Carers Action Plan 2018-20: Supporting Carers Today

Baroness Tyler of Enfield Excerpts

Thursday 21st June 2018 Lords Chamber

[Baroness Tyler of Enfield (LD)]

My Lords, I congratulate the noble Baroness, Lady Redfern, on securing this debate and on introducing it so ably. It is also a huge pleasure and privilege to follow the noble Baroness, Lady Pitkeathley, who has been such a tireless champion of carers for so many years.

I am pleased that the Government have finally published the long-awaited Carers Action Plan. It goes some way towards recognising the needs of carers and providing support for them in the wider health and social care system. This is, of course, welcome. Yet, for the 6.5 million unpaid carers working in this country, recognition is not enough. Today, I want to focus briefly on three key areas where I feel the Carers Action Plan falls short and where action would make a real and measurable difference to the long-term health and well-being of carers.

When starting any discussion of carers, it is vital that we remember that caring comes in many forms. Some find themselves becoming a carer later in life as loved ones fall ill; this is a very different experience from that of the thousands of young people who take up a caring role barely out of childhood or even early childhood in order to support a parent or a sibling. Carers of disabled children face different challenges again. This distinction is vital as different types of carers require different types of support. I am pleased that the Carers Action Plan drew some distinctions here, particularly between carers in work and carers in school—but, as the noble Baroness, Lady Pitkeathley, pointed out, less so in terms of older carers.

We can, and should, do better at recognising the plethora of challenges that all carers face today. Many carers share profound fears about what will happen when they are no longer able to fulfil their caring role. It is worth noting that, despite these widespread fears, only an estimated 25% of families have felt able to make concrete plans about who should take over their caring role in the eventuality of illness or death.

Short breaks and respite care are crucial to support the mental and physical health of unpaid carers, not least because they can use this time to attend doctors’ and hospital appointments for their own health, which is far too often neglected and often deteriorates due to the relentless nature of their caring responsibilities. Too often, carers I have spoken to have caring responsibilities that extend 24 hours a day, seven days a week. That is something we would simply not allow in any paid workforce. As a result of this experience, anxiety, depression and in some cases even suicidal thoughts occur.

During Carers Week a number of excellent events were organised. I attended one myself and spent time speaking to three women who were all caring for their husbands. They were doing an amazing job, and it was inspiring and humbling to talk to them. When I asked what would make a difference to them, they said somewhere to turn when they felt they could not cope. One of the ladies said that she had to tell her GP that she was having suicidal thoughts before she got any help, support and referral. Therefore, although there is a relatively brief reference in the plan to the need for respite and short-term care, the actual opportunities are still too often few and far between.

Respite care allows carers to recharge their batteries and deal with things that pile up in the course of caring. These can be basic things such as being able to pay household bills and deal with personal administration. Respite care is also vital for the carer and the loved one they are caring for to help relieve the pressure. Frankly, it gives individuals space to process the emotionally challenging situation in which they find themselves.

Although respite care is offered through some local authorities, the service is not consistent, and nor are there procedures in place to claim it. It is particularly hard for carers who live in rural locations, such as the lady I spoke about who had to say that she was having suicidal thoughts before she got any help. Distance and the isolation make getting help so much more difficult.

This highlights the need to truly implement the provisions and spirit of the Care Act 2014, too much of which exists on the statute book in name alone and does not really impact on the day-to-day lives of those who need it most. Can the Minister say what specific steps the Government are taking to ensure that unpaid carers, particularly those in rural areas, are given adequate support and information locally about their right to respite care? I mean more than simply spreading best practice, useful though that is.

Turning to employment issues, I am glad that the Carers Action Plan addresses the need to change working cultures and offer more flexible work conditions for carers. However, I was frankly disappointed to see that the Government had failed to address the question of statutory leave for carers. I was very pleased to introduce—three years ago, I think—a Private Member’s Bill on this subject. Although it did not get anywhere—it only had a First Reading—I still feel passionately about the need to address this issue.

