Sajid Javid’s ‘keep it in the family’ advice on health and care is dangerous

Kelly Grehan
© UK Parliament/Jessica Taylor

Every day as a councillor, I receive emails from families in peril. These people are exhausted after finding themselves caring for relatives for a variety of reasons, seeking help from the state – and finding that help is not there for them.

Seeking help to care for someone you love – whether that be a child, a partner or an older relative – is often a deeply painful experience for people. Many have cared for long periods of time, at a great cost to their own physical and mental health, and with a considerable reduction in their standard of living and circumstances. They find asking for help guilt-inducing and terrifying.

Very few people want the state involved in their homes: to bring in strangers to your household to assess your life, your choices, your way of life is deeply difficult, as is having people – however nice – providing personal care to you or your loved one. Many people are so traumatised by the processes of asking for care that they give up and continue struggling. Others who receive care report it to be inadequate and even unfit for purpose.

That’s why Health Secretary Sajid Javid’s words at the Tory Party conference last week made me very angry. He said: “We shouldn’t always go first to the state. What kind of society would that be? Health – and social care – begins at home. Family first, then community, then the state.” Does he think most people go first to the state?

I would hope that the Health Secretary knows there are seven million unpaid carers in the UK. Rather than find ways to support these people, who save the state a fortune, the government has continued to largely ignore them. There is no national carers strategy and many will be suffering after the Universal Credit cut. Unpaid carers have few ways of improving their circumstances, as caring leaves them ineligible for employment. Yet these people are doing exactly what Javid wants – ‘family first’. Odd, then, that they are not more appreciated.

Then there are those 200,000 children in the UK who are growing up in kinship care, many having previously been abused or neglected. Whilst Javid did not mention it being Kinship Care Week last week, these relatives – siblings, grandparents, aunts and uncles and even great-grandparents – are surely an example of what he was referring to: family members undertaking tasks that could otherwise end up on the shoulders of the state.

But such families – often including children with complex needs having arisen as a result of their previous experiences – can find that support for them is quickly removed. They are left to battle for children to receive the services they need and, despite guidance to the contrary, many of the kinship carers are advised by local authorities that they are not entitled to financial support.

The pandemic has left families across the country struggling. Does the Secretary of State for Health and Social Care wish to deter families from seeking help? All the evidence is that early interventions make a massive difference to child development, mental health outcomes and educational achievement, and they are a great weapon in fighting the health inequality and lack of social mobility that plague this country.

The National Children’s Bureau released a review of the case for early help in June. The report found a growing body of evidence showing that sustained investment in early help and preventative services over time can be an effective mechanism for reducing rates of care and keeping children safely in their families.

Families are afraid to seek help, however, seeing it as a sign of failure and worried that bringing agencies into their lives will set off a string of events that will lead them to lose them. In any case, many of these services simply do not exist now. The Early Intervention Grant has been reduced by the government by almost two-thirds – down from £2.8bn in 2010/11 to £1.1bn in 2018/19. As a result, many children’s services departments have been forced to cut back the universal and early help services, such as children’s centres and family support services, which can help parents and prevent emerging problems before they reach crisis point. Maybe Javid thinks this is good – keeping problems within the family to solve.

The Department for Education’s 2019 review of children in need found that, in the majority of cases, families become involved with children’s social care because they are parenting in conditions of adversity, rather than because they have caused or are likely to cause significant harm to their children. The report noted that poverty and deprivation made parenting more challenging and “shapes the experience of raising children”. The review heard from parents and families who were looking for support, but their experience of being assessed added stress to an already difficult situation “without any meaningful support being offered”.

In office, Labour showed the benefits of early interventions. Sure Start centres significantly reduced hospitalisations among children by the time they finished primary school. And according to a Department for Education report, children in the areas where Sure Start programmes had run were less likely to be overweight and mothers reported a number of more positive changes in wellbeing and family functioning compared to mothers in non-Sure Start areas.

We must fight the idea that problems are to be kept within the family and help sought as a last resort. Seeking help with care should be as ordinary as seeking help from your GP about problems with physical health. We should see seeking help as a strength, not an indication of a deficit and, most importantly of all, when help is asked for it should be there. It will strengthen, not weaken, our society in the long term.

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