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You and Yours - Transcript 成人论坛 Radio 4 |
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TX: 20.09.07 - The Unseen Workforce PRESENTER: PETER WHITE |
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THE ATTACHED TRANSCRIPT WAS TYPED FROM A RECORDING AND NOT COPIED FROM AN ORIGINAL SCRIPT. BECAUSE OF THE RISK OF MISHEARING AND THE DIFFICULTY IN SOME CASES OF IDENTIFYING INDIVIDUAL SPEAKERS, THE 成人论坛 CANNOT VOUCH FOR ITS COMPLETE ACCURACY. WHITE Eighty seven billion pounds, that's how much unpaid carers looking after ill, elderly and disabled people save the UK every year, it's the conclusion of that report just published by Carers UK. Professor Sue Yeandle from Leeds University is one of the report's co-authors. Sue, how did you arrive at this fairly startling figure? YEANDLE Well we used a methodology that's based on one published by the Institute of Actuaries, so we're fairly confident in the approach that we've taken. And what we've done and what we've been able to do more accurately than ever before is to use the evidence collected in the 2001 Census which asked every single person in the country about their caring responsibilities to make estimates of the numbers of hours of care provided by carers across the UK. We've also used information, again using official data, on the unit cost of providing one hour of home care to an older or disabled person in their own homes and that figure - that published figure - at the moment is £14.50. So we've used - we've multiplied our estimates of the number of hours of care provided by carers by that figure and that gives us - what even to us - was a startling figure of £87 billion. WHITE So do you also mean that you're not trying to do that equation which would say what about these people, how much might they have earned, how much tax might they have paid - that's not part of the equation at all? YEANDLE That's not been part of the figure that we've produced here, that would obviously add additional costs potentially to the calculation because many people, as I'm sure Carers UK will also confirm from their members and the people that contact them, many people give up work to care and those people of course often are giving up quite senior and highly paid positions. WHITE And can we be clear what do we mean by carer? YEANDLE The definition of a carer used here is the one used in the official Census of Population when it asks people if they give help or support to a family member, a friend or a neighbour because of problems related to old age, disability or frailty and so that does include carers of disabled children, and that is a very important and growing group but it also includes many people who are carers of the elderly. It doesn't include ordinary childcare and it doesn't include anybody who is paid to provide care. WHITE And why this big increase - the figure was £57 billion in 2002 and even allowing for inflation, which probably if you added it up over five years is about 15 or 16%, this is a very big increase? YEANDLE It is and I think it relates to a number of factors. First, I think, and most important, is that the most accurate figures only became available in 2001 and previous calculations were based on estimates from survey data of the number of carers and we know that, for example, the Census made it very clear that we have more caring in some parts of the country than we knew before, for example, in parts of Wales there is particularly high levels of caring which we didn't know about before the Census produced that data. But we've also got increased intensity of caring and we've got this other factor, which I mentioned, people are often aware of the ageing population, which is crucial in understanding the growth of caring, but also improvements in medical care are enabling people who have a disability, people who are ill, to live longer but often requiring support at home and that's another factor. WHITE Let me bring in Imelda Redmond, who's the chief executive of Carers UK. Isn't it unfair to characterise this as saved money, after all this is by no means an entirely unwilling workforce, many people regard looking after their relatives as their responsibility and something they want to do? REDMOND Well that's right, most people want to look after their friends and relatives, they want to make sure that they get good quality of care. What we're highlighting here is what it would cost to replace those carers if they stood down and what we're saying is we don't assume for one second that everyone is going to say I'm not going to do that but when we're looking forward and we're looking at demographic shift then if a significant number of those people say - us people - say I'm sorry but I can't do this we have actually some serious economic impact ... WHITE And why might they do that? REDMOND Why might they do that - they might do that because on the other hand we're also talking a lot about people working longer, people working longer hours, there's greater geographical mobility, smaller family size - all those sorts of things. What we're seeing is not that people are saying that they want to do less but it's becoming more complicated for them to do it and so we need to get the right sorts of support in otherwise we've got a huge cost. WHITE Okay, we'll come back to the issue of support. One such carer is Linda Wisbach, her husband Philip had a brain haemorrhage 16 years ago and although she has a part time job she's been looking after him ever since. WISBACH Now we've got a stair lift and it has actually transformed our lives quite a bit because no longer do I have to carry him up the stairs. I think people thought because I was married to Phil that it was my duty to care for him. But after all as a carer I'm entitled to a life outside of caring and it's taken me a long time to get a really good care