In the UK today, many carers are forced to juggle their caring responsibilities alongside work. That leads to people having to make incredibly hard choices about whether to pursue their career and financially support their family or to care for a loved one. As we have heard, it is estimated that over 2.3 million adults have given up work to care at some point in their lives, and 3 million have reduced their working hours. Of course, the implications of this cut both ways. It damages businesses, which lose skilled staff, often at the peak of their careers, and it hurts the financial stability and security of carers and their families.

It is also worth noting that these caring responsibilities are not spread evenly across society. One in four women aged between 50 and 64 is an active carer, compared with one in six men of the same age. Therefore, the increased pressure that being a carer puts on an employee, often forcing them to take holiday simply to attend doctors’ appointments or to care for a relative after an operation, falls hardest on women later in their career, and it can lead to them experiencing poverty in later life. The introduction of statutory leave for carers, which I see as a logical extension of things that we now take for granted, such as maternity and paternity leave, would help to relieve this pressure and allow this group to take back a greater degree of control over their lives.

As demographics shift and our population ages, the role of carers will become ever more prominent. We will soon reach a point in this country where half the population is aged over 50. We have a responsibility to ensure that unpaid carers are able to pursue a career alongside their caring role. Looking forward, this type of provision will become ever more critical—not least as we are telling people that they need to make provision for their own pension and social care as they get older—in determining how this country deals with our demographic shift.

Putting in place statutory leave for carers will, I think, be closely aligned with changing workplace cultures. I know that quite a few businesses now have enlightened workplace policies and offer their employees carer-friendly policies, including paid care leave—and they see the business benefits of doing that as well as the benefits for the individual. We are falling behind globally in this area. Such an approach to statutory care leave has already been shown to have tangible economic benefits in countries such as Poland and Japan. Will the Minister outline in her concluding remarks the Government’s position on statutory care leave and explain why it was absent from the carers action plan? Will she agree to meet me so that we can discuss this issue further?

I was glad to see that the Carers Action Plan focused on ways to increase support for young carers. The recent Barnardo’s report, Still Hidden, Still Ignored: Who Cares for Young Carers?, found that many young carers struggle to cope with the amount of pressure placed on them, emotionally and academically. Over 50% of young carers asked said that being a carer had impacted negatively on their emotional and mental health, making them feel anxious and worried. Not only is the role of a young carer hard but, as the noble Baroness, Lady Redfern, said, many young carers do not self-identify as a carer and therefore remain hidden. This makes it difficult for councils to fulfil their legal duty to identify young carers and carry out assessments that consider the impact on both the child and the whole family. The last census put the number of young carers in this country at 170,000, yet according to research done by the BBC and the University of Nottingham, the real figure may be four times that. I am pleased, therefore, that the Government have committed to undertake a review into the identification of young carers. Will this review include an assessment of how the Children and Families Act 2014 and the Care Act 2014 have impacted on the identification of young carers?

Finally, I will say a few words about funding. Adult social care is a vital council service that helps to transform people’s quality of life and supports carers of all ages with a range of different needs. It has been estimated that it will face a funding gap that will exceed £2 billion by 2020 unless an urgent solution is found. Indeed, a recent report from the King’s Fund estimated that £2.5 billion will be needed next year alone to keep adult social care afloat, ensure support for carers and ensure that those they care for do not get worse. The forthcoming social care Green Paper must deliver a sustainable solution that ensures the long-term future of social care and, ultimately, secures a future where carers and their families receive the right support, at the right time and in the most appropriate setting. It must also enable local authorities and the NHS to improve joined-up efforts to identify more carers and to offer them a proper carer assessment and plan, as well as the information, support and advice that they need.

I was very disappointed that Tuesday’s Statement on NHS long-term funding was silent on the issue of adult social care, save to push the equally long-awaited social care Green Paper further back into the autumn. The longer we wait for a long-term funding solution to adult social care, the more services such as those I have talked about, including respite care and short breaks, will be lost in the meantime. The number of people who can be supported in their own home and community will be reduced, with immediate knock-on effects on the NHS. It is not rocket science: it just requires some political will.