March 23, 2023 • 38 mins
Reflections on ’A gloriously ordinary life’: In conversation with Baroness Andrews
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The House of Lords Adult Social Care Committee has been looking into what needs to change to create a fair, resilient and sustainable care system that better enables everyone to ‘live an ordinary life’, and in so doing, to have greater choice and control over their lives.
This episode is a reflection, in Baroness Andrews' own words, on the recent report published by the Committee, 'A “gloriously ordinary life’’: spotlight on adult social care’. The report included evidence submitted by colleagues at the Centre for Care, including Kate Hamblin, who hosts this episode.
The Baroness gives a first hand account on the workings behind the report, how crucial research helped shape it, and how those with lived experience were central to its creation and successful reception.
About Baroness Andrews
Baroness Andrews is Chair of the House of Lords Adult Social Care Committee. Baroness Andrews was a Government Whip and Spokesperson in the House of Lords for Health, Work and Pensions, and Education and Skills from 2003 to 2005, before becoming Parliamentary Under Secretary of State at the Department for Communities and Local Government from 2005 to 2009. From 2009 to 2013, she was the Chair of English Heritage.
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Read the report ‘A “gloriously ordinary life’’: spotlight on adult social care’
Read Kate Hamblin's commentary on the report here: https://centreforcare.ac.uk/commentary/2022/12/reflections-a-gloriously-ordinary-life/
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Learn more about our research on the Centre for Care website here: https://centreforcare.ac.uk/
The CARE MATTERS Podcast is produced by Dan Williamson at the Centre for Care.
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Episode Transcript
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(00:05):
The Care Matters podcast is
brought to youby the ESRC Centre for Care and CIRCLE,
the Centre for International Researchon Care, Labour
and Equalities.
In this series,
our researchers welcome expertsin the field and those giving or receiving
care to discuss crucial issuesin social care, as we collectively attempt
(00:30):
to make a positive differenceto how care is experienced
and provided.
Hello and welcome to another editionof the Care Matters podcast.
I'm Kate Hamblin, the lead for the DigitalCare theme in the Centre for Care
and a member of the IMPACT ImplementationCentre's leadership and delivery teams.
(00:53):
This episode focuses on a recent Houseof Lords Committee and report.
The House of Lords Adult Social CareCommittee has been looking into what
needs to change to create a fair,resilient and sustainable care system
that enables everyoneto live an ordinary life
and in doing so, have greater choiceand control of their lives.
In December, the committee publishedits report ''A Gloriously Ordinary Life':
(01:16):
Spotlight on Adult Social Care', and todayI'm joined by the chair
of that committee. Baroness Andrews.
Baroness Andrews was the government whipand spokesperson for the House of Lords
for Health, Work and Pensionsand Education and Skills from 2003
to 2005, before becoming the ParliamentaryUnder-Secretary of State
at the Department of Communitiesand Local Government from 2005 to 2009.
(01:39):
She then moved from 2009 to 2013to be the chair of English Heritage.
Welcome, Baroness Andrews.
Thank you so much.
It's very good to be here.
I'm very happy to take partin such a useful podcast.
Thank you.
I found
the report really fascinatingand I was, full disclosure,
(02:01):
asked to give evidence at the enquiry,but would you mind
maybe telling the listeners first a bitmore about the inquiry and its origins?
Certainly.
I'm so glad you gave its full titlebecause 'A Gloriously Ordinary Life'
was the title suggested to usby one of the people that we took
evidence from, and it sort of sums upactually what it was that
(02:23):
we eventually wanted to sayin very succinct language.
It was a short select committee inquiryand we have two types,
one set of select committees run
for three years, a more or less permanent.
And then there are a seriesof ad hoc committees which we volunteer
(02:44):
and offer up as subjectswhich are very appropriate
for a shorter inquiry,which across different areas of policy.
And because adult social careis such a key issue at the moment,
is such a contentious issue,such an important area
of policy,one of the members of the House of Lords,
(03:04):
Lord Laming, suggestedthat we looked at adult social care,
but we all agreed
once the committee had been appointed
and I should say we camefrom all parts of the House, every policy.
We had a bishop, BishopJames of Carlisle, and of course as well.
We allagreed that it was an enormous topic,
(03:26):
a very, very well trampled over topic.
And we should find somethingwhich nobody had really focussed on.
And so the original focus of our inquirywas to be on unpaid care,
because the whole set of issues
around unpaid care care in the home,a relatively invisible
(03:48):
and very, very hard to graspbecause the data isn't there
and these millions of peopleand the number does vary
between five million and above.
These are the people who really arethe backbone of the system,
without which the whole adult care
(04:11):
set of provisions simply wouldn't work.
And in
deciding to do that,because what we realised it
very quickly wasyou couldn't talk about unpaid carers
without talkingabout the whole set of issues around
disabilityand and growing older and dementia
(04:32):
and all these issueswhich are associated with care.
The people who receive care and the peoplewho provide care in the home
are two sides of the same coin.
And so the to my great joy, to be honest,actually, we found ourselves
in the middle of an inquirywhere we were looking at both
(04:53):
the whole range of issues around
chronic disabilities, adults,
current disability and so and youngadults, working adults, older people.
All these issues which raise
the crucial question you've already raisedis how do people get to choose
what's on offer and how did they get tochoose what is best for themselves?
(05:14):
And so it was a very satisfying,
coherent committee.
And we finished- We had a year,
we took advice from Andrew Dilnot as well.
And he said to usand it was very striking.
And we followed his advicethat one of the problems
about adult social care in its wholeis it's invisible.
(05:36):
I mean, we all know now about carehomes, COVID made that
such an incredibly importantand dramatic and awful issue,
but the rest of adult social careis relatively invisible
unless you're in it,unless you've come up against it.
And that is what makes it so difficult
to create a visible policy for it.
(05:59):
So those are all some of the issueswhich we wrestled with.
And when we published our reportin December on
time, of course we had to
wait for people's judgement.
I'm very pleased to say that
the report has been well received.
It's seen as optimistic
(06:22):
positive, a new positive approach
to adult social care,seeing it for the huge, huge benefit
it is to us all, and with some good pressfor recommendations.
Oh, absolutely.
And I think the thingthat really struck me that, you know,
you did it in a year, but the sheerrange of people you spoke to, you know,
(06:44):
so much lived experience in there,so much people
with practice experience, academics,
just a huge number of voices in there.
And it seems likethere was a very reflexive process of
expanding that focus away from, okay,we can't look at unpaid carers.
We need to take a whole systems approachto this.
(07:05):
Really interesting.
And I think another thing thatstruck me was the sort of
the foregroundingof care will affect us all.
This isn't a peripheral issue if this is,
you know, it's invisible,but it's so common in all.
It will be increasingly common as we age.
So we can't keep ignoring it.
And it was really things that struck me.
