HL Deb 20 May 1970 vol 310 cc1085-118

4.13 p.m.

THE EARL OF LONGFORD

My Lords, I beg to move that this Report be now received. I understand that the noble Lord, Lord Hughes, may wish to speak on this Motion.

Moved, That the Report be now received.—(The Earl of Longford.)

THE MINISTER OF STATE, SCOTTISH OFFICE (LORD HUGHES)

My Lords, as the noble Earl, Lord Longford, has indicated, this may be a convenient moment to make a Statement about the circular on the needs of the disabled with regard to access to public transport which the Government have undertaken to issue to operators and manufacturers of public transport equipment. We have met the noble Lord, Lord Crawshaw, and the noble Viscount, Lord Ingleby, and others representing the interests of the disabled and had a useful discussion on the future action we propose to adopt in the light of this commitment. We are at present engaged in seeking ideas and useful subject matter for this circular, but in the short time which has been available we are not yet in a position to state what it might contain. Nevertheless, we intend to keep in close contact with the noble Lord, Lord Crawshaw, and the noble Viscount, Lord Ingleby, and with representatives of the disabled on developments and we shall be glad to meet them in due course when we have achieved some working basis in order to further the progress we are making.

I should also like to say that the Government are fully alive to the needs of the disabled and are anxious themselves to take an initiative in promoting feasible and reasonable improvements to the public transport system. Clearly, if we are to keep in contact with representatives of the disabled we may well in due course be able to develop our activities in this sphere in a wider area than can be covered in this Bill.

THE EARL OF LONGFORD

My Lords, I am sure that the noble Lords who raised this question so effectively will be most grateful, as I am, to the noble Lord, Lord Hughes, for what he has said.

On Question, Report received.

BARONESS MASHAM OF ILTON moved Amendment No. 1: After Clause 3, insert the following new clause:

Transfer of patients with spinal injuries to specialist centres

".—(1) The Secretary of State shall issue directions to every Hospital Management Committee, Board of Governors of a teaching hospital and Board of Management providing hospital and specialist services under the National Health Service Act 1946 or the National Health Service (Scotland) Act 1947 requiring them to ensure that any patient in a hospital under their management who is suffering from recent disabling neck or back injuries involving the spinal cord or corda equina shall, so far as practicable and reasonable having particular regard to the proper treatment of the patient, be transferred within twenty-four hours or as soon as possible to a centre specialising in the treatment of such injuries.

(2) 'Disabling neck or back injuries' means such neck or back injuries as, in the opinion of a registered medical practitioner having care of the patient in the hospital, have caused or are likely to cause paralysis resulting in disability."

The noble Baroness said: My Lords, I put this Amendment forward at this eleventh hour of the Bill as it deals with a most urgent and scandalous situation now existing in this country. I am trying to press the Minister, whom I greatly admire, to do something more than just giving sympathy; to help safeguard good citizens of this country who, through acidents or illness, become paraplegics and who have become patients in certain National Health hospitals. The Government have taken the responsibility of running this country's Health Service. Throughout the world the correct treatment for paraplegia is known. Sir Ludwig Guttmann, the pioneer doctor in this country, was knighted for his services in the treatment of paraplegia, and Britain was the founder-nation of the paraplegic sports. Sport is not only a physical form of rehabilitation but also a psychological one. It helps people to regain lost confidence and thus it helps the paraplegics back into society.

My Lords, are we now to fall back to the conditions of pre-war days when paraplegics lay rotting as chronic cripples? At this very moment, and for the past 19 months, a man of 29, married with two young children, is existing, helpless, in Middlesbrough General Hospital. On Sunday I visited him and I found him to be a paraplegic, paralysed from the chest down, a similar lesion to my own. He is riddled with pressure sores. His left leg is so contracted that it cannot bend at the knee. His toes are like fixed claws. Four months ago, after having seen so many badly injured people come in and walk out from his ward, this man contemplated taking his own life. After 19 months of hospitalisation he has not started to be rehabilitated and his wife has not even met the doctor in charge. Bladder and renal infection, Which this man has, are the most common cause of depression in paraplegics.

My Lords, this is a very specialised field of medicine. I have attended world conferences in Germany and Dublin, and also lectures on this subject. I have visited many spinal units in various parts of the world and I know what basic equipment is necessary for nursing paraplegic patients. In the same ward is a man of 30, also with a wife and two young children. He is paralysed from the sixth and seventh cervical vertebrae. After one week in hospital he was sat upright. He turned blue and stopped breathing. He has been in Middlesbrough General Hospital for nine weeks.

These men have no feeling from their injury down. They do not call out when their skin is sore. Far more serious is the psychological pain. They lie from day to day and worry about sex problems and how to continue their lives. These were virile young men in the prime of their lives. There is no one in this general hospital who is able to give them expert advice and the training they need. Had they gone to a spinal unit they would immediately have been among others who were learning how to live as normal a life as possible under changed circumstances, and most likely they would have been home within about six months.

I listened with great interest and admiration to the noble Baroness during the debate on the Local Authority Social Services Bill. The noble Baroness stressed the need for prevention of social distress. If she will look into these cases she will find great social distress involving the whole family. When visiting these two patients I was informed that somewhere in the same hospital there were two more paraplegic cases. How many more throughout the country may there be? Before leaving, the wives begged me, with tears in their eyes, to help them get their husbands moved to a spinal unit anywhere in the country. They asked: are these places only for people with money? To me, this is the only way to eliminate this state of affairs that is cruelty of the worst kind. In Southern Ireland there is an excellent system whereby a trained medical team goes in an ambulance or helicopter and collects a spinal patient from the place of accident, transporting him directly to the correct unit near Dublin. Perhaps one day we shall be able to follow their good example.

My own grandfather was a doctor, and many of my close friends are members of this most excellent profession. In all large organisations there are some members who are not as enlightened as they should be. I think your Lordships all accept that there will always be suffering; but I do not accept that there should be unnecessary suffering due to wrong clinical judgment which is swept under the carpet by medical etiquette. The only people who suffer are the patients or their families, and these are the very people who, in many cases, do not know what has happened until it is too late. Hospitals do not like having to accept patients rotting from sores and in low morale. This is what happens when, after months or years, it dawns on the hospital that it cannot manage and the authorities try to transfer the paraplegic. By the time the patient arrives at the correct hospital he is a second-class patient. This is why I now beg to move this Amendment.

BARONESS DARCY (DE KNAYTH)

My Lords, I should like to support my noble friend's Amendment. She has stated her case so fully and so convincingly that I will confine myself to one point, which really arises from the debate on the Committee stage on this new clause in its original form. The noble Baroness the Minister of State, when she mentioned the problem created by the fact that the regional spread of spinal units is not ideal, referred to Sir Ronald Tunbridge's Committee which is "looking at the National Health Service Rehabilitation centres as a whole". It has been suggested to me that this may mean that it is intended to send paraplegics, arthritics and others, all with varied problems, to general rehabilitation centres. Comprehensive treatment is essential in the case of paraplegics. To be effective, it must be rehabilitation not only from the physical aspect, but from the psychological, social and domestic aspects as well.

