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How Much to Give Back to Carers?

This is the final blog of a series of three. It may help to read the previous two to understand what the heck I’m talking about.. I previously outlined why families and the State should have responsibilities to provide care, and that the Commission on Funding Care and Support must consider how care provided by families can be valued in terms of giving something back to families.

The final question to be addressed is how do you work out how much should be given back?

My report nine months ago outlined a method to do this.

Step 1: A person would be assessed to work out how much care they need and the cost of this care (or value of personal budget).

Step 2: A carer agrees how much of the care needed will be provided by them, which results in a reduction in value of the personal budget or care package provided by the State.

Step 3. A % of the value of care provided by the family is given back to the carer

My report outlined projections based on percentages of 15%, 20% and 25%. I found it strange that none of the positive or negative comments on the report were about the percentages that I chose. Just to reiterate, I was saying that Carer A provides X value of care that would otherwise be provided by the State, and that they should get 25% of that value back.

One person did comment that if you started at 25%, what would stop people asking for 40%, or 60% or 80% or right up to 100%? And some may say, if I’m providing care that would otherwise have to be provided by the State, then why should I not receive 100% of that value?

The answer to this goes back to my first blog in this mini-series; care should not be the sole responsibility of the State. In fact, the responsibility of the State is to support families to care, and provide care where families cannot or are unable to meet all needs. So, the starting point is not that families are doing the State’s job, rather the State is adding to or replacing what families do.

Giving carers 100% would be equal to paying families to provide care as you would a care agency. This appears to contradict the responsibility that families have and implies that my wife would only care for me if she were paid to.

So, is 25% correct? Honestly, who knows. There is no definite answer or mathematical proof that can work out exactly what it should be. It would be a judgement call dependent on circumstances at the time. So I’m afraid at the end of these three blogs, I don’t have the final answer but I think I know the direction we have to go in.

Finally, I realise that this blog strongly argues that families have responsibility to provide care. However, individuals also have rights, and individuals should not feel forced into giving up their own life to provide care. The State has a responsibility to help individuals enjoy their own rights to work, leisure and a quality of life while helping them to provide care.

That is the aim.

Take care

Gordon

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August 23, 2010 - Posted by | Big Society, Carers Strategy, David Cameron, Individual Budgets | , , ,

6 Comments »

  1. I do agree that we all have a responsibility to support each other – as families and communities and that the majority of people are willing to do that, which is why there are so many carers who would never give up on their caring roles – often sacrificing their own lives in the process. My personal belief is that we shouldn’t get to the point of sacrifice in caring, as that is an unhealthy way to live your life – physically, emotionally, mentally and usually financially as well. What I like about your proposal for a percentage payback is that it is equitable, according to the level of care and support someone needs – the higher the level of need the higher the care package and accordingly the higher the level of input proportionally from the carer – and the percentage payback would reflect that. This makes sense where there is fairness in the original assessment of the level of need and the amount of support that a carer is willing AND able to provide. In terms of percentage, I would say that 25% would be the minimum and would probably say that 30% is fair. How this would be administrated would be a whole other discussion – are you proposing that this replaces the woefully low Carers Allowance? Also, this payback system would be for carers who are registered as providing care and support for someone, regardless of their personal situation – so working carers would be eligible for this percentage payback – whereas at present as soon as you hit £95/100 you get nothing for caring. It has a lot to be said for it – but would this be acceptable by Government? In this climate it could mean that they have a higher bill than they do at present – and they along with the former Government have really dragged their feet in sorting out Carers Allowance. Let’s keep the discussion going and perhaps if there is wider support for your proposal, we could take it further.

    All the best,

    Jill

    Comment by Jill Pay | August 23, 2010 | Reply

  2. While on the face of it this is an interesting idea, I believe it has its problems.

    First is that the government would be unlikely to go above 10% on the grounds of cost. That would be around £8.7bn on current estimates – except for the fact that not every carer would be eligible due to the wide variation in eligibility for services. So the bill would come down to something a lot lower. Currently social care costs around £20-25bn – not including financial contributions from the service user. So £2.5bn on the 10% model. Currently it costs about £1.8bn in Carers Allowance,but this is paid to far more people than are eligible for services. So more carers would be likely to lose out for the sake of the others, potentially, unless Carers Allowance was kept in the mix for those unable to go out to work. That would help to counterbalance the current unfairness in the system, but ultimately what we’d be asking for is for the government to recognise a need to pay for something they get for free and actually factor in to the calculation of services under personalisation. The Resource Allocation System counts every action of the carer as a need already met and it is removed from the calculation.

