§ Question again proposed, That this House do now adjourn.
11.37 am§ Mr. NewtonI am not sure whether I need the language of Churchill or Burke, but I am relieved to be a Minister in the Department of Health and Social Security rather than in the Department of the Environment. In my capacity as a Minister in the Department of Health and Social Security I propose to bring my substantially interrupted speech rapidly to a close.
§ Mr. Laurie Pavitt (Brent, South)I did not intervene before on what the Minister was saying about the building regulations because I knew that the House was anxious to deal with the private notice question. In view of what he said, will he say whether the clause in the Chronically Sick and Disabled Persons Act 1970 that deals with planning permission needs any amendment? Will the regulations to which he referred have statutory authority, or will it be merely a case of "having regard to" a code of practice?
§ Mr. NewtonThe hon. Member raises a number of rather complex interrelated points. The Department of the Environment work on the building regulations is thought to be a more effective way of securing the aims of the other legislation to which the hon. Gentleman referred. Building regulations are legislation, and will have the effect of legislation. Codes of practice are intended to assist in the process of achieving building regulations that can sensibly be imposed by legislation and enforced because of the need to agree codes in relation to egress. If that does not make the position sufficiently clear, I shall endeavour to write—or ask my hon. Friend in the Department of the Environment to write—to the hon. Gentleman about the point that he has raised.
I am most anxious to let hon. Members on each side of the House have their opportunity to speak. Therefore, I shall simply say that in my speech I have sought to set out some of the things that the Government have done in social security, where we have achieved a substantial increase in the real value of benefits for the long-term sick and disabled; in the provision of health and social services, where, despite economic difficulties, significant progress has been made in the NHS; and in the provision of social services in many local authorities, with real increases in expenditure.
I have sought to show something of what has been achieved by Government Departments other than my own in education to enlarge the opportunities for young disabled people, and in employment to improve and develop services for those seeking employment or employment rehabilitation, and, not least, to enlarge the opportunities for people to enjoy their lives by having access to the facilities that the rest of us take for granted.
I could have covered many other issues, such as housing and technology, but I hope that what I have said shows a clear commitment throughout the Government to meet the needs and to overcome the problems of the disabled. There is, of course, still a great deal to be done, but I believe that in the past four or five years—and, indeed, before that—we have come a long way, and that the present Government are determined to go further at all possible speed.
§ Mr. Deputy Speaker (Mr. Paul Dean)Order. It will be obvious to the House that there are many hon. Members wishing to speak. Time is now getting very short, so brevity will be of great help to us all.
§ Mr. Jack Ashley (Stoke-on-Trent, South)We have just heard a very selective speech from the Minister. It was noticeable that he failed to answer some of the more important questions posed by my right hon. Friend the Member for Manchester, Wythenshawe (Mr. Morris). In being selective, he was showing the art, developed by the Department of Health and Social Security, of balancing a few balls in the air and trying to focus our attention on them, while seeking to divert our attention from some of the major issues.
It was regrettable that the Minister failed to answer the key questions about the so-called temporary cut in invalidity benefit of 5 per cent. He was challenged to define "temporary". The cut has been a major blow to disabled people, and we heard not a squeak from the Minister about that.
One of the main purposes of the debate is for the Minister to be challenged on the Floor of the House and for him to respond. To stand up and read a brief, reciting a few goodies which have been handed out by the Department, is not good enough. We are entitled to answers to our questions; otherwise we are wasting our time by coming here and challenging the Government. Instead of giving us replies, the Minister has concentrated on other things. It was obvious to us that the Minister found it a very difficult task, because he skated over some of the very serious shortcomings of the Government in their handling of the disabled.
The Minister sought to maximise what had been done on the positive side but, in all truth, it was not a very great deal, although there have been some advances such as the mobility allowance. Most of the increases have been eaten up by the increase in motoring costs, so that there is nothing there for the Government to boast about. But the Minister had to try to achieve a balance between saying, on the one hand, what had been achieved and, on the other hand, emphasising the economic difficulties facing the Government and the reasons why they cannot move forward in any substantial way.
I was waiting for the Minister to apologise for not making any significant advances. Instead, he spoke of his concern with the overall problems of the totality of public expenditure. That is rather more sophisticated than the phrases used by the Prime Minister and the Chancellor of the Exchequer. They should take a few lessons from the Minister with responsibilities for the disabled in the use of elegant phrases. But the Minister then used clichés in speaking of "difficult decisions" and "economic stability".
§ Mrs. Edwina Currie (Derbyshire, South)Does my right hon. Friend recognise the words of another Minister with responsibilities for the disabled, who said:
It is my policy systematically to build up services as resources permit".—[Official Report, 6 December 1974; Vol. 882, c. 682.]That was the right hon. Member for Manchester, Wythenshawe (Mr. Morris), speaking in this House 10 years ago.
§ Mr. AshleyI am very glad that the hon. Lady called me her right hon. Friend. It is a privilege and I am greatly 1294 flattered, even though it may be a parliamentary misnomer. Obviously, the hon. Lady has done a little homework, but only a little. It is regrettable that she did so little homework. I can vouch for the accuracy of the sentence that the hon. Lady quoted, but at that time my right hon. Friend went on to triple—or more than triple—the expenditure on the disabled. Massive amounts of cash were allocated by my right hon. Friend at that time. It is unfortunate that the hon. Lady should fall over so badly in seeking to discredit a Minister who did far more for the disabled than any Minister since.
Before the intervention, I was about to say that the present Minister for the disabled cannot make excuses about the overall problems of the "totality of public expenditure" and the "difficult decisions" that have to be made, when at the same time his Government have given £520 million in investment income surcharge. The word hypocrisy has been bandied about. I do not like it and I certainly would not make that charge against this Minister, but the Government in general are guilty of hypocrisy in seeking to claim that they are helping disabled people—they are doing so only to a limited extent—and then failing to do so, while giving their wealthy supporters massive handouts of £520 million.
The Minister mentioned the severe disablement allowance. Somehow, he has managed with the SDA—it is a remarkable accomplishment—to offend disabled people and to unite against him almost every disablement organisation. I had assumed that the abolition of the household duties test would be warmly welcomed and acclaimed, but acclaim for the present measure would be naive. It does not take two very important factors into account.
First, the Minister has feared the "Exocet" of the European anti-discrimination directive, so that instead of improving conditions for the disabled—notably married women—by abolishing the household duties test, he is running away from possible political embarrassment, as he may well have been hit by the directive.
The second factor—the Minister did not mention it—is that he has replaced an instrument of discrimination against disabled married women by an equally deplorable instrument of discrimination against disabled people who happen to be married women.
The clear purpose of the 80 per cent. test in the SDA is exactly the same as the housewives' duties test. It is to exclude married women from benefit. The only significant difference is that the SDA is less likely to run foul of the European directive.
In my opinion it is a very crafty device which has been thought up by some barrack-room lawyer in the Department of Health and Social Security and sold to the Minister. It is an attempt to get the hon. Gentleman off the legal hook of the European directive which would otherwise have impaled him. The object was to get him off that hook while still depriving disabled married women of their entitlement.
It may be legal, but I think that it is immoral and it is also illogical. I am astounded that the Minister does not accept the basic precept that an incapacity benefit should be based solely on tests of incapacity. The 80 per cent. test is nothing of the sort. Drawn as it is from the industrial injuries scheme, it is a test of the loss of faculty, which obviously cannot measure incapacity for work.
I had prepared a great deal more about that, but I am aware of the rude interruption of the private notice 1295 question, so I must press on and leave it there. However, perhaps I may raise a personal example. In industrial injury terms, I could be classified as 100 per cent. disabled because of a total hearing loss. But I am not incapacitated—at least some of my right hon. and hon. Friends do not think I am, although some Government supporters may think differently. But I am not really incapacitated.
The test is grotesque. It says that people who may be classified 100 per cent. disabled can be classified as incapacitated.
§ Mr. NewtonI apologise for interrupting the right hon. Gentleman, but I am surprised that he does not appear to have understood that the fact that he is not incapacitated means that the test is irrelevant to him. Because he is able to work, no one would dream of bothering about whether he is 80 per cent., 90 per cent. or 50 per cent. disabled. The key point is that he is able to work and, if I may say so, he does his job very well. There is no question of attempting to measure capacity by reference to the 80 per cent. test.
§ Mr. AshleyI am grateful for the tone of the hon. Gentleman's comments, but the fact remains that under the new ruling in respect of the SDA some people will suffer non-payment because of the mix-up and the confusion about the 80 per cent. test. When it is in operation I think that the Minister will find that he has made a grave mistake. It is regrettable and deplorable. I think that he will come to regret it and that disabled people and their organisations will prove to be right.
The Government are not only hitting disabled people directly through cash benefits, they are kicking them indirectly in terms of grants to local authorities. The Minister mentioned these grants, but he did not deal with the real issue. One of the most savage cuts is in improvement grants which are vital to the health and happiness of disabled people. I give one specific example. In Staffordshire the county council helps 600 to 800 people a year. From 1 April this year the Government grant for improvement grants has been slashed from 90 per cent. to 75 per cent. In most cases the county council makes up the difference under the Chronically Sick and Disabled Persons Act, brought in by that wicked Minister who used the phrase quoted just now by the hon. Member for Derbyshire, South (Mrs. Currie). The Exchequer reimburses the county for most of the improvement grants. Reimbursement is crucial, especially as no county can now be generous because of the rate penalties. With the old level of improvement grant, Staffordshire could have financed adaptations costing £820,000. But the Government have ruthlessly forced down the figure to £510,000. That means that a lot of disabled people in Staffordshire will be deprived of their housing improvements. They will suffer as a direct consequence of the Government's action. The Government are cutting improvement grants and hacking at the hopes of disabled people.
These are not the only people who are suffering at the hands of the Government. Many of those who hope to benefit from the Government's care in the community policy have been gravely disappointed. The present Minister is trying to help these people and, I know, has an interest in it. However, although this project has been widely supported, it has made only very limited progress. 1296 The latest figures are that from 1979 to 1982 4,000 hospital beds for mentally handicapped people have been replaced by 3,000 hostel places. The Government are to be congratulated on having done that, because it is a welcome advance. However, 46,000 mentally handicapped people are still in hospital, and it has been reliably estimated that a minimum of 5,000 people need not be there.
At the present rate of progress it will take no less than seven years to get these hapless 5,000 people out of inappropriate institutions. We want a faster rate of change, but it is no use pushing people out of closing hospitals on to the streets or into the homes of elderly parents. It is the Government's direct responsibility to see that enough cash in available to provide proper community care, otherwise there will be tragic consequences.
The Minister quoted the Spastics Society. I am very glad to see the former director, the hon. Member for Suffolk, South (Mr. Yeo), in his place. I hope that he will catch your eye later, Mr. Deputy Speaker. Recently the Spastics Society has expressed anxiety about the lack of provision for multiple-handicapped people in the community. It says that often alternative provision is simply not available. It says that care in the community has become a misnomer for family support.
The examples are quite horrifying. There is a severely physically disabled man now being looked after by his 80-year-old mother who has arthritis. I ask right hon. and hon. Members to think of the suffering in that household. There is a 67-year-old disabled widow who lived with her mother who had to watch her bleed to death, quite unable to do anything to help. Such examples give substance to the bleak phrase "lack of provision".
Family doctors are now seriously concerned about what is happening. The General Medical Services Committee is so disturbed that it is conducting its own inquiry. I suggest that the Minister should conduct his own inquiry into what is happening about these people who are deprived of proper community care when they leave institutions. It is very important for him to do so.
The assistant director of an MRC social psychiatry unit at a hospital in the north-east Thames region foresees a population of psychotics drifting in the area once a psychiatric hospital is closed, moving in and out of prisons and doss-houses and living on the streets.
This is the stuff of human suffering and of human tragedy. It is a silent scandal which is spreading throughout our community, with the most vulnerable people suffering most. It is a scandal that requires urgent Government action if severely disabled people and their relatives are not to be left in private purgatory.
The Government will be judged in the House and in the country by the practical work that they do for disabled people and by their attitude towards them. Nothing is more revealing about their attitude than their approach to measures to outlaw discrimination. The Minister mentioned this, and said that legislation on discrimination is only a corner in the field of activity. I do not agree. I think that it is an important aspect of the lives of disabled people. Legislation has a dual purpose: it prevents disturbing behaviour by people towards disabled people, and it emphasises and formalises the fact that disabled people have the same rights and dignity as everybody else.