The noble Baroness has shown that she has studied and understands very well the problems and complications of paraplegia, and I do not need to spell out to her that it is no good simply nursing a paraplegic in hospital for several months—be it adequate or inadequate nursing—and then packing him off elsewhere to start being rehabilitated. Full rehabilitation cannot be achieved where this dichotomy exists. In the United States of America, where in general paraplegics are nursed in hospital and subsequently sent to a general rehabilitation centre, this method is now acknowledged to have been a failure. Sir Ludwig Guttman has been over to the United States, at their request, three times in the past two years to talk about the care of paraplegics, and they are now planning to adopt his methods.

I hope that the noble Baroness can reassure me that she meant simply that the Committee was carrying out a general survey of all types of rehabilitation centres, and not that it was looking into the possibilities of sending paraplegics to general rehabilitation centres, since the regional spread of spinal units is not perfect. If, however, she can give me no such reassurance, perhaps the Minister will convey my misgivings to Sir Ronald. In this field of the treatment of paraplegia we do without question lead the world: it would be tragic if we now took this retrogressive step. I fully support my noble friend's Amendment.

LORD PLATT

My Lords, I should like very strongly to support this Amendment. I know that it may raise considerable difficulties for the Department of Health and Social Security, but I think these difficulties have to be faced.

LORD SEGAL

My Lords, I too have no hesitation whatever in saying a word or two in support of this Amendment. My one anxiety arises from the fact that in the existing centres specialising in the treatment of these injuries there exists to-day a quite considerable waiting list. I would put in a plea that the Government should try to extend the number and scope of the existing centres specialising in the treatment of these injuries, in order to cope with the dreadful leeway that exists at the moment. We have no doubt whatever about the sympathy with which the Government approach this terrible problem, but I should like to urge upon them a sense of the very desperate need that exists for wider facilities. I hope that, if they have any reservations about accepting this Amendment in its present form, at least the spirit of the Amendment will be brought home to them.

LORD CRAWSHAW

My Lords, I also should like to say two or three words in support of my noble friend's Amendment, because ordinary bone breakages are very much something apart from spinal injuries, and ordinary orthopædic hospitals are very different from spinal units. I myself, in the initial stages after an accident, was taken to a general hospital, albeit an extremely good one—the Radcliffe Infirmary at Oxford. I suffered from a pressure sore early on; and although it was not one of the worst, it was there. I am assured that in a place like Stoke Mandeville that would not have happened. So I very much support this Amendment. From my discussions with the men in the wards at Stoke Mandeville I can vouch for the worries and fears about which my noble friend was talking. At least some of these problems, even now, fox and concern the experts at Stoke Mandeville; and they must indeed worry, concern and confuse the medical authorities at general hospitals.

LORD WELLS-PESTELL

My Lords, I wish to support without qualification what the noble Baroness, Lady Masham, has said in moving this Amendment. I should like to emphasise that this particular clause is concerned with the transfer of patients with spinal injuries to specialist centres within 24 hours, or as soon as possible afterwards. I think that this is the important factor. I hope that we shall not get bogged down in respect of treatment that is given to people who are suffering from injuries of this kind if they are left in the hospital. What we are primarily concerned about is the transfer of such patients, within 24 hours or as soon after as possible, to centres specialising in the treatment of such injuries. This is of supreme importance. I hope that my noble friends will not press this Amendment, other than to try to get from the Minister (as I hope we may) an assurance that such a directive will be sent out when the Act is explained to local authorities and to the Regional Hospital Boards.

4.29 p.m.

THE MINISTER OF STATE, DEPARTMENT OF HEALTH AND SOCIAL SECURITY (BARONESS SEROTA)

My Lords, may I first say to the noble Baroness, Lady Masham, that I do not think it would be appropriate for me to discuss in your Lordships' House the individual cases to which she has referred. I have written to her. I should prefer to confine myself to the principle that lies behind the Amendment which she has moved.

This Amendment replaces an earlier proposed new clause which was discussed fully in Committee and then withdrawn—a clause which would have required the notification of certain disabling injuries to the Chief Medical Officer of my Department and of the Scottish Home and Health Department. Noble Lords who were here will recall that on that occasion I advised the Committee not to accept the clause because we did not think it was practicable in legislation to lay down the kind of clinical care to be given to particular patients. We felt that if notification was to serve any purpose it would clearly mean interference by the Department in matters of clinical judgment; a point which the noble Lord, Lord Platt, if I understood him correctly, is willing to accept. I am not quite so certain that it would be accepted by the medical profession as a whole: the noble Lord, Lord Platt, and, indeed, the noble Lord, Lord Segal, are rather exceptional noble Lords. From our knowledge of the profession we rather feel that this would not be warmly welcomed on all sides.

The Amendment we now have under consideration is open to the same objections as the earlier new clause that was put down in Committee. Under it the Secretary of State would be required to issue to hospital authorities directions requiring them to ensure that patients with disabling neck or back injuries as defined in Section 6(2) are transferred as soon as possible to centres specialising in the treatment of such injuries. The only way that hospital authorities could comply with such a statutory direction would be to instruct consultants responsible for the care of the patients. Such a direction would be an interference by the Secretary of State in the clinical care of patients. Ever since the National Health Service was introduced it has been a fundamental principle of the Service that a consultant is in sole clinical charge of his patient and has full clinical responsibility for him. The Secretary of State, and his agents—that is to say, the hospital authorities—do not intervene in matters of clinical judgment, or attempt to advise a doctor on how to treat his own patients.

I am sure that both the noble medical Peers (if I may so call them) would not as a general rule wish this principle to be breached, although they have indicated to the House that they are so prepared for this special class of patient. I must confess if we were to breach this principle I, and no doubt a number of other noble Lords, could think of other classes of patients for whom such intervention might well be invoked. It is true that the proposed new clause contains the qualification … so far as is practicable and reasonable, having regard to the proper treatment of the patient, … but this does not disguise the fact that the clause essentially is aimed at requiring the Secretary of State to issue a direction in clinical matters concerning the care and treatment of patients. This is the reason why on this occasion I must, as I did in Committee, advise the House strongly against accepting the Amendment. I must also advise the House that if, notwithstanding my advice, it were to accept the Amendment, as it could, the Government in another place would have, I think, to take the same point of view as I have done to-day.

I said in Committee—and I repeat it—that the Government are in complete sympathy with the objectives behind the clause. None of us would dissent from the purpose which the noble Baroness seeks to achieve through her Amendment. We want patients suffering from disabling neck and back injuries to have as early treatment as is possible in special centres. There are no divisions between us on this; it is purely a question of method. We do not believe that the method proposed in the Amendment is the right way to achieve the aim. I have already given the Committee—and now I give the full House—an undertaking that the views expressed in this place will be brought to the notice of the Tunbridge Committee, which is at present considering the rehabilitation requirements of patients with spinal injuries, as well as others needing rehabilitation in the National Health Service. I can also give the House the information that my Department proposes to ask hospital authorities to ensure that facilities available at the special centres are known, especially to doctors in accident and emergency departments, and that they are aware that the doctors at the special centres are available to give immediate advice as to treatment, as well as to arrange for early transfer.

