The Unpaid Carer Conundrum

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Last month the Liberal Democrats launched their manifesto, "For a Fair Deal" (2024). The party leader Sir Ed Davey centred his speech on saving the NHS and resolving the care crisis. To achieve this, the Liberal Democrats have pledged free personal care in England, which is similar to the current system Scotland (Triggle et al. 2024). The pledge situates the unpaid carer as an integral part of the party’s belief that to fix the NHS we must properly support care work, bringing unpaid carers out of the “shadows” (Morton & Mckiernan 2024).

Who are unpaid carers?

In order to bring unpaid carers out of the “shadows” (Morton & Mckiernan 2024) we need to first understand who they are. Today, there are both paid and unpaid carers in Britain. While paid carers are people who provide healthcare support to individuals most often within their homes, receive monetary compense for their service, unpaid carers on the other hand, are people who provide regular support to friends, neighbours, or family due to disability, old age, or recurring illness, but who do not recieve monetary compense. Their incredible support to the most vulnerable in society, largely goes unnoticed and is quite often on a volunatry basis. Unpaid carers are therefore, at a cross-section of society: families who pull together, friends who come around to help, and neighbours who offer support.

In Britain, there are an estimated 10.6 million unpaid carers (Carers UK 2022). As one might predict, unpaid carers are an invaluable demographic in a country with a buckling healthcare system. The NHS has suffered under financial and operational issues in the last decade, facing a myriad of challenges from backlogs to staff shortages (Dunn, Ewbank & Alderwick 2023). Unpaid carers are integral in meeting the gaps produced by multiple and intersecting systematic failures, shouldering the financial and operational burden that comes with the territory. This amounts to approximately £162 billion worth of work every year. Unsurprisingly, the hours carers work have been on the rise since 2011, with 1.5 million unpaid carers providing more than 50 hours of support a week (Carers Week 2024, 6; ONS 2023). In taking on these challenges, unpaid carers themselves see their lives impacted, spiralling in a negative direction, which some commentators refer to as having a negative “orientation” (Ahmed 2006).

Current directions

Academic Sarah Ahmed, refers to the direction which carers can take that makes some things "reachable”, while putting others out of reach (Ahmed 2007, 152). The role that carers perform in society often situates them out of reach of their aspirations and desires in particular (Ahmed 2006, 543). Thus, unpaid carers’ work results in orientations that are negative.

According to Carers Week’s newest report, using ONS population data and YouGov Omnibus polling, the largest impact was had on people’s mental health (2024, 13). According to the study, 63% of unpaid carers interviewed had experienced negative mental health effects. This is the equivalent to an estimated 10.1 million people (Carers Week 2024, 13). Unpaid carers also reported negative impacts on their physical health, with 53% of participants experiencing issues (Carers Week 2024, 16). This is equivalent to some 8.5 million people in the UK (Carers Week 2024, 4). Sadly, 17% listed the impact on their health as very negative (Carers Week 2024, 4-11).

Alongside negative impacts on their health, 48% of participants listed their job and ability to work had been effected (Carers Week 2024, 22). This is the equivalent to 7.7 million people in the UK. Whilst alongside this, 47% said their finances and savings had been negatively impacted by their role as an unpaid carer (Carers Week 2024, 4-11). What seems to be clear is that unpaid carers are given a set of directions that produce negative experiences for their health, work and finances (Carers Week 2024, 4-11), which constructs a challenging conundrum. The question we are then faced with is how should we bring this significant community of carers into the light, and orienteer them towards a positive direction?

The Carers Week 2024 report, also found that negative orientations vary depending on the demographic. For example, women are more likely to provide unpaid care and to experience negative effects when doing so (Carers Week 2024, 28). The report also concluded age is another important factor that effects people’s experience, whilst people from low socioeconomic backgrounds are more likely to feel a burden on their finance and savings (Carers Week 2024, 29-31). What this shows us is that unpaid care can have amplified effects on people who already suffer greater discrimination in society. This is a key takeaway for anyone attempting to solve the carer conundrum and re-orienteer carers towards a positive direction. This further underscores the idea that every carer has a unique experience, and carers are not a 'homogenous group (Brimblecombe & Cartagena Farias 2022, 6565).