I commend my hon. Friend the Member for Liverpool, West Derby (Mr. Wareing) for his efforts after my ten-minute Bill made no progress. That was followed by the 1297 Bill promoted by the right hon. Member for Western Isles (Mr. Stewart), which also failed. My hon. Friend's Bill came forward and was widely discussed, but has now fallen. That Bill will come back to the House and eventually, I believe, will be enacted in the House. The Government can oppose it with all their convoluted arguments, but eventually their opposition will be swept away, and we shall have that Bill on the statute book giving disabled people new rights and new hope for the future.
§ 12 noon
§ Mr. Roger Sims (Chislehurst)It is a pleasure to follow the right hon. Member for Stoke-on-Trent, South (Mr. Ashley). He will not expect me to agree with everything that he said, but at least it gives me an opportunity to refer to the work that he does for the disabled, and particularly to express the admiration and respect in which he is held throughout the House for the way in which he copes with his own disability.
The right hon. Gentleman referred to the Bill that was discussed in the House towards the end of last year. I will avoid the temptation to discuss it again at length. Suffice to say that I think that there may be a role for legislation in this field as there is, for example, in racial discrimination, in the sense that it may create the right sort of climate, but I am not persuaded that the Bill promoted by the hon. Member for Liverpool, West Derby (Mr. Wareing) is that Bill. In any event, legislation can do no more than create that sort of climate, and that can be created without the necessity for legislation.
The important question is how disabled people are treated in society, what sort of facilities are made available for them and what consideration is given to their particular problems. After all, we have to recognise that disabled people are not the same as those who have the use of all their limbs and all their faculties. The disabled are necessarily restricted in what they can do. However, a great deal can be done to reduce the limitation on their activities and the extent to which they can enjoy as full a life as possible. It is important to make them feel that they are as much members of the community as anybody else.
Several references have been made to the desirability of integrating disabled persons into the community. I refer particularly to a scheme in my constituency in a place known as Wood Lodge where, thanks to the generosity of Mr. Michael Wheen, its owner, in conjunction with the Guinness Trust, several blocks of well designed flats have been built on a gentle slope in a pleasant woodland setting, built not specifically and only for the disabled, but for a mixed community. On that site, the able bodied, the disabled, the young, the old, single people and families are living together as a community. Thanks to the design and layout, and the devoted work of Mr. and Mrs. Wheen and the staff, a real community has been created there—almost a village within a suburb—of which the disabled people feel part. They are able to live a fuller life than would otherwise be the case. When I went there on an agreeable morning only a few days ago, one of the residents said to me, "It is a new world."
Such schemes deserve the fullest possible support from local authorities, health authorities and the Department. Not only are they of positive benefit to the disabled, but they reduce the need for the people who live there to call on the services of the social services department and the health authorities.
1298 I wish to take this opportunity to draw attention to one group of disabled people to whom I have already referred briefly, who, even if they were present in the House today, would be unable to hear the debate. I refer, of course, to the deaf. It is difficult, if not impossible, for us to imagine what it is to live in an absolutely silent world. In some cases, not only can they not hear others but they literally cannot hear themselves. As I said, it is almost impossible to imagine this, although I had an experience some years ago when I contracted some form of infection in both ears which had the effect of making me completely deaf in both ears for several weeks. That happily brief period gave me some insight into what deafness must be like.
It was an inspiration for me to spend last Saturday with scores of deaf people and those who work with them, and to see them all in lively conversation with each other, lip reading and using sign language. It was a pleasure for them too, I know, to have the right hon. Member for Stoke-on-Trent, South with them for part of that day. A woman with a baby came up and chatted to me about this and that. After five minutes or so, she said, "Of course, I was fortunate. Although I was born profoundly deaf, my mother, although she, too, suffered from a degree of deafness, taught me to speak and lip-read." I had been talking to the woman for five minutes before I realised that she had that affliction. One cannot help admiring the way in which people handle the problem.
That example, also serves to highlight a feature of that disability. Physical disability is usually self-evident. When a person is blind, one can observe that he is blind because he probably has a white stick, yet there is nothing to make it obvious that a deaf person is deaf. The mar, in the street is liable to assume that the person who is deaf and appears not to comprehend is also dumb. Efforts have been made to improve this situation. I cite as an example the Sympathetic Hearing Campaign started by a nearby resident of mine, Mr. Alan Roberts, who has tried to devise a system whereby deaf people can hand over little cards in shops and so on to explain that they are deaf. The shopkeeper is sometimes liable to think that it is a funny credit card. It is not easy to get the message across. Some people have designed badges saying, "I am deaf, please speak slowly," and this obviously must help.
What has been a revolution and an enormous boon to the deaf is the development of teletext. I give all credit to the work of the BBC Ceefax system in developing its "No need to shout" magazine. If hon. Gentlemen who have not watched this have a few moments and press 291 on Ceefax, they will see literally pages of information particularly for the deaf compiled by Alison James. Oracle has a similar magazine, "Earshot", on which Melinda Napier does a great deal of work. Teletext has made a great difference by providing subtitles to programmes so that deaf people can enjoy television.
At present there are only 10 hours of subtitled programmes each week and my strong plea is that efforts should be made to increase the number of such programmes. The BBC says that it hopes to increase subtitling to 30 hours a week by 1987, when ITV hopes to be showing 20 hours of such programmes each week. That is not an over-ambitious aim. If I write to my hon. Friend the Under-Secretary, he will doubtless tell me that it is not a matter for him and that I should write to the Home Office. If I write to the Home Office, I shall be told that it is a matter for the BBC and the IBA. The matter tends to get shunted around.
1299 Subtitling is not something that needs high-level consideration because of the enormous expense involved. The cost is not great, the skills involved are not complex and if staff numbers are a problem volunteers will be willing to help. I hope that pressure will be exerted to extend the subtitling of television programmes. It would be wonderful if subtitling were used on news programmes. At present, deaf people have only a two-minute summary each day. If the television programme "Question Time" were subtitled live, that would open doors to deaf people who take an interest in the world around them.
Subtitling is not technically difficult. Thanks to the work done at Southampton university on the development of Palantype equipment, the right hon. Member for Stoke-on-Trent, South is able now to read what I am saying. The technical expertise exists to provide instant subtitling. It should be done on television and it could be done if there were the political will to get it done. I ask my hon. Friend the Under-Secretary to give those developments a good ministerial shove.
§ Mr. Michael Meadowcroft (Leeds, West)I am pleased to follow the Minister, who, for unusual reasons, must have made his longest ever speech in the House, and the right hon. Member for Manchester, Wythenshawe (Mr. Morris), whose commitment to the cause of the disabled is well known.
I listened carefully to the hon. Member for Chislehurst (Mr. Sims) and I am sure that he did not wish to give the impression, which seemed to come across from his speech, that disabled people are not intrinsically the same as able-bodied people. The human quality exists in every person; it is the ability to express that quality which is different. We should not act out of a feeling of charity towards disabled people. As able-bodied people, we also need that human quality to be expressed as fully as possible.
The difficulty about provisions for disabled people is that they are inevitably constrained by the resources that are available. The implementation of the 1960 Act, piloted through the House by the right hon. Member for Wythenshawe, has always been inhibited by the lack of resources. It is a classic case of the best of intentions being thwarted because there is not unlimited finance.
I do not disagree with any of the positive and constructive proposals that the right hon. Gentleman made today, but I should say that it does not always benefit one's case to suggest that those on the other side of the argument act from motives that are not as generous as one's own.
We always have to cope with the problem that expectations cannot be matched by resources. That is definitely the case with community care. We rightly want to move people out of institutions and into the community, but that involves much support which would probably be less expensive gathered together in one place than diffused throughout the community.
The gains made in the IYDP have not been consolidated as well as they might have been. In some cases, the benefits and advantages demonstrated during that year could have been helped by relatively small grants to voluntary groups that could have continued the work done at that time. Projects started during that year had varying success in different parts of the country, but developments such as the access guides that were published in many 1300 cities and the provision of the DIAL system—the disablement information and advice line—were tremendous benefits that resulted from the concentration on the disabled during the IYDP.
Hon. Members would probably not contradict my view that groups of people with a disability and the relatives of such people know more about the problems associated with that disability than does any individual specialist. We sometimes fail to give enough support to groups of disabled people and their relatives who are seeking to concentrate attention on the practical effects of a disability and the way in which society can assist in overcoming the problems.
The new generation of voluntary and self-help groups is different from those of past years. I do not say that the longer established groups are not worthy or are not still doing invaluable work, but perhaps they too often accepted traditional attitudes rather than seeking to change them. It seems to me that nowadays there is much less working for disabled people than working with them and finding ways of expressing what those people want to do and feel that they can do.
Hon. Members must accept that we shall have limited resources for a long time. We must develop a partnership based on mutual understanding and acceptance of each other's role and give grants to those who can accomplish the most. It is wrong to say that if something is worth doing, the state must do it, just as it is wrong to say that if voluntary bodies can be exploited by privatisation that should be promoted. It is a question of partnership and collaboration between the state and individual groups.
That approach must include making sure that the policies of the state towards grant-aided groups is as fair as it would be towards the state's own provision. For example, grant aid must take account of inflation. It is ridiculous to make sure that there is provision to enable our direct services to cope with inflation by, for example, increasing salaries, yet not take inflation into account when giving grants to voluntary groups, some of whom also employ staff.
I know from having asked questions in the House that the Minister is sympathetic to the view that year-on-year funding is not on if one is seeking to employ people of the best calibre. We must get away from the view that voluntary organisations are not to be trusted as much as local authorities. We should not restrict their spending by limiting their finance to one or two years ahead.
When considering the problems posed by the recession and economic constraints, it is important not to neglect the vital task of raising the consciousness of the able bodied. If we are to extract more resources from a shrinking or at least stable economy, we must make sure that the public are prepared to provide those resources and accept some of the resulting hardships. We cannot simply assert that those resources must be made available. We must make it clear that a price will have to be paid.
It is a sad fact that poverty tends to mean more handicap. The evidence seems to show that the poorer people are—whether in this country or abroad—the more likely they are to be handicapped. We must combat that, particularly during a recession.
There should be more linkage between the services. Often the governmental process is very compartmentalised. We have the NHS, the social services, housing and different aspects of the machine and if they were encouraged to work together more it could be of great assistance. The paradox is that some cash savings may also 1301 be social gains. I shall give one or two examples. After the first pensions were given to elderly people more than 50 years ago, it was discovered that a family with an elderly person in its midst—even if he or she was on a small pension—was more inclined to keep him or her within the home than to put pressure on tha authority to place that person in an institution. That should be borne in mind, as it may not prove any more expensive to give better attendance allowances, if it means that it is less likely that people will be put into institutional care.
Similarly, home helps are a very economical way of keeping people in their own homes. Perhaps we tend to consider the cost of the NHS in isolation from the savings that could be made if we enabled people to remain in their own homes by allowing for the much cheaper provision of, for example, home helps. I am sure that all hon. Members have constituents whom the authorities want to discharge back into the community or into their own homes. However, they are sometimes unable to do so, because of the lack of support services within the community.
More handicapped children could remain in ordinary education if there was a small increase in the number of non-teaching assistants. I have an epileptic boy in my constituency who is due to transfer from the middle school to the high school. The middle school had a non-teaching assistant who could cope with epilepsy, but the high school does not have one, so it looks as though that child will not be able to go to the ordinary high school. However, the cost of sending him to a special school is higher than the cost of providing the non-teaching assistant. That is bizarre.
Within the voluntary sector there are such things as the Anchor housing association's "staying-put" scheme. I know that the Minister has expressed some sympathy for that scheme. By providing small amounts of capital so that people can make small alterations to their homes—such as a downstairs toilet or chairlift—people are encouraged to remain in their own accommodation for far longer than would otherwise be the case. It makes good economic sense, apart from the social benefit.
One of the alarming facts to be brought out by the statistics is that proportionately more disabled than able-bodied people are unemployed and, moreover, almost twice as many disabled people have been out of work for more than 12 months. We should regard that with some shame. Sometimes disabled people have come together to create employment. The economic gain to society, together with the tremendous gain for the people themselves, should be borne in mind. The subsidy required for handicapped people amounts to less than the cost of retaining that person on the unemployed register. Again, the question of linkage should be considered.