(07:27):
Well, thank you for saying that,because you're absolutely right.
I mean, just on the invisibility pointbecause, you know,
we explore the reasonswhy it is invisible,
because its historically invisible,it was never in the heroic settlement
of the welfare state in 1945because the demography was so different.
Expectations aroundwhat women did was so different people
didn't live as long,especially people with disabilities.
(07:50):
We weren't planning for an ageing societyin 1945
and consequently nobody actually
caught up withthe issue and we've known about ageing
is hardly a surprise, but we've still notactually thought about the implications.
And this is one of the implicationsof course, and one of the issues
(08:11):
that we addressed,you know, we couldn't address it
thoroughly, but we raisedit was that we have a million
people already ageing childrenand it would be 2 million in ten years.
But in terms of the range of voices,so what we wanted to do,
we wanted thisto be a different experience
and we decided that
(08:33):
we would co-produce itwith as many people as possible.
And it really was, course,because it's such an interactive issue.
And if you don't listen,if you don't take account,
then there's no point inyou doing this sort of inquiry frankly.
So we had two experts
advising us one expert by experience,Anna Severwight and another one
(08:53):
Jon Glasby who is a well-known academic,so between them they kept us completely
on the right track.
And of course, they brought their contactsand their knowledge and
their perspectives.
And what we tried to dowas to get as many people as possible
in conversation.
And these include and a lot of peoplewho are receiving care.
(09:15):
We have some fantastic witnesseswho told us about
how fearful they were every timethey had to go back to social services
and say, you know,is this something I could get?
Or I do I need a review and thinkingyou might end up getting less.
And then of course we talked to carersand it was,
it was quite difficult sometimes it was,these were public sessions.
(09:38):
I found myself listening to carers
who would be caring for
elderly parents with chronic conditions,sometimes dementia, disabled
young adults, childrenwho were really, really
well loved and well respected
but still really challenging in the home .
(10:01):
Some people caring for two generationsat the same time.
And I said, listen, we're going to listento these extraordinary women and men.
And at the end of
whatever question we'd ask,I would find myself
thinking, I don;tthink I go on with these questions,
it's is not intrusive,is just what we're hearing
(10:23):
is so powerful, it'sso intimate and it's so revealing
of the day to day stress,I wouldn't be able to do this.
And so that sense of co-productionof listening.
Respectfully and closelyto so many different voices.
And then, of course, we heard all thesebrilliant people from the agencies,
(10:47):
many of whom themselves are expertby experience.
They've been carersor they are disabled in different ways.
We took evidence from senior officialsof the Department of Health each of which
were very good, doing their very bestwe took advice from the ageing SS.
We took a lot of advicefrom local authorities
(11:09):
who were doing brilliant thingslike Somerset Wigan
and that's in the reportbecause there is some brilliant practice
which frankly could be sharedmuch, much more widely
we took evidence from other countries,not enough because we didn't have time.
I would love to talk to peoplein Australia, in Holland
(11:30):
and so on,but we had this great expert from Sweden
being very important in the independentliving movement
and we crammed in as many peopleas possible
into these two-hoursessions over the year.
The report really speaks to thatand some of the key words that were coming
as I was reading it were fightand the fear around reassessment, but also
(11:52):
the thing that I found.
Really valuable was the sort of pushback on the family first.
And families should do more, partlybecause, as you say, there is this growing
number of people who are growing up,who are growing older without children,
but also pushing backon those sort of funny, old fashioned
archaic values, which I think alsocontribute to the invisibility of care,
(12:14):
that it's a private matterfor families to deal with women.
And it's tough stuff.
I would think.
They weren't complaining,you know, that they really weren't.
These are these are people of enormousdignity to who said things like, you know,
I've learnt so longI wouldn't be without my disabled child.
I know I love my parents.
(12:35):
I'm proud to do this.
There was there was no complaintabout the relationship.
They complainedabout having been called carers many times
and they're right to, it's such, in a waysuch an exclusive role.
And people are not just carers,mothers of carers of children, you know,
and it's a really clunky thing,but it's not
what gets you into the benefits systemas it was.
(12:58):
So that's somethingwe should really try to change.
But the families by and large actually,
saw it, of course it is a dutyand there's nobody else.
But there is huge joy in it as well
And I mean to complainsuch as they were, were
with the system.
(13:20):
I think there was a really interesting bitwhere you
where the report sort of lays outlike we're using the language of carers,
but we acknowledgethat it is a problematic
and difficult term and often people don't
identify with itand that leads to a sort of
measurement problem that we have.
(13:40):
I mean, one of the things going backto the issue of who we asked to give give
evidence, you know, there are many peoplewho would love to have spoken to
GP's who are doing really important workin referrals
and creating simple pathways, you know,
into the care
arrangements and so on.
(14:01):
People who know in the private sectorwere doing really interesting things
and many people have been in touch with mesince
and that's been a real revelation
because there is an awfullot of good practice out there and people
who are really trying to improve on
and make some universal differences.
(14:21):
You know,
it's a question of
finding a way into it
because the system is so fragmented,because it's a local delivery system.
All the best practice is fairly localand that's what the challenge is.
How do you actually makethe best universal?
I think yeah, that's certainly somethingwe're wrestling with in the IMPACT
(14:44):
implementation centreinto how you scale and spread
practise that might be quite boundwithin a specific local context.
How do you try.
And capture what makes it work to another
completely different local authorityor local area is that challenge, I think.
And I just wanted to ask youabout the title, because I think
(15:05):
one of the things the report really doesand the enquiry has clearly done is to.
To sort of go back to first principlesand think what is adult social care for?
And the idea that it's about declineand crisis and then managing people when
they're very, you know,
most desperateand it's pushing back on that.
(15:25):
I just wanted you to maybe explainwhere that title came from.
Well, as I said,I think it came from Social Care Futures,
because what we were impressed by,
I mean, it is so depressing to be facedwith the litany of failure and, you know,
not least because you're trying to recruitgood people into this workforce.
(15:47):
Why would they want to joina failing institution?
And part of the problem of invisibility
is you can't easily construct a narrative
because it's not graspable as it wereBut it was so obvious to us,
so much of what we have, especially from,you know, people like Social Care Futures
(16:08):
and many others, the centresfor excellence and so on and individuals
. Because it's instinctive to us.
We want to be optimistic.
We've got our health services visible.
Despite all its challenges,we're very proud of.
And the pandemic revealsthe fundamental importance
(16:30):
of social care, residential care,if you didn't understand that already.
But what adult social care offersand what this report is about
is not a service which is set to prop upthe health service.
It's a service which we should be ableto rely on to be confident,
but to have a sense of entitlement
(16:52):
about it, because when we neededit will listen to us
and it will try to offer us
what we want to continue the lives
that give us the greatest pleasureand effect on the title.
'A Gloriously OrdinaryLife' says it all for me.