I can assure the noble Lord, Lord Wells-Pestell, who asked me for an assurance on this aspect, that the Government will be acting in the spirit of this Amendment, although I cannot advise the House to accept it. I am equally sure that it is by these and other informal ways of encouraging liaison that we can secure the objectives upon which we all agree, rather than by passing legislation and by issuing directives to members of the medical profession. I can also assure the noble Baroness that both this debate, and the one that we held in Committee, will have been of great value in drawing the attention of all concerned to the special problems of this class of patient, and to the great importance of making quite sure that there is adequate provision for their care.

I would also say, in reply to the noble Baroness, Lady Darcy, that it is true that the Tunbridge Committee which is considering the whole range of the rehabilitation services that lie within the National Health Service will of course (also within its terms of reference) be considering the particular problem of the rehabilitation of patients with spinal injuries, and in so doing I am quite convinced the Committee will take into account Sir Ludwig Guttmann's work at the spinal injuries centre at Stoke Mandeville, which Sir Ronald Tunbridge and some of his colleagues on the Committee visited in June last year. I hope that this will set her mind at rest about what was said earlier.

I am sorry that I do not feel able to accept the Amendment of the noble Baroness. I hope that the House, having heard the problems that would flow from it, will agree with me that we should not accept it, on the understanding that my Department will engage in the discussions that I have just outlined.

LORD SANDFORD

My Lords, the House will have listened with close attention to the noble Baroness, Lady Masham, when she moved this Amendment. They will also have sympathised with her, as I do, in wishing to deal with the particular problem that she set out. Nevertheless, I hope that she will not press this Amendment because I should have to advise my friends behind me that we support the noble Baroness, the Minister of State at the Department of Health and Social Security, when she says that this particular Amendment is not the best way to deal with the problem.

4.39 p.m.

THE EARL OF LONGFORD

My Lords, we are all aware that in all matters of this kind no one is more sympathetic than the noble Baroness. I cannot speak as an expert; I am not an expert, like one or two noble Lords who have spoken from the Cross-Benches, and one or two leading doctors. I find it hard to know quite what the answer of the noble Baroness will amount to in practice. She said that the Government will act in the spirit of the Amendment, and I am sure that that is her own intention. If that proves to be so, it renders the Amendment unnecessary. On the other hand, she has indicated that the principle of non-interference must not be breached. How you can act in the spirit of the Amendment without breaching that principle, as she has defined it, I am not at all clear. Therefore, speaking for myself, I am not in any way convinced by her arguments, or by the supporting arguments of the noble Lord, Lord Sandford. If I suggest to my noble friends that they do not press this Amendment to a Division it is for one reason only—a reason of time and situation: it has nothing to do with the merits of the case.

I feel that there would be a danger to the Bill if this Amendment were pressed, and for that reason only I think it should not be pressed this afternoon. I regard the absence of this Amendment as a great blot on this Bill, and I am sure that many of us will never rest until we have put it right. Nevertheless, in all the circumstances—simply the conditions of time and the situation—it would be a mistake to press the Amendment.

LORD WELLS-PESTELL

My Lords, I do not want to rise in the defence of my noble friend the Minister—she can well look after herself. But I feel that she has made (if I may be permitted to use the expression) a concession in so far as she has said that the Department will call the attention of the medical services to the existence of these special clinics with a view to getting them used, as I understood her, more effectively in the future than perhaps they have been used in the past. If I have any quarrel with my noble friend the Minister it is with the implied suggestion that the medical profession must not be given any directions. I hope that this is not going to be a doctrine that we must accept in the future. I see no reason why they should be excluded. But on the basis that I think half a loaf is better than no bread at all, I would urge my noble friend and the noble Baroness, Lady Masham, to leave matters as they are, bearing in mind that the Minister has said that, although a directive will not be issued, certainly the medical profession and the medical services will have their attention called to the existence of these clinics and be advised to use them at the earliest possible moment in the treatment of patients with spinal injuries.

LORD PLATT

My Lords, may I, with permission of the House, speak again as the noble Baroness brought me into some of her remarks? She spoke of interference with the proper duties of members of the medical profession to individual patients, and referred to a principle which, at any rate in general, should be observed. But we find ways of skating round it in places. I was for a good many years a member of the Central Health Services Council, and I know that we issued some quite important statements on the causation of disease and also on the prevention of disease. The Department, or the Ministry as it then was, has from time to time issued statements on the dangers of certain treatments and indeed on the dangers of certain contraceptives and matters of this kind.

I should have thought that this Amendment as worded was a matter of prevention; of not telling a doctor how to treat an individual patient but telling him how to avoid certain serious complications. I should have thought that the words, "having particular regard to the proper treatment of the patient" went a long way towards letting the Department out of this dilemma about not directing the doctors.

LORD SEGAL

My Lords, may I also be allowed to add a word or two in support of the noble Lord, Lord Platt? The question is not entirely a matter of issuing directives to the medical profession or interfering with their treatment. But there are instances where it is known that the medical profession is apt to be somewhat conservative—and I take care not to use that word in the political sense.

What can be done by the Ministry is to take positive action in the sense of educating, or assisting to educate, certain doctors who may be confronted with these very difficult cases. I remember one particular instance where parents pleaded with the doctor in charge of a gravely injured case to have the patient transferred to one of the special treatment centres under the care of a well-known doctor, who ought to be nameless; and they were greeted with the remark on the part of the doctor in charge of the case, "What, under that quack!" It was simply an instance where new methods of proved value may not quite have seeped through to certain members of the medical profession. In this connection, positive information intended to assist in the education of certain doctors on some of the generally accepted more modern methods might with advantage be used by the profession.

BARONESS SEROTA

My Lords, may I, with the leave of the House, say very briefly that both noble Lords who have just spoken have exactly made the point that I was trying to make. My right honourable friend, on the advice of a number of professional bodies, issues guidance and, on occasion, directions. There is a constant stream of such advice flowing from the Department on a whole range of issues—some people might think too much advice. My only point was that one does not need to do this through legislation.

BARONESS MASHAM OF ILTON

My Lords, I should like to express my thanks for all the support which has been given to this Amendment. It is a very important subject and I hope that the noble Baroness the Minister will at some time see some of the conditions of patients who have not had the correct treatment. I thank her for her assurance that she will look towards helping to educate the doctors concerned. I think, with the noble Lords, Lord Platt and Lord Segal, that she should not be frightened of letting the doctors know what they should do. It is very strange that if one employs people and they do wrong one cannot show them the correct way of doing what they should be doing.

I can assure the House that, so far as the cases which have been mentioned are concerned, I will not allow them to remain in the condition they are in now. Yesterday I spoke to Sir Ronald Tunbridge on the telephone, and I hope that by various means we shall ensure that they receive the correct treatment, which they really need. Because of the position of the Bill in regard to the time factor, I very grudgingly now beg leave to withdraw this Amendment.

Amendment, by leave, withdawn.

Clause 4 [Access to, and facilities at, premises open to the public]:

4.47 p.m.

VISCOUNT INGLEBY

My Lords, this is a drafting Amendment. Thanks to the noble Lord, Lord Kennet, places of adult education are now dealt with separately under a new clause and therefore it is not necessary to have them included in this clause. I beg to move the Amendment.

Amendment moved—

Page 3, line 33, at end insert— ("( ) This section shall not apply to any building or premises intended for purposes mentioned in subsection (2) of section (Access to, and facilities at, university and school buildings) of this Act.")—(Viscount Ingleby.)

THE PARLIAMENTARY SECRETARY, MINISTRY OF HOUSING AND LOCAL GOVERNMENT (LORD KENNET)

My Lords, this clause meets in part an Amendment to Clause 4 withdrawn during the Committee stage on an undertaking by the Government to discuss an alternative Amendment. This new clause applies the same type of requirements as those in Clause 4 to new university and school buildings and extends them to use by students and staff. The test of public admission is not applied. As the classes of disabled persons who benefit under the new clause are different from, and wider than, those under Clause 4, Clause 4 is amended to exclude these buildings. That is the effect of what is now before the House. The Government are fully in support of the Amendment.

On Question, Amendment agreed to.

VISCOUNT INGLEBY

My Lords, I beg to move Amendment No. 3, which provides that where special facilities are provided for disabled people under Clauses 4 to 6 of the Bill they shall be adequately sign-posted. I beg to move.

Amendment moved— After Clause 6, insert the following new clause:

Signs at buildings complying with ss. 4–6

".—(1) Where any provision required by or under section 4, 5 or 6 of this Act is made at a building in compliance with that section, a notice or sign indicating that provision is made for the disabled shall be displayed outside the building or so as to be visible from outside it.

(2) This section applies to a sanitary convenience provided elsewhere than in a building, and not itself being a building, as it applies to a building."—(Viscount Ingleby.)

LORD KENNET

My Lords, I do not think I need say more on behalf of the Government about the Amendment moved by the noble Viscount, except to say that this, too, is the fruit of discussion between the Government and the Promoters of the Bill. The Government are in favour of it and indeed have rendered a certain amount of help with the drafting.

On Question, Amendment agreed to.

VISCOUNT INGLEBY moved Amendment No. 4: After Clause 6, insert the following new clause:

Improvement of access to local authority's buildings open to the public.

".—(1) Where the public are admitted, whether on payment or otherwise, to a building owned and occupied by a local authority (not being a building used for purposes mentioned in subsection (2) of section (Access to, and facilities at, university and school buildings) of this Act), and the means of access within the building, or within the parts of it to which the public are admitted, are reasonably adequate for the needs of members of the public visiting the building who are disabled, the authority shall, if need be, adapt the means of access to the building so as to make provision, in so far as it is in the circumstances both practicable and reasonable, for the needs of any such members of the public.

(2) In this section 'local authority' means a local authority within the meaning of the local Government Act 1933 or the Local Government (Scotland) Act 1947 and any joint board or joint committee of which all the constituent authorities are local authorities within the meaning of either of those Acts."

The noble Viscount said: My Lords, this Amendment provides that where access in local authority buildings, once the disabled person is inside, is reasonably good, consideration shall, if necessary, be given to adapting the means of access from the outside. I would express my sincere thanks to the noble Lord, Lord Kennet, for his help in connection with this clause. I feel it is a considerable step forward that we have here a clause dealing with access to existing buildings, and I am grateful to him for his help in this matter. I beg to move.

LORD KENNET

My Lords, this replaces a wider Amendment which was moved during the Committee stage. The earlier one required handrails and ramps to be fitted, if practicable, to existing buildings to which members of the public are admitted. The Amendment was withdrawn after the Government had suggested that an Amendment limited to public buildings where the provision of facilities would be of value might be acceptable. This new clause applies only to existing buildings owned and occupied by a local authority where, as the noble Viscount, Lord Ingleby, has explained. the internal design is such that disabled members of the public would be able to use the building once they got into it. In such circumstances the authority would be required to adapt the external aspect of the building to meet the needs of the disabled so far as it was practicable and reasonable.

My advice to the promoters in regard to this Amendment is to withdraw it, and I will now tell the House why. This seems to me to be a matter which could be dealt with equally well either by legisation or by circular—by advice from the Government to local authorities. I would raise no objection to its being dealt with by legislation, and if the mover of the Amendment chooses not to withdraw it I would not advise the House to reject it. I should, however, like to put the point that if this provision stands in Statute Law it may generate a feeling in the local authorities and in general that that is all they are required to do. It might be preferable that it should not stand in Statute Law because the Ministry will certainly send out circulars which will request the local authorities to do a great deal more than this Amendment would require them to do. It is a question of judgment. I have no strong views, but on the whole it may be that we should actually get more buildings in the condition we all want if this were not put into Statute Law and if wider advice were sent out in circulars when the Bill comes into effect. Therefore I mildly advise that the Amendment should be withdrawn.

VISCOUNT INGLEBY

My Lords, I should like to accept the advice of the noble Lord, Lord Kennet. I should like to see these provisions go a little further than they would do under this Amendment. Therefore I will withdraw the Amendment and continue, I hope, in a spirit of co-operation in the future. I beg leave to withdraw the Amendment.

Amendment, by leave, withdrawn.

VISCOUNT INGLEBY moved Amendment No. 5: After Clause 6, insert the following new clause—

(University and school buildings) Access to, and facilities at, university and school buildings

(".—(1) Any person undertaking the provision of a building intended for purposes mentioned in subsection (2) below shall, in the means of access both to and within the building, and in the parking facilities and sanitary convcriences to be available (if any), make provision, in so far as it is in the circumstances both practicable and reasonable, for the needs of persons using the building who are disabled.

(2) The purposes referred to in subsection (1) above are the purposes of any of the following:—

  1. (a) universities, university colleges and colleges, schools and halls of universities;
  2. (b) schools within the meaning of the Education Act 1944, teacher training colleges maintained by local education authorities in England or Wales and other institutions providing further education pursuant to a scheme under section 42 of that Act;
  3. (c) educational establishments within the meaning of the Education (Scotland) Act 1962.").

The noble Viscount said: My Lords, this Amendment extends the principles of Clause 4—that is, access to new buildings—to future places of education: schools, colleges and universities. Here again I should like to record my thanks to the noble Lord, Lord Kennet, for his co-operation. I beg to move.

LORD KENNET

My Lords, I have nothing to add to what I said about this Amendment when we were discussing the paving drafting Amendment, which was Amendment No. 2. The Government fully accept it.

On Question, Amendment agreed to.

LORD HUGHES moved Amendment No. 6: After Clause 18, insert the following new clause:

Badges for display on motor vehicles used by disabled persons

(".—(1) There shall be a badge of a prescribed form to be issued by local authorities for motor vehicles driven by, or used for the carriage of, disabled persons; and—

  1. (a) subject to the provisions of this section the badge so issued for any vehicle or vehicles may be displayed on it or on any of them either inside or outside the area of the issuing authority; and
  2. (b) any power under section 84C of the Road Traffic Regulation Act 1967 (which was inserted by the Transport Act 1968) to make regulations requiring that orders under the Act shall include exemptions shall be taken to extend to requiring that an exemption given with reference to badges issued by one authority shall be given also with reference to badges issued by other authorities.

(2) A badge may be issued to a disabled person of any prescribed description resident in the area of the issuing authority for one or more vehicles which he drives and, if so issued, may be displayed on it or any of them at times when he is the driver.

(3) In such cases as may be prescribed, a badge may be issued to a disabled person of any prescribed description so resident for one or more vehicles used by him as a passenger and, if so issued, may be displayed on it or any of them at times when the vehicle is being used to carry him.

A badge may be issued to the same person both under this subsection and under subsection (2) above.

(4) A badge may be issued to an institution concerned with the care of the disabled for any motor vehicle or, as the case may be, for each motor vehicle kept in the area of the issuing authority and used by or on behalf of the institution to carry disabled persons of any prescribed description; and any badge so issued may be displayed on the vehicle for which it is issued at times when the vehicle is being so used.

(5) A local authority shall maintain a register showing the holders of badges issued by the authority under this section, and the vehicle or vehicles for which each of the badges is held; and in the case of badges issued to disabled persons the register shall show whether they were, for any motor vehicle, issued under subsection (2) or under subsection (3) or both.

(6) A badge issued under this section shall remain the property of the issuing authority, shall be issued for such period as may be prescribed, and shall be returned to the issuing authority in such circumstances as may be prescribed.

(7) Anything which is under this section to be prescribed shall be prescribed by regulations made by the Minister of Transport and Secretary of State by statutory instrument, which shall be subject to annulment in pursuance of a resolution of either House of Parliament; and regulations so made may make provision—

  1. (a) as to the cases in which authorities may refuse to issue badges, and as to the fee (if any) which an authority may charge for the issue or re-issue of a badge; and
  2. (b) as to the continuing validity or effect of badges issued before the coming into force of this section in pursuance of any scheme having effect under section 29 of the National Assistance Act 1948 or any similar scheme having effect in Scotland; and
  3. (c) as to any transitional matters, and in particular the application to badges issued under this section of orders made before it comes into force and operating with reference to any such badges as are referred to in paragraph (b) above (being orders made, or having effect as if made, under the Road Traffic Regulation Act 1967).

(8) The local authorities for purposes of this section shall be the common council of the City of London, the council of a county or county borough in England or Wales or of a London borough and the council of a county or large burgh in Scotland; and in this section 'motor vehicle' has the same meaning as in the Road Traffic Regulation Act 1967.

(9) This section shall come into operation on such date as the Minister of Transport and Secretary of State may by order made by statutory instrument appoint."

The noble Lord said: My Lords, this clause fulfils the undertaking I gave in Committee on April 30, when the noble Baroness, Lady Masham, and the noble Lord, Lord Napier and Ettrick, withdrew their clauses on the same theme. Basically, the clause embodies a scheme for identifying disabled drivers and disabled passengers and their vehicles by a special badge. The badge will be issued by local authorities in Great Britain on application and on proof of disablement of a character which the Minister of Transport and the Secretary of State will define in regulations. It also provides that badges may be issued to institutions concerned with the care of the disabled for use on their vehicles when they are being used to convey disabled people about. These matters are provided for in subsections (1) to (4). As in the present Yellow Badge scheme, the badge will convey no privilege in itself. The intention is that regulations will be made under the Road Traffic Regulation Act 1967 which will provide for types of exemption from parking and waiting restrictions to be adopted by local authorities in their traffic regulation orders in respect of vehicles displaying the badge at the time. And it is made clear in subsection (1)(b) of the clause that these regulations can be used to secure for the purpose of the exemptions the recognition by one authority of badges issued by another. Subsection (5) requires local authorities to maintain a register of disabled persons and vehicles for whom badges are issued, and subsection (7) provides for various formal matters to be covered by regulations to be made under the clause.

If your Lordships approve the clause the intention will be to begin consultations with the organisations for the disabled, the local authority associations and the police over the content of the regulations to be made under the clause and those to be made under the Road Traffic Regulation Act. The consultations will be conducted by the Ministry of Transport, who are taking over from the Department of Social Security the main responsibility for work in relation to disabled drivers and passengers. I commend the clause to your Lordships. It provides in law for matters hitherto dealt with mainly by administration and extends their scope notably in providing for statutory recognition of the needs of disabled passengers. I beg to move.

LORD NAPIER OF ETTRICK

My Lords, I am most grateful to the noble Lord, Lord Hughes, for what he has just said. This is entirely satisfactory.

LORD SEGAL

My Lords, may I be allowed to direct my noble friend's attention particularly to the form that this badge might take? I would suggest that it should not be, as in the case of badges issued by some local authorities, merely a piece of paper displayed on the windscreen of a car, and that consideration might be given to adopting a form of badge which could be either luminous or illuminated and displayed also on the rear of a car. I suggest this because cases have occurred where a disabled patient, returning on his own from a long journey far from his home, has been overcome by fatigue, or, for other reasons, has been delayed in his arrival home, so that after nightfall, the slow pace at which he was travelling and his own condition of exhaustion might render him a possible accident hazard. It would be to the advantage of everyone concerned if the form of badge could be such that it could be illuminated or luminous at night.

LORD RAGLAN

My Lords, this clause dealing with badges gives advantages to disabled people, but it has crossed my mind that these badges may be in demand from spurious clients, rather like the C.D. plates which I am told are used by people who are nothing to do with the Diplomatic Service. So obviously the local authorities will have to keep their issue under very tight control. I should like to ask my noble friend Lord Hughes who in the local authority is to decide who comes in the category of being eligible for one of these badges.

BARONESS MASHAM OF ILTON

My Lords, having put Amendments down at Committee stage on this subject, I am pleased to support this new Amendment. A great deal of work has been done by the Ministry of Transport in a short time, and over this problem of parking they have been most helpful. This will be the first time the disabled passenger, who generally has even more problems than the disabled driver, has been recognised. It should give them encouragment for the future. At least it is a start. From one Scot to another, I should like to thank the noble Lord, Lord Hughes.

THE EARL OF LONGFORD

My Lords I think the least that one of the promoters of the Bill like myself can say is "Thank you" heartily to the noble Lord, Lord Hughes.

LORD HUGHES

My Lords, I am very grateful for the welcome which has been given to this Amendment. It remains for me to refer to only two points; first of all, the point put by my noble friend Lord Segal about badges. I will certainly make certain that that expression of view is drawn to the attention of my right honourable friend, the Minister. The answer to the query raised by my noble friend Lord Raglan is that the categories of disabled people eligible for the badge will be set out in the regulations, and the local authority issuing the badge will do so in consultation with the welfare officer and with the medical officer of health.

On Question, Amendment agreed to.

BARONESS SEROTA

My Lords, in moving Amendment No. 7, I should explain, and apologise for the fact, that the Amendment printed on the Marshalled List refers incorrectly to Section 19 when it should refer to Section 20, and I wish to move the Amendment in this corrected form. It is purely a drafting Amendment denoting the particular clauses which extend to Northern Ireland. I beg to move.