The present system of rate penalties together with the possible imposition of rate capping may be disastrous for handicapped people and may even cause the NHS more expense. More emphasis should be placed on preventing handicap. Not enough attention is paid to diet and its effect on health. There is more and more evidence to show that many of our disabling diseases could be alleviated by a better diet. When the side effects of drugs are visible, as in the appalling case of thalidomide, they are quickly tackled. However, it makes one wonder what lesser side effects may exist, and perhaps we should give that much more attention.
§ Mrs. CurrieDoes the hon. Gentleman realise that many disabilities, such as asthma—which I suffer from—are rendered innocuous and harmless by suitable drug therapy?
§ Mr. MeadowcroftI am grateful to the hon. Lady for assisting me with that point. There may be all sorts of things such as diet, drug therapy and so on, that we do not necessarily know about but which could assist in prevention.
The hon. Member for Chislehurst drew attention to the tremendous benefit of technology, and the substantial contribution made to the House by the right hon. Member for Stoke-on-Trent, South. We are very fortunate to have a visible example of what technology can do. With the skill and ingenuity of scientists and engineers, the potential for disabled people may be much greater.
I have come across some people whose medical conditions will not improve and who are on the maximum benefits possible but who are forced continually to submit to medical examinations. That is a small point, but it is very important to those involved. Why are they subjected to continual medical examinations when it is understood that their condition will not improve and that they cannot receive more benefit by being given a different categorisation?
From time to time I put in a plea about the arts. They are not some optional extra. Often, I am moved by the contribution that the disabled make to the arts and, in turn, by the contribution that the arts make to them. It should be borne in mind that people's skills, talents and compassion can all be involved in plays such as "Children of a Lesser God" and, more controversially, "Crystal Clear". In addition, the arts can contribute to someone's sense of belonging and well-being. Perhaps that is one aspect of this debate that deserves to be given more attention and which would not cost much. It might well benefit many people in our society.
§ Mr. David Amess (Basildon)I sense that the mood of the House is one of humility, and I for one, was particularly moved by the words of the right hon. Member for Stoke-on-Trent, South (Mr. Ashley). As the hon. Member for Leeds, West (Mr. Meadowcroft) said, all hon. Members would wish to do all that they could to assist with the problems and needs of the disabled. For once. a debate clearly cuts across party lines. Many hon. Members will know of disabled constituents who cope in quite remarkable circumstances in their quest to lead perfectly normal lives. Whenever we think that we have problems and that life is not fair, it is salutary to remember the plight of the disabled, who cope with life despite the loss of sight, sound or movement.
For example, a married couple in my constituency suffer from cerebral palsy. They are totally confined to wheelchairs, yet they cope admirably with their three perfectly normal children. The gentleman communicates by using a board with letters attached to it. He travels 300 miles a week to work in London.
We must be careful when discussing such matters because disabled people are strongly independent and do not want our sympathy. They would not take kindly to patronising comments. Nevertheless, they have a right to expect fair treatment. That is how Governments can assist. I congratulate my right hon. Friend the Secretary of State 1303 and his Department on the contributions they are endeavouring to make towards that end. I am particularly pleased to speak on a subject that is of growing importance, given the Government's current preoccupation with the relevance of social services money for those in need and their attempt to make a coherent whole of a wide variety of provisions.
A wide variety of different allowances do not always provide a solid floor for the disabled. Too many disabled people must apply for allowances to many different boards and hearings committees, all of which test different types of disabilities. That is time-consuming for the potential recipient and expensive for the Government. The system is the product of an outmoded concept of the welfare state, and it still fails to catch all whom it is designed to help.
For example, one of my constituents had a tumour on the brain which left her eyesight and mobility severely impaired. She applied for both mobility allowance and attendance allowance, but was refused both. Subsequent appeals have led nowhere. It is obvious to the lay observer that the lady needs assistance, but she does not qualify under several schemes because of the criteria. She is slipping through the net of haphazard programmes. I appreciate the Minister's difficulties. There is no obvious or easy solution.
The answer might be to restructure the disability system so that all grants stem from a central, cohesive scheme. Allowances would rest on the result of one set of medical tests, interviews, and so on. I favour an all-embracing points system to determine the graduated allocation of moneys related to the increase in points. As the condition deteriorates, revaluation would increase points and money to correspond with the demands that deterioration places on the disabled person. Thus, the fundamental purpose of the welfare state would be met—of providing assistance to those who really need it. At the same time, the Government's monetary policies would be met by no longer classing different benefits with different disabilities. By offering a wholesale benefit, the choice would be returned to the consumers. They would decide how to spend the money and what kind of benefit they wished to receive. Such decisions are as much a right for a disabled person as for anybody else.
My second theme involves discrimination. I cannot agree with Opposition Members in their unfounded belief that legislation is the way to deal with the problems. As my hon. Friend the Member for Chislehurst (Mr. Sims) said, we must address ourselves to specific problems and specific remedies. Several of my constituents have brought problems to my attention, notably about access and attitude. Under the Education Act 1981 disabled children are encouraged to attend ordinary schools rather than special schools. However, only a few schools, including many in my constituency, provide adequate access for wheelchairs. The whole concept of the Act is undermined. The discrimination is not intentional, but it is thoughtless inaction.
A constituent's educational choice has been restricted by lack of facilities. He may attend any School, but the inconvenience and suffering involved in moving a wheelchair up and down flights of stairs limit his freedom. Other constituents tell me that they cannot use some restaurants and shops or the underground.
1304 I welcome the Government's publicity campaigns, but they should be generously upgraded. To place the problem in context, I refer to the various undertakings being conducted by the Department. A review should be undertaken of all provision for disabled people at this time, when the Conservative Government are bringing coherence and cohesion to many of our systems. It is time that the same process was applied to systems involving disabled people.
As we come out of the recession, it is appropriate to emphasise that care for the disabled does not necessarily imply greater expenditure or massive legislation, but rather reform to ensure that the money reaches those who need it and in the amounts corresponding to their needs.
Conservatives believe in the right of the individual to carve his own destiny. The disabled have that right as much as any person. In matching finance to needs, we give them that right, which has been denied to them through thoughtless discrimination.
Basildon is trying to raise enough money to build a new centre for the handicapped. I understand that we are about £35,000 short. So, if there is any spare money in the Department, Basildon would certainly welcome it.
§ Mr. Jim Callaghan (Heywood and Middleton)Some time ago I was fortunate enough to secure a place in the ballot for Private Members' Bills. However, when I saw that I was No. 16 I realised that I did not have a great chance of getting my Bill on to the statute book. I chose the chronically sick and disabled as the subject of my Bill. I worked on it for a number of months, but, unfortunately, lost the Bill. However, I was determined to bring it to the statute book in one way or another. I brought in a No. 2 Bill, whose purpose was to ensure that facilities were provided in any new commercial or industrial building to enable those with disabilities to gain access and to be able to work in those buildings.
Hon. Members are often inundated by people with various causes asking us to put a variety of matters dear to them on the statute book. I chose the chronically sick and disabled because I worked for 12 years with a lady who suffered a very severe disability. She was wholly disabled from the waist downwards. Dorothy Wykes worked for 40 years in a school, without taking a single day off. It was a privilege to work alongside that lady. I am delighted to say that other men on the staff, including Albert Weeks, Maurice Hopwood and Ray Robertson—whose political beliefs I do not know—helped Dorothy to get around the school by such simple actions as putting wheels on chairs. They helped her to fulfil a wonderful task for the community.
When Dorothy eventually decided to retire, the staff—past and present—and the neighbours in the community decided that, unknown to Dorothy, they would like her to be honoured. Moves were made to discover whether some recognition could be given to dear old Dorothy for the 40 years of unbroken service despite her dreadful disability. The reply to our inquiries came from an individual whom I would not describe as uncaring, but rather as unthinking. He said that because Dorothy had not contributed to society, other than that for which she was paid, she did not deserve any recognition.
I am delighted to say that, although she was not aware of this, I dedicated my Bill to Dorothy. There was a nice sequel to that, because the publicity that she received went 1305 throughout the world. Many pupils that she taught, now in Australia, New Zealand and Canada, wrote to Dorothy congratulating her on her magnificent service to society.
I was reminded of Dorothy recently when one of my constituents wrote to me complaining that a major art gallery did not have facilities to enable people in wheelchairs or with severe handicaps to enter it. When I made inquiries, I discovered that the facilities were available, but that the persons needing them were not aware of that and, therefore, did not realise that they could visit the gallery.
A committee of inquiry under the chairmanship of Sir Richard Attenborough has been sitting for two years. It is funded by the Government, at a cost of £10,000, and its report, on facilities for the disabled to enter art galleries, museums and places of the heritage, is eagerly awaited.
I intended raising matters of this sort a week ago, in the debate on the arts, but I ran out of time, so I am taking this opportunity to spotlight for the Minister the needs of the disabled in terms of the arts. My object in this debate is to ask the Minister to explore the extent to which existing facilities enable people with disabilities to involve themselves in the arts as participants and spectators, and having reviewed the position, to make recommendations and give directions to encourage the development and improvement of better opportunities for all disabled people to enjoy and participate in arts and heritage ventures.
I also invite the Minister to produce guidelines for venue administrators on how to make things easier for disabled people in arts and heritage buildings. Disabled people are often disregarded, though not deliberately, by arts and heritage bodies, for example. Those who fund arts and heritage activities, such as the Arts Council, Government Departments, local authorities and trusts, do not, in the main, pay attention to the needs of the disabled.
Venues often fail to provide accurate information to people with disabilities. Local authorities, as the largest employers in the arts, often do not fulfil their obligations under the employment quota. When we glibly talk about fine arts and heritage facilities, we should remember that many, unintentionally, exclude disabled people and in many cases, therefore, their families and friends. It is estimated that one in 10 of the population has some disability, and obviously families can be affected.
Solving problems to make more arts provision for disabled people should not necessarily be equated with making more money available. Certain physical facilities must cost some money, and arts provision, given more money, could expand. A fairer distribution of resources and opportunities in the arts could be brought about by a better awareness of the differing needs of the various members of the community.
It is a common misconception that it is costly to adapt premises for full accessibility. That is not necessarily true, although in some instances that is used as an argument for doing nothing, when all that is required is some ingenuity and limited expenditure. This building is a good example of that. The Palace of Westminster stands on an eight acre site and has four major floors, giving about 32 acres. When it was mooted that we should provide facilities for the disabled, and we had to consider how the disabled were to get into the building, there was considerable worry about how that would be achieved. In the end, all that was needed were two ramps to enable people to get in. Thus, 1306 it did not warrant the fears that people had about it costing a great deal of money. I am sure that many an galleries are in a similar position.
The majority of people with disabilities do not use wheelchairs; only about 3 per cent. of the disabed use wheelchairs. Simple adaptations benefit the majority of users, such as clearly marked steps, non-slip surfaces, non-reflective surfaces, easy to read and well positioned notices and staff knowing what facilities are available and being able to offer assistance in the correct way. That sort of help can minimise most physical obstacles.
Building owners, such as local authorities and theatre and cinema chains, should ensure that local managers have clear and appropriate instructions on the admission of disabled persons, and full information on facilities for disabled people should be available to staff and others on request.
There is to be a major change in the Government's funding of the arts, an issue which was dealt with at great length just over a week ago in the arts debate. Following the proposals to abolish the six metropolitan councils and the GLC, Lord Gowrie, the Minister for the Arts, announced that £16 million would be made available to the Arts Council for areas of the arts that are presently covered by the GLC and the metropolitan councils. Perhaps the new organisations should place emphasis on the need for bodies which administer public funds to take a lead in devising a policy for arts provision and training and to incorporate in policy statements a commitment to the full participation of those with disabilities.
§ Mr. Tony Banks (Newham, North-West)My hon. Friend has mentioned the proposed abolition of the metropolitan councils and the GLC. He has mentioned also that money is not necessarily the prime factor. However, I am sure that he will accept that money is exceedingly important. Is he aware that the GLC is involved in a major review of all its many operations in London to ensure that facilities are available to the disabled? The GLC is funding many of London's theatres so that they can provide facilities for the disabled to allow them to enjoy the arts. This all costs money and these programmes will be at some risk if the GLC is abolished.