(17:12):
And when I was
on Tuesday, when I was
at the launch of the Archbishop's
Commission on Reimagining Social Care,
the term they used is the full life,the fullness of life.
And they had a videowhich included two phenomenal
ladies, both severely disabled,
(17:34):
who described in their terms
what it meant to havea gloriously ordinary life ,like
birthday parties, like going shopping,you know,
like feeling that there was thingsin the course of their day,
it didn't matter at allthat they were as they were.
(17:54):
They were doing things they wanted to do.
People wanted them to be able to do.
And so it comes into the co-productionargument, of course.
And at the moment,you know, the adult social care
serviceis so strapped in what it can offer.
Is minimum
quiteoften to keep people safe in their homes,
(18:16):
to keep them
stabilised,
in terms of their their health conditionsand so on and so forth.
It can't help them to reach the ambitionof being as.
Their best selvesas they remember themselves,
as they want to continue to be.
(18:38):
I think one of the recommendationsis around sort of
returning to the Care Actwhere wellbeing is at its core
and that speaksto this sense of the person
and what they think would enable themto have that wellbeing,
which you knowis about having an ordinary life.
And it's not about just managing riskand managing conditions
(19:00):
and getting people out of hospitalas quickly as possible.
It's it's there legislation.
It's just they.
See that is what is so frustratingabout all of this because,
you know,there's a litany of failed promises. And,
you know, I'm arguing
constantly outside this reportthat this report
(19:22):
makes a case for a positive, creative,
ambitious vision for social care,which is what it should be.
It shouldn't be somethingthat we're fearful to engage with
or despair about having tobecause it's a last resort.
It should be a welcome first resortbecause we know is there to help
and it will help us as best it'sand we come together.
(19:45):
The CARE Act more or less says that.
It doesn't use the term co-productionand it doesn't use the term invisible
or anything like that,but it is about wellbeing,
it's about autonomy,independent living and all these things.
But because not entirelybecause of funding, a failure of will
and a lot of the act has been swallowedby the urgency of other things.
(20:09):
You know, we can mention a lot ofthe things that have gone on since 2014,
but the point is that ithasn't been implemented
and it needs to beand we don't need lots of new legislation.
We really don't,I think we need to revisit the act
and probably the guidanceso critically now because we know more now
we're a bit more
aware of the frailty of the system.
(20:33):
But my goodness, it's a good it'sa good piece of legislation.
Yes. Thank you.
And I think that that's the kind of keyrecommendations are the other
recommendationsyou'd want to highlight as being
what's the key things that we need to donext, really?
Well, there are a lot of recommendations.
And I have to say, we we thought hardabout how many recommendations
(20:54):
we all should put.
In the end, we just said what we thoughtneeded to be done.
One recommendationwhich addresses the invisibility point,
and it may sound likean easy recommendation, but it's not,
is actually having someone
to act as an advocateand an agent of change
(21:15):
for the whole sector, we recommendeda commissioner for care and support.
Now this would be someone modela combination like on the children's
commissioner, the old persons commissionerin Wales, who has got some teeth,
you know, who can actually challengeand point
to and rage about awful practise,
(21:39):
who can act as the voice of
the people who work in the system
and the people who receive it.
Now it will be an enormous jobif you tried to do everything.
You just actually need to have somebodyto underwrite a job description,
which is practicableand which fills the really big gap,
(22:01):
which is there is nobody thereand nothing there at the moment.
So that's one recommendation.
And I actually think that it should beone of the first things to be done.
The second thing is very obvious actually.
We do need a workforce planand there are lots of groups
working on the possibilities of workforceplans, frankly, and they really are .
(22:24):
We need to audit, respect and enhance
the skills of the care workforce.
As long as they considered unskilled,
as long as they're considered to be,
we can pay themless than the minimum wage.
We're never going to have that
sustainable,resilient workforce that we need.
(22:48):
So we really need to rethink
how we employ
and train and sustain and retain people.
Another thing actually that is
urgent,
I think, is to tackle what we do not know.
(23:10):
And one of the things and again,this is about invisibility.
Is the absence of data
when so many thingsactually we simply did not
we couldn't answerbecause the data wasn't there.
And we don't really know.
I mean, we've had new,
you know, new numbersrecently, the number of carers and so on.
(23:32):
So we need a centralised-I hate the term- We need some
we need somebody like maybe the Centrefor Care, to bring together
what we do know, to identify the gapsin our knowledge and our research base,
to actually work out who's doing what,where and what needs to be filled in.
For example.
(23:54):
I said that there are about
another million people ageing
without children by ten years,but we don't know.
We only collect data on women.
We don't knowhow many of those will be men.
We don't know, for example, what
the typical care package costs.
(24:16):
Let me read you something.
Andrew Dilnot, if I can find it quickly
describes the problem
very well, he said basically
it was like being in a shop
'needing social care atthe moment is a bit like being in a shop
with no prices, you know, how much to carefor your partner
(24:37):
or parent with cost per week or month,
but you have no idea how many weeksor months that need will go on.
So you simply do not knowwhat the bill is.'
There's one form of lack of dataand that's very,
very important, that's personaland that's about how much it costs us.
But, you know, all across there are gaps.
(25:00):
So that's another thing.
But, you know,
when we were talking about sorry,I mean, I'm
going through all the recommendations now
when we were talking about unpaid carers
and the things that need to be doneurgently, we need to honour
the promises that were made by successivegovernments to unpaid carers.
Carers
(25:20):
leave where was that for goodness sake,where are those five days?
And where's the plan for respite?
How do we work more closely with employers
and require them to provide carers?
So that's theand then the carer's benefit.
Carersbenefit is the lowest of all benefits
(25:42):
with high barriersin terms of working hours to claim it.
We need to revisit our address
because if you canpay carers a little more.
Not only do you keep them
in better health,
they get some decent food and some rest,and that helps everybody
(26:07):
and helps the whole service,but it's their rights and dignity to that
and it puts a valueon these invaluable services.
So that's another another set ofrecommendations around that.
And then
when we come on to the
the narrative, the bigger picture.
(26:29):
I just want our politiciansand in fact I would like
the national conventionthe bishops would come up with.
And everybody in the fieldjust start talking
about the gloriously
obvious possibilities of adult social careand what it does.
One of the people
(26:50):
that we didn't take evidence fromso we couldn't quote him officially said
the difference between the health serviceand adult social care
is that the health service saved my life.
and adultsocial care has enabled me to live it.
And I think that is a fabulousdescription.
(27:12):
I think, you know, I'm
not saying we don't acknowledgethe impossibilities,
the difficult situations we face dayin, day out in East Sussex, for example.
Some friends of mine have just been toldthey need to then have to wait 19 weeks
to get support.
(27:33):
And this is somebody in pain.
Real pain needs real help.