package put together, I've hung on to my job and I think if I hadn't cared for my husband so well he probably wouldn't have survived. Philip, he can't walk, he's partially sighted, he can't move his arms, he has coordination problems, he has diabetes, epilepsy and of course suffers from terrible depression. And I try to cope with all of that and it's so difficult because I mean he's my husband and his whole life has been completely taken over by his disability and his illness. Up till a year ago I did everything for Philip - wash, shower, dress, shave, brush his hair, all his medication, all his food, help him to eat, help him with his toileting - everything you take for granted actually. DOUGLAS It was a conscious decision on your part, wasn't it, for him not to go into a home? WISBACH Yes because at the time our son was six and I mean it was such a devastating thing, I mean it was a miracle when Philip did survive and I was determined then that there was no way Philip was going to stay in a home because that would have been the end of our family. And I didn't want it to affect my son's life, what kind of life would it have been knowing his dad was in a home and he was unable to have a proper parenting role and it would have affected their relationship. DOUGLAS What impact has being a carer had on your life? WISBACH Well it was the most terrible shock when I found how difficult it was for carers and disabled people actually, the lack of services are quite appalling, and the discrimination was awful, I mean I really feel sometimes like a second class citizen and totally invisible sometimes. And the isolation that carers face is dreadful. Not being able to go out made me ill, one day I woke up and I was absolutely frozen, I was rigid, and by the time I got to the doctor she said to me - look, you're going to have make a decision, either you get help from social services or you give up your job because you're physically and mentally exhausted. So I was off work and then I developed agoraphobia and anxiety, which is the most dreadful thing, but I fought back and I am better now. But I know for a fact that if my care package is cut then I'll become ill again. Well this is our mattress elevator, I think it's called, and this lifts Philip up because Philip can't get up by himself. This puts him in a sitting position so I can help him transfer off the bed and then he holds on to the hoist here, then I transfer him into his wheelchair. I only got that after I became ill. It's amazing the amount of things I got after I became ill, which sounds awful really, I'm not being ungrateful but this is the point I'm making - if they only invested in carers I wouldn't have become ill. What I have now is I have carers who look after my husband so I can go to work, I have carers who sit with Philip while he waits for the ambulance and I usually go swimming or I go out and do shopping - that sort of thing that ordinary people do may I add - and I get help with the housework, the housework was cut because I got more housework help than anyone else and that was wrong yet how many people for people as disabled as my husband and work? Well I don't know the answer to that because the local authority couldn't tell me. And I've recently been told that all the housework is going - so that means I'll lose it in the near future - and that will affect me because I like to live in a clean house like anyone else but if I have to pay for that then it'll be difficult it'll probably mean I'll have to work more hours. DOUBLAS Do you think the government really appreciate people like you and the work that you do? WISBACH I don't think they give us recognition. I'm shocked to hear about the amount of money that we save the government and I feel that the government really should pay more money back to carers in the form of a better form of carers allowance and I think if the government would invest in carers then carers wouldn't become ill and they would save the local authority a lot of money in respite and other services. Carers really are in a crisis and I just hope that our new prime minister will recognise this and do something about it and do something about it soon. This country's got to make its mind up are we going to care for vulnerable people or not. WHITE Linda Wisbach talking to John Douglas. Imelda Redmond of Carers UK has been listening to that. Linda does now have an effective care package but that only happened, as she said, after she became ill, how typical is that? REDMOND Unfortunately that is all too typical, it's the sort of story we hear in our organisation all the time. People - partly they don't know where to go to get help, they're not directed to social services to ask for an assessment, they're not directed to organisations like Carers UK, so they're left to struggle. So I'm afraid it's fairly common. WHITE But social services do have, don't they, a statutory duty to give assessments to carers as well as the people they're caring for, is that not happening? REDMOND Social services do have that statutory duty, it's happening but not enough carers are getting assessments, a tiny minority get assessments. But the real problem is that often they don't get anything as a result of the assessment, you have to really quite - work quite hard, get good advice before you go to your assessment so you know what to ask for and sometimes people just don't even know what to ask for. WHITE So where would people get that advice from - isn't that the sort of advice they ought to get from you? REDMOND They can get that advice from us, from our telephone helpline, our website or our publications. WHITE But you're suggesting it's difficult to find, perhaps they don't always know about you either. REDMOND They don't always know about us, they don't even know that they're a carer and that's not surprising because they are, as Linda said, a wife, a daughter, a