‘We’re all pre-carers’

Convincing people who are not carers to think of themselves as pre-carers would shift the narrative on informal care, a session on how to fix the NHS and social care at the Cambridge Festival heard last week.

Emily Kenway, author of Who cares?, said a change is needed in how we think about care to encourage people to think about what they would need if they were carers, she said, because it will happen.

Kenway spoke of how informal carers are the backbone of how care occurs in the UK, outnumbering paid care workers by three to one. Yet they are largely invisible, she said, despite the impact of caring leaving them more likely to use food banks, have mental health issues and higher mortality rates. She stated that the answer is not more paid care, although more funding is a good thing, because she said paid care is always insufficient. This is due to the unpredictability of care needs, the wishes of those being cared for, the fact that family members know the person needing care more and the central importance of love.

She called for a change in the way that work functions to enable people to balance care and work, for instance, shorter working weeks. This needs to be legislated for rather than being voluntary, she stated, to ensure everyone benefits and not just the middle class. She said paid job-protected carers’ leave similar to maternity pay is also important as is the level of carers allowance, currently only around 75 pounds a week. 

In addition, Kenway spoke about the need for consistency of care and to include the person being cared for in care decisions. She spoke about the model proposed by the Equal Care Co-op where the person being cared for is seen as being part of a team and is in charge of the team, where possible.

Other speakers talked about the NHS. Professor Mike Kelly, former Director of the Centre of Public Health Excellence at the National Institute for Clinical Excellence, said that what the NHS needs is a ground-up approach to care, basing what the service does on evidence, focusing on prevention and rebuilding the trust of NHS workers. He said the last thing it needs is another reorganisation. 

Thara Raj, Director of Population Health and Inequalities at Warrington and Halton Teaching Hospitals NHS Foundation Trust, outlined the extreme pressures on the NHS and said 20% of people in hospital beds were medically able to be discharged, but had no care package in place. She spoke of the work her hospital did to reduce repeated attendance by some patients, but said funding for such projects was often short-term. Raj also spoke about the need to address social issues, such as poor housing, that contribute to poor health.

Geoff Wong, Associate Professor of Primary Care at the University of Oxford and a GP, discussed the pressures on GPs and the ‘elephant in the room’ – rationing – which he said has always taken place to some extent, citing prescription charges as an example. He would like to see the public being included more in decisions on funding care. 

*Watch the full discussion, chaired by Hilary Cooper, co-author of After the virus, here.

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