But what we can sayis that above and beyond this,
there is a goalthat we should be reaching for.
And that I think that is about telling
this bigger story and raising our spiritsand making it a national imperative.
(27:55):
And finally, I want to addressI mean, there's housing, we've got
we need to do something urgent
about ageing in placeso people can go back to their homes.
They don't linger in hospital.
Their homes are safe, they're warm.
They're not going to fall down the steps.
You know, they're not going to electrocutethemselves with faulty wiring.
They needwe need a housing policy which is geared
(28:19):
to an ageing society, and that's marketfinancing, extra care, housing.
It's the whole range of housing optionsthat all within reach.
I mean, the developers could do ittomorrow.
They really could.
All that new housing could be done throughlifetime home standards
without any difficultyand they should be mandatory.
And we've always said this.
So there's a lot of issues aroundhousing and inescapably
(28:44):
there's the issue around fundingbecause frankly, you know,
when health service costs 156 billiona year and adult social care 17 billion,
and if we only had what has been asked
and estimates vary between
about 6 billion a year,
(29:06):
the cost of the healthservice would come down.
So, I mean,those are the other recommendations.
I think those are some of the key ones.
Yeah, no, absolutely.
And I think there's a lot of themunderpinned by the commitment
to co-production as well.
So yeah, I mean,that is at the heart of the design
because co-production is,you know, it goes from.
(29:29):
Me as a disabled person,
say, working with my care provider,
Just say 'I would like to be able to
Go here on a Wednesday.
Can you arrange for me to do some,you know,
some open
university programmes or something?'You know, because it's not just a question
(29:50):
of when will a carer come inand then it goes from that
to the systemic implementation of policy
which is geared around that conversation
around joint goals and places like Wigan
and Somerset have done this
(30:11):
and they've done it because they could seethat it was the best way
of maximising,of optimising their resources notleast
and ensuring that people actuallywere satisfied with the service
and then actually you know, franklysome prevention
mechanisms are really good,Wigan is a good example
So obviously this is about Wiganbut there's no reason
(30:33):
why it shouldn't be about other placesif you make those adjustments.
Somerset has got micro-communitydevelopment, a huge amount of community
development in our report, of course,your community assets, community strengths
on capacity which can be built upnot that expensively,
let the local authoritiesdo what they do best,
which is to create this agencywithin the community.
(30:56):
And the voluntary sectorsare absolutely essential.
And they are so creative, so nimble.
And I
speak as someone who has spenta lot of time in the voluntary sector
So there's a lot about thatand about co-production in that sense.
And of course,then you come on to another form
of co-productionin terms of independent living
(31:17):
and the ability to choosewho does your care.
Now, you may choose family
and many people would.
You may choose some friends or neighbours,
but you might choose a personal assistant.
And increasingly, actually,I think we need to make that choice
(31:39):
more realistic and at the momentit is beyond the reach of so many people
because there are so few that they are,you know,
they can't afford to stay.
As a personal assistant,we talked to one lady
who had employed over the courseof a year,
(31:59):
27 different personal assistants,all of whom in the end found
they couldn't survive on the money.
And of course, if you're dealingwith a personal assistant,
you become a small business,you have to know about health and safety,
national insuranceand everything else is too much.
Too much for people.
Yeah, that that that's really interesting.
(32:21):
And we've been in as part of IMPACTwe've been doing stuff around choice
and control for people.
And you know,
there are the policy mechanismsthat sit in between direct payments
and commission services,but the take up is so low because again,
the sort of acknowledgementthat there will be an administrative
burden placed on someone to managean individual service
phone, for example,isn't factored in to any of the costs.
(32:45):
Well, that's right.
And it costs, it costs emotionally.
It is very taxing.
Yeah.
There isn't that sort of acknowledgementthat there is an additional
you know, there's a benefit,but there's also a cost there.
Someone has to weigh upwhether they can take that on.
And if if, if ultimately the churn of PAsthey're having
(33:05):
is not sustainable, then.
But it goes back to the earlier
question you asked me about, you know,well 'family first'.
Well, yeah, I mean, you we take itas read, the family will be first.
But, you know, just these people actually,who don't have children
with children like minelive the other side of the world.
(33:26):
But people who don't want to askthat of their family, who don't feel
they should be required to, who don't feelthey should put the
pressure on them to step inbecause there's no other choice.
And families who do that willingly,
but not knowinghow long it's going to last.
(33:48):
some of the witnesses told us
they gave up academic jobs, very high
level professional jobs.
Years later, they were caring for
more than one of their family and
they didn't say it with bitterness.
Because that was a choice they made, but
(34:09):
it was not a choiceThey should have had to make.
You know, when we talked to carersI think one of the things that struck
me, as always, struck me actually,
is how modest carers
expectations are,how modestly what they ask
for is so modest,and yet we ask so much of them.
(34:30):
Absolutely.
And it's is sort of short termismI think in the way
that a family first but.
That will have a knock on effectto pensions and. As.
That's creating other dependencies
within that system that we've done
within the Centre for Careand Sustainable Care work around
(34:52):
the financial implicationsfor carers, the health
and wellbeing implications for carers.
So yes, they're taking on carethat could be
or might have been taken on by the outof social care system otherwise.
But they themselves are more likelyto then drawn other forms of support
because
caring is is hardand if you have to give up work then yes,
(35:13):
you financially are going to struggleand the sort of very small
and short term approach to italmost by by policy.
Thank you.
What I want to knowunderstand is what happens next.
Obviously, this is the start of something,not the end of something.
Well, indeed, indeed it is.
I mean, I think we've all beenI mean, I've been talking
(35:36):
on behalf of the committeeand this was not a solo effort.
There were 12 of us involved.
And we've all been very pleasedat the response
and the fact that we seemto have struck a chord
and we seem to have been saying something
new in a fieldwhere there is an awful lot of voices.
(35:59):
So what we do now, Is
frankly campaign on the basisof what we discovered.
You can't leave this.
This is far too important.
So, for example, we are waitingfor a government response to our report.
We have a debate in this House.
We asked questions,asked a question yesterday
about the budgetand where adult social care would fit.
(36:21):
I've been engaged in correspondencewith the Chancellor who chaired the health
and social care select committee
in which he was a passionate advocatefor adult social care.
We're trying to sort of understandwhere the money
and the new money he promised inthe autumn is actually going to go.
Where we will see it.
We will try obviously,
(36:43):
to influence the political partiesin the run up to the election.
I hope we'll be here for peoplewho want to give us more information.
I'm you know, I'm in the businessof listening to any good ideas now.
I'm trying to do what I can tojoin people up and so on and so forth.
(37:03):
It's unusual, in a
way, for a committeeto have a sort of shadow life
after it's finished its work officially.
But I think all of us feel actually
that this is one of the great issuesof all time.