    As much as the idea has its merits, I don’t see any government changing its thinking quite so radically as that.

    Comment by charles47 | August 25, 2010 | Reply

  3. In responce to Charles47’s comment. I agree that given the present climate and the present governments scissor-happy ways, it does seem unlikely that any small percentage payback is likely. However I think that the present system of supporting carers financially is untenable, with so many carers suffering financial hardship as a result. I believe there is some leverage on the part of carers to change that, if there is encough encouragement and support to do so. I think some of the more savvy carers will being to withdraw the level of support they agree to in the assessments, when they see the monetary value of that support – in some ways this is a threat to the money-saving agenda of the personalisation budget. We are in such uncertain times at present, but already reports about the lowest paid being proportionally worse off with the governments changes to beneits and taxation are coming out and the cracks will become more evident quite quickly, including how changes to eligibility criteria in response to local authority social service cuts will affect those in need and their carers.

    Comment by Jill Pay | August 25, 2010 | Reply

  4. Hi Charles and Jill (and other readers)
    I’ll try to deal with some of points you’ve raised. You both clearly analyse the implications of my proposal and it’s good to draw out the detail.

    Jill – you are spot on that a prerequisite for this system is that carers are consenting to the amount of care they are willing and able to provide. I actually think such a system would prompt more carers to take control of this.

    Would it be in addition to Carer’s Allowance? The welfare system may be changing too but I do see this in addition to benefits that some carers would receive.

    How would it be administered? This would depend on what the new funding system of social care looks like but it could be distributed by the insurance provider.

    Charles, I actually think the costs would be much lower than you estimate. The rebate would be based on what the carer is contributing that the State/insurance provider would otherwise have to provide/pay for. Whilst the total value of all hours of care provided by carer (at £14.50 p/h) = £87bn it is unclear that this is actually what would need to be spent by councils to meet needs if carers did not provide care. Of course, there could be other consequences of this.

    Lastly, there is evidence (cited in the Crediting Carers report) that the failure to support carers does produce extra costs in residential and hospital care. Increasing support to carers can improve patient outcomes and reablement, improve discharge processes, reduce readmissions and delay the need for residential care.

    Finally, this proposal will not in itself solve every problem for every carer. My very first blog said that no one thing could do this and that remains. But I think it would mean that more carers would get more support.

    Comment by Gordon | August 25, 2010 | Reply

    • I agree with you, Gordon, that the cost will be lower overall, but the analysis using current social care costs was closer – between £2bn and £2.5bn as approximately 10% of the current spend. But bear in mind that this will go down, not up, as budgets are squeezed – and the proposal will cost more, not less.

      I also agree that the trend needs to reverse but that requires a shift in political thinking that moves away from seeing the most vulnerable as a drain on “hard working taxpayers”.

      Maybe where we need to start is by getting the real story of caring out there: we see enough “superscrounger” articles, where are the counterbalance stories?

      Comment by charles47 | August 26, 2010 | Reply

  5. Hi Gordon, Charles and others

    Just picking up on your point from the Crediting Carers report – at the Standing Commission we began a discussion on the business case for supporting carers and I think this is important. As you say it is an investment in a very effective way of supporting someone in need to support carers. Unfortunately funding decisions are often made in a very short-sighted way and I fear that this will be the case with the cuts – there will be some knee-jerk reactions which don;t allow for strategic or forward thinking about funding, at least at local level.

    Generally I think your proposal offers a creative and fair way to support carers better financially and perhaps it would be a good idea to formalise it somehow as a serious proposal. I would definitely support that.

    Comment by Jill Pay | August 25, 2010 | Reply


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