Does focus on services for the carer detract from a whole-family approach?

Margaret Thatcher and Gordon Brown outside Downing Street

I've been thinking about what's changed

I’m coming to the end of 10 years in the carer’s movement so I’ve been thinking about what’s changed.

Every campaign and movement for change starts by carving out its identity. It has to be clear about who it’s for and who it’s not, so that, in our case, the government and the public understand who carers are and why their needs matter.

I think the carer’s movement has done that pretty well. People still say “carer” when they mean “paid care-worker”, but you only had to look at the three party leaders competing to sing the praises of unpaid family carers to realise that understanding of carers has hit the mainstream. I can’t imagine Thatcher, Kinnock and Steel/Owen having that conversation.

That necessary focus on carving out a space in public policy for carers has had some downsides, though. In fighting against being lumped together with services for people with long term conditions, we haven’t always had enough of a focus on whole-family solutions. Nine times out of ten, carers come to Carers’ Centres with a crisis in the life of the person they are caring for, which has in turn become a crisis for them. It is usually some time before the Centre can help that person to begin to reconnect with themselves as an individual, rather than seeing themselves solely as their relative or friend’s carer. In the messages we give to government, I think we are still finding the right balance between promoting the need for independent services which are first and foremost for the carer, and helping policy makers to understand that decisions made about people’s health and social care support are decisions that affect whole families.

Getting this right will become ever more important, because councils and the NHS are about to come under huge pressure to cut and amalgamate services and because we have seen the personalisation reforms (personal budgets, direct payments etc) have both good and bad effects on the people who continue to provide the bulk of many support packages: the unpaid carers.

We are all inter-connected and interdependent. Both those who give and those who receive care and support can be excluded from ordinary life chances such as employment, community life and full participation in family relationships.. The state can barely afford health and social care as it is. Without a whole-family approach that feels joined up and supportive to unpaid carers, as well as to the people they support, that funding gap will widen and we will again see the NHS and social services teeter on the brink of collapse.

But if over the next ten years, the carer’s movement can help to make it self-evident to every council and local NHS trust that carers are both fundamental to delivering services, and also individuals in their own right, the rewards unlocked for families and for the state will be huge.

While I’m moving on to a new job, I have been thinking about the many carers for whom caring is life-long. Working with carers has, I hope, left an indelible mark upon my life. I’m grateful for that and for the thousands of contributions of time, expertise and experiences The Trust receives from carers: there would be no change without you.


Alex Fox, guest blogger this week, is Director of Policy and Communications at The Princess Royal Trust for Carers


May 11, 2010 - Posted by | Carers movement, Health, Social Care | , , , , , ,


  1. Alex, that is sad news to hear you are leaving the carers world. I know you have done such a great deal of work for carers in those ten years, that I would like to say a simple thank you.
    Did you know that we did get the unpaid carer mentioned out of 7,000 policies
    There will be many who will try to continue in the work that you have mapped out over the years and I will remember all what you taught me. Thank you.
    all best

    Comment by Wendy | May 11, 2010 | Reply

    • Wendy – that’s really kind of you. I’ve really appreciated the input from you, Chill4us and the other online carer communities. I think it’s a strength in the carers’ movement that there are both charities and grassroots groups working towards the same ends. It’s been great to work with you.

      Alex Fox | Director of Policy and Communications | The Princess Royal Trust for Carers Direct: 0113 2688817 | Mobile: 07896 291846 14 Bourne Court | Southend Road | Woodford Green | Essex | IG88HD Switchboard: 0844 800 4361 | Fax: 0844 800 4362 | Web: | Charity Registration number: SC015975

      Comment by Alex | May 12, 2010 | Reply

  2. Alex, I agree that the ideal way forward is to look at the whole family, but I think the problem lies with the fact that organisations cannot actually find a mindset that achieves that. The tendency is to concentrate on the single issue and deal with it, without considering the rest. And often carers are ignored because of this.

    One example: a social worker once told my mother – soon to be a 50 year veteran of caring – that an holistic assessment of my father didn’t include her as a carer or the fact that she was also caring for my disabled sister. It’s not just an ironic statement: it’s truly worrying.

    Needless to say someone else finally carried out the assessments.

    Comment by charles47 | May 12, 2010 | Reply

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )


Connecting to %s

%d bloggers like this: