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Good Value for Money? Public Investment in ‘Replacement Care’ for Working Carers in England

Published online by Cambridge University Press:  18 June 2018

Linda Pickard
Linda Pickard*
Affiliation:
Personal Social Services Research Unit, London School of Economics and Political Science E-mail: l.m.pickard@lse.ac.uk
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Abstract

In the context of increasing need for long-term care, the reconciliation of employment and caring is an important social issue. In England, the annual public expenditure costs of unpaid carers leaving employment are approximately £2.9 billion. Previous research shows that provision of paid services to people cared for by working carers, sometimes known as ‘replacement care’, is effective in helping unpaid carers to remain in employment. This study makes an estimate of the public expenditure costs of ‘replacement care’ for working carers in England. Using data from the English Longitudinal Study of Ageing and 2015–16 costs data, the study finds that the public expenditure costs of ‘replacement care’ for working carers are approximately £2.5 billion a year, which is considerably lower than the costs of carers leaving employment. The study concludes that greater public investment in ‘replacement care’ to support working carers in England would represent good value for money.

Keywords

Unpaid careemploymentpaid servicessocial careEngland
Type
Articles
Information
Social Policy and Society , Volume 18 , Issue 3 , July 2019 , pp. 365 - 382
Copyright
© Cambridge University Press 2018 

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References

Age UK (2018) Paying for Care and Support at Home, Factsheet 46, London: Age UK, https://www.ageuk.org.uk/globalassets/age-uk/documents/factsheets/fs46_paying_for_care_and_support_at_home_fcs.pdf [accessed 05.04.2018].Google Scholar
Arber, S. and Ginn, J. (1995) ‘Gender differences in the relationship between paid employment and informal care’, Work, Employment and Society, 9, 3, 445–71.CrossRefGoogle Scholar
Arksey, H. and Glendinning, C. (2008) ‘Combining work and care: carers’ decision-making in the context of competing policy pressures’, Social Policy and Administration, 42, 1, 1–18.Google Scholar
Ben-Galim, D. (2011) Making the Case for Universal Childcare, London: Institute for Public Policy Research (IPPR).Google Scholar
Brennan, D. (1994) The Politics of Australian Child Care. From Philanthropy to Feminism, Melbourne: Cambridge University Press.Google Scholar
Bouget, D., Spasova, S. and Vanhercke, B. (2016) Work-life Balance Measures for Persons of Working Age with Dependent Relatives in Europe. A Study of National Policies, European Social Policy Network (ESPN), Brussels: European Commission.Google Scholar
Bridges, S., Hussey, D. and Blake, M. (2015) The Dynamics of Ageing: The 2012 English Longitudinal Study of Ageing (Wave 6). Technical Report, http://doc.ukdataservice.ac.uk/doc/5050/mrdoc/pdf/5050_elsa_w6_technical_report_v1.pdf [accessed 05.04.2018].Google Scholar
Brimblecombe, N., Pickard, L., King, D. and Knapp, M. (2017) ‘Perceptions of unmet needs for services in England: a comparison of working carers and the people they care for’, Health and Social Care in the Community, 25, 2, 435–46.CrossRefGoogle ScholarPubMed
Brimblecombe, N., Pickard, L., King, D. and Knapp, M. (2018) ‘Barriers to receipt of social care services for working carers and the people they care in times of austerity’, Journal of Social Policy, 47, 2, 215–33.CrossRefGoogle Scholar
Burchardt, T., Obolenskaya, P. and Vizard, P. (2015) The Coalition's Record on Adult Social Care: Policy, Spending and Outcomes 2010–2015, London: CASE.Google Scholar
Cabinet Office (2017) Government to Set Out Proposals to Reform Care and Support, 16 November 2017, https://www.gov.uk/government/news/government-to-set-out-proposals-to-reform-care-and-support [accessed 05.04.2018].Google Scholar
Care Act 2014 (c.23), London: The Stationery Office (TSO).Google Scholar
Carmichael, F. and Charles, S. (2003a) ‘Benefit payments, informal care and female labour supply’, Applied Economic Letters, 10, 7, 411–15.CrossRefGoogle Scholar
Carmichael, F. and Charles, S. (2003b) ‘The opportunity costs of informal care: does gender matter?’, Journal of Health Economics, 22, 5, 781–803.CrossRefGoogle ScholarPubMed
Carr, E., Murray, E. T., Zaninotto, P., Cadar, D., Head, J., Stansfeld, S. and Stafford, M. (2016) ‘The association between informal caregiving and exit from employment among older workers: prospective findings from the UK Household Longitudinal Study’, Journals of Gerontology: Psychological Sciences and Social Sciences, https://doi.org/10.1093/geronb/gbw156 [accessed 05.04.2018].CrossRefGoogle Scholar
Colombo, F., Llena-Nozal, A., Mercier, J. and Tjadens, F. (2011) Help Wanted? Providing and Paying for Long-Term Care, Paris: Organisation for Economic Cooperation and Development (OECD).CrossRefGoogle Scholar
Comas-Herrera, A., Wittenberg, R. and Pickard, L. (2010) ‘The long road to universalism? Recent developments in the financing of long-term care in England’, Social Policy and Administration, 44, 4, 375–91.CrossRefGoogle Scholar
Curtis, L. and Burns, A. (2017) Unit Costs of Health and Social Care 2017, University of Kent: Personal Social Services Research Unit.Google Scholar
Doty, P., Jackson, M. E. and Crown, W. (1998) ‘The impact of female caregivers’ employment status on patterns of formal and informal eldercare’, The Gerontologist, 38, 3, 331–41.CrossRefGoogle ScholarPubMed
Edmiston, D., Patrick, R. and Garthwaite, K (2017) ‘Introduction: austerity, welfare and social citizenship’, Social Policy and Society, 16, 2, 253–9.CrossRefGoogle Scholar
Ettner, S. L. (1995) ‘The impact of ‘parent care’ on female labor supply decisions’, Demography, 32, 1, 63–80.CrossRefGoogle Scholar
Fine, M. D. (1999) The Responsibility for Child and Aged Care. Shaping Policies for the Future, SPRC Discussion Paper No. 105, University of New South Wales, Sydney: Social Policy Research Centre, https://www.sprc.unsw.edu.au/media/SPRCFile/dp105.pdf [accessed 05.04.2018].Google Scholar
Fine, M. D. (2012) ‘Employment and informal care: sustaining paid work and caregiving in community and home-based care’, Ageing International, 37, 1, 57–68.CrossRefGoogle Scholar
Health and Social Care Information Centre (HSCIC) (2016) Personal Social Services: Expenditure and Unit Costs, England, 2015–16, Leeds: HSCIC.Google Scholar