§ Mr. CallaghanI could not agree more with my lion. Friend. It is obvious that money is important. As I have said, I sought to pilot a Bill through the House. It foundered at one stage because the Government would not provide money. I was eventually successful, but I had to find ways and means of getting the Bill on the statute book with a few teeth, even if the Government were not prepared to provide money. That experience leads me to agree with my hon. Friend that money is crucial.
Art-funding agencies such as the Arts Council, regional arts associations, local authorities and central Government should require clients to demonstrate an awareness of the needs of the disabled. Funding should be contingent upon such a commitment being made by all clients in receipt of public money. Commercial organisations and charitable trusts, for example, which make grantaid available or sponsor arts organisations and events should require clients to demonstrate that they are meeting, where practicable, the needs of those with disabilities. This might include the requirement that access information be carried in publicity material and that premises must meet access requirements within an agreed period.
1307 Funding incentives, such as matching funding and tax advantages, should be pursued. The Manpower Services Commission should be encouraged to fund more arts-related projects. Such projects should be assessed in conjunction with appropriate arts and disability organisations. Agencies such as the MSC should publicise more widely the funds that are available to adapt premises and to provide equipment for employees with disabilities. There is still an employment quota and employers such as local authorities, health authorities and arts organisations should be required to meet it. Funding agencies should make that a funding criterion.
Whatever system of local government funding of the arts is adopted after the proposed abolition of the GLC and the six metropolitan councils, a clear-cut responsibility should be assigned for considering the needs of the disabled. There should be well-recognised procedures for financing projects that will provide benefits for the disabled. A wisely directed policy of public funding has a vital role to play in enabling the disabled to have fuller involvement in the arts.
I ask the Minister to review arts funding and related policies to assist the disabled to enjoy the arts and to participate in them. He should review the education, training and employment of personnel in artss subjects. He should investigate better ways of providing transport for the disabled to and from art venues. Finally, I ask the Minister to review his policy for providing access to buildings and the costs of participation in art pursuits for the disabled.
§ Mr. John Hannam (Exeter)I welcome this debate on the needs of disabled people and thank the Government for providing the time to hold it. I congratulate my hon. Friend the Under-Secretary of State on his excellent speech. I apologise because I shall be absent at the end of the debate as I have to get to another engagement.
Anyone involved with disablement will know that there is no exact beginning or end to the campaign for the integration of and improvements for handicapped people. There should be a process of steady improvement over a wide area, including many different provisions—aids adaptation, preventive care, education and measures to cure and alleviate various handicaps.
Since the early 1970s and the Chronically Sick and Disabled Persons Act, which was introduced in the late 1960s by the right hon. Member for Manchester, Wythenshawe (Mr. Morris), there has been a period of sharp acceleration on all those fronts of provision for the disabled. The process started with the identification of the disabled in our society. Subsequently, a wide range of benefits and aid were provided to enable them to lead decent lives, to travel, gain employment and enjoy leisure pursuits. I include among those leisure pursuits the provision to which the hon. Member for Heywood and Middleton (Mr. Callaghan) referred—access to the arts—which obviously is important.
In general, the objective is to integrate the disabled people as normal human beings, albeit people with some sort of impediment. When our economy is prospering, the disabled gain greater and faster advances than when things are difficult, because they share in the disappointments that others face. In that context, I congratulate the 1308 Government on maintaining the level of progress that successive Governments have achieved during the past 15 years. As my hon. Friend the Under-Secretary of State pointed out, the figures speak for themselves. Since 1979 total expenditure on the disabled has increased in real terms by 30 per cent. With the development of the new comprehensive study of the extent of disablement in the population, I feel proud that the Conservative party is maintaining the impetus that was established in the early 1970s and renewed in 1981 during the International Year of Disabled People.
I have just returned from Lisbon where I attended the world congress of Rehabilitation International. I can vouch for the high esteem in which this country is held throughout the world for its provision for the handicapped. My hon. Friend the Under-Secretary of State was there also and made an excellent contribution.
There are many different subjects to which one can refer in this debate, but I wish to be reasonably brief. I shall limit my remarks to three immediate issues coming before Parliament this year. They relate to access, partial incapacity and that controversial old question of VAT. I wish to concentrate my attention on access.
Time and time again disabled people find themselves unable to participate in everyday life, simply because of poor provision of access. Since the International Year of Disabled People there have been a number of improvements, but major obstacles still prevent disabled people from achieving full mobility. I stress the importance of providing access to employment. With increasing computerisation there should, in theory, be a widening of the opportunities open to disabled people in the job market. The Manpower Services Commission will provide a disabled employee with whatever equipment he needs to assist him in carrying out employment, and such a service has proved invaluable to a great many disabled people.
The advent of computerisation has provided disabled people with work opportunities in sheltered employment. Outset has set up a project called Outset Office Supplies whose aim is for disabled people to work in a sheltered environment and to offer accountancy and administrative services to outside organisations. The organisation can offer data processing facilities and has a well-equipped printing shop and mailing facilities. In enabling disabled people through the use of information technology to develop and harness their capabilities and expertise, the project is offering a valuable service to disabled people and outside organisations.
In spite of those important technological developments, unemployment among disabled people remains twice as high as among their able-bodied counterparts. That will continue, unless we can introduce a partial incapacity benefit enabling disabled people to work part-time without losing their invalidity benefit.
Many disabled people, because of the extent of their disability, cannot work full time and are thus classified at present as wholly incapacitated. Some could undertake part-time work but are discouraged from so doing because they would lose their entitlement to invalidity benefit, and the part-time salary would not be sufficient compensation.
The solution must be a partial incapacity benefit. The case for such a benefit is strong and has been accepted by the Government. The Social Security Advisory Committee stated in its 1982–83 report that such a benefit would not merely assist a number of disabled people who currently 1309 have no incentive to work even when suitable work is available but would be entirely consistent with the Government's long-term objective of a more coherent system of benefits for the disabled.
In April 1982, the Economist intelligence unit, in conjunction with the Multiple Sclerosis Society, prepared a report on benefit for partial disability in which it presented an excellent case showing that such a benefit could actually produce savings for the economy because of the large number of full invalidity pensions currently paid to people who could switch to part-time work and a lower rate of benefit. It suggested, indeed, that the Government's estimate of a cost of £30 million was unrealistic and that savings of at least £5million could be achieved.
In June 1982, the then Minister with responsibilities for the disabled—my hon. Friend the Member for Hornsey and Wood Green (Sir H. Rossi) told the all-party disablement group that the Government welcomed the report and that the Department was considering the feasibility of the options put forward. The present Minister with responsibilities for the disabled then told us in December 1983 that officials were gathering information on partial incapacity benefits in other countries and that he hoped that this would be brought together early in 1984. In the debate on the Chronically Sick and Disabled Persons (Amendment) Bill he said that the Government would study the case for a partial incapacity benefit.
We are now nearing the end of the 1983–84 parliamentary Session, but we have heard nothing more about the Government's proposals for such a benefit. This is a matter of concern and I hope that my hon. Friend the Minister will be able to tell us about the results of the work carried out by the Department in the past couple of years.
Questions of access for the disabled are now coming to the fore across the whole range of Government Departments and we all welcome that. Today's debate is to be answered by a Minister from the Department of Health and Social Security, whereas questions of access fall largely to the Department of the Environment. At present, we are especially concerned about the proposed amendment to the building regulations to which reference has already been made today. As I have said, there have been a great many improvements in access for the disabled and since the early 1970s we have been campaigning to ensure that all new public buildings are constructed to allow sufficient access for the disabled.
We thought that we had finally found a solution to an apparently intractable problem when in February last year my hon. Friend the Minister for Housing and Construction issued a consultation paper on access to all floors for disabled people. That was warmly received by all disability organisations, but when the consultation was over the Department felt it necessary to introduce a second consultation proposal to the effect that access would be to ground floors only, stating that this would be purely for an interim period pending a BSI code of practice on means of escape for the disabled.
Disability organisations have been unanimous in rejecting the proposal for access only to ground floors and it seems that the Department of the Environment was under pressure from fire authorities to impose such a limit. First, disabled people do not want a precedent to be set whereby they are allowed into buildings only on condition that various means of escape are provided. That could have adverse implications. For instance, should the code 1310 of practice on escapes provide that all new buildings should be built with a specific type of lift? That could well be used as a reason for not allowing disabled people above the ground floor in any of the old buildings that do not have such a facility. That is completely, and understandably unacceptable to disabled people.
Secondly, while fire authorities must of course be consulted over means of escape, it should be stressed that their role has always been consultative and should remain so. One example is the Royal Association for Disability and Rehabilitation. Its headquarters is in London. It is a five-storey building and it employs disabled people on all floors. It was not until the organisation had held extensive consultations with the fire officer and shown him that it could provide a good management system for getting disabled people out of the building in the event of an emergency, that the building was approved for use by disabled people. The important point was that the organisation established the existence of an efficient management system. That is where we come to the present. We are still waiting for adequate provision for access for disabled people. Unfortunately, unless the Department of the Environment can be persuaded of the strength of the views held by disability organisations, it seems that we shall still have some time to wait.
I am confident that my hon. Friend will listen with great sympathy to the case. I hope that he can impress his colleagues in the Department of the Environment with our arguments. The House will appreciate the frustration of getting so near to the solution of the problem and yet being halted by what appears to be an unnecessary technicality.
Value added tax on building alterations is linked closely with access for disabled people. Buildings are often altered specifically to accommodate the needs of disabled people and it is important that such developments continue. It was, therefore, with great disappointment that I heard in the Budget the Chancellor's intention to impose 15 per cent. VAT on all building alterations. That has an adverse effect not just on the improvement implications for the disabled individual but for the many charities that care for disabled people. The additional financial burden placed on charities is considerable. Immediately after the Budget the Spastics Society estimated that it would cost it an additional £120,000 for the year ending June 1985.
Shortly afterwards, the Chancellor introduced some exemptions on alteration work carried out for disabled people. They included the installation of ramps and the widening of doorways and passages. That reduces the burden to a certain extent, but it still leaves that charitable organisation with an additional cost of between £70,000 and £90,000 each year. That money must be found from the hard-earned funds raised by charities.
I could give further examples of other charities facing substantial burdens as a result of increased VAT. Without a doubt, it is having a debilitating effect on charities, and the consequences fall on those whom they are aiming to assist, because disabled people form a large category of those whom they serve.
My intention is to seek an early change in the Finance Bill by an amendment on Report. I hope that hon. Members on both sides of the House will support the all-party disablement group in seeking to reduce the unfair burden of VAT on disablement charities.
I can come closer to home with the subject of access to Parliament. I am pleased to say that this Session has at last seen an end to the thorny access problems in the Palace 1311 of Westminster. That has been another long and intractable problem. Recently the Royal Association for Disability and Rehabilitation has provided a Gimson stairmate which is a portable machine that carries wheelchairs up and down stairs. It has been lent to the House and will provide an invaluable asset to the Palace particularly in approaching the Interview Rooms and the Grand Committee Rooms. The Administration and Accommodation Sub-Committee met on Tuesday of this week to finalise arrangements surrounding the loan and the equipment has been accepted for a trial period of one year.
A further and more dramatic announcement this week has been that the Services Committee has decided, after discussion, that guide dogs for the blind will now be allowed into the Public Gallery. Two spaces have been provided for the dogs, ending a period of great injustice for blind people. I should like, on behalf of those concerned in the campaign for the change, to thank the Services Committee for its help, and also Mr. Speaker for his approval of the new arrangement.
§ Mr. Tony BanksWill the hon. Gentleman tell the House what the Services Committee proposes to do about making provisions available for the completely deaf? Why cannot there be some screens in the Public Gallery so that the deaf can see what is being said in the Chamber?
§ Mr. HannamThat is a question which has not been dealt with through the offices of the all-party disablement group. It is one that the hon. Gentleman might wish to raise with us. If he does, we shall certainly take it up with the Services Committee. I am not a member of the Services Committee, so I cannot give an answer to that question on its behalf.
Before the hon. Gentleman intervened, I was referring to the solution of a very long-standing problem. We must be grateful that a trial period of one year has been approved. I hope that that will not mean that the decision will be reversed at some future stage.
I have restricted my remarks to three important areas but I am sure that a range of other issues will be mentioned in the debate. If we can today persuade my right hon. Friend the Chancellor of the Exchequer to make some concessions on VAT, my hon. Friend the Minister for Housing and Construction to make concessions on the building regulations problem, and my hon. Friend to introduce a partial incapacity allowance, I shall be a much happier man. However, he is already committed to a £35,000 contribution. I would settle for two out of the three. If I leave the Minister to make the choice I am sure that he will do what he can to help.
I congratulate the Minister on his work for the disabled. The limitation of resources is kliown to everyone involved with the disabled, and also by the disabled themselves. His commitment to their cause is recognised and appreciated by them.
§ 1.7 pm
§ Mr. D. E. Thomas (Meirionnydd Nant Conwy)I endorse everything that has been said in the debate, and in particular the remarks about partial incapacity benefit made by the hon. Member for Exeter (Mr. Hannam). I hope that we shall have a satisfactory response from the Department.
1312 I thank the right hon. Member for Manchester, Wythenshawe (Mr. Morris) for his speech, and his remarks about my hon. Friend the Member for Caernarfon (Mr. Wighley) and repeat his question about implementation of the Disabled Persons Act 1981. I apologise, Mr. Deputy Speaker, for the fact that I shall have to leave early in order to get back to my constituency for a meeting tonight. Anything positive that the Minister is able to say on my colleague's Act will be welcomed by my colleague and myself.
The debate has been wide ranging, because there can be no simplistic definition of disability. It is important that we should define disability in broad social terms which include people who are incapacitated from occupation as well as being incapacitated in terms of self-care. If we consider the problem in those broad terms, obviously we have to include within our category of people whom we consider to be disabled, and whose problems we debate, persons who suffer from the disability of mental illness. It is about such people that I should like to speak in the brief time available to me. There is perhaps a tendency not to include that group in our general debate and to concentrate on physical incapacity, whereas mental illness as an incapacity affects a large proportion of our population.
One in eight women and one in 12 men are admitted to hospital for psychiatric treatment at some time during their life. I refer to Susan Kingsley's excellent study, commissioned by the GLC, of mental health services in London, and published by that organisation's health committee. That is another example of the way in which the GLC is bringing to light major policy issues in a coordinating way, across the boundaries covered by central Government policies. That survey of people admitted to London hospitals stressed that 60 per cent. of those affected were women. We have to look very seriously at the evidence of the disproportionate demand on psychiatric services, the incidence of mental illness and the increase in disability which affects women.
It is very distressing to recognise from the statistics that single women are no more likely to suffer from mental illness than single men. It appears that married women are especially vulnerable to domestic isolation and all the other tendencies that lead to forms of depression. This has been studied carefully by George Brown and Tirril Harris in a major work on "The Social Origins of Depression." The pioneering work of such organisations as the Women's Therapy Centre on stress and the need for support groups for women suffering from postnatal problems, the menopause, bereavement and so on demonstrates the need for a new sensitivity on the part of our mental illness services generally and on the part of the Department in making its overall provision for mental health services and the needs of women.
So much of our discussion about community care, as the Minister admitted, tends to gloss over who the carers are. As the Minister said, in most cases the carers are women. Whatever the emotional benefits that derive from the caring experience, the caring experience for other persons who are disabled or ill themselves affects the health of so many women. We need to look carefully at that when we stress the alleged benefits of community care. It has to be real community care and not caring by members of extended families or by households.
It is important to look at the provision made for persons within the community when they are discharged from the 1313 traditional mental hospitals. Many of us are worried about the interrelationship between housing and mental health provision because we fear that it adds to such people's disability—in other words, their social disability—in terms of their ability to return to playing a full role in the community.
As a result of Government policies in reducing the expenditure available to local authority social service departments and housing departments, and because there are not sufficient resources available for the housing association sector, the private sector is moving in a fairly big way into providing forms of lodging in boarding houses and other private institutions which are not adequately controlled and inspected. The local authorities make regular inspections of these premises when they are registered under the local authorities, but not all are properly registered and not all are properly inspected. We may be decanting people into the community only by moving them from one institution into another.
The definition of community care should never be the one that I have heard used by one expert—that the community is the place into which one is discharged from an institution.
We need to look not only at the patterns of care in terms of housing in the community in the rehabilitation of persons who have suffered from mental illness but at the employment opportunities. Their importance has been stressed in the case of other disabled groups. For persons who are suffering or have suffered mental illness, their position is worse in terms of employment than that of other disabled persons.
I quote again from the report recently prepared by Susan Kingsley on mental health services in London. She says:
Opportunities for employment for people who have been mentally ill or who suffer from chronic mental disability are even more limited than opportunities for employment for the physically disabled. In 1980 while 13 per cent. of the registered disabled population as a whole were unemployed, a quarter of those registered disabled through mental disorder were unemployed.We have to look at the role of the DROs and the extent to which they are able to provide specialist support and employment opportunities for mentally ill people. We also need to look to employers themselves, although in the present economic climate perhaps we look in vain to the private sector to provide the kind of care that should be available, although if Tory philosophy holds good Government supporters should at least be talking to their friends in the employers' organisations to try to ensure that there are small sheltered workshops or some kind of hostel work schemes in the private sector which can ensure a return to a form of work or part-time work for people who are disabled through mental illness.It is essential that there should be no reduction in the role of the disabled resettlement officer. This applies to all disability and not just to that arising out of their experience of mental illness. I understand that there are fewer than 500 DROs in Britain as a whole, and about 90 are part time. I urge the Minister to ask his colleagues to look again at the role of the DRO service, particularly as it applies to the mentally ill and to other types of disability.
I deal finally with possibly the most important group in society—one that is increasing in size—which suffers from a combination of disabilities, the elderly. Here again, one is often dealing with a combination of physical disability and depression. It is important that the diagnosis 1314 of the condition of an elderly person should combine the approaches of psychiatry and those of other forms of geriatric medicine. As the health advisory service report of 1982 "The rising tide: developing services for mental illness in old age" reminded us, there is to be a massive increase in demand by elderly people over the age of 65 for services, and particularly services connected with mental illness.
One quarter of people over the age of 65 suffer from some form of mental illness. Much of it is amenable to treatment. In view of the added difficulties of self-care from which many such people suffer, we must ensure that adequate provision is made in the National Health Service and in the social services departments. Joint funding is important here. The Minister speaks of the amount of joint funding as if it were a major part of the NHS funding, but it is of course a minuscule part of the total funding. If the Government are serious about approaches which cross the border between the NHS and the social services departments, there should be a substantial increase in joint funding. The Minister has told us that this has been increased by 50 per cent., but there must be a substantial increase in joint funding because this is a flexible way of dealing with the issue of the elderly.
Nearly half of all mental illness in patients in our hospitals is accounted for by elderly people. The majority of elderly people who are in need of psychiatric help seem to be getting little assistance from the statutory agencies. We should look at ways in which we can provide forms of care for elderly persons who are unable to care for themselves because of the combination of psychological and physical illness, and at ways in which we can make their lives not only more tolerable but more interesting and easier for them, whether it be through the social services departments or the NHS.
In the NHS, we should not be admitting so many mentally ill elderly people into old large mental hospitals. We should be considering ways of providing social beds in community hospitals to ensure that, when such people must have recourse to a hospital bed, it is provided not as part of the service of the old mental hospitals, but as part of the community medical service.
I have concentrated on that aspect because it has been neglected in previous on disability. After all, we all have to face getting old. It is important that the House should always be sensitive to the needs of the disabled of every age group.
§ Mr. Deputy Speaker(Mr. Harold Walker)Order. I imply no criticism of the hon. Member for Meironnydd Nant Conwy (Mr. Thomas), but I am sure that the House would want the Minister to reply to the debate. Approximately 50 minutes' debating time is left, and eight hon. Members are seeking to catch my eye. The arithmetic will be fairly obvious.
§ Mr. Conal Gregory (York)I shall be mindful of your words of wisdom, Mr. Deputy Speaker.
I wish to address my remarks substantially to the disabled in the community. How can we make life as normal as possible for the disabled? Community care ought, indeed, to be encouraged. I am sure that leaders of 1315 local authorities are right to increase expenditure on personal social services for 1983–84 by 12.5 per cent. in real terms against 1978–79.
Health and local authorities should be encouraged to work even more closely with voluntary bodies to match services to the needs of the disabled. I am heartened to note that about £16 million has been allocated over the next four years for pilot schemes of community care. Care in the home is cheaper and more natural to a disabled person than is care in a hospital.
We need more community physiotherapists. I saw how well that system operates in Norfolk. So far, there is only one community physiotherapist in the York district. Their work can be particularly valuable for preventive treatment of conditions such as arthritis. For example, if a physiotherapist sees a patient at an early stage, she can help to prevent contractures and possibly reduce the need for surgery at a later date.
Many stroke patients can be treated at home and often make a better recovery in their home environment, since relatives assist and the patient is not disoriented by going into hospital. However, in those cases, it is vital that the family is given support.
The disabled appreciate the financial support that the Government have given. Expenditure on cash benefits is 21 per cent. higher in real terms than under the Socialist Government. In particular, the mobility allowance, which was made tax-free from April 1982, was increased from £10 a week under Labour to £19 a week in November last year. Mobility is a key element in assisting the disabled to enjoy as normal a life as possible and it was surely right for the Government to remove as from March this year, VAT and car tax from family cars designed for disabled people or substantially adapted for their use.
For the disabled who rely on public transport I commend the work of a major provider—British Rail—in its aim to help that sector. When undertaking structural alterations at rail stations, British Rail rightly brings its facilities for the handicapped up to date. For example, in York it plans to provide ramps for passengers in wheelchairs, public telephones that operate at a convenient height for the chairbound and special alarms in inter-platform lifts so that disabled users can call for aid from a permanently manned position. I understand that British Rail aims to have 55 major stations fully accessible to disabled travellers.
Will councils follow that lead in giving greater access to public buildings and in providing pedestrian facilities for the disabled? Textured pavements, as we can see outside the House and as I have seen abroad, are useful, as are pelican crossings, but borough engineers must not speed up the time allocated for crossing with warning bells.
On the subject of transport, I am worried about abuses of the orange badge scheme. It is vital that the disabled can use that facility to have as normal a life as possible. The two-hour restriction on parking is very limiting for disabled people and does not allow adequate time for shopping. I urge my hon. Friend the Under-Secretary to press on the Secretary of State for Transport the need for stronger penalties for able-bodied abusers of the facility.
There is a lack of facilities for the young mentally handicapped once they have left school. We need more support for the family and greater liaison between the 1316 social service departments and health authorities, both for this group and for the confused, elderly mentally handicapped.
If I may make a comparison within the EC, the DHSS would be well advised to compare help for the disabled in Denmark with that provided in the United Kingdom. The Danes have developed a range of domiciliary, day care, sheltered accommodation and nursing home provision which shows a strong political commitment. Indeed, we are prepared to spend less than half as much as the Danes and the Dutch on services that are vital to underpinning care for the elderly, including the elderly handicapped.
The Government are clearly committed to helping the voluntary sector by ensuring that additional funds are channelled to charities that assist the disabled. The Labour party maintains a traditional suspicion of voluntary activity that is unwarranted. Indeed, "Labour's Programme 1982" condemned the proposal that voluntary organisations should take responsibility for the care of mentally handicapped people. The Labour manifesto for the 1983 general election made no mention of the role of voluntary organisations in helping those in need. The right hon. Member for Manchester, Wythenshawe (Mr. Morris) did not add his party's support, and that, too, was a significant omission. By contrast, the Conservative party is anxious to promote the activities of all voluntary bodies.
§ Mr. Tony Banksrose——
§ Mr. GregoryI shall not give way, as I am mindful of Mr. Deputy Speaker's comments. I am sure that the hon. Gentleman will have an opportunity to speak.
Finally, I hope that my hon. Friend the Minister will speed up the full-scale survey that has been announced into the extent of disablement among the population as that will assist the Government further in formulating their policies, which have already been shown to be compassionate and thoughtful towards the disabled.
§ Mr. Ernie Roberts (Hackney, North and Stoke Newington)I shall be brief so that my hon. Friends can also contribute to the debate. Hackney suffers considerable poverty but the disabled, both black and white, are right at the bottom of the heap. Hackney borough council is doing its best to make their life bearable. It is the first authority in Britain to appoint an officer with staff to deal specifically with the problems of the disabled. But, as has been said, money is urgently needed to deal with those problems. Indeed, it is certainly required by an authority such as Hackney borough council if it is to give the disabled the assistance that they require. However, it cannot help as much as it would like, because the Government have cut its budget by about £30 million. The few services for the disabled that are provided by the local authority are under threat. I refer, for example, to the Diala-Ride scheme of the GLC and the London boroughs. That scheme gives the disabled the mobility to enjoy life, yet it is threatened by the Minister who has now taken London Transport out of the hands of elected representatives.