This means that the unpaid carer conundrum is an intersectional problem. Intersectionality is a term, coined by American legal scholar Kimberlé Crenshaw (Crenshaw 2016). This critical approach centres on how collided disempowered identities interact and produce discrimination (Crenshaw 2020). This is an important aspect to bear in mind when examining carer experiences, as unpaid care work varies depending on who is doing the work. Here, certain demographics of carers, those who possess one or more of the protected characteristics in the Equality Act 2010, are more likely to experience negative orientations.

What this means is that the direction unpaid carers are afforded by society is variable, namely the direction and experience is incrementally worse for those who have pre-existing protected characteristics. The degradation of the country's health and social care infrastructure over the last decade and a half, prolongs the suffering of that unpaid carers experience.

Looking forward:

This conundrum is already a factor for the upcoming election and a central issue in resolving the current health and social care crisis. Although, it is difficult to ascertain whether there is a clear solution at this time.

Having examined the party manifestos, it seems that the Liberal Democrat party have proposed the clearest plan, one which would certainly offer a dynamic change for people in England. This proposed plan mirrors the pre-existing system in Scotland, which would intend to provide free support for carers across England (Triggle et al.). As Nick Triggle points out, this policy is not “a silver bullet” as “much depends on who is eligible for free personal care”. This results in many people failing to pass the assessment for free care (Triggle et al.).

Although, the system in Scotland is not without issues, it is promising to see that one of the parties (Liberal Democrats) is placing unpaid carers’ needs at the forefront of their manifesto. What is clear is that the success of any future policy shall depend on its ability to attenuate to the negative orientations and intersectional identities of unpaid carers, and this is something we will continue to monitor post-election.

Bibliography: 

Ahmed, S. (2006). Orientations: Toward a Queer Phenomenology. GLQ: A Journal of Lesbian and Gay Studies 12(4), 543-574.  https://www.muse.jhu.edu/article/202832.

Ahmed, S. (2007). A phenomenology of whiteness. Feminist Theory, 8(2), 149–168. https://doi.org/10.1177/1464700107078139

Brimblecombe, N., & Cartagena Farias, J. (2022). Inequalities in unpaid carer's health, employment status and social isolation. Health & social care in the community, 30(6), e6564–e6576. https://doi.org/10.1111/hsc.14104

Carers UK. (2022). State of Caring 2022. rep. Carers UK. Available at: https://www.carersuk.org/reports/state-of-caring-2022-report/ (Accessed: August 2023).

Carers Week (2024). No choice but to care. [online] Carers Week. Carers Week. Available at: https://www.carersweek.org/about-carers-week/latest-news/posts-folder/2024-1/june/no-choice-but-to-care-report-launches/#:~:text=The%20No%20choice%20but%20to,is%20around%2010%20million%20people. [Accessed 11 Jun. 2024].

Crenshaw, K. W. (2016), 'The urgency of intersectionality', Kimberlé Crenshaw: The urgency of intersectionality | TED Talk

Crenshaw, K. W. (2020) Intersectionality matters: under the blacklight: history rinsed and repeated [Podcast]. 28 April 2020. Stream 14. Under the Blacklight: History Rinsed and Repeated by Intersectionality Matters with Kimberlé Crenshaw | Listen online for free on SoundCloud

Dunn, P., Ewbank, L. and Alderwick, H. (2023). Nine Major Challenges Facing Health and Care in England - the Health Foundation. [online] www.health.org.uk. Available at: https://www.health.org.uk/publications/long-reads/nine-major-challenges-facing-health-and-care-in-england.

Morton. B. and McKiernan. J. (2024) Libd Dem Mnifesto to pledge £9bn NHS and Care ‘Rescue Package’, BBC News. Available at: https://www.bbc.co.uk/news/articles/crgg9l8z4lpo (Accessed: 19 June 2024)

Office for National Statistics (ONS), released 19 January 2023, ONS website, statistical bulletin, Unpaid care, England and Wales: Census 2021

Triggle, N. et al. (2024). Lib Dem manifesto: 11 key policies explained, BBC News. Available at: https://www.bbc.co.uk/news/articles/cqeevzldj0jo (Accessed: 19 June 2024).