Social care — our response to Commission on Care

To:

Eva Neitzert and Pam Cole, Women’s Budget Group

Belinda Phipps, Fawcett Society

Juanita Elias and Shirin Rai, Warwick University

We were glad to attend the launch of the PSA Commission on Care report, Towards a New Deal For Care and Carers in November, and see the shift towards recommending national provision and free care, since the seminar presentation in May 2016 which had more emphasis on self-funding future care.  Your focus on exploitation of women migrant workers is important.

Obviously the social care crisis is headline news and the suffering of people dependent on homecare support or stuck in hospital is immense, unbearable and shameless.  Before Christmas, the Labour leader Jeremy Corbyn asked to meet with the Prime Minister about emergency funding to local councils (letter 16 December). But since then, no new funds have been announced by central government, only permission to increase Council Tax and Health minister David Mowat now saying that people should look after their own parents rather than expect Council services.

Eva mentioned that you will be having a roundtable to discuss what next; we look forward to that.

Having read the report now, we have some comments on the direction of the recommendations, which we hope you will consider. Discussing your report led us to expand on our comments about carers, whereas our submission last year focussed on independent living for older and disabled women.

Central government funding vs increased individual taxation. While recommending a National Care Service and government investment in social care infrastructure, the report talks about introducing a social care levy (page 41), which sounds like an extra tax or insurance scheme people would have to pay into, in addition to National Insurance. We are concerned that this feeds the government agenda of individual responsibility and personal insurance, not collective responsibility and taxation from those who can afford it, including corporations (as you know, corporation tax has been lowered). Likewise with Council Tax increases. This morning on the BBC Radio 4 Today programme, Lord Warner formerly of the Dilnott commission again raised the social care levy as an extra individual tax.

ADASS (directors of adult social services), the Local Government Association and many others, say that increasing Council Tax by 2% or 3% won’t go anywhere near filling the funding gap.  Surrey County Council has announced an increase of 15%. Relying on Council Tax revenue is problematic because councils with mainly low-income communities raise less revenue from Council Tax while at the same time having more need.  Bristol Mayor Marvin Rees pointed out that central government is cutting its support grant to his council, an ongoing policy of targeting Labour councils with low-income areas.  We would add that depriving people of services is in effect a tax on the poorest people, who since 2013 have also had to pay Council Tax contributions due to abolition of Council Tax Benefit.

Money in the hands of unwaged and waged carers.  As we mentioned at the launch and discussed with Shirin, the recommendations don’t come out for increased Carers Allowance as a carers’ wage.  Why this lack of support for carers when you highlight that their work is worth £119 billion per year (page 16) and that many thousands of carers are “without recompense or wages” (page 31)?   (The figure you give is also conservative given that Carers UK estimated this work to be worth £132 billion in November 2015. It is not clear whether this valuation includes child carers who are not registered in the ways adults are, who claim carer benefits or services. Instead of providing disabled mothers and fathers with services, children are grossly exploited, which contradicts the Children Act.)  And Health minister David Mowat’s statement that relatives should do more is class-biased as high earners can always pay for someone else to do it – no one expects a banker to take care of his elderly mother or disabled son.

“Improving financial support for carers” is a main demand from Carers UK, alongside the priority of relieving women’s overwhelming workload via funding for services. One way to acknowledge the £132b saving is by remunerating unwaged carers.  Carers Allowance is a pittance, many women are excluded by eligibility rules so claim Income Support as well or instead.  But carers on Income Support are subject to benefit sanction for not attending work-focussed interviews and are therefore discriminated against and periodically put under pressure because their work is not counted as work, even though the government counts on it and intends to increase it.  You don’t mention that.  There is a growing feeling among women that the only way we will get the resources we need is in cash.

As Single Mothers’ Self-Defence, Mothers At Home Matter, Vanessa Olorenshaw and others said at the seminar, mothers are the first carers, and mothers are often caring for parents or relatives at the same time as caring for children.  To qualify for inadequate disability benefits, mothers of disabled children have to prove that the care they provide is over and above the level of care a non-disabled child would receive.  Separating carers for older and disabled people from mothers, has weakened carers’ crucial case for financial recognition and support from a society which is dependent on them for its very existence. And dividing older people from carers hides the fact that women needing care are often also carers for others, age exploitation which is similar to what happens to child carers.