The so-called technical changes in the rules of supplementary benefit next November will hit the disabled and one-parent families in my area. Those in need of mobility allowance and invalidity benefit are finding it very difficult to get such allowances and benefits. Incidentally, there was proof of that two weeks ago on a 1317 television programme involving Esther Rantzen. She said that, after showing a particularly bad example, she had received hundreds of letters of complaint from those denied such benefits or allowances. I have taken up serious cases with Departments, which have behaved just like Scrooges. It takes too long to obtain a reply to a claim. Disabled people have lobbied the House, but their pleas have fallen on deaf ears. They have certainly heard sympathetic words from Conservative Members, but those hon. Members have then returned to the Chamber and voted against their demands.
Words of sympathy are not enough. The disabled need the assistance that they demand. The Minister gave a figure for the amount spent by the Government on the disabled and other services. Important as it is, I am sure that he knows that that sum is only onequarter of the amount spent by the Government on armaments. The disabled can be defended only if they are given the protection that they need. Indeed, many of them were, in any case, disabled by war. The Government are striving more and more to devolve their responsibilities for the disabled on to private people, voluntary organisations, and in some cases, the areas of private profit. Assisting disabled people is a Government responsibility. All disabled people have a right to that assistance.
I have received many letters from the relatives of handicapped people protesting at the threatened closures of neurological rehabilitation units in Hackney and elsewhere. The provision of care for mentally disabled people is essential. I intend to write to the Minister about the threatened closures.
Another problem is the growing number of registrations of private homes run for private profit. One area has reported that four new homes are being registered each month. They are subsidised by local authorities.
Many local authorities are overspending on care for disabled people and providing the social services which they are expected to provide by law. Local authorities break the law if they do not provide for the needs of disabled people, but many of them are unable to provide facilities because they are being forced, again by law, to keep within the rate-capping proposals.
Hackney borough council took the problem to the courts. The judge said that the Minister did not have to consider laws on provision for the needy. That is the excuse for not facing the responsibility of making provision for disabled people and the needy. I hope that the Minister will ignore such advice and make the necessary money available.
§ Mr. Timothy Yeo (Suffolk, South)In view of the time pressure, I shall omit opening pleasantries and start immediately with the question of benefits. The Minister knows my view that only a comprehensive disability cost and incomes scheme will meet the needs of disabled people, but I recognise the problem of resources. I hope that the current survey of the numbers of disabled people will provide a basis for a more accurate costing of an improved comprehensive scheme.
If the severe disablement allowance is to be the basis of such a scheme, it will need some revision. The introduction of the severe disablement allowance is welcome because it enables us to abolish the much hated household duties test.
1318 Further education is of special importance to young people with special needs. They often reach school leaving age with less maturity and fewer of the skills needed to obtain employment than other youngsters. For that reason, the availability of full-time further education for all young people up to the age of 19, as required under the existing law, is vital. It is deplorable that some local education authorities resist providing full-time education. Only half as many students with special needs enjoy that type of full-time education as ordinary students.
Local authorities sometimes give way under pressure from parents and voluntary organisations, but a damaging interruption in the education of a handicapped youngster can occur. I urge the Minister to press the Secretary of State for Education and Science to issue a circular to all local education authorities clarifying their legal obligation to provide full-time further education up to the age of 19 for all young people who desire it.
Public attitudes towards disability affect a large number of disabled people. Surveys show that a substantial proportion of the public believe that people with a speech impediment are mentally handicapped—an entirely erroneous view. At the end of last year the Spastics Society conducted a poster campaign in the undergrounds and elsewhere. One poster showed a wheelchair-bound couple on their wedding day with the caption:
When people said John and Mary should be in an institution, it wasn't marriage they had in mind.The horror of many people at the thought of the severely disabled experiencing normal emotional and sexual relationships, especially in marriage, remains a factor with which we must contend. What is required is a recognition that the disabled are people first and disabled second. They have the same emotions, anxieties, aspirations, fears and a desire to be contributors as well as recipients in the community as has anyone else.There is some role for legislation in eliminating some of the more flagrantly prejudiced attitudes towards the disabled. In the words of Martin Luther King:
Morality cannot be legislated but behaviour can be regulated. Judicial decrees may not change the heart but they can restrain the heartless.I believe that anti-discrimination legislation, which should be the responsibility of the Home Office and not that of the Department of Health and Social Security, could play a part in fostering more positive attitudes.We are all partly to blame for that, even those voluntary organisations that claim to serve the needs of the disabled. Too frequently their publicity material is dominated by a visual portrayal of the disabled in emotive terms as pathetic or dependent individuals deserving of charity. Every such portrayal postpones the day when the disabled will be treated as equal, first-class citizens—not as a favour or condescension, but as of right.
The hon. Member for Leeds, West (Mr. Meadowcroft) mentioned prevention, and especially the prevention of those handicaps that affect people from birth. There is still a need to educate prospective parents, especially mothers, about the preparation for conception and pregnancy, including advice about the importance of pre-conceptual care and the dangers of smoking in pregnancy, which is directly associated with higher incidence of handicap. Secondly, measures need to be taken during pregnancy, notably early and regular attendance at ante-natal clinics. Another critical factor during that period is poverty. The current review of maternity benefits is, therefore, highly 1319 relevant. I appreciate the problem of resources, but an increase in the maternity grant to restore something of its original real value is urgently needed.
The final aspect of prevention concerns the point of delivery. Great strides have been made in neo-natal intensive care which have led to the saving of many babies who would previously have died. But the provision of neonatal intensive care units remains inadequate—barely half of what the DHSS itself believes is needed. I appeal to my hon. Friend to persuade his colleagues to give urgent priority to establishing a more adequate national network of neo-natal intensive units.
I warmly welcome the amendment to the Rates Bill, recently approved by the House, which singles out expenditure by local authorities in grants to voluntary organisations as a special category on which appeals can be made to the Secretary of State. Voluntary organisations also receive central Government funds, and I congratulate my hon. Friend on the increases in the Budget for section 64 grants. I plead with him for section 64 funding to be concentrated on smaller organisations and those whose work does not have a strong emotive appeal. I plead, secondly, for quick answers to applications from the small organisations whose cash resources are usually less than those of the large household names. An organisation such as the Campaign for the Mentally Handicapped, which has done so much valuable work, can have its survival jeopardised by a delay in approving a grant application or, even worse, by the withdrawal of funding.
Although there are many other aspects on which I should have liked to speak, and I regret not having mentioned a number of them, I shall now sit down in the interests of other hon. Members who wish to speak.
§ Mr. Robert N. Wareing (Liverpool, West Derby)The Government have been generating the myth that the disabled are benefiting from their policies. Continually the disabled are told by Ministers, including the Prime Minister, that they have cause to thank the Tories.
Consider the myth, for example, that cash benefits have increased by 21 per cent. since the Conservatives took office. On 24 November last, the Minister revealed that only 4.3 per cent. of the 21 per cent. supposed increase in case benefits was an actual increase in the rate of benefit and that 16.7 per cent. was represented by the numbers claiming attendance and mobility allowances.
Authorities such as my Merseyside county council are to be commended for their work in ensuring that take-up campaigns are successful, and in Merseyside that has resulted in an additional £1 million being injected into the economy. Conservative Members who attack the metropolitan counties and the GLC should remember that the attitude of those bodies to voluntary organisations for the mentally handicapped and chronically sick has been extremely generous.
The Government have slashed the value of benefits. My right hon. Friend the Member for Manchester, Wythenshawe (Mr. Morris) referred to the abolition of the earnings-related supplement for sickness and unemployment benefit. That has meant an average loss of £13 a week for a person on sickness benefit. The real value of the invalidity benefit has been cut by 5 per cent. since 1980 and that has meant a loss of £2.35 for a couple in receipt 1320 of invalidity pension. The recent social security change announced by the Secretary of State—the increase from 50p to £1 in the available scale margin, including heating allowance—is another example of the miserly attitude of this Government to the worst hit in society.
Yesterday we debated the gap between the rich and poor in Britain. Some people in Liverpool are in a terrible plight. Whereas we have wealthy people who can afford to floodlight their houses every night, only a stone's throw from those properties are elderly and disabled people who have to think hard before deciding whether to get some heat from one or two bars of the electric fire.
§ Mrs. CurrieIs it not a fact that a large number of public buildings in Liverpool are also floodlit, the cost being borne by the rates?
§ Mr. WareingNot only can we not floodlight our public buildings, we are having to close one. St. George's hall is having to be closed because of the cuts imposed by the Government. We are taking that step because we in Liverpool believe that housing for deprived people is more important than keeping open a large public building.
According to official estimates that I have obtained from the Library, cuts in social security spending between 1980 and 1984 have amounted to £4£3 billion. That has been done by this "generous" Government who promised to introduce a more coherent system of benefits. That was what the electorate were told by the Tories in their 1979 manifesto. Far from creating a more coherent system, they have provided the severe disablement allowance. We are, of course, pleased that the household duties test is being abolished, but, as my right hon. Friend the Member for Wythenshawe pointed out, many organisations, including the Disablement Income Group, have said that they would prefer the existing system, even with the duties test, to what they regard as the totally irrelevant 80 per cent. disability test.
My right hon. Friend the Member for Stoke-on-Trent, South (Mr. Ashley) said that the 80 per cent. severe disablement allowance would penalise a host of the disabled. It was suggested that an individual would have to be incapable of work if he were to benefit. A host of those who are 60, 40 or 20 per cent. disabled will be incapable of work and will get nothing. Under industrial injuries legislation there are gradations of disability and there is not a complete cut-off at 80 per cent. The Minister has admitted that 16,000 of existing HNCIP beneficiaries would have been denied any allowance if the SDA had been in existence.
The cut-off applies also to age. The test of incapacity for work followed by severe disablement being accepted if there is 80 per cent. disability is a test which is applied only after the age of 20 years. This is a disincentive to employment and training by those who are under 20. To escape the 80 per cent. test it will be necessary before the age of 20 to prove that one is incapable of work. Why is there a double test after the age of 20?
If industrial injuries legislation had been applied ony to those who were 80 per cent. disabled, it would have ruled out thousands of those who are now beneficiaries. Between October 1980 and September 1981, only 210 of 6,020 who were benefiting because of industrial injury or disease would have been regarded as 80 per cent. disabled.
The Minister has not referred to section 6 of the Disabled Persons Act 1981. I ask him when he replies to 1321 refer to the three consultation documents which have been issued since 1981, which suggest that there should be even further discrimination against the disabled by introducing building regulations—which are designed to help them—which apply only to ground floors in new buildings. It seems that means of escape is being too closely associated with helping the disabled to enter buildings. In the establishment in which I lectured prior to entering this place—the building had been recently renovated—it was impossible for the disabled to be educated in any part of the building beyond the ground floor.
All those who are involved with disabled organisations know that in the first Session of this Parliament the Government have activated their ranks to ensure that antidiscrimination legislation is not passed. What is fit for Tory south Australia and Liberal Canada is not apparently to be applied in Britain, where it is still possible and legal for a person to be shown the door of a public house if he tries to enter in a wheelchair. It is still legal for the disabled to be refused entry to a cinema or theatre. It is still legal for people to object in a public house to the admittance of someone who is deaf. They can ask for that person to be debarred and refused the opportunity of buying a drink. That is the present position, despite the attempts to change it of hon. Members such as me.
The way in which the Government have acted towards the Bill that I introduced last November is disgraceful. The Minister of State, Department of Transport absented herself from her constituency because she was ordered to be in the Chamber by the Government Whips. If the Government allow hon. Members their head and have some sympathy with the idea of the House having a free vote on this issue, they should prove the point next Friday. On Friday 6 July, my Bill will come up for consideration for probably the last time during this Session. Can we expect, yet again, the Secretary of State for the Environment to be used as the Government's cipher to prevent disabled people from being assisted by my proposed legislation? My offer is still open to work with the Government to look at the Bill's details. I believe that most decent people expect the Bill to receive a Second Reading.