I think ageing, demographic change, ageingand climate change are the great issues
(37:24):
of our time and this belongsin that whole set of issues.
Of course, itimpacts from climate change as well.
So that's basically it's a personal
ambition,but it is shared with a lot of people.
Absolutely.
And certainly one that the Centre for Careand IMPACT also share with you as well.
(37:46):
Thank you so much for your time,Baroness Andrews.
Thank you for for speaking to us.
And I would urge any listenerswho have maybe got a flavour
of the report to actually go and read it.
Cover to cover.
It's just the wealth of experiencein there.
The wealth of interesting practiceis really fascinating
and all buildsto those really concrete recommendations.
(38:10):
Thank you.
Thank you very much.
It's been a huge privilegeand I really it's been
an opportunity for me to think aloud againabout what we did.
And that in itselfis really refreshing and energising.
Thank you.
The Care Matters podcast is
brought to youby the ESRC Centre for Care and CIRCLE,
the Centre for International Researchon Care, Labour
and Equalities.
In this series,
our researchers welcome expertsin the field and those giving or receiving
care to discuss crucial issuesin social care, as we collectively attempt
(00:30):
to make a positive differenceto how care is experienced
and provided.
Hello and welcome to another editionof the Care Matters podcast.
I'm Kate Hamblin, the lead for the DigitalCare theme in the Centre for Care
and a member of the IMPACT ImplementationCentre's leadership and delivery teams.
(00:53):
This episode focuses on a recent Houseof Lords Committee and report.
The House of Lords Adult Social CareCommittee has been looking into what
needs to change to create a fair,resilient and sustainable care system
that enables everyoneto live an ordinary life
and in doing so, have greater choiceand control of their lives.
In December, the committee publishedits report ''A Gloriously Ordinary Life':
(01:16):
Spotlight on Adult Social Care', and todayI'm joined by the chair
of that committee. Baroness Andrews.
Baroness Andrews was the government whipand spokesperson for the House of Lords
for Health, Work and Pensionsand Education and Skills from 2003
to 2005, before becoming the ParliamentaryUnder-Secretary of State
at the Department of Communitiesand Local Government from 2005 to 2009.
(01:39):
She then moved from 2009 to 2013to be the chair of English Heritage.
Welcome, Baroness Andrews.
Thank you so much.
It's very good to be here.
I'm very happy to take partin such a useful podcast.
Thank you.
I found
the report really fascinatingand I was, full disclosure,
(02:01):
asked to give evidence at the enquiry,but would you mind
maybe telling the listeners first a bitmore about the inquiry and its origins?
Certainly.
I'm so glad you gave its full titlebecause 'A Gloriously Ordinary Life'
was the title suggested to usby one of the people that we took
evidence from, and it sort of sums upactually what it was that
(02:23):
we eventually wanted to sayin very succinct language.
It was a short select committee inquiryand we have two types,
one set of select committees run
for three years, a more or less permanent.
And then there are a seriesof ad hoc committees which we volunteer
(02:44):
and offer up as subjectswhich are very appropriate
for a shorter inquiry,which across different areas of policy.
And because adult social careis such a key issue at the moment,
is such a contentious issue,such an important area
of policy,one of the members of the House of Lords,
(03:04):
Lord Laming, suggestedthat we looked at adult social care,
but we all agreed
once the committee had been appointed
and I should say we camefrom all parts of the House, every policy.
We had a bishop, BishopJames of Carlisle, and of course as well.
We allagreed that it was an enormous topic,
(03:26):
a very, very well trampled over topic.
And we should find somethingwhich nobody had really focussed on.
And so the original focus of our inquirywas to be on unpaid care,
because the whole set of issues
around unpaid care care in the home,a relatively invisible
(03:48):
and very, very hard to graspbecause the data isn't there
and these millions of peopleand the number does vary
between five million and above.
These are the people who really arethe backbone of the system,
without which the whole adult care
(04:11):
set of provisions simply wouldn't work.
And in
deciding to do that,because what we realised it
very quickly wasyou couldn't talk about unpaid carers
without talkingabout the whole set of issues around
disabilityand and growing older and dementia
(04:32):
and all these issueswhich are associated with care.
The people who receive care and the peoplewho provide care in the home
are two sides of the same coin.
And so the to my great joy, to be honest,actually, we found ourselves
in the middle of an inquirywhere we were looking at both
(04:53):
the whole range of issues around
chronic disabilities, adults,
current disability and so and youngadults, working adults, older people.
All these issues which raise
the crucial question you've already raisedis how do people get to choose
what's on offer and how did they get tochoose what is best for themselves?
(05:14):
And so it was a very satisfying,
coherent committee.
And we finished- We had a year,
we took advice from Andrew Dilnot as well.
And he said to usand it was very striking.
And we followed his advicethat one of the problems
about adult social care in its wholeis it's invisible.
(05:36):
I mean, we all know now about carehomes, COVID made that
such an incredibly importantand dramatic and awful issue,
but the rest of adult social careis relatively invisible
unless you're in it,unless you've come up against it.
And that is what makes it so difficult
to create a visible policy for it.
(05:59):
So those are all some of the issueswhich we wrestled with.
And when we published our reportin December on
time, of course we had to
wait for people's judgement.
I'm very pleased to say that
the report has been well received.
It's seen as optimistic
(06:22):
positive, a new positive approach
to adult social care,seeing it for the huge, huge benefit
it is to us all, and with some good pressfor recommendations.
Oh, absolutely.
And I think the thingthat really struck me that, you know,
you did it in a year, but the sheerrange of people you spoke to, you know,
(06:44):
so much lived experience in there,so much people
with practice experience, academics,
just a huge number of voices in there.
And it seems likethere was a very reflexive process of
expanding that focus away from, okay,we can't look at unpaid carers.
We need to take a whole systems approachto this.
(07:05):
Really interesting.
And I think another thing thatstruck me was the sort of
the foregroundingof care will affect us all.
This isn't a peripheral issue if this is,
you know, it's invisible,but it's so common in all.
It will be increasingly common as we age.
So we can't keep ignoring it.
And it was really things that struck me.
(07:27):
Well, thank you for saying that,because you're absolutely right.
I mean, just on the invisibility pointbecause, you know,
we explore the reasonswhy it is invisible,
because its historically invisible,it was never in the heroic settlement
of the welfare state in 1945because the demography was so different.
Expectations aroundwhat women did was so different people
didn't live as long,especially people with disabilities.
(07:50):
We weren't planning for an ageing societyin 1945
and consequently nobody actually
caught up withthe issue and we've known about ageing
is hardly a surprise, but we've still notactually thought about the implications.
And this is one of the implicationsof course, and one of the issues
(08:11):
that we addressed,you know, we couldn't address it
thoroughly, but we raisedit was that we have a million
people already ageing childrenand it would be 2 million in ten years.