Amendment moved— Page 11, line 26, after ("provided") insert ("by sections 7, 12 and 20").—(Baroness Serota.)

On Question, Amendment agreed to.

BARONESS SEROTA

My Lords, I beg to move Amendment No. 8 without the reference to the improvement of access to local authorities' buildings open to the public. The purpose of this Amendment is to draw attention to clauses for which an appointed day provision will operate and to make provision for the coming into force of the remainder of the Bill. I beg to move.

Amendment moved—

Page 11, line 27, at end insert— ("( ) This Act shall come into force as follows:—

  1. (a) sections 1 and (badges for display on motor vehicles used by disabled persons) shall come into force on the day appointed thereunder;
  2. (b) sections 4, 5, 6 ('signs at buildings complying with sections 4–6'), and ('access to, and facilities at, university and school buildings') shall come into force at the expiration of six months beginning with the date this Act is passed;
  3. (c) the remainder shall come into force at the expiration of three months beginning with that date.")—(Baroness Serota.)

On Question, Amendment agreed to.

Then, Standing Order No. 41 having been suspended (pursuant to Resolution of May 18):

5.14 p.m.

THE EARL OF LONGFORD

My Lords, I beg to move that this Bill be now read a third time. I hope it will be convenient if I move this Motion formally and reserve my few remarks, which will be very few, for the end.

Moved, That the Bill be now read 3a.—(The Earl of Longford.)

THE DEPUTY SPEAKER (LORD AILWYN)

The Question is, That this Bill be now read a third time. As many as are of that opinion will say, "Content"; the contrary, "Not Content". The Contents have it.

On Question, Bill read 3a, with the Amendments.

THE EARL OF LONGFORD

My Lords, I am sorry: we have not achieved quite the purpose I was seeking. I beg to move that the Bill do now pass, and I hope that I can move this formally, giving noble Lords an opportunity, of which I know many wish to take advantage, to say a few words.

Moved, That the Bill do now pass.—(The Earl of Longford.)

THE DEPUTY SPEAKER

The Question is, That this Bill do now pass. As many as are of that opinion will say "Content"; the contrary, "Not Content". The Contents have it.

THE EARL OF LONGFORD

My Lords, I hope that the House does realise that I was trying to provide an opportunity for noble Lords to say a few words at the last stage. The procedure is peculiar, but I cannot believe that it can have shut out speakers.

LORD ILFORD

My Lords, would it not have been in order for noble Lords to do that on Third Reading?

THE EARL OF LONGFORD

My Lords, it would have been, but it was put to the House and carried without an opportunity being given. Let us just pause for a moment. I said it would perhaps be convenient if I moved the Third Reading formally and then reserved my remarks to the end, leaving it to noble Lords to say a few words—and I know that a number of noble Lords wished, and still wish, to say a few words. At that moment I assumed noble Lords would offer their thoughts.

THE DEPUTY SPEAKER

My Lords, I have no power, as your Lordships know, on the Woolsack to do other than my duty, to put the Question, That the Bill do now pass. I waited for noble Lords to speak and nobody spoke. Therefore the Bill has now passed.

THE EARL OF LONGFORD

My Lords, on a point of order, I have never known this in 25 years in the House. It was a perfectly simple situation. I cannot believe that the House would wish to shut out a number of speakers. I moved the Motion formally and gave an opportunity to noble Lords to speak; and I think that some of our friends speaking from a sitting position were waiting for a spokesman on the Opposition Bench to say a few words. In that slight hiatus the noble Lord on the Woolsack deemed the Motion to be carried. But I would put it to your Lordships that the House would be making a laughing stock of itself if it said there could be no discussion. I must ask the acting Leader, the noble Baroness, to give us some guidance. I cannot believe that the House wishes to shut out comment.

BARONESS SEROTA

My Lords, the noble Earl has far more experience than I have in regard to the procedure of the House. I can only say that, if the noble Lord the Deputy Speaker says that the Bill has passed then it has. I, too, wished to speak on Third Reading, but I was waiting for noble Lords who have taken an active part in the debate on the Bill to speak first; and that is why I did not leap up and speak. Once the Bill has passed I am in some difficulty about advising the House to reopen the discussion.

LORD HUGHES

My Lords, may I make a suggestion? Obviously, we cannot speak on this Bill after it has passed, but the House is very tolerant of departures from the strict letter of the Standing Orders, and it seems to me that all that is desired is that there should be some expression of views about the Bill. I do not think it would outrage our procedure as much as speaking after the Bill has passed if noble Lords and noble Baronesses speaking on the next Bill referred to things which they wanted to say on this Bill.

VISCOUNT GOSCHEN

My Lords, would it not be possible, as there are noble Lords and Ladies with disability, and probably not quite so acquainted with the rules of the House, on this occasion to ask the noble Lord on the Woolsack to put the Question, That the Bill do now pass, again, and then any noble Lord or Lady who wished to would be able to say a few words?

LORD SORENSEN

My Lords, I did not hear whether the Question was actually put. It is a serious point.

THE EARL OF LONGFORD

My Lords, I hope that the House will follow the last suggestion and will allow a few comments on the Motion, That the Bill do now pass.

BARONESS MASHAM OF ILTON

My Lords, perhaps you can put the blame on us four who could not leap to our feet. I should like to take advantage of the opportunity offered by my fellow Scot to say a few words. Since the Chronically Sick and Disabled Persons Bill has been in this House it has given me great pleasure to be so closely associated with the noble Earl, Lord Longford, the sponsor of the Bill. The noble Earl has great human under standing of the difficulties of many people in society; and I do not think this Bill could have been in better hands. Many people throughout this country have been watching this Bill, as it refers to their problems or the problems associated with them in some way. I have heard it said that some of the Amendments discussed in this House have been the most important points made. I personally think that the clause dealing with people who are in institutions——

LORD SHACKLETON

My Lords, may I interrupt the noble Baroness? I am very sorry, but we are now entirely out of Order. It is unfortunate that these things sometimes happen, but it would be quite wrong for any Member of your Lordships' House to make a further speech after the Bill had passed all its stages and there is no Motion before the House which would enable them to do so. I do not wish to deprive those who have laboured so hard on this Bill, but I do not think I could recommend the House to permit further speeches. It is a matter for the House, but I think it would be the view of the House that this would be wrong.

THE EARL OF LONGFORD

My Lords, the noble Lord was not present when this discussion commenced. The truth is that nobody intended this result. It was arrived at, if I may say so with the greatest respect to the noble Lord on the Woolsack, because he put the Motion and announced the Bill as being passed, when no one quite realised what was happening.

SEVERAL NOBLE LORDS

No.

THE EARL OF LONGFORD

Well, that was so. There really is no doubt about it. I had previously explained to the noble Baroness that I proposed formally to move the Motion. A number of noble Lords wanted to speak, and I thought it better that they should speak first and that I should say a few words in conclusion. To be frank, this situation has arisen because the noble Lord on the Woolsack announced that the Bill had passed.

