sub60

Response

to the

Human Rights and Equal Opportunity Commission

Discussion Paper 2005

Women, men, work and family

September 2005

This submission was prepared by: Julie Austin, Senior Policy Adviser in consultation with policy staff of Carers Victoria

Date: September 2005

On behalf of: Carers Australia

PO Box 73

DEAKIN WEST ACT 2600

Telephone: 02 6122 9900

Facsimile: 02 6122 9999

Email: caa@carersaustralia.com.au

Website: www.carersaustralia.com.au

Carers Australia (CA) is the peak organisation representing Australia’s 2.6 million unpaid family carers. The people being cared for have disabilities, chronic physical or mental illness, or are aged and frail.

Our members comprise of the eight state and territory carers associations, who directly provide services to carers in their communities.

Carers Australia congratulates the Sex Discrimination Unit of the Human Rights and Equal Opportunity Commission for taking the initiative in producing this discussion paper to drive the debate and undertaking the research needed to inform the debate.

We are particularly pleased that issues around workforce participation and pressures on families extend to caring for people with disabilities, chronic physical and mental illness or who are aged and frail. In relation to workforce participation, hitherto carers have mostly been overlooked with the primary focus being parents of young children. As your paper points out a large percentage of carers are of workforce age and are in the workforce and therefore caring and employment responsibilities have to be balanced. This is not easy, as with any situation where there are multiple responsibilities. In terms of caring, there are less likely to be formal support arrangements in place, in contrast to childcare, making it more difficult for carers to manage.

We note in your paper that you have analysed the existing national statistical data on carers and carers workforce participation, cited some of CA’s previous position papers on this subject and noted the NATSEM (2004) study on future projections of carers which CA commissioned. We therefore will not re-iterate that to you, but refer to more recent research work CA has been involved in to develop our understanding of this and contribute to the public debate. We will also make some general comments on the paper and respond directly to some of the questions posed in the paper that relate to carers.

General comments

We support the paper’s conclusions that change is likely to involve interventions at a number of levels - legislative, social policy (including family assistance, and income security), workplace cultural change and attitudinal change. As well attention should also focus on the interface between different areas of policy: workplace policy, income support policy and community support/ family support/ supplementary care services policy and the costs of care. These policy relationships need to be considered more fully to appreciate the barriers and disincentives to work and to promote caring as a matter in the public domain, as opposed to being a private matter for families to manage.

The focus of the paper concerns inequality between men and women in work and family responsibilities. In addition to this, there is the inequity between families in caring responsibilities during the life course. Long-term carers of people with severe and profound disabilities commonly experience greater difficulties in balancing work and care - indeed for many, work may not be an option. As a consequence they may experience disadvantage in terms of finances, health and well-being and social involvement, and have little opportunity to provide for their own retirement.
The paper works from the average and commonplace situations regarding families and work. A focus on the minority of severely disadvantaged long-term carers would introduce other perspectives.

For example, included in the diversity of care situations are:
- Long-term parent carers of people with severe and profound disabilities or chronic mental illnesses, including sole carers.
- Long term partner or parent carers of people with acquired brain injury or neurological conditions.
- Long term offspring carers of people with dementia

Considering this diversity would strengthen the discussion paper, particularly if a greater focus on the supplementary support services needed to redress this were included.

The thrust of the paper is the sharing of care between men and women and achieving a balance with work. We note there is a strong emphasis on primary carers which is not just a divide between men and women but also other family members who could also take more responsibility in sharing the care of their relative with a disability or who is frail and aged. The role of the primary carer should not be ascribed or accepted, as is the same for the role of women.

New research to inform the debate

Access Economics

Access Economics (2005) has prepared a report for Carers Australia (to be released 10 October) on the economic value of informal care in Australia. It examines the employment status of carers and found overall 56.1 per cent of carers participate in the workforce (employed either part or full time or are looking for work) compared to 67.9 per cent of non carers. Primary carers have particularly low rates of labour force participation – only 39.0 per cent in 2003. In the 2003 SDAC survey, 36 per cent of primary carers who were not working or unemployed indicated they would like to work, particularly on a part time basis.

In terms of full time work, Access Economics calculated that carers are less likely to be working full-time than the Australian average of 42 per cent, using a gender age standardised rate. In particular the rate of full time employment among primary carers is just 19.2 per cent, less than half that of the general population. The rate of non-primary carers is also lower than the Australian average at 36.4 per cent.

Conversely, carers are more likely to be working part time. The age standardised rate of part-time employment is 22.8 per cent and 21.1 per cent for non primary carers, compared to 17.2 per cent of the general population.

This difference between the standardised employment rates for carers and that of the general population was used as a measure of the rate of forgone employment due to informal care responsibilities. From this Access Economics calculated the opportunity cost or income forgone by carers in not working in paid employment.

Using very conservative estimates based on the difference in participation rates and average weekly earnings of the general population, this equates to 1.1 per cent of Australia’s current workforce and $4.9 billion in 2005 in lost earnings to carers. Expressed another way, these are resources that are diverted each year from production in the formal economy to informal care.

Australian Unity Wellbeing Index

In putting an economic value on carers’ work, no account is taken of the cost to the carer’s own physical and mental health. There have been many studies done that indicate that in long term care situations the carer’s health is likely to deteriorate as a result of the stress and strain of intense caring. The most recent report on this comes from the Australian Unity Wellbeing Index produced by the Australian Centre on Quality of Life at Deakin University (2005).

As a special survey topic on caring, the results showed:

Living in the same household as a person who requires care reduced wellbeing irrespective of whether the person is the primary carer or not.
The burden of care is greater if the person requiring care is elderly rather than a young child.
The dual care of children and an elderly or disabled person is likely to damage the wellbeing of the carer.
Caring for an elderly or disabled person without the assistance of a partner is likely to damage wellbeing.
Caring for an elderly or disabled person while also carrying a full-time job is likely to damage wellbeing.

Sole parent carers

We note in the discussion paper (page 17), the comments on sole parent families and their relatively low participation rate in the workforce. Carers Australia is currently conducting exploratory research into issues that are pertinent to sole parent carers, specifically. While the final results are not available at the time of writing, the preliminary results from the three focus groups conducted indicate that:

Carers want to work and not being able to work is a major issue for them
Working is a positive experience as it provides an outlet, gives them a sense of self worth and allows them to interact with ‘normal’ people
Many of the carers interviewed were well educated and highly skilled
Part time work is feasible if the child is able to attend school regularly
Where the child requires frequent medical appointments, work becomes difficult to manage as few employers offer sufficient flexibility
Leaving the child with high care needs alone after school is not an option
Earnings from employment insufficient to pay for alternative care
Jobs need to fit the lifestyle dictated by being a sole parent carer
Earning an independent income has a negative effect on Centrelink benefits and is likely to leave the person financially worse off.

The final results of this research, which is the first of its kind we believe in Australia, will be available in the coming months.

ABS data on why carers are not working

The ABS 2003 SDAC data indicates 66,700 primary carers who were unemployed or not in the labour force would like to work. The main barriers identified that were preventing employment were:

No alternative care arrangements available	19,800
Difficulty in arranging working hours	10,900
Loss of skills from being out of the workforce	3000
Age	8,300
Not specified	23,600
Total (including no barriers anticipated)	66,700

The highest ranking identified reasons were alternative care arrangements were not available and lack of flexibility in working hours. This accords with the preliminary findings from sole parent carer research referred to above.

International comparisons

We note that the discussion paper highlights the difference in workforce participation between Australia and European countries, particularly for women aged over 55 which is a peak age group for women in a caring role. For the general population of women in this age group the participation rate in Australia is 40.8 per cent, which is much lower than northern European nations, the United Kingdom and the US. In Sweden 69.7 per cent of women 55-64 years are in paid work.

To explore what is happening overseas, in terms of carers participation in the workforce, the CEO of Carers Australia, Dr Jennifer Bowers is visiting the UK and Europe at the time of writing this paper. Part of the visit will comprise looking at what is happening in some of the largest companies in the UK and the Action for Carers and Employment program (ACE), funded by the European Union Social Fund’s Equal Program

The first ACE National Partnership (Carers UK, 2004) focused on barriers facing individual carers who want to work, such as lack of confidence and carer-friendly employers by developing pre vocational training, providing advice and guidance and promoting carer-friendly workplaces.

However, it was found that even when all these barriers have been surmounted and everything else is in place, none of it helps if appropriate, alternative care services for the person being cared for are not available. The second ACE National Partnership is focussing on improving those social care services which will make a difference to working carers' lives.

ACE National aims to:

Carry out research into the factors that influence why, how and if carers access alternative care services that enable them to work
Use local delivery partnerships to identify existing care services which enable carers to work, and to explore how they can be improved
Evaluate how carers are involved in consultation on care service provision
Develop a national policy partnership that will use the lessons of the delivery partnerships to influence long term development and investment in the social care sector, including working to establish a National Care Strategy.

As this is a very large task, ACE National has brought together a range of partners in policy, service delivery and research. While Carers UK are taking the lead, other countries such as Estonia, Italy, Latvia and the Netherlands are running parallel programs.

Carers Australia hopes to be able to learn from this work and adapt it to suit our conditions. Dr Bowers hopes to be able to discuss her findings with you in the coming months.

Local solutions

In the 2005-06 federal Budget, the Government announced funding of $95.5 million over four years to enable day respite centres to extend their hours of operation, giving an estimated 5,000 employed carers each access to 480 extra hours of respite per year.

Carers Australia understands that applications from service providers will be sought in the coming weeks to take up this opportunity. As no details are available at this stage, it is not clear how this will be delivered.

It is a welcome move that will hopefully provide carers with some new options in alternative care. However as it is for respite care and appears to be for a limited number of hours, it would not be expected to be a main source of alternative formal care. Rather, regular permanent arrangements are needed over extended hours.

Regular day care centres mostly operate for limited hours like school hours, which do not suit people who are working, so obviously longer hours are needed as is the case with child care centres.

Care in the home of the person needing support is very expensive and is mostly done through private arrangements. CA understands that in some states care packages are provided for some people which provide for care in the home, but ongoing funding appears to be very insecure.

Clearly, we have a long way to go before suitable alternative care is widely available to enable carers to work, knowing the person they support is safe and their needs are being met.

Responses to questions

Are there particular difficulties in balancing paid work with caring for frail aged people or family member with disabilities?

Balancing paid work and care of frail elderly and people with disabilities can be influenced by:
- Level of support and assistance needed
- Capacity to be safe at home unsupervised
- Geographical access
- Poor availability of suitable day care services, with few long day care options and vacation care for adolescents and adults
- Day programs which are often non existent or inappropriate for people with later onset disabilities or neurological conditions such as acquired brain injury or MS
- Extent of informal support available which can even relate to size of families and accessibility and willingness of family members
- Workplace responsiveness in terms of, for example, flexitime, reduced hours, job redesign, work at home, unpaid leave, and the carer’s capacity to negotiate with employers
- Availability of paid work in hours suited to demands of caring.

Do the experiences of people caring for frail aged parents or family members with disabilities differ for men and women?

- Generally women are the primary carers and where necessary are more likely to opt out of the workforce to care. This is less common for men.
- The common advent of women opting out of the workforce to care disadvantages them in terms of financial independence and their own retirement.
- More women parents are likely to be sole parent carers than men, and unable to participate fully in the workforce.

What workplace flexibilities are useful for particular types of carers?

There is a range of ways workplaces can be flexible, all dependant on the level of care required, and the individual needs of the care situation and the nature of paid work to be done.

For example, care for a frail older family member with a degree of independence can be assisted by acceptance of the need for personal monitoring or support phone calls, extended lunch hour to allow meal preparation, carer leave for appointments, reduced working hours or flexitime, or work at home.

Care for an adult with significant disabilities may require reduced working hours through job sharing, flexible work hours, job redesign, reduced work responsibilities for a period, paid and unpaid leave, extended annual leave provisions and shift changes.

What effects, if any do external factors such as partner and community attitudes, social policy or workplace relations have in shaping men’s and women’s decisions about paid work and family arrangements?

The paper has a comprehensive description of the impact of these factors particularly related to care of children.
The weakness of the paper in having an inadequate focus on supplementary support service options for carers has been outlined.
Partner and family attitudes are an important factor in balancing the care of older people and work. The availability of an informal support network/ sharing the caring can be crucial.
Income security policy, without the support of adequate supplementary support services for sole parent carers, can be a disincentive to parent carers entry into the workforce.

Do women’s and men’s different paid and unpaid work obligations affect their economic outcomes, health, relationships and life chances? Do men and women or particular groups of people experience any such effects differently?

Women are more likely to be out of the workforce (full or part time) to care, loose career opportunities, may have difficulty re-entering workforce. Less able to prepare for own retirement.
Long-term women carers may be the most disadvantaged, particularly over a life time of parenting and caring. Their assets at the onset of caring, particularly home ownership can also affect this.
Impact of the paid and unpaid work squeeze on families and relationships – especially impact on women, and consequences for health and family breakdown.

What will be the effect of the ageing population upon men’s and women’s willingness and abilities to undertake unpaid caring work?

The ageing of the population, together with the increase in care at home will impact on the need for unpaid care. The extent to which men or women will be prepared to do this requires:
- A greater sharing of the care as suggested in the paper across family members
- A greater proportion of carers will be aged over 65 and likely to be retired
- Where women have not secured sufficient superannuation and assets to retire they may have to work longer than they would like to.
- ABS data shows as men age they are more likely to be carers, particularly in the 75 years and over age group.

Is unpaid caring work important for developing social cohesion and social capital? And, if so, how?

Caring for one another is about building trust, social cohesion and networks of mutual support, community building and societal well-being.
Yet, unpaid care is undervalued economically and socially relative to paid care.
There are risks that social capital will continue to be a matter largely for women, unless there is a shift in valuing and recognising unpaid work.

Conclusion

Given that the demographics of Australia’s population are changing toward a greater number of older people in the community and a greater number with disabilities, it is likely more people will be needing care, both informal and formal. A NATSEM study (2004) found that over the next 30 years persons over 65 years are projected to account for 63 per cent of all profoundly and severely disabled persons (up from 44 per cent in 2001). Over the same period the ratio of carers to people aged 65 and over needing care (profound or severe disability) will drop from 57 per cent in 2001 to 35 per cent by 2031.

This declining ratio of primary carers, coupled with the pressures on younger people to work and provide for their own retirement, will mean more people likely to be called on to care, a greater need for alternative care and more stress on people as they balance their competing roles and responsibilities.

Over the past twenty five years we have seen an evolution in working arrangements to include more part-time work, casual work, shared jobs and working from home arrangements. There has been a range of reasons for this, including the drive for more family friendly workplaces. Along with this the childcare industry has grown substantially to provide alternative care for children.

As yet, the awareness level and response by employers to family friendly work arrangements that extend to care for the elderly and people with disabilities is nowhere as advanced. Nor is there an industry akin to the childcare industry to provide adequate alternative care for adults needing care. The drivers for this will be the ageing of our population, people’s need to work, and the scarcity of skilled workers in the labour force. For employers to attract people with the right skills they must offer attractive conditions, which includes a family friendly working environment and conditions.

Carers Australia is working to:

build the awareness level among employers, by talking with major employers and business groups such as CEDA and by putting the value of informal care and productivity into an economic context
encourage researchers to look more closely at the issue through such avenues of the Ageing Well Research Network
seek out innovative responses and adapting them to the Australian context such as the ACE program in the UK and Europe.

We congratulate HREOC on taking the lead in this important debate. We would be very pleased to contribute further as the debate progresses and we look forward to seeing the final report.

References

Access Economics, The Economic Value of Informal Care, Report by Access Economics for Carers Australia, August 2005

Australian Bureau of Statistics, Survey of Ageing, Disability and Carers, 2003

Australian Centre on Quality of Life Deakin University, Australian Unity Wellbeing Index Survey 13, Melbourne, July 2005

Carers UK, Action for Carers and Employment program (ACE), www.carersuk.org/Aboutus/ACENational

Human Rights and Equal Opportunity Commission, Striking the Balance: Women, men, work and family, Discussion Paper 2005

NATSEM, Who’s going to care? Informal care and the ageing population, Report prepared for Carers Australia, Canberra, 2004