Unpaid carers are worth a fortune to the public purse; they pay a crushing price

When you consider how unpaid carers are essentially subsidising the UK’s health and social care systems, little wonder governments have been slow to proper reform

Mark Cantrell
6 min readJun 22, 2023
A close up of a woman holding an elderly lady’s hand.
Stock image courtesy of Pixabay.

AS a political economy the UK has pretty much abandoned carers to their fate, it seems; the same goes for the loved ones they care for.

That sounds pretty grim, but it’s hard not to reach such a stark verdict, given the parlous state of the nation’s adult social care system and little sign of meaningful reform.

Yet without their efforts, that system — along with health services — would collapse. So says professor Matt Bennett, deputy director of Sheffield University’s Centre for Care.

“The economic contribution made by unpaid carers has increased by 29% in the last decade and paints a stark picture of the savings they make to health care budgets,” said Bennett.

“Without unpaid carers, our health and social care systems would collapse.

“In fact, our work shows that people are providing more hours of unpaid care than ever before.”

Bennett and his team analysed the latest census data and crunched the numbers on behalf of the charity, Carers UK, to calculate the estimated value of carers’ unpaid labours. The latter organisation published the findings in a report last month.

The findings reveal how the nation’s specialised system of professional care and support is effectively carried on the backs of an army of unpaid (but committed) amateurs.

There are currently some five million unpaid carers in the UK; around 1.5 million of them are now providing more than 50 hours of care a week.

Unpaid carers essentially donate a staggering sum to the UK economy; the value of their services in England and Wales is calculated at £445 million every day. That comes to a breathtaking £162 billion per year.

By contrast, the NHS budget for England and Wales in 2020/21 was put at an estimated £164 billion; for England alone, it was £156 billion.

Bennett and his team were particularly concerned to find that the burden of unpaid care has increased — but is borne on fewer shoulders.

“It is deeply concerning that the increase in the value of unpaid care over the last decade is a result of fewer carers providing more hours of care,” said Helen Walker, chief executive of Carers UK.

“The ever-declining availability of social care means there is shrinking support for families to pull on — and they are left without a choice but to put other areas of their life on hold and provide more care.

“Having to care round the clock for a loved one has significant implications for people’s ability to stay in paid work, remain financially resilient and maintain their health. Lacking adequate support, unpaid carers feel they are being taken for granted.”

Caring for a family member or friend is very much a labour of love, even if for the individuals concerned there is also a sense of needs must in the face of dwindling options. The hours can be long, with little respite.

They provide care to people who have a disability, illness, a mental health condition, or who need extra help as they grow older. The latter is a growing issue, as society ages — bringing with it an increase in degenerative conditions such as dementia.

According to the Alzheimer’s Society there are over 900,000 UK residents living with some form of dementia. That figure is projected to surpass one million people by 2030, and exceed 1.5 million by 2050.

Despite increases to NHS funding over the last 10 years, increases to social care funding have not kept pace, the report argues, and the care system is now relying ever-more heavily on unpaid carers to prop it up.

As Carers UK points out, providing increased hours of unpaid care leaves family members little choice but to give up work, or reduce their hours to do so. Their own physical and mental health needs suffer, too.

It’s a chronic and worsening situation not alleviated by years of half-hearted efforts at reform. Failed proposals, junked plans, fudges, and politicians kicking the problem into the long grass have generated much in the way of headlines, but no lasting solutions.

About 12,000 people a day become an unpaid carer, according to research the Centre for Care undertook last year. These people are “often a lifeline for the most vulnerable in our society” said research associate, Dr Maria Petrillo,

“The data [in this latest report] shows how heavily the health and social care system relies on unpaid carers,” she added. “Even so, our estimates cannot put a true value on the costs of unpaid care. [I]t is often done out of love and immense respect for the person needing support, and can be at cost to carers’ health, careers, social and family lives and even their financial health.”

An exercise in futility it may prove, but the Centre for Care’s report makes some urgent recommendations to help improve the lot of unpaid carers.

Among them, Bennett and his team call for better rights for unpaid carers, along with support from the NHS and social care systems.

There also need to be more support and stronger rights in employment for those with caring responsibilities, such as carers’ leave and flexible working.

Furthermore, the Government needs to recognise the additional costs of providing care, and take steps to alleviate financial hardship and poverty.

Steps in this respect include reviewing Carers Allowance (currently £76.75 per week for those providing 35 hours or more of care) and reform the benefits system to make it more amenable to carers’ circumstances.

The report also calls for the amendment of the Equalities Act 2010 to make caring a protected characteristic. The aim there is promote equality and tackle discrimination.

“The Government must show that it values and supports unpaid carers by investing in and delivering quality care services for families in the longer-term,” said Carers UK’s Walker. “Carers need a funded National Carers Strategy and recognition within the NHS. For hundreds of thousands of carers on low incomes, they are desperate to see their financial support urgently reviewed.”

For its part, a month or so prior to the Carers UK/Centre for Care report, the Government announced a range of measures aimed at social care and unpaid carers. Among them, it promised to invest £25 million to support unpaid carers, with additional funding to help with things such as respite breaks.

According to a Department of Health & Social Care media factsheet, the Government is also set to increase the value of its Better Care Fund, which is intended to bring together health, social care and housing to “help older people and those with complex needs live at home for longer”.

It is claimed this will rise from £7.7 billion last year to £8.1 billion this year, and up once more to £8.7 billion in 2024. This is said to include £1.6 billion to improve hospital discharge arrangements.

Not quite pocket change, perhaps, but these figures rather pale in comparison to the value Bennett and his research claim unpaid carers are already providing the government. Investing in their continued ability to function as carers is surely a sound bet?

Something certainly needs to be done, as Walker pointed out in the report’s introduction: recognising the “huge contribution” carers provide for society is “vital”; so, too, is enabling them to continue without burning out.

“More must be done to ensure that carers have the financial, practical and workplace support they need,” she added. “Supporting carers to continue providing care, as well as participate in everyday life through work, education and leisure, is cost-effective and in everyone’s best interest.

“Without this essential support, carers are more likely to reach breaking point, with huge implications for themselves and the people they care for, as well as the NHS and adult social care system.”

So, who will care for the carers?

MC

For transparency’s sake, Mark Cantrell was until recently a full-time unpaid carer for a parent with dementia.

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Mark Cantrell
Mark Cantrell

Written by Mark Cantrell

A UK writer and journalist, Mark Cantrell is also the author of two novels: Citizen Zero and Silas Morlock. Read more of his work at tykewriter.wordpress.com