The report comes out for non-financial recognition.  This policy, which has been in place for over 20 years, has shown itself to be sorely lacking and often brutal.  In the current climate it is discredited.  After the Carers (Recognition and Services) Act 1995, carers said that the assessment of their own needs was used to find out and exploit their unwaged work.  (This testimony cannot be found in Council consultations of carers as Councils aim to show they are complying with the law on assessment.)  Successive legislation says that carers should be supported but the overwork goes on and is relied on to make cuts that impoverish mothers and other carers even further. It is time organisations like the Fawcett Society and Women’s Budget Group supported the demands of carers, all carers, for adequate and decent financial recognition.

‘Being a care worker: key findings’ (page 33). Some of us were homecare workers in the past and feel that the issue of decent pay and a living wage is misrepresented in the report.  The survey asks women what is their “motivation” but this downplays the important implications of decent wages.  Women carers, both waged and unwaged, especially those who care for loved ones, feel a stigma or embarrassment if they say outright they are concerned about money, as if they are only doing it for the money, rather than the money enabling them to do it.  This is precisely how carers are taken advantage of.  To overcome this, women could have been asked why they didn’t think that pay was as important as job satisfaction. Emphasising emotional reward and recognition over financial perpetrates women’s exploitation and undermines the case for decent pay.  It ignores that valuing care worker’s relationships with people should translate into decent wages.  Not to do so demeans and devalues care work, care workers’ relationships and the people they assist. You wouldn’t expect any other workers, especially in traditionally male occupations, not to be concerned with their pay. Workers all deserve to be able to pay our bills and not be embarrassed for not being concerned with that. Inclusion London’s report: “One Year On: evaluating the impact of the closure of the Independent Living Fund”, includes testimonies from disabled women and men about how the budgets they are left with are not enough to pay their personal assistants.

Professionalising the care work force. We don’t support this recommendation, which does not deal with the problems brought by privatisation and zero-hour contracts. It will not improve the quality of care, and will result in race and class discrimination against BAME and immigrant women, and women with limited literacy.  It will result in worse relationships.  “Professionalism” has been used against women reliant on care, with carers coming in refusing to do essential housework such as cleaning or cooking, saying “I’m a trained carer!”.  This makes carers unaccountable and unresponsive to the needs and wishes of the people they are supposed to assist.  It sets up conflict. Professionalism widens the gap between the carer and the cared for, as if feelings have to be put aside – professional standards replace caring about what you do and how the person feels.  When we worked as a home help or had home helps who were directly employed by the Council, the difference in quality of care was due to having status as a supported respected employee, not only full-time but also paid for unsocial hours and time off to attend the funerals of people you had cared for, with the time and breathing space to do not only what is needed but what is wished, to improve quality of life.  Training in the narrow sense, has now been stripped of this dimension.

Integration of NHS and social care.  Social care support services should enable us to live independently and help prevent neglect where our health deteriorates to the point where we have to call in the NHS.  Obviously there should be homecare in place when we are ready to leave hospital; we should not be blamed and insulted as “bedblockers” for shortages in social care which we are the first victims of.  There should also be pleasant intermediate places, not like hospitals, to convalesce if we are not quite ready to go home, as there used to be.  But disabled women worry that integration will be used to increase institutionalised care and undermine staying in our own home.  At the moment both social care and the NHS are like massive bureaucracies that do not respond to our needs and wishes but which impose their solutions on us according to their own criteria.  In addition, under the “personalisation” policy, we are burdened with management, bills and accounting for the homecare we receive, charged for from our disability benefits. Many of us feel that instead of the budget freeing us to live our lives, we are weighed down by this and treated as beholden to the Council as the budget provider.

We are against the privatisation and marketisation of care where people are treated as commodities.  We want a return to non-profiteering provision of care of our choice for all of us who need it.

Let us know your thoughts on this. We look forward to being in touch with you.

Cheryl and Claire

Cheryl Mclennan   Claire Glasman

WinVisible (women with visible and invisible disabilities)

Crossroads Women’s Centre

25 Wolsey Mews

London NW5 2DX

Email: win@winvisible.org

Tel: 020 7482 2496

February 2017