To get serious about fixing social care we must lend a hand to the many Londoners who do it unpaid. The funding announced in the government’s most recent budget provided only a sticking plaster for the burgeoning issues that social care workers and commissioners are facing. My recent report for the London Assembly, Who Cares?, sets out why giving a hand to London’s 610,000 unpaid carers must now be a priority for the London Mayor.
Cuts to social care left have London councils facing a funding gap of £100m by 2019/20. Demand and costs are still rising faster than funding. The Mayor has little funding or mandate with which to bridge this chasm. But, by building on the recommendations in my report, he can make intelligent interventions to support the city’s unpaid carers.
Good social care needs a partnership between the professional and the family – all the more so given aspirations to carry out more care work at home. However, unpaid caregiving has risen faster than the elderly population, suggesting that family carers are stepping up to fill gaps left by cuts to formal social care provision. They must be helped to do that better, so that workers can fulfil the tasks only they are trained for. That isn’t the case at present, and though many social care workers form close, cooperative relationships with the families they work with, their situations can still be stressful, not helped by pressures on resources.
UNISON and the Coram Foundation polled carers and found many feel discriminated against at work, take pay cuts or leave their jobs altogether. Given the demographics of caring, this means that women are driven out of the workplace or on to wages that don’t reflects their skill levels. Carer’s allowance and carer’s credit are inadequate. The sums on offer are paltry and the requirement that people in need of care are given at least thirty-five hours of it a week is unrealistic. Research shows that commitments above ten hours a week are enough to prevent people from working.
As a GP, I see growing numbers of older patients with complex conditions. What I tend not to see is the army of family and friends supporting them. Yet see them I should, because caring takes a toll. Two in five carers devoting more than 50 hours a week to the task suffer from bad health. That’s more than twice the rate for non-carers.
Women pick up the lion’s share of unpaid care, with 100,000 more of them than men providing it in London. Perhaps that is why it is so undervalued. Carers UK estimate that unpaid care in London alone is worth £13.8 billion annually. With this comes financial hardship and poor health, consequences that are set to become more concentrated in already-deprived areas. Tower Hamlets (15.9 per cent), Islington (11.8 per cent), Hackney, and Southwark (both 11.4 per cent) have seen the most significant increases in the value of unpaid care provided since 2011.
That is why I’m calling on the Mayor to work with the NHS to run check-ups for carers when they accompany someone to a health service. Health professionals should also proactively identify whether a patient has a carer – even if they don’t think of them as such – so they can be supported. At the moment, two-thirds of carers aren’t given the support they need by medical professionals and only one in ten is even identified as a carer in the first place.
Support in the community will be a central pillar of this. My report also recommends that the Mayor uses his social prescribing strategy, now being drafted, to ease the journey of carers through social services. Health and social care services in pleasant and welcoming community centres would give carers somewhere they actually want to go, where they can get a bit of respite, information and company.
As the social care system is short of workers, not helped by the effects of Brexit and the government’s insistence on treating staff as unskilled, volunteers can help. They can never replace trained workers, but they can provide some of the background support that a trained worker cannot. Mayoral leadership on cross-generation volunteering would be welcome and improve social integration too. The Mayor could even look to expand co-housing schemes that offer young people reduced rent in return for doing a few regular chores and providing company for someone else.
This is a problem that the Mayor can address. In doing so he would help the limping social care system until the government gets a grip and publishes the green paper that should have appeared last summer. Unpaid carers should be able to look to the government and find a helping hand. My report shows how the Mayor can offer one in the meantime.
Dr Onkar Sahota is the London Assembly Member for Ealing & Hillingdon.