Health and Social Care Information Centre (HSCIC) (2017) Health Survey for England, 2016: Adult Social Care, Leeds: HSCIC, https://digital.nhs.uk/catalogue/PUB30169 [accessed 05.04.2018].Google Scholar
Heitmueller, A. (2007) ‘The chicken or the egg? Endogeneity in labour market participation of informal carers in England’, Journal of Health Economics, 26, 3, 536–59.CrossRefGoogle ScholarPubMed
Her Majesty's Government (HMG) (1999) Caring About Carers. A National Strategy for Carers, London: TSO.Google Scholar
Her Majesty's Government (HMG) (2007) Putting People First: A Shared Vision and Commitment to the Transformation of Adult Social Care, London: TSO.Google Scholar
Her Majesty's Government (HMG) (2008) Carers at the Heart of 21st-Century Families and Communities. “A Caring System on your Side. A Life of your Own”, London: TSO.Google Scholar
Her Majesty's Government (HMG) (2010) Recognised, Valued and Supported: Next Steps for the Carers Strategy, London: TSO.Google Scholar
Her Majesty's Government (HMG) (2014) Carers Strategy: Second National Action Plan 2014–2016, London: TSO.Google Scholar
Her Majesty's Government (HMG) and Employers for Carers (2013) Supporting Working Carers: The Benefits to Families, Business and the Economy, London: Carers UK.Google Scholar
Hoff, A. (2015) Current and Future Challenges of Family Care in the UK. Future of an Ageing Population: Evidence Review, London: Government Office for Science, http://dera.ioe.ac.uk/24148/1/gs-15-18-future-ageing-family-care-er09.pdf [accessed 05.04.2018].Google Scholar
House of Commons (2014) Care Act 2014. Explanatory Notes, London: TSO.Google Scholar
House of Commons (2016a) Oral Evidence: Adult Social Care, HC 47, Monday 12 September 2016. Communities and Local Government Committee, Adult Social Care Inquiry, London: House of Commons, http://data.parliament.uk/writtenevidence/committeeevidence.svc/evidencedocument/communities-and-local-government-committee/adult-social-care/oral/38203.pdf [accessed 05.04. 2018].Google Scholar
House of Commons (2016b) Written Evidence Submitted by the Department of Health and Department for Communities and Local Government, Communities and Local Government Committee, Adult Social Care Inquiry, London: House of Commons, http://data.parliament.uk/writtenevidence/committeeevidence.svc/evidencedocument/communities-and-local-government-committee/adult-social-care/written/38264.pdf [accessed 05.04.2018].Google Scholar
House of Commons (2017) Adult Social Care, Communities and Local Government Committee, Ninth Report of Session 2016–17, HC 1103, London: House of Commons.Google Scholar
House of Commons (2018) Joint Inquiry Launched on Long-term Funding of Adult Social Care, 28 January 2018, https://www.parliament.uk/business/committees/committees-a-z/commons-select/communities-and-local-government-committee/news-parliament-2017/social-care-green-paper-17-19/ [accessed 05.04.2018].Google Scholar
House of Commons Health Committee (1996) Long-Term Care: Future Provision and Funding. Volume II. Minutes of Evidence and Appendices, HC 59-11, London: House of Commons.Google Scholar
Hussein, S., Stevens, M. and Manthorpe, J. (2011) ‘What drives the recruitment of migrant workers to work in social care in England?’, Social Policy and Society, 10, 3, 285–98.CrossRefGoogle Scholar
King, D. and Pickard, L. (2013) ‘When is a carer's employment at risk? Longitudinal analysis of unpaid care and employment in midlife in England’, Health and Social Care in the Community, 21, 3, 303–14.CrossRefGoogle Scholar
Kröger, T. and Yeandle, S. (2013) ‘Reconciling work and care: an international analysis’, in Kröger, T. and Yeandle, S. (eds.), Combining Paid Work and Family Care. Policies and Experiences in International Perspective, Bristol: Policy Press, 3–22.CrossRefGoogle Scholar
Lilly, M. B., Laporte, A. and Coyte, P. C. (2007) ‘Labor market work and home care's unpaid caregivers: a systematic review of labor force participation rates, predictors of labor market withdrawal, and hours of work’, The Milbank Quarterly, 85, 4, 641–90.CrossRefGoogle ScholarPubMed
Lundsgaard, J. (2006) ‘Choice and long-term care in OECD countries: care outcomes, employment and fiscal sustainability’, European Societies, 8, 3, 361–83.CrossRefGoogle Scholar
MetLife Mature Market Institute and National Alliance for Caregiving (2006) The MetLife Caregiving Cost Study: Productivity Losses to U.S. Business, New York: Metropolitan Life Insurance Company.Google Scholar
Milne, A., Brigden, C., Palmer, A. and Konta, E. (2013) ‘The intersection of employment and care: evidence from a UK case study’, European Journal of Social Work, 16, 5, 651–70.CrossRefGoogle Scholar
Motel-Klingebiel, A., Tesch-Roemer, C. and von Kondratowitz, H.-J. (2005) ‘Welfare states do not crowd out the family: evidence for mixed responsibility from comparative analyses’, Ageing and Society, 25, 6, 863–82.CrossRefGoogle Scholar
