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FRONT LINE FIRST-SOCIAL SERVICES

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As Winter approaches it brings with it the prospect of the NHS plunging into crisis and newspapers are full of repo...
As Winter approaches it brings with it the prospect of the NHS plunging into crisis and newspapers are full of reports of bed blocking by older people. The implication is the victims are to blame.

The secretary of state for health Alan Milburn has announced an additional£300m for social services over next two years. Despite being launched alongside guidance on improved commissioning of residential care, the primary aim of the funding seems to be to get older people out of hospital beds and into homes.

For most older people residential care is not the preferred option. A strategy for emptying hospital beds might as easily concentrate on the provision of services and support needed to allow people to return home. Central to such support is the role of unpaid carers.

Unpaid carers continue to provide the bulk of care. The type of care they are asked to provide may include tasks most would regard as nursing. Social services have the powers to help, but the support carers receive is limited.

According to the General Health Survey 1998, there are nearly 6 million unpaid carers in Great Britain - 71% of whom care for a person over the age of 65, and 30% provide over 20 hours a week of care.

Councils should take account of the carer's contribution in providing services. Since April, councils have had powers under the Carers and Disabled Children Act 2000 to provide services to the carers.

The Department of Health has asked councils to be innovative in using these powers. Help is not limited to social services. For example if a child-sitting service would free the carer to provide support, councils should consider it.

However, the early indications are that these powers have had limited impact. Carers are entitled to have their needs assessed but must request it themselves. Even if they do need services, councils have no statutory duties to provide them.

Caring can have a major financial impact. Carers of working age may have to give up or reduce their paid work. Carers who leave employment to care lose opportunities to build up pensions and savings for their retirement.

Those carers providing substantial care and earning less than£72 a week may be entitled to Invalid Care Allowance, but at£41.75 it does not replace lost earnings.

The benefits available are complicated so carers should talk to a local advice agency to ensure both they, and the person they care for, receive any financial support they are entitled to.

Stephen Lowe and Sally West

Community care policy officer and income policy officer, Age Concern England

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