal carers in UK. This focuses on five areas – financial assistance, employment, identification and support, support networks and technology – which are informed by the rest of the report. Our objective across each policy area is to provide greater support for informal carers.
(4) Clarke. C (2012). The “Too Difficult Box”: Its Temptations and How to Avoid Them. The Political Quarterly, 83(2), 303–310.
(5) https://www.ageuk.org.uk/latest-news/articles/2018/july/1.4-million-older-people-arent- getting-the-care-and-support-they-need–a-staggering-increase-of-almost-20-in-just-two- years/
(6) https://www.health.org.uk/news/new-figures-reveal-82-british-public-support-increase- social-care-spending
(7) Health and Social Care and Housing, Communities and Local Government Committees, Long- term funding of adult social care, 2018, https://publications.parliament.uk/pa/cm201719/cmselect/cmcomloc/768/768.pdf (accessed 17 September 2018).
(8) https://www.gov.uk/government/news/government-to-set-out-proposals-to-reform-care- and-support (accessed 17 September 2018).
(9) Financial Times, David Cameron admits shortcomings on social care, 2017, https://www.ft.com/content/b9c248d4-d679-11e7-8c9a-d9c0a5c8d5c9 (accessed 17 September 2018).
(10) Rachel Sylvester, At last, a radical solution to the social care crisis, 2018, https://www.thetimes.co.uk/article/at-last-a-radical-solution-to-social-care-crisis-8c7bm2qwb (accessed 17 September 2018).
(11) In comparison with 2015 statistics found in ‘Valuing Carers 2015’. For the full methodology behind our estimate please see Appendix One.
(12) Marilyn Waring and Gloria Steinem, If women counted: A new feminist economics (San Francisco, Harper & Row, 1988).