But in terms of the range of voices,so what we wanted to do,
we wanted thisto be a different experience
and we decided that
(08:33):
we would co-produce itwith as many people as possible.
And it really was, course,because it's such an interactive issue.
And if you don't listen,if you don't take account,
then there's no point inyou doing this sort of inquiry frankly.
So we had two experts
advising us one expert by experience,Anna Severwight and another one
(08:53):
Jon Glasby who is a well-known academic,so between them they kept us completely
on the right track.
And of course, they brought their contactsand their knowledge and
their perspectives.
And what we tried to dowas to get as many people as possible
in conversation.
And these include and a lot of peoplewho are receiving care.
(09:15):
We have some fantastic witnesseswho told us about
how fearful they were every timethey had to go back to social services
and say, you know,is this something I could get?
Or I do I need a review and thinkingyou might end up getting less.
And then of course we talked to carersand it was,
it was quite difficult sometimes it was,these were public sessions.
(09:38):
I found myself listening to carers
who would be caring for
elderly parents with chronic conditions,sometimes dementia, disabled
young adults, childrenwho were really, really
well loved and well respected
but still really challenging in the home .
(10:01):
Some people caring for two generationsat the same time.
And I said, listen, we're going to listento these extraordinary women and men.
And at the end of
whatever question we'd ask,I would find myself
thinking, I don;tthink I go on with these questions,
it's is not intrusive,is just what we're hearing
(10:23):
is so powerful, it'sso intimate and it's so revealing
of the day to day stress,I wouldn't be able to do this.
And so that sense of co-productionof listening.
Respectfully and closelyto so many different voices.
And then, of course, we heard all thesebrilliant people from the agencies,
(10:47):
many of whom themselves are expertby experience.
They've been carersor they are disabled in different ways.
We took evidence from senior officialsof the Department of Health each of which
were very good, doing their very bestwe took advice from the ageing SS.
We took a lot of advicefrom local authorities
(11:09):
who were doing brilliant thingslike Somerset Wigan
and that's in the reportbecause there is some brilliant practice
which frankly could be sharedmuch, much more widely
we took evidence from other countries,not enough because we didn't have time.
I would love to talk to peoplein Australia, in Holland
(11:30):
and so on,but we had this great expert from Sweden
being very important in the independentliving movement
and we crammed in as many peopleas possible
into these two-hoursessions over the year.
The report really speaks to thatand some of the key words that were coming
as I was reading it were fightand the fear around reassessment, but also
(11:52):
the thing that I found.
Really valuable was the sort of pushback on the family first.
And families should do more, partlybecause, as you say, there is this growing
number of people who are growing up,who are growing older without children,
but also pushing backon those sort of funny, old fashioned
archaic values, which I think alsocontribute to the invisibility of care,
(12:14):
that it's a private matterfor families to deal with women.
And it's tough stuff.
I would think.
They weren't complaining,you know, that they really weren't.
These are these are people of enormousdignity to who said things like, you know,
I've learnt so longI wouldn't be without my disabled child.
I know I love my parents.
(12:35):
I'm proud to do this.
There was there was no complaintabout the relationship.
They complainedabout having been called carers many times
and they're right to, it's such, in a waysuch an exclusive role.
And people are not just carers,mothers of carers of children, you know,
and it's a really clunky thing,but it's not
what gets you into the benefits systemas it was.
(12:58):
So that's somethingwe should really try to change.
But the families by and large actually,
saw it, of course it is a dutyand there's nobody else.
But there is huge joy in it as well
And I mean to complainsuch as they were, were
with the system.
(13:20):
I think there was a really interesting bitwhere you
where the report sort of lays outlike we're using the language of carers,
but we acknowledgethat it is a problematic
and difficult term and often people don't
identify with itand that leads to a sort of
measurement problem that we have.
(13:40):
I mean, one of the things going backto the issue of who we asked to give give
evidence, you know, there are many peoplewho would love to have spoken to
GP's who are doing really important workin referrals
and creating simple pathways, you know,
into the care
arrangements and so on.
(14:01):
People who know in the private sectorwere doing really interesting things
and many people have been in touch with mesince
and that's been a real revelation
because there is an awfullot of good practice out there and people
who are really trying to improve on
and make some universal differences.
(14:21):
You know,
it's a question of
finding a way into it
because the system is so fragmented,because it's a local delivery system.
All the best practice is fairly localand that's what the challenge is.
How do you actually makethe best universal?
I think yeah, that's certainly somethingwe're wrestling with in the IMPACT
(14:44):
implementation centreinto how you scale and spread
practise that might be quite boundwithin a specific local context.
How do you try.
And capture what makes it work to another
completely different local authorityor local area is that challenge, I think.
And I just wanted to ask youabout the title, because I think
(15:05):
one of the things the report really doesand the enquiry has clearly done is to.
To sort of go back to first principlesand think what is adult social care for?
And the idea that it's about declineand crisis and then managing people when
they're very, you know,
most desperateand it's pushing back on that.
(15:25):
I just wanted you to maybe explainwhere that title came from.
Well, as I said,I think it came from Social Care Futures,
because what we were impressed by,
I mean, it is so depressing to be facedwith the litany of failure and, you know,
not least because you're trying to recruitgood people into this workforce.
(15:47):
Why would they want to joina failing institution?
And part of the problem of invisibility
is you can't easily construct a narrative
because it's not graspable as it wereBut it was so obvious to us,
so much of what we have, especially from,you know, people like Social Care Futures
(16:08):
and many others, the centresfor excellence and so on and individuals
. Because it's instinctive to us.
We want to be optimistic.
We've got our health services visible.
Despite all its challenges,we're very proud of.
And the pandemic revealsthe fundamental importance
(16:30):
of social care, residential care,if you didn't understand that already.
But what adult social care offersand what this report is about
is not a service which is set to prop upthe health service.
It's a service which we should be ableto rely on to be confident,
but to have a sense of entitlement
(16:52):
about it, because when we neededit will listen to us
and it will try to offer us
what we want to continue the lives
that give us the greatest pleasureand effect on the title.
'A Gloriously OrdinaryLife' says it all for me.
(17:12):
And when I was
on Tuesday, when I was
at the launch of the Archbishop's
Commission on Reimagining Social Care,
the term they used is the full life,the fullness of life.
And they had a videowhich included two phenomenal
ladies, both severely disabled,
(17:34):
who described in their terms
what it meant to havea gloriously ordinary life ,like
birthday parties, like going shopping,you know,
like feeling that there was thingsin the course of their day,
it didn't matter at allthat they were as they were.
(17:54):
They were doing things they wanted to do.
People wanted them to be able to do.
And so it comes into the co-productionargument, of course.
And at the moment,you know, the adult social care
serviceis so strapped in what it can offer.
Is minimum
quiteoften to keep people safe in their homes,
(18:16):
to keep them
stabilised,
in terms of their their health conditionsand so on and so forth.
