People providing unpaid care for sick or disabled family members and friends are saving Northern Ireland’s health service £5.8 billion in care costs each year, according to new research from Carers NI and the ESRC Centre for Care. ^[1]

The care they are providing for their loved ones would cost Health Trusts a combined £16 million every day, or more than half a million pounds (£0.7 million) each hour, if it was being delivered by staff – an increase of over 40% in the last decade and significantly higher than the equivalent rise in England (+30%) and Wales (+17%) during the same period. ^[2]

In total, unpaid carers in Northern Ireland are saving the equivalent of 80% of the Department of Health’s entire day-to-day spending budget for 2023-24. ^[3]

Campaigners say that Northern Ireland’s deteriorating health system is treating unpaid carers like ‘workhorses’ and called for the immediate return of the Stormont government to reform services.

Louise Vance, 43, lives in Belfast and provides unpaid care for her mum, who suffers from chronic heart and lung conditions and memory loss following a brain haemorrhage. She said:

As an unpaid carer I feel neither cared for nor respected by the health system. When my mum’s condition deteriorates in any way, the extra care burden is always pushed onto me. I reached breaking point at the beginning of the year and tried repeatedly to highlight the immense pressure I was under, but the Trust turned a blind eye. I am a workhorse to them, nothing more. Our Health Trust’s limited toolbox of services and money leaves me in a constant state of high anxiety and stress, scared for both my mum’s physical and mental health and my own. The little support I do get is pathetic and does nothing to alleviate the pressure I am under on a daily basis. Carers like me are unsupported, uncared for, dismissed and expected to just keep on supporting our loved ones under totally unsustainable conditions until we burn out.”

According to the research, the annual amount of money saved by unpaid carers is greatest in the Northern Health and Social Care Trust (£1.3 billion), followed by the Belfast Trust (£1.1 billion) and the Southern Trust (£1 billion). ^[4]

The research report argues that Northern Ireland’s ageing population, rising prevalence of disability and long-term health conditions and lack of capacity in domiciliary care services are behind the growing pressure on unpaid carers. It calls for a legal right to breaks from caring, development of a new Carers Strategy and expanded provision of community care packages across Health Trusts.

Craig Harrison, Public Affairs Manager for Carers NI, said:

These figures lay bare the extraordinary contribution that our unpaid carers are making to Northern Ireland’s health system every year. If our GP surgeries are already too full, social care caseloads too long and A&E departments too crowded, how much worse would it be if our unpaid carers disappeared even for a few days? The system would completely fall apart without them, but the thanks they get in return too often falls way short of what they need to keep themselves well and enjoy even a basic quality of life. Local carers are going years between one break and the next, living with devastating levels of mental ill-health and running themselves into the ground as they keep the health service afloat. Their devotion to their loved ones has been exploited for too long, and the deeply frustrating thing is that while health leaders know what the solutions are to relieve the totally unsustainable pressure facing carers, they’re completely hamstrung by the lack of a Health Minister. We need to get our priorities straight, restore the political institutions and begin dealing with the massive challenges facing Northern Ireland’s carer population.”

Professor Matt Bennett, of the Centre for Care, University of Birmingham, and research lead on the report, said:

The economic contribution made by carers has increased by 42% in the last decade and paints a stark picture of the savings they make to health care budgets. Without unpaid carers, our health and social care systems would collapse. In fact, our work shows that people are providing more hours of unpaid care than ever before. We hope policy makers see the urgent need to act to support unpaid carers."

The research shows that during the last decade, the increase in the amount of money unpaid carers are saving the health service in Northern Ireland (42%) is significantly higher than in England (30%) and Wales (17%).

Notes to editors

1. The analysis was undertaken by researchers at the Centre for Care and published by Carers NI, using 2021 Census data on the number of people providing unpaid care by sex and hours of care in Northern Ireland. This is calculated against the nominal unit cost for domiciliary care in each Health and Social Care Trust in 2011 and 2020.
2. The monetary value of unpaid care provided in Northern Ireland in 2011 was £3.5bn, rising to £5.8bn in 2021, an increase of 42%. During the same period, the value of unpaid care rose by 30% in England and by 17% in Wales.
3. The Department of Health’s resource (day-to-day spending) budget for 2023-24 is £7.3bn.
4. The estimated value of unpaid care in each Health and Social Care Trust per year is:
   • Northern Trust: £1.3bn
   • Belfast Trust: £1.1bn
   • Southern Trust: £1bn
   • South Eastern Trust: £985m
   • Western Trust: £800m
5. Carers NI is Northern Ireland’s membership charity for unpaid carers. We work to represent and support the over 220,000 people in Northern Ireland who provide unpaid care for ill, older or disabled family members or friends – fighting for increased recognition and support for all carers and to ensure they have a voice in policymaking.
6. The Centre for Care is a research-focused academic and policy and practice collaboration funded by the ESRC (Economic & Social Research Council) as one of its flagship research centres. It works with care sector partners and leading international teams to provide accessible and up-to-date evidence on care – the support needed by people of all ages who need assistance to manage everyday life. For more information click here.
7. The Centre for Care is funded jointly by the Economic and Social Research Council (ESRC) and the National Institute for Health and Care Research (NIHR) (Department of Health and Social Care). The views expressed are those of the author(s) and not necessarily those of the ESRC, UKRI, NHS, the NIHR or the Department of Health and Social Care.