Carers and Work-Care Reconciliation:

International Conference University of Leeds

Work-Care Reconciliation: Caring for older people

in Australia and England

Bettina Cass

Social Policy Research Centre

University of NSW

13 August 2013

Definition of carers in this presentation

•We began by defining who were included as unpaid carers:

•carers who care for a family member or friend, including children and adults with disability,

chronic illness or frailty due to older age.

•Unpaid care and its gendered dimensions are often invisible in the community and in

policy-making and often also in workplaces: Care is provided for children across the board,

children and older offspring with disability or chronic illness, spouses/partners and other

relatives and friends with disability or chronic illness and frail older parents. ‘

This presentation is concerned with carers of workforce age who care for older people

who may be parents, parents-in-law or spouses. It focuses on their circumstances and

employment policies in both countries which facilitate employment-care reconciliation.

• Analysis drawn from “Working Carers of older people: steps towards securing adequate

support in Australia and England” in Kroger, T and Yeandle, S (eds) (2013) Combining Paid Work and Family Care, Policy Press, Bristol, augmented with more recent policy

analysis from the Carers and Social Inclusion ARC Linkage Grant Project at the SPRC

(Chief Investigators: Trish Hill, Bettina Cass, Sue Green, Partner Investigator Sue

Yeandle)

The unpaid family care infrastructure of home-based

elder care policies in Australia and England• In both countries in the latter decades of the 20th century, especially from the

late 70s early 80s, increased public policy concern with population ageing and

ensuing “demographic panic”: policy emphasis on containing and sustaining

escalating costs of health care, accommodation and support services for ageing

population with increased longevity

• Accompanied by older people’s expressed wish to remain in home and

community, sometimes but not always requiring home-based care services, with

entry into residential care increasingly at older ages and in circumstances of

extreme physical frailty and mental/psychological impairment

• Accompanied by women’s increased labour force participation and coexistent

policy emphasis on workforce “activation” to increase overall rates of market

participation and tax revenue to meet increased costs of aged care policies

• Responding to escalating expenditure on residential support and older people’s

desire to stay at home, where necessary with domiciliary support services and

(less visible and with costs hidden) an infrastructure of unpaid family carers,

aged care policy emphasis and priorities shifted from residential to home care.

• Articulated public policy anxiety: will women’s propensity and time to care be

diminished? Will the increased need for elder care be matched by the supply of

family carers? Strategies to sustain family caregiving in an era of Activation.

Gender and relational matters

• Both women and men have care responsibilities, but there is in all countries agreater prevalence of women as carers through the life-course especially amongcarers of older people who are aged parents and parents-in-law

• A fundamental question for policy-making: what are the implications ofcaregiving for women’s labour force participation and resources, through theyears of expected workforce participation in an “adult worker”economic/social/political model in Australia and the UK?

• Understanding unpaid care as a relationship: with family members both intra andinter-generationally, with children, spouses/partners, siblings; aged parents,parents-in-law and other relatives; and with friends and neighbours. Caring inthe contexts of disability and chronic illness and in this presentation caring forfrail older people needs to be seen as inextricably relational, embedded instrong sense of duty, responsibility and life-course reciprocity.

• Investment policies in creating flexible employment practices for employeesseeking to accommodate their employment responsibilities with caregiving;investment policies in fostering and supporting entry and re-entry (with training ifrequired) to labour force participation; investment policies in community servicessupporting carers and the people for whom they care

• MUST be brought together with a focus on the wellbeing, quality of life andopportunities available to older people and people with disability and chronicillness who require care. Prioritise the relational core of caregiving as the centralfocus of policy development.

Circumstances of caregiving

• Both countries have introduced systems of direct payments or person-directedcare rather than providing non-customised services; modernisation agendapredicated on notions of empowerment, choice and personal control for theimmediate consumer. Direct payment schemes open to older people in Englandfrom 2000 and more latterly in Australia. These person-directed mechanisms forolder people likely to increase the responsibilities of family carers in managingdirect payments and also in augmenting the care services which can bepurchased.