It can't help them to reach the ambitionof being as.
Their best selvesas they remember themselves,
as they want to continue to be.
(18:38):
I think one of the recommendationsis around sort of
returning to the Care Actwhere wellbeing is at its core
and that speaksto this sense of the person
and what they think would enable themto have that wellbeing,
which you knowis about having an ordinary life.
And it's not about just managing riskand managing conditions
(19:00):
and getting people out of hospitalas quickly as possible.
It's it's there legislation.
It's just they.
See that is what is so frustratingabout all of this because,
you know,there's a litany of failed promises. And,
you know, I'm arguing
constantly outside this reportthat this report
(19:22):
makes a case for a positive, creative,
ambitious vision for social care,which is what it should be.
It shouldn't be somethingthat we're fearful to engage with
or despair about having tobecause it's a last resort.
It should be a welcome first resortbecause we know is there to help
and it will help us as best it'sand we come together.
(19:45):
The CARE Act more or less says that.
It doesn't use the term co-productionand it doesn't use the term invisible
or anything like that,but it is about wellbeing,
it's about autonomy,independent living and all these things.
But because not entirelybecause of funding, a failure of will
and a lot of the act has been swallowedby the urgency of other things.
(20:09):
You know, we can mention a lot ofthe things that have gone on since 2014,
but the point is that ithasn't been implemented
and it needs to beand we don't need lots of new legislation.
We really don't,I think we need to revisit the act
and probably the guidanceso critically now because we know more now
we're a bit more
aware of the frailty of the system.
(20:33):
But my goodness, it's a good it'sa good piece of legislation.
Yes. Thank you.
And I think that that's the kind of keyrecommendations are the other
recommendationsyou'd want to highlight as being
what's the key things that we need to donext, really?
Well, there are a lot of recommendations.
And I have to say, we we thought hardabout how many recommendations
(20:54):
we all should put.
In the end, we just said what we thoughtneeded to be done.
One recommendationwhich addresses the invisibility point,
and it may sound likean easy recommendation, but it's not,
is actually having someone
to act as an advocateand an agent of change
(21:15):
for the whole sector, we recommendeda commissioner for care and support.
Now this would be someone modela combination like on the children's
commissioner, the old persons commissionerin Wales, who has got some teeth,
you know, who can actually challengeand point
to and rage about awful practise,
(21:39):
who can act as the voice of
the people who work in the system
and the people who receive it.
Now it will be an enormous jobif you tried to do everything.
You just actually need to have somebodyto underwrite a job description,
which is practicableand which fills the really big gap,
(22:01):
which is there is nobody thereand nothing there at the moment.
So that's one recommendation.
And I actually think that it should beone of the first things to be done.
The second thing is very obvious actually.
We do need a workforce planand there are lots of groups
working on the possibilities of workforceplans, frankly, and they really are .
(22:24):
We need to audit, respect and enhance
the skills of the care workforce.
As long as they considered unskilled,
as long as they're considered to be,
we can pay themless than the minimum wage.
We're never going to have that
sustainable,resilient workforce that we need.
(22:48):
So we really need to rethink
how we employ
and train and sustain and retain people.
Another thing actually that is
urgent,
I think, is to tackle what we do not know.
(23:10):
And one of the things and again,this is about invisibility.
Is the absence of data
when so many thingsactually we simply did not
we couldn't answerbecause the data wasn't there.
And we don't really know.
I mean, we've had new,
you know, new numbersrecently, the number of carers and so on.
(23:32):
So we need a centralised-I hate the term- We need some
we need somebody like maybe the Centrefor Care, to bring together
what we do know, to identify the gapsin our knowledge and our research base,
to actually work out who's doing what,where and what needs to be filled in.
For example.
(23:54):
I said that there are about
another million people ageing
without children by ten years,but we don't know.
We only collect data on women.
We don't knowhow many of those will be men.
We don't know, for example, what
the typical care package costs.
(24:16):
Let me read you something.
Andrew Dilnot, if I can find it quickly
describes the problem
very well, he said basically
it was like being in a shop
'needing social care atthe moment is a bit like being in a shop
with no prices, you know, how much to carefor your partner
(24:37):
or parent with cost per week or month,
but you have no idea how many weeksor months that need will go on.
So you simply do not knowwhat the bill is.'
There's one form of lack of dataand that's very,
very important, that's personaland that's about how much it costs us.
But, you know, all across there are gaps.
(25:00):
So that's another thing.
But, you know,
when we were talking about sorry,I mean, I'm
going through all the recommendations now
when we were talking about unpaid carers
and the things that need to be doneurgently, we need to honour
the promises that were made by successivegovernments to unpaid carers.
Carers
(25:20):
leave where was that for goodness sake,where are those five days?
And where's the plan for respite?
How do we work more closely with employers
and require them to provide carers?
So that's theand then the carer's benefit.
Carersbenefit is the lowest of all benefits
(25:42):
with high barriersin terms of working hours to claim it.
We need to revisit our address
because if you canpay carers a little more.
Not only do you keep them
in better health,
they get some decent food and some rest,and that helps everybody
(26:07):
and helps the whole service,but it's their rights and dignity to that
and it puts a valueon these invaluable services.
So that's another another set ofrecommendations around that.
And then
when we come on to the
the narrative, the bigger picture.
(26:29):
I just want our politiciansand in fact I would like
the national conventionthe bishops would come up with.
And everybody in the fieldjust start talking
about the gloriously
obvious possibilities of adult social careand what it does.
One of the people
(26:50):
that we didn't take evidence fromso we couldn't quote him officially said
the difference between the health serviceand adult social care
is that the health service saved my life.
and adultsocial care has enabled me to live it.
And I think that is a fabulousdescription.
(27:12):
I think, you know, I'm
not saying we don't acknowledgethe impossibilities,
the difficult situations we face dayin, day out in East Sussex, for example.
Some friends of mine have just been toldthey need to then have to wait 19 weeks
to get support.
(27:33):
And this is somebody in pain.
Real pain needs real help.
But what we can sayis that above and beyond this,
there is a goalthat we should be reaching for.
And that I think that is about telling
this bigger story and raising our spiritsand making it a national imperative.
(27:55):
And finally, I want to addressI mean, there's housing, we've got
we need to do something urgent
about ageing in placeso people can go back to their homes.
They don't linger in hospital.
Their homes are safe, they're warm.
They're not going to fall down the steps.
You know, they're not going to electrocutethemselves with faulty wiring.
They needwe need a housing policy which is geared
(28:19):
to an ageing society, and that's marketfinancing, extra care, housing.
It's the whole range of housing optionsthat all within reach.
I mean, the developers could do ittomorrow.
They really could.
All that new housing could be done throughlifetime home standards
without any difficultyand they should be mandatory.
And we've always said this.