LORD SHACKLETON

My Lords, I agree that I was not present, but I fear that I cannot always be present when the House slips a bit. I have been advised (and there seems to be a degree of consensus among those who were here) that both the Motion, That the Bill be read a third time, and the Motion, That the Bill do now pass, were properly put.

SEVERAL NOBLE LORDS

Hear, hear!

LORD SHACKLETON

Whatever the noble Lord may have intended, it is his responsibility to rise at the proper moment. I have no power to forbid the noble Earl to speak, and I hope that we shall end this exercise in an amicable fashion. But I sense from both sides of the House that there is a feeling that, perhaps through inadvertence or failure to hear, the Question was properly put. I would ask the noble Earl, Lord St. Aldwyn, or the noble Lord, Lord Aberdare, who were here, to shed some light on this matter. I understand that the noble Viscount, Lord Goschen—

VISCOUNT GOSCHEN

My Lords, may I reply to the noble Lord the Leader of the House? I was here, and in both cases the Question was properly put; there is no doubt about that. The only query in my mind is whether, as there are some noble Lords and Ladies here who are not able quickly enough to catch the eye of the noble Lord on the Woolsack, we might ask him to put the Question again. I have indicated this approach already.

LORD SEGAL

My Lords, while we all accept the ruling of my noble friend the Leader of the House, may I make a submission? The majority of your Lordships are able to indicate their desire to speak by rising to their feet, but in certain instances this is not possible. Some other means ought to be accepted—perhaps by the raising of a hand, or in some other way—to indicate that a Member who is unable to rise to his or her feet wishes to speak. This is perhaps a deficiency in the accepted Rules of the House which might be taken account of, and some slight variation made in exceptional circumstances.

EARL ST. ALDWYN

My Lords, I fully accept everything that the noble Lord the Leader of the House has said. I personally was not here, but I have been advised that the Questions were properly put. However, I think that there has been a genuine misunderstanding and I am wondering whether we might ask the noble Lord on the Woolsack to be good enough to put the Question again, so that those noble Lords and Ladies who wish to make speeches should be able to do so.

LORD SHACKLETON

My Lords, I think that that is a helpful suggestion. I am bound to say to my noble friend Lord Longford that it was really for him, had he wished, to continue the debate at the correct point, and it is no good his saying that he was reserving his position. It is important to appreciate that noble friends who have fought so valiantly, and whose performances we so greatly admire, find it more difficult to catch the eye of the noble Lord for the time being on the Woolsack. But of course it is not merely a question of rising to one's feet, but rather one of speaking up. I suffered through a failure to get to my feet at the right moment on what was to be my maiden speech in another place, on the Motion, "That the Speaker do now leave the Chair". I was a young Member, and everybody else was rather young. I did not get to my feet; the Speaker left the Chair and there was no debate at all. That lesson has bitten deeply into my soul. It emphasises (though I do not wish to be too pontifical) that one needs to know the procedure in your Lordships' House. However, I think that this is an unusual situation. I can see that it would be particularly desirable that the Question should be put again and, if the noble Lord who sits on the Woolsack feels that he can now again put the Motion, "That the Bill do now pass", this would enable noble Lords to speak.

THE DEPUTY SPEAKER

The Question is, That this Bill do now pass.

THE EARL OF LONGFORD

My Lords, before we go further, perhaps I may be allowed to express my thanks to the noble Lord the Leader of the House, and gladly accept any blame for any misunderstanding there may have been.

VISCOUNT INGLEBY

My Lords, may I say just a word or two at this point? I feel that we have had a wonderful selection committee on this Bill. I think the selection committee did very well when they chose the captain in another place. They did equally well when they chose the captain in your Lordships' House. The team has consisted partly of helpers in this House and partly of helpers outside, perhaps not very experienced in their task. We have bowled an occasional no-ball, but I think that it has been a most successful team. I look forward very much to the next match. I should like to thank the noble Earl, Lord Longford, our captain in this House, who has had the difficult responsibility of having to decide, with half an eye on the clock, when to declare the innings closed. I think he has done a wonderful job.

5.18 p.m.

BARONESS DARCY (DE KNAYTH)

My Lords, as this Bill has progressed through its various stages, first in another place and then in this House, one theme has recurred insistently: information. There have been demands for new information and demands that existing information be more effectively given out. We have a good many clauses on information in this Bill which are most welcome—information on welfare services, on research and development, on special educational facilities for deaf-blind, autistic and dyslexic children. I regret, however, that many proposed clauses and Amendments relating to information have not been accepted. I particularly regret the failure to include the clause on improved information from the Department of Health and Social Security to prescribers. Lack of information from the Department to prescribing authorities on the full range of equipment available is in many cases preventing the disabled person from getting the most up-to-date equipment, or resulting in his being issued with one type of equipment when an alternative model would have been better suited to his needs. Several pieces of equipment that could be of great value receive but a brief mention in the foreword of the handbook issued by the Department. It is most regrettable that there is equipment available which can be issued by the Department, and yet for some reason no one is told about it.

I greatly welcome the broadening of the scope of the annual report on research and development planned in Clause 19, and I hope most sincerely that it will not be limited in the way that the handbooks to prescribers are. I also regret the exclusion of the new clause on information on domiciliary physiotherapy which could have been of great value to many disabled people. There has been an equally loud and persistent demand for improvements in the scheme for helping the disabled towards outdoor mobility. Nearly all attempts to include new clauses relating to mobility have failed. However, it may be that the very welcome Clause 18, which allows powered wheelchairs and "Emma" trolleys on pavements, may encourage more severely disabled people to escape from the confines of their homes. This small taste of freedom may encourage them to clamour for further freedom of movement. The noble Baroness, the Minister, reminded us during Committee stage that the Government do not have to legislate in order to increase the categories of people eligible for vehicles. I very much hope that they will soon see their way to extending the scope for these categories, and that in the meantime some way can be found to give the disabled passenger some financial help towards outdoor mobility.

It is with the greatest possible enthusiasm that I welcome to-day's new clause on parking, which is an important first step towards helping the disabled passenger. It was disturbing that, until to-day, those most in need of help were given none whatsoever. A disabled person with a progressive disease, or who, for some other reason, suffered a deterioration in his physical condition, forfeited all assistance towards outdoor mobility once he was too disabled to drive his invalid tricycle. All financial help still depends on the disabled person being able to drive 'himself. In another place, the Joint Under-Secretary of State summarised the policy as, restoring to an individual as much personal physical mobility as it is possible to provide. Surely this principle is outdated and we need to review the whole policy. Surely it must be possible to provide a solution that does not penalise whole families While purporting to help the individual. The disabled, in common with their able-bodied fellows, are members of families. The disabled mother has children to transport and care for, the disabled passenger has a husband or wife, or constant attendant. Their lives are being made more difficult; they and their families are being cut off from society, and in many cases the more severely disabled, although quite capable of holding a job, are prevented from doing one by lack of transport.