• In England, carers of a parent or parent-in-law are among the largest group of

carers; carers of a parent were usually middle aged. Much of the care takes

place outside of the carer’s own household (unlike spouse care or care of a child

with disability, which is typically co-resident). Most gave practical help (meals,

shopping, housework, household repairs, transport, medical appointments), and

also social/emotional/psychological support.

• Australia has 2.6 million carers -12% of the population- and the ABS uses the

contentious concept of “primary carer”, the person who provides the most care

for a person with disability, chronic illness or frail aged. In 2009 there were 771,

400 primary carers of whom 350,000 cared for a person aged 65+ (either their

spouse or a parent). The assistance provided is similar to that provided England.

Circumstances and cost of Caregiving

• Living independently does not do justice to older people’s need for assistance: in Australia most of the 1.3 million people aged 60+ who required care in 2009 received support from an unpaid carer (76%); and many (56%) received help from a formal provider or providers. Most of those requiring assistance got help from both unpaid family carers and formal services, indicating that formal services did not meet all of their needs (ABS, 2012).

• Costs of caregiving: leaving employment, reducing hours of paid employment, working intermittently in part-time casual positions - the employment circumstances least conducive to entitlement flexible working arrangements

• In Australia: Survey of Employment arrangements, Retirement and Superannuation (2009) found that among people of working age, carers were less likely than non-carers to be employed (61% compared with 74%) and were less likely to work full-time. People aged 45-64 caring for a parent were more likely to say that they were outside the labour force because of their caring responsibilities.

• In the UK, the CES study (Yeandle et al, 2007) found that many people of

working age caring for an older person said they would rather be working, but

almost half said that they had been away from employment for so long that they

would need extra support to return to the labour force. Fewer than half of the

employed carers felt that they had adequate services to enable them to work.

Statutory Workplace mechanisms

for managing employment and care

.

• Australia: analysis of the HILDA Survey: flexible working arrangements,involving access to one or more types of special leave for caring: permanentpart-time work, flexible start and finish times and home-based work improves theodds of carers staying in employment (Hill, et al, 2008). Lack of access to anyflexible work arrangements, and being in casual and part-time work increasedthe chances of employees leaving work when they became carers.

• England extended its 2002 “right to request flexible working” legislation (forcarers of a disabled child) to carers of adults in 2006. In a 2008 workforcesurvey most employed carers reported working flexibly - part-time work, flexi-time, compressed or annualised hours, or working from home. However aminority of requests by employed carers were turned down and this was morecommon for older employees (Leighton and Gregory, 2011). (2002 Carers andDisabled Children Act; 2006 Work and Families Act)

• Some carers also benefitted from modest improvements in return to work

support schemes and additional services offering carers breaks, training and

support programs (Yeandle and Wigfied, 2011).

Statutory Flexible work Arrangements

• In Australia 2010: Fair Work Act : NES (National Employment Standards) paidpersonal/carers leave for 10 days per year, at employee’s normal hourly rate(unless casual employees) if employed continuously for 12 months with sameemployer; short-term unpaid carers leave for 2 days per occasion to care for animmediate member of family or household; right to request a change in workarrangements for carers of children under school age or a child with disabilityunder 18 years old for employees with 12 months continuous service with theiremployer. At the time of the completion of the book no right to request was inplace for carers of adults aged 18 and over with disability, chronic illness or frailaged, but this was rectified with a significant amendment in June 2013,

• . 2013 Fair Work Amendment Act Subsection 65(1):

• Employee may request change in working arrangements, if:

the employee would like to change his or her working arrangements because ofthose circumstances;

• then the employee may request the employer for a change in workingarrangements which may include changes in hours of work, changes in patternsof work and changes in location of work.

• (b) the employee is a carer (within the meaning of the Carer Recognition Act2010); which has no age exclusions for either carers or the person receivingcare

Support through workplace culture, Carers’ Rights legislation

• Key issues in implementation of right to request flexible work arrangements are:

• the extent to which employees are aware of and seek to take up these entitlements to make a request for changes in their working arrangements

• The extent to which employers take account of, and support employees in making these requests

• The culture of workplaces in recognising and supporting employees’ caregiving responsibilities

The Australian Carer Recognition Act 2010 sets out how carers should be supported by publicly provided services which should be ‘timely, responsive, appropriate and accessible’ (Australian Government, 2011a:13).

