Government risks setting too high an eligibility bar for carers to gain support

New rights to support for carers in the Care Bill are welcome but the government risks setting the eligibility threshold too high, says Chloe Wright of Carers UK, in this guest post.


The government's Care Bill aims to put the rights of carers on a par with those they care for. It includes enhanced rights for carers to assessments and, for the first time, carers will have a legal right to services when they reach the eligibility threshold, in the same way as disabled people. The recently published draft eligibility criteria describe this threshold for both disabled people and carers and aims to reflect the previous ‘substantial’ level that most local authorities currently operate.



The current carers’ support system


In the current system, local authorities look at the carer in the context of their caring role and how sustainable it is. Government guidance on carers’ assessments state they should look at the health of the carer, their ability to choose how much and what kind of caring they provide, their ability to look after their own domestic needs, their ability to work alongside caring and finally, at the risk to their other relationships and social support systems.


The risk to the caring role is then graded in categories modelled on those for disabled people,  ie ‘critical, substantial, moderate and low’. Importantly, at the moment, unlike for the disabled person, there is not a duty on the local authority to provide a service to the carer to meet that need.  In practice, many interpret this existing discretion in how to address needs as discretion not to meet them at all.


However, the Care Bill would introduce a duty to meet needs above eligibility threshold – through services to the carer or to the disabled person.



Greater emphasis on well-being


The language of the new criteria reflects a greater emphasis on the well-being and opportunities of the carer. The current guidance is designed to determine “the degree to which a carer’s ability to sustain that role is compromised or threatened either in the present or in the foreseeable future by the absence of appropriate support”.  In contrast the new criteria look at the needs that the carer has as a result of providing care.


This shift in emphasis to looking directly at the impact of caring on the carer is welcome. However, there is an immediate and unwelcome consequence of this approach relating to the impact on the health of the carer.


One of the circumstances that would entitle a carer to support under the criteria is if “as a consequence of providing care, the carer’s physical or mental health is, or is at risk of, significantly deteriorating”. By defining the carer’s health needs narrowly in terms of whether they are deteriorating as a result of the impact of caring, this appears to set too high a bar.



Too high a bar for eligibility



The carer must prove significant deterioration of health and, secondly, that this was as a result of caring. This does not take account of the state of their health already and it also starts from a position where there is an assumption that caring will result in a deterioration of health. We’d like to see a system that supports disabled people and carers so that carers’ health does not worsen.


In contrast, the current guidance says there is a substantial risk to the sustainability of the caring role when“significant health problems have developed or will develop” and thereby takes account of the fact that the carer might already be in poor health.



The recent Census results showed that those caring for 50 hours are more than twice as likely to be in ‘bad health’ as non-carers. With a rapidly increasing carer population and the number providing over 50 hours of care a week rising even faster, caring is a growing public health issue.


Given this, putting the right support services for the carer in place as early as possible is key to the carer’s right to well-being, as well as the sustainability of the caring role.


Three in five of us will care at some point in our lives. For both the sustainability of family caring, and to deliver on wider public health and well-being objectives, we cannot afford for a decline in health to be an expected or inevitable part of caring. To deliver this, and act preventively, these new rights to support for carers should also widen access to support through the eligibility criteria, rather than waiting for declining health and the risk of collapse.



Chloe Wright is senior policy and public affairs officer at Carers UK


- See more at:|SC|SCDDB-20130708#sthash.0pVn8o4X.dpuf


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