The Under-Secretary of State spoke the truth once today when he talked about the need to stabilise public expenditure. Conservative right hon. and hon. Members who have a heart and want to help disabled people are imprisoned by their antediluvian economic philosophy.
Britain is a rich country receiving an oil bonanza from the North sea. The sum of £10 billion is being allowed to go to cheap labour markets. The social cost to our country of mass unemployment, which has been largely created by this Administration, is £17 billion.
Provisions for the welfare of the disabled cannot be maintained, far less established, by a system of economic capitalism. No matter how many arguments there are about the need for resources, the fact is that this country has the necessary resources. Those needs can be met only by an Administration with not only a heart but an economic philosophy to fit the times in which we live.
§ Mr. Michael Howard (Folkestone and Hythe)I am grateful for the opportunity of making a brief contribution. I suppose that it was too much to hope that the debate would be entirely free of the partisan litany of charge and counter-charge which characterises so many of our 1322 . I do not propose to tread on that ground, save to take up the point made by the hon. Member for Liverpool, West Derby (Mr. Wareing) in his peroration about resources.
My hon. Friend the Member for Derbyshire, South (Mrs. Currie) referred to the statements made by the right hon. Member for Manchester, Wythenshawe (Mr. Morris) when he had responsibility for these matters. He lamented the lack of resources. I thought that I detected a delicate retrospective hint from the right hon. Gentleman when he referred to the "unfinished agenda", which was awaiting him towards the end of the last Labour Government. Any debate on this subject which occurs without a recognition that resources are limited is a futile contribution. I especially welcome the recognition of that fact by the hon. Member for Leeds, West (Mr. Meadowcroft).
The greatest contribution that the Government can make to this problem is to pursue policies enabling greater wealth and resources to be created in our society. Those resources can be devoted to, amongst other things, the care of the disabled both directly by the Government and by voluntary sources.
Many hon. Members have spoken about the desirability of caring for and working with the disabled in the community. I share the view that that is desirable.
It must not be thought, however, that that obviates all the difficulties or that anyone living in a normal house on a normal estate is necessarily living a normal life. There are many people for whom any kind of normal living in the community is a distant dream. Many need to be part of a caring environment in which special attention is given to their individual needs and disabilities. In every such case, the quality of the care depends on the individuals responsible for it and the contribution made by those people is not sufficiently recognised. I believe that it is part of our responsibility as Members of Parliament to be aware of that contribution and to pay tribute to it wherever and whenever we can.
I wish to pay tribute to two remarkable communities in my constituency. I use the word "communities" rather than "institutions" because it far more accurately describes the atmosphere created for those who, though unfortunate in their disabilities, are fortunate indeed to benefit from the kind of care that is provided there.
Parkfield special school occupies purpose-built premises in Folkestone opened in 1964. It has 58 day children and 19 residential children, all of whom have severe learning difficulties and a large proportion of whom have other associated problems. The objective that the staff set themselves is to ensure that each child is educated to the maximum of his or her potential. Great emphasis is placed on self-help skills and personal independence compatible with each child's development.
The dedication and devotion of the staff at that school must be seen to be believed and visiting the school is a humbling experience. The lion's share of the credit must go to the headmaster, Mr. Chris Soulsby, as I believe that the headmaster sets the tone for any school, although the successes could not have been achieved without the devoted work of other members of the staff, both teachers and welfare assistants.
Parkfield is a local education authority school. The other community to which I wish to pay tribute is in the voluntary sector. I refer to the home at Lympne Place run by the Home Farm Trust, a registered charity founded in 1962 which now has nine homes in England. The trust was 1323 set up by the parents of children attending special schools who were conscious of the difficulties that arise when children reach the age at which they have to leave such schools—a problem referred to earlier in the debate by my hon. Friend the Member for York (Mr. Gregory). Those parents wanted to provide a decent place for their children to live in, a satisfying job for them to do, the opportunity to relate to others with disabilities, and the security of tenure for life. That is what the homes provide. They are purchased, renovated and commissioned with voluntary money, and revenue expenses are for the most part met by local authority sponsorship and payments by the Department of Health and Social Security.
Lympne Place has a magnificent location, overlooking the English channel. Moreover, the propinquity of the Port Lympne wildlife park means that there are literally elephants at the bottom of the garden. The quality of life provided at the home is truly remarkable and residents are encouraged to make the maximum possible contribution to the running of the community and the many decisions involved, whether they work on the farm, in the workshops, or elsewhere. Great emphasis is placed on what is described as "good practice" on the part of the staff, but that is a prosaic phrase indeed to describe the selfless care devoted to the residents by the staff under the supervision and leadership of their warden, Mr. Joe Graham.
I have taken up the time of the House in describing what actually goes on in these communities in south-east Kent because there is a tendency for of this kind to become immersed in a welter of statistics and for us to become prisoners of the abstract and lose sight of the realities of everyday life for the disabled and the contribution of so many of the people who care for and work with them. That is why I wished to pay tribute to the people engaged in that kind of care and I am grateful to have had the opportunity to do so.
§ Mr. Jeremy Corbyn (Islington, North)There seems to be a rather high degree of self-satisfaction running around the House from some hon. Members when the reality is that the majority of disabled people in our community tend to be unemployed, poor, have poor job prospects and find it difficult to enter any public building, particularly this one.
We are plainly pleased that the Services Committee has announced that guide dogs for the blind can come in and that there will be better facilities for wheelchair access to the building, but it is a bit late. It is 1984. Many public buildings, other than Parliament, have had those facilities for many years. It is time that greater thought was given to that subject in this building.
Disabled people, as many surveys show, tend to be discriminated against in many other ways. A recent shopping survey produced by the Disabled Income Group showed that it is much more expensive for disabled people to go shopping because they have to pay for transport. The GLC recently carried out a survey of unemployed people and found that 58 per cent. of disabled people had been unemployed for over a year compared with 33 per cent. of Londoners without disabilities. That is yet another example of the way in which discrimination works against disabled people.
1324 The burden of what I want to say is about transport and travel for disabled people. Anyone who has to get around on crutches or in a wheelchair or who is completely unable to move can use a "Dial-a-Ride" service in some London boroughs, and some council areas throughout the country. Disabled people can telephone and a special vehicle comes to the house and takes them where they want to go. It is a patchy service. In some areas it works well; in some areas it relies on rather inadequate voluntary help and in some areas it does not exist at all.
My borough has an excellent "Dial-a-Ride" service run by a local organisation with the support of the local authority and the GLC. That is the type of partnership that there should be between public authorities and voluntary organisations, but when Opposition Members moved an amendment to the London Regional Transport Bill in Committee asking that the new London Regional Transport authority be given responsibility to ensure that the disabled can travel freely around London, it was defeated by Conservative Members. When we said that the issue of transport was a matter of right, not of privilege, and that the job of a regional transport authority was to ensure that that right was a reality for the people of London, that amendment was defeated by Conservative Members, and when a further amendment was moved on Report that was also defeated by Conservative Members.
When the Minister replies we need to know what he means by travel for the disabled, because those Labour-controlled local authorities and others that have sought to introduce a "Dial-a-Ride" service and proper facilities for the disabled to travel will be penalised through the Rates Bill. The authorities will be told that they are overspending, and those services may be put in jeopardy. We need a clear answer from the Minister on that point.
We also need to know what attitude the Department of Transport will take, as it has decided that it knows better than millions of people in London how the London transport system should be run. We need also to hear about the problem of access to stations and buses.
A local organisation in my constituency called the Islington Access Project recently produced an excellent document called "Transport and Disability". The organisation went through all the British Rail and London Transport stations in the borough and described all the difficulties faced by disabled people when doing something simple such as travelling on a tube. I shall give the example of Finsbury park station:
Entrance: from Seven Sisters Road is level subwayTo platform: North bound, subway, then 33 steps in all.That goes on in every station throughout London. It is almost impossible for people with wheelchairs and crutches to get on London Transport trains because of the access problems in those stations. If the Government think that they can run London Transport, disabled people in London need to know what action will be taken to make access to those stations easier.A recent survey has shown that, while those with severe disabilities need, use and rely on Dial-a-Ride services where they are available, the service is very patchy in the country as a whole. About 10 per cent. of the entire population, including elderly people, could well benefit from the use of some kind of Dial-a-Ride service, yet the Government have completely ignored that demand and need and are penalising my borough council and others for 1325 providing that very service. Indeed, they are trying to abolish the GLC, which has supported the Dial-a-Ride services throughout London to a very high degree.
There is a close causal link between spending on the National Health Service, spending on local government, and the way that people are treated. Disabled people obviously need and rely very much on NHS for community services such as district nursing, chiropody, physiotherapy, speech therapy, and bathing and incontinence services. They rely on a mixture of the local health services and the services of the appropriate local authority.
In my area we have an increasing elderly population, many of whom have no younger relatives able to look after them. They rely entirely on the NHS or on the local authority for their every need. They are stuck in a vice between the cuts in NHS service spending imposed on the North-East Thames regional health authority and the spending cuts imposed on the local authority. Under the grant-related expenditure formula, applied service by service across my borough council, we have been informed that we are 31.8 per cent. overspent on our social services budget. The only way that the kind of budget that the Government are imposing can be met is by severe cuts. That will lead to more isolation and more deprivation for elderly and disabled people in my constituency, and for others in inner city areas.
I am concerned at the rather strange statements made by Conservative Members, including the Minister—he may wish to refer to this later—about the care for the mentally ill and mentally disabled. In his honeyed words, the Minister says that care must be brought back into the community and that the community must take care of people. I agree that the community should take care of people, but the Government should be prepared to pay for it.
The older mental health institutions and hospitals are being closed and insufficient funding is being passed to the district health authorities to enable them to provide accommodation. It means that other patients tend to be pushed out of hospital. There is a continuous knock-on effect of cut followed by closure followed by loneliness followed by disappearance from the public mind of those with disabilities.
We are facing a very serious problem. Conservative Members may say that it is a cross-party issue. There are many people in this House who have made tremendous efforts to deal with demands for facilities for the disabled. We applaud them for their efforts, but we remember with much bitterness the way that my hon. Friend the Member for Liverpool, West Derby (Mr. Wareing) was treated when he introduced his Chronically Sick and Disabled Persons (Amendment) Bill. We remember the disgraceful way in which that Bill was voted down by the payroll vote of the Government. Then the Government had the audacity to come back and say that it is not really a statutory responsibility but something to do with volunteers and charities. If the Government are so keen on raising money for the health and social services as charities, let them have flag days to collect money for cruise missiles.
Those with physical, mental or any other disabilities deserve to be looked after by the rest of the community, but not in a way that is as cold as charity, and not in the patronising way that is often offered by Conservatives. There should be a proper system of statutory protection and Government funding to ensure that the services that they so desperately need are made available. We shall 1326 continually return to that subject. The ogre of cuts in our social services and in NHS spending that is haunting so many people throughout the country will mean that the people with disabilities in our community will be worse and worse treated in the future. They have no prospect of any better treatment while this Government remain in office.
§ Mr. John Carlisle (Luton, North)During the debate we have heard about the remedies for the disabled and the resources available. I shall speak briefly about one therapeutic remedy that is available to the disabled and to which we should be devoting more resources. It concerns sport for the disabled.
It is good to record that since the International Year of Disabled People in 1981 and the Sports Council's initiative of the Sport for All project, including the disabled, a lot more money has been spent on and a lot more time has been given to disabled people. However, my hon. Friend and my hon. Friend the Minister responsible for sport should perhaps give closer attention to where the money is being spent and how much is being allocated. There is no doubt that if we are in the business—as I hope we are—of remedy and prevention, the ability of disabled people to play sport is one of the simplest and cheapest ways. Those of us who have been to the various games at Stoke Mandeville—and I pay tribute to their organisers—cannot but marvel at the ability of the young and the old and the way that they play their sports, often against able-bodied competition.
There is no doubt that with the great strain on existing resources our disabled sportsmen are not coming off as well as they should. I am saddened, for example, today to see that in the eastern region report on sport and recreation, which reached my desk this morning, only some £4,500 has been allocated to one facility for disabled sport-that at Barrow farm for disabled riders—whereas the total grants and moneys lent by the Sports Council are some £500,000. At less than 0.1 per cent., that suggests that we have our priorities wrong.
