In the course of the election campaign, both major parties have made gestures of support towards carers—the largely ignored, but significant constituency that looks after the frail elderly and those with physical, intellectual and psychological disabilities. The various policies and promises made by Prime Minister Howard and opposition leader Rudd, however, will not resolve the many and varied needs of carers and their charges.
There are an estimated 2.6 million informal carers in Australia—more than 12 percent of the total population. Of these, nearly half a million are primary carers, responsible for providing the majority of care to another person. Many are spouses or partners, children looking after their parents, and parents caring for a disabled son or daughter.
For many, caring is a psychologically and emotionally stressful task, made more difficult by inadequate financial support and other assistance. Carers are constantly juggling their time to make use of the bewildering, but limited, array of respite and home care services from local, state and federal governments. Many find that keeping a job is unaffordable because of the prohibitive cost of organizing professional care.
Comments from a focus group cited in a Task Force on Care Costs report published last week highlighted the difficult situation facing carers. “Most people want support—not to be carried—to stay in the workforce,” one focus group participant said. “I felt I was being penalised for having a daughter with a disability. I was forced out of the workforce into poverty. There is no childcare for children with autism; the boss doesn’t understand that.”
Another commented: “Sometimes you’re doubly disadvantaged—even triply. You’re caring for someone with a disability or frail and aged, you’re not working, which means you’re in that poverty cycle, and often, especially with kids with disabilities, the rate of marriage breakdown is about 90 percent.”
A survey entitled “The Wellbeing of Australians—Carer Health and Wellbeing,” published last month provided a chilling overview of the levels of stress and depression among carers. Its results are based on the Personal Wellbeing Index (PWI)—a measure that combines indices of health, personal relationships, safety, standard of living, achieving in life, community connectedness and future security, to provide an overall estimate of personal satisfaction.
PWI surveys initiated in 2001 by Deakin University’s School of Psychology have established a large body of comparative data. The average PWI for all Australians varies between 73.4 and 76.4 out of a possible 100, but the average PWI for carers is well outside the normal range at just 58.5. To underline the alarming nature of the result, the report’s authors drew a comparison with body temperatures—where a reading so far away from the norm would be life-threatening.
The report noted that the result was “the lowest value we have ever recorded for a large group of people.” By way of comparison, the PWI for those on low annual incomes of less than $15,000 was 71.4, and for the unemployed 66.6—still far lower than that for carers. The survey reported that a staggering 65 percent of carers suffered some form of depression, with 37 percent suffering severe or extremely severe depression. By way of comparison, a federal government assessment in 1997 found that 6 percent of the population as a whole suffered depression.
The report found that 20.6 percent of carers are unemployed. They suffered a dramatic drop in income, related to difficulties in balancing a career and caring responsibilities. Average annual income for male carers is $24,800 less than the Australian average, and for females $15,300 less. Financial difficulties are further exacerbated by the increased costs associated with caring—including transport, professional care and medical costs.
The report found that 45 percent of primary carers have household incomes in the two lowest income quintiles, compared to 23 percent for non-careers. The main contributing factor is that 47 percent of primary carers rely on government pensions and allowances as their main source of income.
Yet the federal government provides a pittance. The maximum fortnightly carer payment for singles is $525.10 and $438.50 for each member of a couple. But the payment is both asset and income tested, drastically reducing the number of people eligible and the amounts paid out. A fortnightly carer allowance of $98.50 may also be paid, but is completely inadequate to cover extra costs.
Along with an aging population, the failure of Labor and Coalition governments to fund alternative forms of care over the past two decades has contributed to the steadily rising number of carers. The social responsibility of looking after those unable to care for themselves has effectively been offloaded onto individuals. And the cost savings to government have been huge.
According to the latest estimates, the federal government pays out $1.3 billion a year on carer payments and $1 billion on carer allowances. However, an Access Economics study in 2005 estimated the savings to government at a massive $30.5 billion—the cost of replacing informal, unpaid carers with professional care.
Given the size of the constituency involved, Labor and Liberal both pay lip service to the importance of carers, but their promises amount to inadequate bandaid solutions for what is an immense social problem. Howard has announced extra money for respite care and home visits by nurses, as well as an annual $500 utilities allowance to those on carer payments—a drop in the bucket that will do virtually nothing to alleviate financial stress. Labor has matched the government’s utility payment and made its own proposals for the disabled. But the thrust of Labor’s policy is to press for reform of federal-state relations—opening the door for sweeping rationalisation and cost cutting.
Much of the extra money promised is a straight hand-out to the expanding for-profit private businesses involved in providing home care, nursing visits and respite care for the aged and disabled. Aged care has become big business, with large chains not only controlling nursing homes but extending their services into other areas.
In September 2007, the Carers Alliance registered as a political party and decided to stand Senate candidates in four states. The step clearly reflects the anger felt by many carers at the contempt of the major parties towards their plight. At budget time, the Howard government has repeatedly ignored the modest demands of Carers Australia, for instance, for a doubling of the carer allowance from $98.50 a fortnight to $197. But, like other single issue parties, the Carers Alliance in no way challenges the two-party system but is based on pressuring it.
Carers should not have to beg for handouts. The SEP insists that high quality aged and disabled care must be freely available to all. Access to high quality care in public institutions with qualified staff, proper facilities and specialised medical attention should be a right that is not limited to the wealthy. Moreover, a full range of options must be provided that correspond to the different situations confronted by those who are unable to look after themselves. Only in that way can family members make a genuinely free choice. Those who decide to opt for providing care at home should receive a living wage and have access to free, high quality respite care whenever needed, to allow time for relaxation, study, sporting activities and cultural interests. None of these elementary demands is compatible with an economic and social system that is based on private profit, rather than social need.
Authorised by N. Beams, 100B Sydenham Rd, Marrickville, NSW