However, the Act does not establish carers’ rights or create legally enforceable obligations for public service care agencies or associated providers (Phillips and Magarey, 2010:2).

The Australian Act is unlike the UK Carer Recognition and Assessment Act which gives carers the right to receive an assessment of their service needs and places an obligation on local authorities to provide services and take account of carer’s wish to continue or re-enter paid work. But, budget issues at local authority level are significant in determining the level and amount of services able to be provided: legislation AND sufficient budget must be considered when identifying the impact and effectiveness of policies.

Addressing service gaps

In the 2000s, legislative reforms in the employment sphere, around the extension of the right to request flexible working and access to a period of carers leave have been of considerable significance in both countries. But research in both countries shows that such entitlements reach only a minority of carers due to lack of information about entitlements, employment insecurity, and a sense that requesting such entitlements would not be positively received. Also, the part-time, casual and precarious nature of female carers’ employment militates against the confidence to make claims and to have those claims succeed.

• In England: publicly-funded social and healthcare support available to carers

through national social and healthcare systems: below are services for carers

and do not include services for recipients of care

• Right to carer’s assessment which includes right to have needs assessed but

services follow at Local Authority (LA) decision based on available budget

• LA-funded carer’s services - respite, training, health checks, direct payments;

available to small minority

‘

.

Addressing service gaps

• In Australia: A range of services for carers provided under the National Respite

for Carers Program, including:

over 600 community based respite services,

a network of Commonwealth Respite and Carelink Centres- provide information

on respite services, community aged care, disability and other support services

and assist carers to access respite (short-term and emergency

the National Carer Counseling Program

the Carer Advisory Service (Australian Government,

In the aged care reform package Living Longer, Living Better, a network of Carer

Support Centres will be established to provide information, counseling,

education and training, and referrals to support services

The proposed additional services will bring an increased level of support, but

they are not explicitly designed to assist carers to remain in, enter or re-enter

employment.

Required: Implementation of an extensive national system of long day respite

programs such as the Long Day Respite program to provide timely, appropriate

and affordable respite services which adequately support carers and care

recipients and enable carers to better reconcile care and paid work.

• As set out as an option for reform in AHRC (2013) Investing in Care Report

Conclusions

• In the 2000s, legislative reforms in Australia and England in the employment

sphere, around the extension of the right to request flexible working arrangements

and access to a period of carers leave have been of considerable significance in

both countries. But research in both countries shows that such entitlements reach

only a minority of carers due to lack of information about entitlements, employment

insecurity, and lack of sufficient, accessible and appropriate breaks from care, in

particular through publicly provided or subsidised services.

• If the aim of work-care reconciliation is to be met for all carers and in this

presentation carers of older people, services will need to be more comprehensive,

accessible and universal. In addition, the support of business owners and

managers is crucial if existing and expanded entitlements and services are to be

taken up by carers.

• This will be critical if carers of older people including frail elderly parents are to

avoid falling out of work, suffering damage to their workforce progression and

stability, and long-term financial well-being, or coming under great pressure as they

struggle to reconcile paid work and unpaid care in the years ahead.

Key policy observations

The principles underlying our vision for the design of integrated policy

mechanisms to achieve a care-friendly or at best a care-centred work-care

reconciliation model would be based on the principles of recognition, conferral of

rights and redistribution of resources

Recognition would entail legislative and wider socio-cultural recognition of the

value of care to care recipients, families, communities and economies and the

costs of care borne by caregivers;

the conferral of rights would entail carers’ rights to have their particular needs

recognised and assessed in the labour force, in workplaces and in access to

services for themselves and the people for whom they care, so that they can

combine caregiving with paid employment and a range of other life domains.

Redistribution would entail redistribution of resources, benefits and services, so

that the privately borne costs of care are redistributed across the

community/governmental/community services/ employment relations spheres.