mother so on. WHITE Let me bring in Anne Williams, who's president of ADASS, that's the Association of Directors of Adult Social Services, she's in our Manchester studio. Anne Williams why are so few carers being assessed? WILLIAMS I think directors of adult social services are very acutely aware of the unmet needs among the carers and we've heard graphically about that today. And this report adds to the growing body of evidence about the dilemmas and pressures facing carers. We are dealing with an unprecedented demand because of the demographic changes that have been highlighted and that many local authorities are now in a position of tightening eligibility criteria, so that only those with the most substantial or critical needs can be met. And that is why - and Imelda is quite right - that although we're getting better at identifying carers and doing carers assessments it's often very difficult within eligibility criteria to offer services. WHITE Is there a natural human reaction here then with budgets being squeezed - there must be a temptation amongst health workers and social services staff to take one look at household, you go and knock at the door, you see someone fairly healthy looking, apparently coping, sigh with relief and walk away? WILLIAMS Well there is that temptation. WHITE It happens doesn't it? WILLIAMS I think there are many carers who are very reluctant to tell us about the needs they've got and the help they need. WHITE We've already had a number of e-mails, Winifred's got some of them. ROBINSON Several carers have called to say they feel it's unfair that they receive so little financial help yet save thousands of pounds every day for the NHS service. One is typical: I was a carer for 30 years and I now live in poverty, I was told that I had saved the NHS over £2,000 every year yet I am treated with no respect and at the time I was given no help. This from Annabel Ayres who wants to highlight how much support is available to carers that is not very well published. She says: I've recently become aware of the availability of attendance allowance because my mother has bone cancer and is applying for the benefit but she was the main carer for my father for the last two and a half years and both she and my mother-in-law care for partners suffering from illness and depression but neither of them was ever informed by their GP or any of the large number of doctors that saw them that their husbands would also have been eligible for attendance allowance. WHITE Okay. Anne Williams, if I can put that - that's not just the job of GPs is it, that's a social services function as well? WILLIAMS It is and we need to get better at providing information and we're all working on that. Adult social care is very complex and I think more and more people are becoming aware, as they need it, and information in various forms is key to this. WHITE Let me just go back to Imelda Redmond before we have to end. Your report has seven recommendations, we're not going to get seven in, but can you talk us - you must just mention a couple. This question of a social contract - what do you mean? REDMOND Well what we mean by that is that we need to have a contract with the community, with people, as to what they can expect when they need care. At the moment what happens is people phone social services in a crisis, they have no idea that they're going to have to pay for that care, they have no idea what steps need to be taken, they don't know where to begin. And what we want is a very transparent system where people can quite easily work out what the state will provide and what they'll need to do for themselves and what they can expect. I mean Linda's a good example, she talked about how long it was before they got a stair lift, if she'd had that from day one life would have been very different for her and Philip. WHITE Right and you're also asking for anti-discrimination legislation, haven't we got enough anti-discrimination legislation - aren't these financial things you want much more important than legislation? REDMOND Well Peter the thing is there are a whole raft of things that need to be done simultaneously - carers need to be lifted out of poverty, carers allowance is dreadfully low - £48 a week - it's a shock. But we want anti-discrimination legislation because that changes the way public services treat carers. At the moment it's fine for them to sort of ignore them but with that legislation in place they have to treat them differently. WHITE Imelda Redmond, Anne Williams and indeed Sue Yeandle thank you all very much. We will be coming back to the minister trying to get some answers to this at the end of the programme. Now as we heard at the beginning of the programme a report published today claims that unpaid carers looking after ill, elderly and disabled people save the United Kingdom around £87 billion every year. The nation's health bill would effectively double if it weren't for the estimated six million unpaid carers taking at least some responsibility for the care of their family and friends. People like Linda Wisbach whose husband had a severe brain haemorrhage 16 years ago and who's been his major carer ever since. WISBACH I'm shocked to hear about the amount of money that we save the government and I feel that the government really should pay more money back to carers in the form of a better form of carers allowance. And I think if the government would invest in carers then carers wouldn't become ill and they would save the local authority a lot of money in respite and other services. Carers really are in a crisis and I just hope that our new prime minister will recognise this and do something about it and do something about it soon. This country's got to make its mind up - are we going to care for vulnerable people or not? WHITE Well the report was published by the campaign group Carers UK whose chief executive is