Older People: Their Place and Contribution in Society

Baroness Pitkeathley Excerpts

Friday 14th December 2012 Lords Chamber

[Baroness Pitkeathley]

My Lords, your Lordships’ House has a wonderful record in longevity, as we have heard several times in the debate, but if the temperature in the Chamber drops any lower, I think it will see quite a few more of us off. It is an honour and privilege to speak in this debate and I congratulate the most reverend Primate on his magnificent contribution, on securing the debate, and on the title he has chosen for it—the “contribution” made by older people. Too often when we discuss the place of older people in society, we focus on the problems. We talk about the demographic time bomb, the drain on the resources of the NHS, social care problems and so on. I do it myself all the time when I speak about the problems faced by those delivering social care both now and in the future. But what it is easy to forget is that older people themselves are often the ones providing care, and it is on that caring contribution that I want to focus. We should recognise the contribution made by older people as providers of social care and childcare for grandchildren.

The latest census figures were published on Wednesday and show that the number of carers over the age of 65 is increasing even more rapidly than the general carer population. We are still awaiting the analysis but it certainly looks as though while the total number of carers has increased by 10% in the past 10 years, the number of carers aged over 65 may have increased by as much as 15%. The reasons for this are not difficult to see. The bulk of care in our society has always been provided within families, with twice as many unpaid carers, nearly 6.4 million, as there are paid staff in the health and social care systems combined. The care they provide is valued at a staggering £119 billion every year, which is easily the cost of another health service. If anyone says that families do not care any more—and I am sorry to say that I have heard that several times today—I am afraid that I want to scream. Everyone here in this debate will know at least one, and probably several, older spouses who are caring for a partner with Parkinson’s, some form of mental illness, dementia, arthritis or diabetes. The list is endless. Most of them do not want to stop doing it; they do it because of the love they have for their partner or out of a strong sense of duty, or for the simple reason, as many a carer has said to me, that, “It is what you do”.

Caring for relatives can be a positive experience and many report that it is so, but of course taking on the responsibility of caring, however willingly you do it, has its consequences. It can have very negative consequences for your own health, for example. More than 60% of carers report that their health has suffered as a direct result of caring—either their emotional or physical health, but often both. The vow that people take in the marriage service,

“in sickness and in health”,

is very real in these situations. Age UK research shows that of 2 million older people with care-related needs, nearly 800,000 receive no support of any kind from public or private sector agencies. Many live alone and will suffer the loneliness that many noble Lords have drawn attention to today. However, many others are cared for by a spouse who is becoming increasingly frail themselves because of the stress of caring, and increasingly unable to get any kind of support because of cuts in local services or the charges that councils are now imposing.

As noble Lords will know, councils are increasingly unable even to consider meeting care needs that are assessed as being non-severe or moderate. Research by the Association of Directors of Adult Social Services shows that 83% of councils have eligibility criteria set at substantial. If your needs are not seen as substantial, you do not get any help. As one carer aged 87, caring for his wife of 85, who is severely afflicted with arthritis, said, “They say her needs are not substantial because she can get dressed and be wheeled into the shower that we had installed at our own expense. Of course she can’t dress herself but we manage it between us in about an hour and a half every day. They used to give me a break from caring once a month and took her into a care home for 24 hours, but of course it’s all stopped. But we soldier on—what else can we do?”. What else indeed?

Neither should we ignore the financial consequences of caring. There are extra heating bills, not to mention extra laundry, specialist foods and so on, but what causes most frustration among older carers is a lack of recognition within the benefits system. Those caring for more than 35 hours a week are entitled to carer’s allowance, currently just over £58 a week, but if you are in receipt of the state pension you cannot receive carer’s allowance because of the overlapping benefit rule. You are doing no less caring but you cannot be recognised financially. That causes a great deal of frustration and anger among older carers.

I turn briefly to those older people who provide huge amounts of childcare. This has also been mentioned several times today. Many older people wrote to Carers UK as part of its Sandwich Caring survey and talked about their caring experiences and where they impact on other aspects of their life. Many families rely on grandparents to provide childcare for their children while they are at work. In fact, grandparents are the biggest providers of childcare, as we all know. However, many found themselves caring at the same time for a parent with a sudden illness, a long-term condition, a stroke or dementia, and were therefore unable to provide the vital childcare in the way that they had done. They were painfully aware of the financial pressures this placed on their sons and daughters, not to mention the fact that they had enjoyed spending time with their grandchildren. More investment in care and a stronger care system, integrated better with health, would enable more of these grandparents to do both. As women have children later in life, this linking of caring responsibilities with grandparenting will become much more widespread.

Chronic underfunding has led to a crisis in our social care system, putting huge pressure on existing care services, the NHS and particularly on family members who provide care. This brings costs not only for carers and the people they care for but for the economy and public services more widely. Demand for the unpaid care provided by families and carers is increasing, and it has been estimated that nearly 3.5 million additional carers will be needed by 2037.

The care and support White Paper published in July presents a positive vision for the future, as does the draft Care and Support Bill, which is about to begin pre-legislative scrutiny; I declare an interest as a member of that committee. The Bill strengthens the rights of carers and those using care and support services, as well as bringing clarity and accessibility to social care law. However, a significant gap remains between the demand for care and support services and the ability of local government to provide good-quality social care to those in need. If this funding gap is not filled, and if a fairer and more sustainable model for the future funding of social care is not agreed, families and society will continue to pay the price.

I have said many times in your Lordships’ House that if we as a nation do not change our attitude to care and caring needs, we will be in serious trouble. We seem wilfully to ignore the fact that most of us will need care at some point in our lives. Report after report shows us that we do not plan for that and are not even aware that we will have to pay for social care. I ask the Minister, as I have asked others: when may we expect a reply from the Government to the Dilnot report and when may we expect this new thinking on social care to come on to the public service agenda?

I focused on the serious subject of providing and needing care, which can be depressing. If ever I am depressed about the passing years, I think of the example set for me by my auntie Ida. She is 94, lives alone, has an active social life, grows all her own fruit and vegetables and, as the Seville orange season approaches in January, will be preparing for her marathon marmalade-making session. She makes about 150 jars to give away because, as she puts it, “I like to make it for all the old people, bless them”.