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The question should not be “what is the cost of creating transformation?” but rather “what is the cost of not doing so?”

Guest blog by Fiona Collie, Carers Scotland

What do we want to see for ourselves and loved ones? To be nurtured, to have friendships and connections, to enjoy our lives and the ability to fulfil aspirations.

Too often these things are unattainable, especially for people with disabilities, older people, and unpaid carers. Not because they cannot be reached but because they are simply seen as too costly. The lives, hopes and dreams of people who use or need social care, and their carers, are not seen as of sufficient value. Carers are a resource to be drawn upon; disabled and older people: a cost to be borne.

The Independent Review of Adult Social Care talked of a need to think of social care differently – “to stop seeing funding social care support as this burden but rather as an investment in the economy and our society”. To truly transform we need to be far more ambitious about investing in social care than currently proposed for the National Care Service.

The proposals are, however, positive. They offer a much-needed shift in how we view social care. The principles underpinning the legislation; focused on early intervention, ensuring human rights, enabling people to thrive and co-producing solutions are, if delivered, transformational. However, all of this relies on ambitious investment.

Fundamental change is critical to enabling carers and the person they care for to thrive. There remains, however, a huge gap between warm words and effective support for this to happen.

One example is hospital discharge, often dehumanizingly characterised as “bed blocking” to grab political headlines. When Carers Scotland asked[1] carers about their experiences of hospital discharge; nearly two thirds were neither involved nor consulted, and only 15% were given any choice about providing care. Few got the support they needed to care safely with less than a fifth (18%) saying they received sufficient services. In the middle of a cost-of-living crisis, over a third (37%) said they felt pressurised to take time off work to care, creating or exacerbating financial insecurity. Some even had to leave work altogether. This is despite the Carers Act 2016 enshrining carers’ right to be involved and placing duty on the NHS to involve them.

Too often carers are seen as the easiest, and certainly the cheapest, option while insufficient thought is given to their health, finances or employment, nor the wider economic impact, when considering the impact of caring. But this lack of support is not simply a symptom of current pressures. Research on the lives of carers, over several decades, finds that they and the person they care for cannot get the level of support they need and the impacts of this are significant.

Poverty is consistently higher for carers than non-carers[2] and the cost-of-living crisis has been devastating. More than a quarter of carers have had to cut back on food or heating, and more than 10% have had to use foodbanks.

Nearly 7% of carers are forced to give up work to care with a further 5% reducing their working hours[3]. A similar proportion cannot take up paid employment because of caring4].

This comes with both economic and personal costs. In 20175] estimated found 345,000 working age carers in England left work and remain out of employment costing £2.9 billion in taxes on lost earnings and replacement social security payments. Employers are losing talented people after investing significant resources.

Those at the peak age of caring (45-66 years) lose on average £6,300 a year because they must stop/reduce their hours[6] creating a financial penalty for carers.

Carers are also more likely have a long-term poor health condition than non-carers[7] and 16% more likely than non-carers to live with two or more long-term conditions[8.

Two thirds of us will be carers at some point and most of us will feel this impact. We must be more ambitious – for current and future carers. More carers are being lost into chasms, emerging with their financial security in tatters and health so poor that they need immediate and more expensive crisis support.

The SWBG transformative approach can change this picture. The question should not be “what is the cost of creating this transformation?” but rather “what is the cost of not doing so?”.

Fiona Collie is Head of Policy and Public Affairs at Carers Scotland

Read the SWBG research – Towards a transformative universal adult social care support service for Scotland




[1] State of Caring in Scotland 2022, Carers Scotland, 2022

[2] Poverty in the UK, Joseph Rowntree Foundation, 2023

[3] Juggling work and unpaid care: A growing issue, Carers UK, 2019

[4] Scotland’s Carers, Scottish Government, 2015

[5] Pickard, Linda, King, Derek, Brimblecombe, Nicola and Knapp Martin (2017). Public expenditure costs of carers leaving employment in England, 2015/2016. Health and Social Care in the Community. ISSN 0966-0410

[7] Carers’ health and experiences of primary care, Carers UK, 2021

[8] “Caring as a social determinant of health: Findings from a rapid review of reviews and analysis of the GP Patient Survey” Public Health England, 2021

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