Imelda Redmond. REDMOND People - partly they don't know where to go to get help, they're not directed to social services to ask for an assessment, they're not directed to organisations like Carers UK, so they're left to struggle. So I'm afraid it's fairly common. WHITE But social services do have, don't they, a statutory duty to give assessments to carers as well as the people they're caring for, is that not happening? REDMOND Social services do have that statutory duty, it's happening but not enough carers are getting assessments, a tiny minority get assessments. But the real problem is that often they don't get anything as a result of the assessment, you know you have to really work quite hard, get good advice before you go to your assessment so you know what to ask for. WHITE Well care services minister Ivan Lewis joins us now. Minister, first of all, how do you react to these figures which are pretty extraordinary - £87 billion - and have been assessed on the basis of professional standards of care that people would have to pay? LEWIS We recognise that carers make a tremendous contribution to their families, our communities and our society, that's why the Prime Minister announced in March we're going to have a new deal for carers, building on the extra money we've made available - over a billion pounds since '99. We're having hundreds of consultation events up and down the country, speaking directly to carers themselves about the things that matter to them most. And next year the Prime Minister will announce the new deal for carers. I'm today here speaking to you from Bury, my own constituency, I'm attending 10 consultation events and carers are telling me - we've done three already this morning - what the issues are for them. Those issues are: first of all, they want a system which is on their side in health and social care, rather than a system which they feel they're battling against all of the time. They also want a life of their own in terms of the right to work, the right to have some leisure time and to know that the person they love will be properly cared for whilst they're doing other things. WHITE Can I tell you what they're telling us. I'm a carer - these are people who've e-mailed us - I'm a carer who's disabled, look after two children with autism, live from day to day, I've given up on some benefits I'm entitled to because it's just so damned hard. And another caller saying: I'm a care - I'm caring for someone, I'm very angry that people who are unemployed receive more money than I do. He says carers work up to a hundred hours a week they deserve recognition for that work. Are they going to get it because this is all predicated on budgets really isn't it? LEWIS Yeah of course, any government's got to make difficult decisions about limited resources. But what we've said with the announcement that the Prime Minister is going to have a new deal for carers, with the fact he set up the standing commission on carers recently, is that carers are to have a new priority in our society, people are living longer, disabled people now quite rightly have full lives. And that means that more and more is being asked of families, also of course people remain in their own homes rather than go and live in institutions. WHITE So minister where's that money going to come from? LEWIS Well it will be one of the priorities for the government going forward. The government recognises ... WHITE So from tax - will it mean - is it coming from more tax because people will ...? LEWIS Well we're about to - for example we're about to find out how much money we're going to get for health and social care through the comprehensive spending review over the next three or four years. There's also the money that's spent through the Department of Work and Pensions on benefits, there's the money that's spent in local government. What we've got to make sure is that it's a cross government strategy. Carers tell us it's about respite care, it's about benefits that they're entitled to, it's about the right to work, it's about the right to have a decent quality of life. And it's also about whether the care system treats the people that they love with dignity and respect. So it's a whole range of issues that make a difference to the quality of carers' lives. We're determined that this is now going to be one of our nation's priorities going forward. We've already done a lot - over a billion pounds of extra money, the right to request flexible working for carers, enhanced pensions, a new package of support specifically for respite for the parents of disabled children. But there is a lot more that we need to do to reflect the contribution that carers make to our society. WHITE The rumours are that there's going to be no more money specifically for social care in the budgetary settlement. LEWIS Well let's not second guess the announcements that are going to be made by the Chancellor, it's worth more than my job's worth to tell you today what's going to be in the comprehensive spending review. The government has a pretty good record on investing in public services. It's true that the social care system is under pressure because of demographics - people living longer - but the Prime Minister's signalled that carers are to be one of his priorities going forward because it's about supporting families and stronger communities. People with disabilities and older people have the right to expect the maximum possible quality of life, it's go to be about the government and professionals, local government, the NHS and carers working together to make sure that we do support people to have the quality of life that they deserve. WHITE Thanks very much and this programme will be returning to that subject in a couple of months time. Back to the You and Yours homepage The 成人论坛 is not responsible for external websites |
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