So there's a lot of issues aroundhousing and inescapably
(28:44):
there's the issue around fundingbecause frankly, you know,
when health service costs 156 billiona year and adult social care 17 billion,
and if we only had what has been asked
and estimates vary between
about 6 billion a year,
(29:06):
the cost of the healthservice would come down.
So, I mean,those are the other recommendations.
I think those are some of the key ones.
Yeah, no, absolutely.
And I think there's a lot of themunderpinned by the commitment
to co-production as well.
So yeah, I mean,that is at the heart of the design
because co-production is,you know, it goes from.
(29:29):
Me as a disabled person,
say, working with my care provider,
Just say 'I would like to be able to
Go here on a Wednesday.
Can you arrange for me to do some,you know,
some open
university programmes or something?'You know, because it's not just a question
(29:50):
of when will a carer come inand then it goes from that
to the systemic implementation of policy
which is geared around that conversation
around joint goals and places like Wigan
and Somerset have done this
(30:11):
and they've done it because they could seethat it was the best way
of maximising,of optimising their resources notleast
and ensuring that people actuallywere satisfied with the service
and then actually you know, franklysome prevention
mechanisms are really good,Wigan is a good example
So obviously this is about Wiganbut there's no reason
(30:33):
why it shouldn't be about other placesif you make those adjustments.
Somerset has got micro-communitydevelopment, a huge amount of community
development in our report, of course,your community assets, community strengths
on capacity which can be built upnot that expensively,
let the local authoritiesdo what they do best,
which is to create this agencywithin the community.
(30:56):
And the voluntary sectorsare absolutely essential.
And they are so creative, so nimble.
And I
speak as someone who has spenta lot of time in the voluntary sector
So there's a lot about thatand about co-production in that sense.
And of course,then you come on to another form
of co-productionin terms of independent living
(31:17):
and the ability to choosewho does your care.
Now, you may choose family
and many people would.
You may choose some friends or neighbours,
but you might choose a personal assistant.
And increasingly, actually,I think we need to make that choice
(31:39):
more realistic and at the momentit is beyond the reach of so many people
because there are so few that they are,you know,
they can't afford to stay.
As a personal assistant,we talked to one lady
who had employed over the courseof a year,
(31:59):
27 different personal assistants,all of whom in the end found
they couldn't survive on the money.
And of course, if you're dealingwith a personal assistant,
you become a small business,you have to know about health and safety,
national insuranceand everything else is too much.
Too much for people.
Yeah, that that that's really interesting.
(32:21):
And we've been in as part of IMPACTwe've been doing stuff around choice
and control for people.
And you know,
there are the policy mechanismsthat sit in between direct payments
and commission services,but the take up is so low because again,
the sort of acknowledgementthat there will be an administrative
burden placed on someone to managean individual service
phone, for example,isn't factored in to any of the costs.
(32:45):
Well, that's right.
And it costs, it costs emotionally.
It is very taxing.
Yeah.
There isn't that sort of acknowledgementthat there is an additional
you know, there's a benefit,but there's also a cost there.
Someone has to weigh upwhether they can take that on.
And if if, if ultimately the churn of PAsthey're having
(33:05):
is not sustainable, then.
But it goes back to the earlier
question you asked me about, you know,well 'family first'.
Well, yeah, I mean, you we take itas read, the family will be first.
But, you know, just these people actually,who don't have children
with children like minelive the other side of the world.
(33:26):
But people who don't want to askthat of their family, who don't feel
they should be required to, who don't feelthey should put the
pressure on them to step inbecause there's no other choice.
And families who do that willingly,
but not knowinghow long it's going to last.
(33:48):
some of the witnesses told us
they gave up academic jobs, very high
level professional jobs.
Years later, they were caring for
more than one of their family and
they didn't say it with bitterness.
Because that was a choice they made, but
(34:09):
it was not a choiceThey should have had to make.
You know, when we talked to carersI think one of the things that struck
me, as always, struck me actually,
is how modest carers
expectations are,how modestly what they ask
for is so modest,and yet we ask so much of them.
(34:30):
Absolutely.
And it's is sort of short termismI think in the way
that a family first but.
That will have a knock on effectto pensions and. As.
That's creating other dependencies
within that system that we've done
within the Centre for Careand Sustainable Care work around
(34:52):
the financial implicationsfor carers, the health
and wellbeing implications for carers.
So yes, they're taking on carethat could be
or might have been taken on by the outof social care system otherwise.
But they themselves are more likelyto then drawn other forms of support
because
caring is is hardand if you have to give up work then yes,
(35:13):
you financially are going to struggleand the sort of very small
and short term approach to italmost by by policy.
Thank you.
What I want to knowunderstand is what happens next.
Obviously, this is the start of something,not the end of something.
Well, indeed, indeed it is.
I mean, I think we've all beenI mean, I've been talking
(35:36):
on behalf of the committeeand this was not a solo effort.
There were 12 of us involved.
And we've all been very pleasedat the response
and the fact that we seemto have struck a chord
and we seem to have been saying something
new in a fieldwhere there is an awful lot of voices.
(35:59):
So what we do now, Is
frankly campaign on the basisof what we discovered.
You can't leave this.
This is far too important.
So, for example, we are waitingfor a government response to our report.
We have a debate in this House.
We asked questions,asked a question yesterday
about the budgetand where adult social care would fit.
(36:21):
I've been engaged in correspondencewith the Chancellor who chaired the health
and social care select committee
in which he was a passionate advocatefor adult social care.
We're trying to sort of understandwhere the money
and the new money he promised inthe autumn is actually going to go.
Where we will see it.
We will try obviously,
(36:43):
to influence the political partiesin the run up to the election.
I hope we'll be here for peoplewho want to give us more information.
I'm you know, I'm in the businessof listening to any good ideas now.
I'm trying to do what I can tojoin people up and so on and so forth.
(37:03):
It's unusual, in a
way, for a committeeto have a sort of shadow life
after it's finished its work officially.
But I think all of us feel actually
that this is one of the great issuesof all time.
I think ageing, demographic change, ageingand climate change are the great issues
(37:24):
of our time and this belongsin that whole set of issues.
Of course, itimpacts from climate change as well.
So that's basically it's a personal
ambition,but it is shared with a lot of people.
Absolutely.
And certainly one that the Centre for Careand IMPACT also share with you as well.
(37:46):
Thank you so much for your time,Baroness Andrews.
Thank you for for speaking to us.
And I would urge any listenerswho have maybe got a flavour
of the report to actually go and read it.
Cover to cover.
It's just the wealth of experiencein there.
The wealth of interesting practiceis really fascinating
and all buildsto those really concrete recommendations.
(38:10):
Thank you.
Thank you very much.
It's been a huge privilegeand I really it's been
an opportunity for me to think aloud againabout what we did.
And that in itselfis really refreshing and energising.
Thank you.
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