I urge my hon. Friend, given more time, as I hope he will have in the future, to talk to the Minister with responsibility for sport and the chairman of the Sports Council and to plead for more money to be made available to those disabled people who wish to take part in sport. They face enormous costs. The cost of equipment for the disabled is bound to be higher than that for ordinary sportsmen. They also face enormous problems with access to buildings and to the facilities within those buildings. I have in mind, for example, changing facilities. Many sports centres provide access for the disabled, but once inside the sports centres the disabled find that the facilities are inadequate for their purposes.
My hon. Friend should give a lot more attention to this problem. Sport is now becoming a very popular pastime for the disabled. It is one from which they take enormous pleasure and one in which they can show those of us who are lucky enough to be fully able-bodied how good they are at these sports.
I look forward to the coming games at Stoke Mandeville. I hope that they 'will not be bedevilled by the politics of the anti-apartheid movement this coming July. I pay tribute to my hon. Friend the Minister with 1327 responsibility for sport that he and, I think, His Royal Highness Prince Charles will attend to give those games the credence that they deserve.
I implore my hon. Friend not necessarily to increase the resources available, because everyone realises the strains under which the Government, the local authorities and the Sports Council work, but to try to persuade local authorities and regional councils that more money should be directed towards the disabled so that we can support their facilities and improve their own prospects.
§ Mr. Alfred MorrisI need not detain the House for more than a few minutes. The onus is now on the Minister to reply to the many important questions that have still to be answered and he needs time to do so.
There have been some very thoughtful and distinguished speeches from right hon. and hon. Members on both sides of the House. What is extremely sad is that many hon. Members who wanted to take part in the debate have been unable to do so. I regret especially that my hon. Friend the Member for Newham, North-West (Mr. Banks) has been unable to participate. He has been here for most of the day, notwithstanding other commitments. I am sorry he has not been able to speak. I am sorry, too, that there is no time for me to comment in detail on the speeches that have been made.
The Minister gave the impression in his speech that I had searched high and low for every criticism that could be made of the Government's policies. That is not so. Unfortunately, because of the pressure of time, I was unable to use in my opening speech many penetrating criticisms of the Government that were put to me by voluntary organisations that are household names.
Let me give three examples briefly. I could well have spoken of the heavy and gratuitous additional handicap imposed on many disabled people by the huge increase in prescription charges under the present Government. A great many people have written to me in the strongest possible terms on that matter. The increase is from 20p per item when we were in office to £1.60 today, an increase of 700 per cent. Even the pre-payment certificates have been increased by 586 per cent. That is a direct and unacceptable tax on the chronically sick.
Again, I could have said much more about the need for a blindness allowance. The Government have said that the arguments for such an allowance are unanswerable. For our part, we accepted that view at the general election. We made a commitment to give substantial further financial help to blind people. I hope that the Minister will be able to say a word about the need now urgently to review the claims of blind people.
My third brief point is one that the hon. Member for Suffolk, South (Mr. Yeo) will endorse. I could have dwelt at considerable length on the onerous burden of value added tax on charities. The present Government have doubled that burden. Many organisations that exist to help the disabled have to cut the assistance they can give because they pay hundreds of thousands of pounds in VAT. I understand that the hon. Member for York (Mr. Gregory) gave the impression that the Opposition are not much interested in the voluntary sector. That is the reverse 1328 of the truth. We are committed to meeting all the needs of disabled people and appreciate that not all of them can be met by the statutory sector.
My hon. Friend the Member for Islington, North (Mr. Corbyn) referred to dial-a-ride schemes. Because of the cut in the number of telephones that are being installed, many severely disabled people cannot dial-a-ride simply because they have no telephones. I put it to the Minister that there should be more relational thinking in the Government's approach. It is no good commending diala-ride schemes to people who have no telephones with which to contact anybody outside their homes.
There are many important questions for the Minister to answer. He will recall that I asked him for a categorical assurance that the current review of cash benefits for the disabled will not be allowed to result in any reduction, in real terms, in the total expenditure now provided for disabled people and their families. I must also ask the hon. Gentleman again, how temporary is "temporary" as defined by the Government in relation to the 5 per cent. cut in invalidity benefit? My right hon. Friend the Member for Stoke-on-Trent, South (Mr. Ashley) underlined the importance of that question. We feel that the cut should be made good at the earliest possible date, not least because of what has happened to the weekly allowances for the children of invalidity pensioners and what is intended with regard to the proposed new earnings rule for their spouses.
The Minister has a difficult task in replying to all the questions that have been put to him. I shall not speak any longer, because I want him to have as much time as possible to reply. We expect full and definitive replies to the many important questions that have been put to him in the debate.
§ Mr. NewtonBy leave of the House, I shall reply to the debate and, for obvious reasons, I shall have to rattle through as many comments as I can. I should tell the right hon. Member for Stoke-on-Trent, South (Mr. Ashley) that the reason why I did not mention all these points at the beginning is that I thought that it would be easier to do so now.
The right hon. Member for Manchester, Wythenshawe (Mr. Morris) has re-emphasised a number of matters. Cash benefits for the disabled are not the subject of any of the current social security reviews, but the interests of disabled people will obviously be borne in mind by all of us who are conducting reviews, and not least by myself in my review of supplementary benefits.
I think that the right hon. Gentleman knows the Government's position on the restoration of the abatement of invalidity benefit. The benefit ought to be taxed, but is not. The abatement was in lieu of taxation and it will be restored when the benefit is taxed. That position is clear and remains unchanged.
I ask the right hon. Gentleman to recognise that on last year's figures half the people on invalidity benefit might pay more in tax than they would gain from the restoration of the abatement and the poorest of those receiving the benefit do not lose because of the abatement, as they receive supplementary benefit. If the restoration of the abatement took people off supplementary benefit, they would lose all additional help on heating, because that help 1329 is given only to those on supplementary benefit. There is a complicated interrelationship of benefits, but I hope that I have made the main point clear.
My reference to the sort of additional expenses that the attendance allowance might be used to meet was intended to be no more than a reflection of the fact that people may use the allowance to meet whatever expenses they wish. The attendance is not tied to any particular expenses, and anything that I say should not be taken as a view on how people should spend the allowance. It is up to them.
§ Mr. Tony BanksIs the Minister aware that it is estimated that about 10,000 Londoners who are eligible for the attendance allowance are not claiming it, possibly because they are not aware of it? What proposals does the hon. Gentleman have to advertise such allowances more extensively?
§ Mr. NewtonI am not sure whether the hon. Gentleman was here for my first speech, when I made it clear that we are taking a number of steps to improve take-up. As we do not know how many people would qualify for the attendance allowance, it is impossible to work out a maximum take-up figure. However, we know that the number of claims rose by about 20 per cent. in the last year for which figures are available and, therefore, there is a presumption that take-up is rising. In some parts of the country we have been sending social security officers to establishments such as adult training centres to bring benefits to the attention of those who might qualify for them.
In the time available, I shall not attempt to say much more about the severe disablement allowance, which has been much discussed. However, neither this Government nor the previous Government, as the right hon. Member for Wythenshawe knows, have felt able to afford the sum, now estimated to be about £300 million, that would be required to pay non-contributory invalidity pensions to everybody who might qualify.
The Labour Government chose their priorities by saying, "We shall let men and single women have the benefit, but we will cut out married women." I believe that that was unjustified. Our proposal is much more rational. We say that we will act even-handedly between single people and married couples and between men and women, but we will choose our priorities in the distribution of benefit according to the severity of people's disability. That is more rational and more sensible.
My hon. Friends the Members for Exeter (Mr. Hannam) and for Basildon (Mr. Amess) spoke about the development of the benefits system, either through partial incapacity benefit or through a comprehensive benefit. I say to them that almost everybody who has looked at that issue, including Peter Large, on behalf of the DIG, and the Social Security Advisory Committee, in one of its variants of a possible partial incapacity benefit, has concluded that a device closely related to the assessment of loss of faculty under the industrial injuries scheme would be required to make sense of such a development.
Not one person who has criticised the changes on the available scale margin has recognised that part of our proposals is to extend, for the first time, automatic heating additions to all retired people over 65—at present, they do not get those additions until they reach the age of 70—and to introduce a new higher rate of heating allowance for those who are perhaps most at risk—those over 85. Those are significant offsets to the proposal. 1330 When the available scale margin was introduced in 1966 by the Labour Government it consisted of the whole difference between the short-term rate and the then newly created long-term rate of supplementary benefit. If someone was on the long-term rate, the whole of his 45p, which was the difference between the two rates, was taken off his additional requirements. There has been very little change since then. The difference between the short and long-term rates for a married couple is now about £11 a week, and we are proposing only a modest change from 50p to £1 in the scale margin. I do not say that it is the most attractive proposal that I have had to defend but it is entirely reasonable, given the growth in the long-term rates and the fact that the long-term rate is intended to reflect the fact that those receiving it have need of additional requirements.
§ Mr. Alfred MorrisDoes the Minister accept that this new burden bears very heavily on some severely disabled people who need special diets and help with laundry, often because they are incontinent? Can it possibly be right to "save" tens of millions of pounds on a benefit that is designed to help such cases?
§ Mr. NewtonThe right hon. Gentleman is exaggerating if he relates that proposal to tens of millions of pounds. I should remind him that the chief Opposition Front Bench spokesman on social security, the hon. Member for Oldham, West (Mr. Meacher) described the difference between 50p and £1 as paltry when the proposal was announced. Incidentally, it was not smuggled out, but was stated quite clearly in the Secretary of State's uprating statement. I realise that he had misunderstood the proposal and that he was speaking in that context. However, he described the figure involved as paltry. It does not lie in the mouths of Opposition Members now to pretend that there is some massive attack on the rights of the sick, disabled and elderly.
The hon. Member for Hackney, North and Stoke Newington (Mr. Roberts) has obviously had to leave the Chamber, so I shall not repeat what I said about our attempt to improve the administration of mobility allowance. The right hon. Member for Wythenshawe spoke about "Care in the Community" and the problem of Great Barr. I have had some inquiries made, but in view of the time I would prefer to write to him about the position rather than to attempt to elaborate on it now.
My hon. Friend the Member for Suffolk, South (Mr. Yeo) and several other hon. Members mentioned prevention. As my hon. Friend knows, we have set up a review of maternity benefits conducted by officials to see whether we can make the most effective use of the resources that are there. I can give no great commitment in that respect, but we are at least conscious of my hon. Friend's concern, and of his wider anxiety about prevention, which is very much reflected, for example, in the campaign that my right hon. and learned Friend the Minister for Health announced not so long ago to help to reduce still further the incidence of rubella. As my hon. Friend knows, that disease is a significant cause of some of the most difficult handicaps. Some children are born both deaf and blind. Indeed, I met such children earlier this week when I visited the Royal School for the Deaf in Manchester.
With regard to section 64 grants, I congratulate the hon. Member for Leeds, West (Mr. Meadowcroft) and my hon. 1331 Friend the Member for Suffolk, South on their great good sense and sensitivity in their remarks about voluntary organisations. I have very much in mind the need to try to ensure greater stability of funding, although I think that there is slight unease between that and the demand that we should also provide built-in safeguards against inflation. But they said something that is very dear to my heart about doing what we can to encourage some of the smaller, newer self-help organisations, which can play a very important part alongside the statutory services in helping to meet some of the real needs of those with severe handicaps and their careers. I think, for example, of Contact a Family. Indeed, a few weeks ago I spent part of my weekend with that organisation, which is mainly concerned with the parents of very severely handicapped children.
It is doing an enormously good job. It is particularly encouraging to have my hon. Friend the Member for Suffolk, South with us, who is the representative of one of the larger and better-funded voluntary organisations. When he gets back to the Spastics Society, I hope that he will not be persecuted for saying that we should look particularly at the needs of some of the newer and smaller groups. But that is right.
I shall not have time to deal with all the issues raised in the debate. Much that has been said about the Manpower Services Commission is misleading. There is no intention to close jobcentres. Proposals are for an increase in the number of outlets. The staff vacancy display and service will remain at all existing locations. Moreover, the commission has recently approved a number of proposals designed to make the employment rehabilitation service) more effective. This will involve an increased proportion of disabled people using employment rehabilitation centres. The MSC encourages disabled people to make full use of the mainstream jobcentre services. I am told that the disablement resettlement service continues to cater for all disabled people, including the mentally ill.
§ It being half-past Two o'clock, the motion for the Adjournment of the House lapsed, without Question put.