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1. Carers may be seen as the threads that hold the complex web of community care together. A very large number of those people who receive community care services to help them manage their own lives are dependent on the care and support of a carer - or a number of carers. Carers, frequently without reward or recognition, spend much of their time looking after others, enabling the people they care for to carry on living in their own home and enjoy as full a life as possible.
2. Community care has undergone a revolution over the past 10 years or so. The range of services which can be offered, and the ways they can be provided, have expanded and diversified. A guiding principle underlying many of the changes has been that of enabling people to carry on independent life in the community. Thanks to these changes, fewer people who need care have to be cared for in hospitals or other institutions, and more are being helped to live among their friends and family, in familiar surroundings. These changes are good news. But the success of the new ways of supporting people in the community depends very heavily on unpaid carers, and as carers play an increasingly vital role, the importance of supporting them properly also increases.
3. Every caring situation is unique. We do not need to understand every individual's circumstances or motivations for what is often a very personal and private activity. But we all need to recognise the existence and the value of carers, both to the individual person they care for, and to the community more widely.
4. The importance of supporting carers is heightened by demographic trends. We are as a whole an ageing population, as the proportion of older people grows, and increasing numbers of people live longer. There will be progressively more people who need care, and fewer younger people to care for them. We are likely to see more caring situations where older people are cared for by other older people.
5. While the numbers of people needing care are set to rise, social trends seem likely to reduce the number of potential carers. Families have become less stable, smaller and more fragmented, and extended family networks which may support a person who needs care are becoming ever less common. In addition, the role of women in many families has changed, with increasing numbers active in paid employment and less available to act as carers. And while there is a strong personal commitment underpinning most caring relationships, there is evidence that some carers may be feeling increasingly that they are missing out on other opportunities as a consequence of their caring. All of which points to a future where the numbers of people needing care will increase, while the number of those willing and able to act as carers may reduce. This reinforces the importance to all of us of valuing and supporting existing carers, and of removing disincentives or penalties that may be attached to caring at the moment.
6. An emerging area of carer recognition and support is the issue of carers and work. Recent research has indicated that 1 in 8 people in the workforce are carers. A number of government policies over recent years have sought to make an impact on this area. The introduction of the State Second Pension is intended to compensate for the loss of pension opportunities as a result of caring. The Employment Relations Act 1999 recognises the needs of people with caring responsibilities for emergency time off. The New Deal 50+ includes provision for former carers to return to work. Recent announcements of changes to Invalid Care Allowance (ICA), the main carers benefit, reinforce the message that carers need to be supported in balancing paid work with their caring responsibilities. We want to take account of the need to balance work and care responsibilities and, in particular, to emphasise the value of carer assessment in achieving that balance.
7. We take account of the context set by the Scottish Office's 1998 "Modernising Community Care" policy document, which emphasised strongly the aim of increasing support to people at home, and the key role of carers in enabling and supporting that. The Scottish Executive has made clear its intention to continue to improve the way community care services are provided, to encourage health and social work and other agencies to work seamlessly together. We are aware of the work of the Joint Futures Group which has reported to the Executive recommending new approaches across a wide range of community care and health service fields. We do not wish to pre-empt what may flow from this work, but it is essential that the Executive ensures carers feature as a central part of its plans to provide care for people in more effective, more sensitive ways.
8. We also recognise the examples of the Executive's recent Learning Disability Review, and its development of new care standards. Carers have been closely and directly involved in both these initiatives, and the needs of carers are being recognised as a result. We take account of the Executive's proposals on the way ahead for long term care for older people in Scotland in response to the Royal Commission's recommendations. We welcome the recognition given in that response to the contribution of carers, which will become increasingly crucial as more older people are cared for in the community. We are particularly pleased to see the commitment to providing resources for more short break services, to be targeted initially on those people whose carer has not had any break in recent years. We believe our own recommendations are in the same direction and spirit as the Executive's policies in this area.
9. In drawing up our own proposals for improving support to carers through legislation and supporting guidance, we have also taken account of key elements of the Executive's policies, including the central emphasis placed on social inclusion. By the very nature of what they do, carers are often invisible to most members of the community and to statutory agencies. Caring takes up a major part of many carers' time, and often means that carers are not able to have a full independent life or take up paid employment. And when the cared-for person needs additional help from the NHS or other services, the presence of a carer and the contribution they make are all too often ignored or disregarded. So carers as a whole may find it particularly hard to access the full range of opportunities available to others, and are a group of people likely to be overlooked in planning and decision-making. The Scottish Executive's Carers Strategy has already started to address this at a national, strategic level. We believe our proposals will go a significant way towards improving the position of carers in individual caring situations.
10. We believe that the recommendations made in this report reflect very closely the wider context of what is happening in community care and the NHS. We are also confident that our proposals fit clearly within the framework of the Executive's own strategy and vision for a more inclusive, fairer Scotland.
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