Speech to North-West Carer Network Conference 25 January 2012 – by Liz Kendall MP, shadow minister for care and older people
It’s a real pleasure to be here today. This is my first speech as the shadow minister for care and older people, and I couldn’t think of a better conference, a better audience, or a better time to make it.
Learning about the work you’re doing to support carers across the North West has been a real inspiration.
Identifying the ‘hidden carers’ who desperately need help and support, but too often fall through the net.
Delivering specialist support, for example to those caring for people who misuse drugs or alcohol.
Helping young carers, and those who care for the terminally ill.
Providing information and training for people who look after someone with dementia.
And helping carers have a life outside caring, through access to leisure facilities, proper breaks and respite care.
There are more than 768,000 unpaid carers in the north-west. Across the UK there are 6.4 million carers – 1 in ten of the population. This is expected to rise to nine million over the next 25 years.
Carers are the backbone of our families, communities and society.
You understand the vital work they do, day in day out, looking after their family, friends and neighbours.
You work tirelessly to improve their lives, by getting them the support they need and deserve.
And you have achieved a huge amount, of which you are rightly proud.
Labour’s record
When Labour was in government we backed your efforts.
We introduced new rights for carers, including a right for carers to have their needs assessed independently of the person they care for, and a right to request flexible working.
We helped improve information and advice for carers, and funded training for carers like the Expert Carers Programme.
And we funded breaks for carers, including £370m to support breaks for families caring for disabled children and £150m for breaks for carers of adults between 2008 and 2011.
But we all know there is far more that still needs to be done.
The number of carers who actually come into contact with local councils or voluntary organisations is a drop in the ocean.
Some people don’t even realise or think of themselves as a carer. Others don’t want to ask for help and support because they’re worried people will think they can’t cope.
Even when carers do come forward, they struggle to get information and advice about what help and support is available in their area.
Many find the services on offer don’t fit around their particular needs, especially if they are struggling to hold down a job.
And services still too often end up offering last minute help and support when families have already reached a crisis point, rather than preventing a crisis from happening in the first place.
The underlying problem is our system of care was established in a very different age.
In 1948 the average life expectancy for men was 66. Now it is 78.
Some health conditions that are now common amongst very old people were almost unknown back then, and many disabled children died at a very young age.
Social expectations were also very different 60 years ago. Disabled adults had fewer rights, and people automatically assumed that women would stay at home to care for their families.
Social care wasn’t included in the creation of the NHS and the state provided support only for people who had no family and could not afford to take care of themselves.
Although many changes have taken place since 1948, the welfare state hasn’t kept pace with changing needs and expectations. But it must if it is to retain support and resources in the long term.
Care and support for our ageing population must be at the heart of a reformed welfare state – as integral to this country in future as the NHS is today.
We must start with the needs of families and communities, not with those already in the state funded system of social care, which had too often been the case in the past.
And we need to recognise the huge resources families and communities can offer, if they get the right help and support.
The growing crisis in care
Achieving this won’t be easy in these difficult economic times.
Local council budgets are being cut by a third over the course of this parliament.
Adult social care makes up around 40 per cent of local council budgets and is their biggest discretionary spend.
So it is little wonder that many are having to cut services and support for older and disabled people and their carers.
The result is a growing crisis in care.
The care minister Paul Burstow recently told the health select committee there is no care crisis, no shortage of money, and no need for local councils to cut services for adult social care.
But you know the true story.
The King’s Fund, the Association of Directors of Adult Social Services and the government’s own figures from the Department of Communities and Local Government all show more than £1bn has been cut from local council adult social care budgets since the coalition came to power.
Eight out of ten councils are now providing care only for those with substantial or critical needs.
Preventive services have all but disappeared in many areas.
Charges are increasing – for home care, residential care, day care and meals on wheels.
And these charges vary hugely across the country. We recently published figures from a survey of local councils which show that while home help is free in Tower Hamlets, it costs more than £20 an hour in Cheshire East.
The case for change
We must address the immediate and growing care crisis, and reform the system for funding social care in future.
The good news is that there is a real opportunity to make progress, through the cross party talks that are now taking place on the recommendations of Andrew Dilnot’s Commission on funding social care.
With the state of our economy and our fraught political culture, achieving cross party agreement will be ‘challenging’… to say the least.
But Ed Miliband, Andy Burnham and I are determined to play our part in taking the long-term decisions the country needs to improve care and support for our older and disabled people and their families.
We are genuine and serious in our commitment to meaningful cross-party talks.
And I think there are three key arguments that need to be made, more loudly and passionately than ever before, to ensure all of the political parties meet the challenge we now face.
Firstly, we need to make a basic moral argument.
Which is that Britain – still one of the wealthiest countries in the world, despite all the economic problems we face – can and must provide a far better system of care for frail and vulnerable people.
The current system is profoundly unfair. Families face different costs and services in different parts of the country.
And there is real anger that older people who have worked hard all their lives – either in paid employment or by bringing up children – are forced to sell their homes, losing the rewards of their hard work, through no fault of their own.
This unfairness is something any new system must seek to address.
Secondly, there is a compelling economic argument.
In the north-west, half of all carers are not in paid work.
Nationally, one in five carers say they have had to give up their job because the right services and support aren’t available to help them balance their work and caring responsibilities.
So carers lose their income. Businesses lose vital skills. The economy loses carers’ wages. And taxpayers pick up an increasing benefit bill.
Our economy needs the skills and talents of carers, and families need the income carers get from work. This challenge will only increase as our population ages and more people live longer and care for longer.
It is particularly pressing for the ‘squeezed middle’ – too ‘rich’ to get benefits but too poor to afford the spiralling costs for care – who desperately need to work to provide a better life for themselves and their families.
Thirdly, transforming care and support for our ageing population is vital for the future sustainability of the NHS.
Far too many older people end up in hospital, or get stuck in hospital, because the right NHS and social care services aren’t available in the community or at home.
The lack of preventive services also affects carers. Those who provide a significant amount of care are twice as likely to suffer from poor physical and mental health as non-carers.
More than two-thirds of carers say they often can’t get to see their GP about their own health concerns because they can’t take time off from caring.
Failing to provide genuinely preventive and integrated health and social care doesn’t just mean poor services for older people and their carers – it costs the taxpayer more too.
For example, delayed discharges are up 16 per cent since August 2010 and now cost the NHS more than half a million pounds every single day.
Conclusion
Doing nothing is not an option, for older and disabled people and their carers, for the economy and for the future of the NHS.
We will pay more for our ageing population. The question is how we do this.
Do we continue to fund an unfair and inefficient system where:
• fewer and fewer people get the help they need;
• costs vary widely across the country;
• some people end up losing everything they’ve worked for; and
• an increasing number of older people end up in hospital or residential homes when they don’t need to, costing the taxpayer more?
Or do we grasp the nettle and deliver genuine reform to ensure a fairer, more effective and efficient system:
• based on people’s needs, not where they live;
• that pools risks and protects families from catastrophic costs; and
• which provides more personalised and integrated services at an earlier stage, to improve outcomes for older people and their carers, and deliver better value for money for taxpayers?
Labour stands firmly on the side of reform.
I want to learn from and build on the work you’ve been doing to support carers, who must be at the heart of our new system of care.
It has been a real privilege to come and speak to you today. I look forward to hearing your thoughts and questions and to working with you in the months and years ahead.
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