Tipping point of too few carers for older people has been reached five years early, MPs hear

BMJ 2012; 344 doi: (Published 13 January 2012) Cite this as: BMJ 2012;344:e383
  1. Matthew Limb
  1. 1London

Social care in the United Kingdom has reached a “tipping point” where there are too few carers available to support demand, senior charity figures have told MPs.

It was estimated in 2008 that it would take until 2017 for this moment to arrive as numbers of elderly people rose, the health select committee’s inquiry into social care heard.

But Emily Holzhausen, for Carers UK, suggested it had come about earlier because of cutbacks in social care since April 2011 and the effects on families of caring for disabled adults and children.

She told MPs, “Families who provide unpaid support are the backbone of care in the community to the tune of £119bn [€142bn; $182bn] a year. We’ve reached the tipping point where there’ll be an increasing gap between what families can provide and what the state or private means provide. We are there now.”

The committee is inquiring into issues facing the government as it prepares to draw up a social care white paper in the spring.

Representatives of Carers UK and the Princess Royal Trust for Carers, which have submitted written evidence to the health committee calling for urgent and extensive reform of social care, were questioned on 10 January.

Carers UK says that successive governments have failed to fund the social care system to keep up with demand.

Ms Holzhausen, the charity’s director of policy and public affairs, told MPs that the system relied on some 6.4 million carers in the UK but did not support them adequately.

Many carers faced the “double bind” of funding rising care costs for family members from their own income or savings while having to give up work to provide care, she said.

“They want a social care system that helps rather than hinders them,” Ms Holzhausen told the MPs. “A bit of support can keep people in work.”

The committee heard about difficulties people faced in being assessed as eligible to receive support from local authorities, the risk of “carer breakdown,” and its impact on hospital admissions.

Liz Fenton, chief executive of the Princess Royal Trust for Carers, which supports a network of carer centres, said these were reporting more cases of carers getting into debt.

She said hard pressed local authorities were apt to “put pressure” on carers to take up the biggest part of care for their loved ones.

People with the biggest caring responsibilities were often over 65 and may have their own health problems while the support needs of children as carers were also “overlooked,” she said.

The Conservative MP David Tredinnick asked whether there were “blackspots” around the country where support for carers was particularly poor.

“They are everywhere,” Ms Fenton told the committee. She added, “If the NHS had a statutory responsibility for supporting carers, that could make a huge difference. There is no real measurement yet of the benefit to the NHS of supporting carers.”

The two charities have urged the government to implement recommendations of the Dilnot commission, including establishing national eligibility criteria for social care, portable assessments that would allow people to relocate more easily, and a £35 000 cap on individuals’ lifetime contributions towards their social care costs (BMJ 2011;343:d4261, doi:10.1136/bmj.d4261).

Ms Holzhausen said that the proposals from Andrew Dilnot, a former director of the Institute for Fiscal Studies, would help people to plan ahead to meet their future needs.

MPs also questioned two social housing experts. James Mumford, senior researcher at the Centre for Social Justice, said that single general practices should take charge of medical care for entire residential and nursing homes rather than providing sporadic care to individuals in different homes.

“GPs are not going into residential and nursing homes because they are a clinical iceberg—they don’t know where to begin,” he said.

David Orr, chief executive of the National Housing Federation, which represents housing associations in England, called for a guaranteed “housing voice” on new health and wellbeing boards.


Cite this as: BMJ 2012;344:e383

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