Organisation for Economic Cooperation and Development (OECD) (2012) Investing in High-quality Early Childhood Education and Care, www.oecd.org/education/school/48980282.pdf [accessed 05.04.2018].Google Scholar
Phillips, J., Bernard, M. and Chittenden, M. (2002) Juggling Work and Care, Bristol: The Policy Press.Google Scholar
Pickard, L. (2001) ‘Carer break or carer blind? Policies for informal carers in the UK’, Social Policy and Administration, 35, 4, 441–58.CrossRefGoogle Scholar
Pickard, L. (2004) The Effectiveness and Cost-Effectiveness of Support and Services to Informal Carers of Older People, London: Audit Commission.Google Scholar
Pickard, L. (2012) ‘Substitution between formal and informal care: a ‘natural experiment’ in social policy in Britain between 1985 and 2000’, Ageing and Society, 32, 7, 1147–75.CrossRefGoogle Scholar
Pickard, L., King, D., Knapp, M. and Perkins, M. (2012) Overcoming Barriers: Unpaid Care and Employment. Findings from the Scoping Study, London: National Institute for Health Research (NIHR) School for Social Care Research (SSCR), http://www2.lse.ac.uk/LSEHealthAndSocialCare/pdf/Findings_10_carers-employment_web.pdf [accessed 05.04.2018].Google Scholar
Pickard, L., King, D., Brimblecombe, N. and Knapp, M. (2015) ‘The effectiveness of paid services in supporting unpaid carers’ employment in England’, Journal of Social Policy, 44, 3, 567–90.CrossRefGoogle ScholarPubMed
Pickard, L., King, D., Brimblecombe, N. and Knapp, M. (2018a) ‘Public expenditure costs of carers leaving employment in England, 2015/2016’, Health and Social Care in the Community, 26, e132–e142, https://onlinelibrary.wiley.com/doi/epdf/10.1111/hsc.12486 [accessed 05.04.2018].CrossRefGoogle Scholar
Pickard, L., Brimblecombe, N., King, D. and Knapp, M. (2018b) ‘‘Replacement care’ for working carers? A longitudinal study in England, 2013–2015’, Social Policy and Administration, 52, 3, 690–709, http://onlinelibrary.wiley.com/doi/10.1111/spol.12345/epdf [accessed 17.04.2018].CrossRefGoogle Scholar
Scharlach, A. E., Gustavson, K. and Dal Santo, T. S. (2007) ‘Assistance received by employed caregivers and their care recipients: who helps care recipients when caregivers work full time?’, The Gerontologist, 47, 6, 752–62.CrossRefGoogle ScholarPubMed
Schneider, H., Heinze, J. and Hering, D. (2011) Betriebliche Folgekosten Mangelnder Vereinbarkeit von Beruf und Pflege [Company-based Follow-up Costs of Lacking Reconciliation of Employment and Eldercare], Berlin: Steinbeis University, http://www.carersatwork.tu-dortmund.de/download/Expertise_final.pdf [accessed 05.04.2018].Google Scholar
Schneider, U., Trukeschitz, B., Mühlmann, R. and Ponocny, I. (2013) ‘“Do I stay or do I go?” – Job change and labour market exit intentions of employees providing informal care to older adults’, Health Economics, 22, 10, 1230–49.CrossRefGoogle ScholarPubMed
Social Protection Committee (2014) Adequate Social Protection for Long-Term Care Needs in an Ageing Society. Report Jointly Prepared by the Social Protection Committee and the European Commission, Luxembourg: European Union, http://bookshop.europa.eu/en/adequate-social-protection-for-long-term-care-needs-in-an-ageing-society-pbKE0414706/ [accessed 05.04.2018].Google Scholar
Timmins, N. (2017) Social Care: Who Cares? London: King's Fund, https://www.kingsfund.org.uk/blog/2017/06/social-care-who-cares [accessed 05.04.2018].Google Scholar
Twigg, J. (1996) ‘Issues in informal care’, in OECD (ed.), Caring for Frail Elderly People: Policies In Evolution, Paris: OECD, 81–92.Google Scholar
UNISON (2012) ‘UNISON challenges councils to embrace Ethical Care Charter’, London: UNISON, https://www.unison.org.uk/news/article/2012/11/unison-challenges-councils-to-embrace-ethical-care-charter/ [accessed 05.04.2018].Google Scholar
UNISON (2013) UNISON's Ethical Care Charter, London: UNISON.Google Scholar
United Kingdom Home Care Association (UKHCA) (2015) The Home Care Deficit. A Report on the Funding of Older People's Home Care across the United Kingdom, Version 1, March 2015, Wallington: UKHCA.Google Scholar
United Nations (UN) (2016) Growing Need for Long Term Care: Assumptions and Realities. United Nations Briefing Paper, http://www.un.org/esa/socdev/ageing/documents/un-ageing_briefing-paper_Long-term-care.pdf [accessed 05.04.2018].Google Scholar
Vickerstaff, S., Loretto, W., Milne, A., Alden, E., Billings, J. and White, P. (2009) Employment Support for Carers, London: Department for Work and Pensions.Google Scholar
Wittenberg, R. and Hu, B. (2015) Projections of Demand for and Costs of Social Care for Older People and Younger Adults in England, 2015 to 2035, London: Personal Social Services Research Unit.Google Scholar
Yeandle, S., Bennett, C., Buckner, L., Fry, G. and Price, C. (2007) Managing Caring and Employment, London: Carers UK.Google Scholar