A new care landscape

The Business of Care, Demos, March 21st 2007

Neil Churchill

Communications Director

Care in 2007 • 6 million people in the UK currently provide some form of

unpaid care• Older people provide a significant portion: 16% of men

and 17% of women aged 50+ provide unpaid care. • 70% of the people cared for are over 65• In the next 25 years it is estimated that the number of

people providing care will have to increase to 9 million

The Deficit Model of Care

We tend to think of care as being delivered:

(1) Formally by a (professionally trained and skilled) workforce; and

(2) Informally by relatives and friends, who may or may not be in paid work.

Our understanding of care has largely been characterised by the relationship between the care-giver, who we tend to perceive as female, and the care-receiver, who is assumed to be dependent.

The Demographic Realities

Demographic and socio-economic change means our future expectations of care-giving can no longer be based on the assumptions of the past.

We know there will be:

• A near doubling in percentage of 65+ population between now and 2050.

• A lower proportion of older people living in married households by early 2030s

• An 47% increase in the 50+ population living in rural areas over the next 2 decades

Care Model under Pressure We also need to consider the impact of the following:

• The introduction of a higher State Pension Age on the numbers of people working for longer

• Potentially shrinking pool of formal care workers.

A MORI Poll for Carers UK (2006) showed that 35% of

people surveyed will not or cannot provide care in the future. The British Social Attitudes survey indicates that people are willing, but don’t feel they

can be mainly responsible.

A Bleak Care Landscape?

Questions:

Will longer working lives and a reduced state role place impossible pressures on informal care?

Or can we construct a new care ethic that moves away from notions of dependence but which is centred on adjustment and co-production instead?

Networks of care

It’s useful to think of care not just as an act of citizenship, or an economic contribution, but also as a social ‘glue’ that can increase social cohesion.

A new ‘ethic of care’ would see care valued as a ‘public good’ and mainstreamed into a range of daily activities. Care would no longer be ‘left to certain people’, but it would be ‘co-produced’ and mainstreamed into all our lives.

Who are the caregivers of the future?

It’s worth questioning certain orthodoxies about who will provide unpaid care and what care constitutes. Increasingly care is being conceived of in reciprocal terms. Positive examples include:

• ‘Homeshare’ schemes• Community networks of support (e.g: Timebank

schemes)• Extra care housing being treated as a community

resource that other members of the community can use.

Model of Inter-Dependency

IndividualIndividual

FamilyFamily

LocalLocalAuthorityAuthority

Friends/Friends/ColleaguesColleagues

NeighboursNeighbours

Time bankTime bank volunteervolunteer

TemporaryTemporaryLodgerLodger

HealthHealth MentorsMentors

Housing Housing residentsresidents

New forms of New forms of reciprocal supportreciprocal support

Traditional FormsTraditional FormsOf SupportOf Support

But…New Pressures on Networks

Individual Making Individual Making AdjustmentsAdjustments

GrandchildrenGrandchildrento look afterto look after

Family membersFamily members migratingmigrating

Loss of BridgingSocial Capital

Extended WorkingExtended Working LivesLives

A New Divide?

There’s a risk a gulf might emerge between those people that benefit from the networks they belong to and those

people that remain dependent on the state.

The well networked

• Light-touch government•Inter-dependent

The Poorly Networked

•Difficult to map•But dependent on government

IndividualIndividualIndividualIndividual

StateState

DistantDistantFamilyFamily

Policy Implications

The recent announcements in the New Deal for Carers were a welcome advance.

However, to truly move away from a deficit model of care we need to stop thinking solely in terms about what the state can do to help support care-givers and care-receivers.

In a ‘mosaic society’ we need to give greater thought about how care can be embedded in communities and transcend traditional ties.