Local authorities are facing the twin threats of funding cuts and a rise in the demand on frontline services. The strain will be felt across the board, but nowhere more acutely than in the health and social care sectors.
Hertfordshire County Council is tackling the problem in what might seem an unusual manner. They are encouraging carers to identify themselves and ask for financial support.
I met up with John Ley, an unpaid carer, at his home in Broxbourne, Hertfordshire to try and understand this counterintuitive policy.
‘We’ve been through it a bit haven’t we?’ I am sitting in the Ley’s front room with John, 55, his wife Linda, 53, and their Golden Retriever, Bella. John has just finished listing the multiple medical problems that his family has to deal with. Linda was diagnosed with early-onset Alzheimer’s in May of this year and his daughter Katie, 22, has Downs Syndrome and Type 1 Diabetes. As if this wasn’t enough, John is also diabetic.
Faced with these challenges, the Leys, like all carers, need extra support and this is what their council strives to provide.
Hertfordshire County Council, in partnership with the county’s clinical commissioning groups (CCGs), launched a new joint strategy last October to support people like the Leys. They are encouraging those with caring responsibilities to come forward for a free assessment to ensure they get the help available to them.
Last year, the council and the CCGs invested more than £2.4m to support carers. Now, as part of their new strategy, they are committing an additional £1m for this year and they are aiming to increase the number of carers receiving support from voluntary sector partners, such as Carers in Hertfordshire and Crossroads Care, by more than 10% per annum over the next three years.
John, a freelance journalist, has found the council’s help to be a great relief. ‘Its made so much difference’, he says. Before going freelance, he was a sports reporter with The Telegraph for 27 years. In this role he met everyone from Alex Ferguson to Harry Redknapp. His home office is knee deep in football books and old match ticket stubs cover the walls. Surveying the scene it is clear that there is no distinguishing between his work and his hobby. In the past, he travelled the world with all the major teams, covering games in 55 countries. Now though, because of his caring duties, he struggles to find the time to go even as far as London.
Katie’s diabetes and Linda’s Alzheimer’s make it impossible for him to go anywhere for long periods. ‘Linda was always on top of [Katie’s diabetes]’, he tells me, ‘but now she can’t get her head around how much insulin she should have’. This means John is now unable to take on full-time work. ‘I turned a job down last week’, he says, ‘simply because it meant I would have had to go into the office…there have been job offers but I can’t do them because I need to be around.’
The risk is not hypothetical. Last May, Katie had a severe diabetic turn. ‘Her blood sugar shot through the roof’, John explains, ‘and I rushed her up to Harlow at 11pm. She spent a week in hospital. If I was in the office then what would we have done?’
The council and its partners offer a number of different services to support carers, but John has found the Money Advice Unit (MAU) to be particularly helpful. ‘We stumbled across the MAU through word of mouth’, he tells me. A council run service, the MAU provides people with advice on what benefits they are eligible for. Hearing about it through a friend who works for Carers in Hertfordshire, John contacted them. They explained that Katie is eligible for the employment and support allowance (ESA). ‘We got ESA and the Money Advice Unit worked hard on that for me…[they] helped me fill in the forms over the phone.’
John was very impressed with the MAU. One lady, Hari Buyukertas, even went out of her way to ensure the Leys were getting the most they could. ‘She helped me apply for a higher rate’, John says, ‘so Katie gets more now. Its something like an extra hundred pounds a month.’ These kinds of direct payments make a huge difference. As John puts it: ’it just takes the pressure off’.
But Hertfordshire is doing more than straightforward benefit payments. They are trying to look after the health of carers themselves. Dr Hari Pathmanathan, a Hertfordshire GP and chair of East and North Hertfordshire CCG, emphasises the damaging effect caring can have on carers. ‘In my day-to-day work’, he says, ‘I see the impact that looking after a dependent friend or family member can have. Being a carer is often both physically and mentally demanding, with worry, broken sleep or the weight of responsibility all taking their toll. We know that the health and wellbeing of carers can be affected by their caring roles.’
With this in mind, the charity Carers in Hertfordshire, which works with the council, has come up with Carers’ Passports. These provide carers with access to over 350 discounts/concessions with many different companies, including Boots, Paradise Wildlife Park, Virgin Experience, and, according to their website, many local businesses. John has a Carers’ Passport.
‘Every Boots in Hertfordshire’, he tells me, ‘gives you 10% off. Quite a lot of restaurants will give you 10% off. We’re very lucky just up the road—a three minute drive—is a brilliant zoo, Paradise Park, and they let us both in for nothing.’
This makes it financially easier for carers and those they look after to get out the house and to stay active. This helps both physically and mentally, and is particularly important for the carer’s health. ‘One thing carers are told’, John says, ‘- and its one thing Carers in Hertfordshire are good at -: the biggest danger is forgetting yourself. Now I have high blood pressure and type two diabetes as well so I have to be careful.’ The passport allows John to take a bit of time off. He's a huge sports fan but he rarely gets the chance to spend a few hours at, say, a football match. He can now, however, justify visiting a favourite museum for a breather. ‘One of my passions is speedway—bikes—and they’ve got the national speedway museum there so I dip in there every now and then and just indulge for ten minutes or so…its great.’
John struggled at first with the idea of accepting benefits. He says he felt guilty. But it was soon pointed out to him that, as a taxpayer, it is his right, and this is the advice he gives other carers: ’the help is there for people who deserve it and don’t feel guilty about it because they do want to help you.’
There is another dimension to the council’s drive to encourage carers to claim the support that is available to them. There are over 109,000 unpaid carers in Hertfordshire who look after their family, friends and neighbours. Were they to stop doing this then the state would bear the brunt of the cost of care. Unpaid carers save the council approximately £2bn, so it makes financial sense for Hertfordshire to ensure that people like John are able to continue to look after the ones they love.
This is why it is sensible for councils to invest in preventative care. In the long run, it’s a lot cheaper.