Closely allied to the mobility theme is that of access. I welcome most warmly the clauses dealing with access and facilities suitable to the disabled, and in particular to-day's new clause concerning places of education. But there is one startling omission—that is, access to, and facilities in, places of employment, such as factories, offices, et cetera. So lack of transport in certain cases, and lack of facilities and access, are still to prevent the disabled from going out and earning their livings and paying their income tax. In fact, the whole question of employment has featured very little in this Bill. I feel that a greater effort should be made to train the physically disabled for work suited to them. There is still too much emphasis on workshop work: in most cases of physical disablement by accident or disease the brain is not affected, and surely a physically disabled person with a need to compensate mentally should be encouraged to use his brain. I feel that this lack of reference to employment is a serious error. I, too, have seen figures which prove conclusively that: unemployment among the disabled is increasing yearly. A disabled person who cannot work and cannot contribute to the community loses his self-respect. I believe that this is a problem which must be tackled very soon.

I hope I have not sounded too critical of this Bill. On Second Reading I welcomed it as being humane and extensive. I still think it is humane and extensive—indeed, a little more so than when it arrived in this House. And here I should like to thank your Lordships for having listened so kindly and so attentively, and for so long, to the views of the "mobile Bench". This Bill will be of enormous value to the chronically sick and disabled, but we must not sit back and congratulate ourselves on having achieved the ultimate in their rehabilitation. Rehabilitation has many facets. It means being as active and independent as possible, certainly, but it also means holding down a steady job, a worthwhile job; looking after a family; contributing to society; leading a full and satisfying life. You do not fully rehabilitate a person by providing him with a job but no transport to get him there. Equally it is no use providing him with access to a place of work if he has not been trained to do the job. Much must be put into rehabilitation, but the debt will be more than repaid in many ways by a truly rehabilitated person—financially, socially, and domestically. He and his whole family, and indeed the community will benefit beyond measure. We must realise that we still have a long way to go, but I hail this Bill as a big step, a vital step, towards the true reintegration of the disabled into the able-bodied world.

LORD CRAWSHAW

My Lords, I shall not keep your Lordships very long—some of you may be getting a little restless. However, I also should like to give my thanks to everybody who has supported and discussed this measure. I think that this very fact has given great encouragement to disabled people. In saying that, I want to pay my tribute to all the associations for the disabled who have followed this Bill so carefully through Parliament. Your Lordships will see that this "mobile Bench" is not the only one; we have another one over my right shoulder. I should like to thank them very much—the group known as Access for the Disabled, and the Joint Committee on Mobility for the Disabled, have been gleaning a tremendous amount of information, and their close attention has been most welcome to us and most valuable.

BARONESS MASHAM OF ILTON

My Lords, I have found it most interesting to see the two Front Benches supporting each other over this Bill. The Bill deals with many different aspects. It has had to be rushed through in this House, and much is being left untouched. I hope that this is a start for much progress in this field in the future.

5.27 p.m.

BARONESS SEROTA

My Lords, I am sure it would not be the wish of the House that I should use this particular occasion, when we are considering the last stage of this Bill, to add substantially to the many hundreds of thousands of words that have been spoken about it, both in Parliament and outside. By any criteria, I think one will judge it as a remarkable Private Member's Bill; remarkable in its length for a Private Member's Bill, and remarkable for its scope, and also perhaps most remarkable for the enthusiasm which it has received both inside and outside Parliament.

There have been occasions when Ministers have had to utter words of warning, and indeed have had to advise the House that certain lines of thought should not be pursued at the present time, but I can assure your Lordships that these particular objections have not been to the objectives of the Bill but to the practical and legal considerations, and I believe both Houses have accepted them in that spirit. The Bill is also, as the noble Lord, Lord Crawshaw, has just reminded us, a remarkable one in that all sides of the House have had the constructive help, the wisdom and, I would say, restraint from many who have been active in the fields of voluntary service. Many of them have freely given much of their time to the promoters of this Bill. It has also been remarkable in its sponsors. Mr. Alfred Morris and his colleagues in another place will always have the honour of having conceived and fostered the Bill, and they are indebted in this House to the noble Earl, Lord Longford and the many Peers who have helped him steer the Bill through until this moment of time.

This, of course, like all Bills, is only the beginning. There is much work to be done, and I hope the House will credit the Government with the will to get on with it, if only for the fact that the Government have already done so much work on this Bill. The honourable Member for Stoke-on-Trent, Mr. Ashley, speaking on the Third Reading in another place, had a phrase for this when he said: The Government have leaned over backwards to give every conceivable assistance to this measure. … All the work which has been put in by the Government has not been visible. It has been like a duck's feet. They have been paddling away like mad. but the work has not been visible in the House."—[OFFICIAL REPORT, Commons, 20/3/1970; col. 926.] I was not quite sure, when I read the account of the debates in another place, whether my honourable friend on that occasion was thinking of Ministerial effort or bureaucratic effort. I certainly hope it was both, because I know—and I think colleagues here who have shared responsibility for this Bill on the Government Front Bench will agree—that all Departments have worked hard. We are deeply grateful to Parliamentary Counsel and our legal and other professional staff, who have worked together so hard to see this Bill through to the Statute Book.

In some respects our deliberations in recent days have been a little rushed, but, speaking now as an individual, I make no complaint of that, because I am anxious to get the Bill on the Statute Book; and your Lordships, I hope, will have moved towards this to-day. But none has worked so hard on the Bill as (he handicapped themselves. To my mind, it is their Bill, and it is the Bill of those who have represented them. As we know, it is largely of their designing and, as I said on Second Reading, it carries a message to all of us who are entrusted with the task of providing services for the handicapped; namely, that we should take special care. Your Lordships' House has taken this message so much to heart today that, in fact, we shall be passing the Bill twice rather than the customary once.

5.31 p.m.

THE EARL OF LONGFORD

My Lords, I believe that the whole House can take pride in a Bill which, as the noble Baroness has said, will always be associated with its creator, Mr. Alf Morris; and, as she also said, it can fairly be looked upon as the Bill of the handicapped themselves, both inside and outside this House. Here, as elsewhere, it has been entirely a non-Party, or an all-Party, effort and in that sense I pay equal tribute to all concerned. But one must especially thank the Ministers, led by the noble Baroness, Lady Serota, and including the noble Baroness, Lady Phillips, the noble Lord, Lord Hughes, and the noble Lord, Lord Kennet. One thanks them individually for their very great and genuine sympathy, and for their very hard work. One also thanks the Government for making the time available under these peculiar and difficult circumstances. When it comes to Parliamentary time, it is generally understood that the Opposition must concur with the Government for an arrangement to be reached, and therefore we thank all elements in the Opposition, particularly the leaders.

The most moving champions here have naturally been those who have spoken from wheelchairs. When I pressed for an opportunity for a few final words, I was not aware that one or two of them were going to pay a tribute to me: that was certainly not my object in getting a few words on the Record. But if we reflect on the performance of the handicapped in this House, we can fairly say that it is an example to everyone, and in particular it will have encouraged the handicapped and strengthened them, not only in this country but, when the news reaches them, all over the world. As has been said, this Bill, like other human things, is imperfect, and the circumstances have prevented as full a discussion as would no doubt otherwise have taken place. But we have had a very full discussion in the existing situation, and we are aware that the Government have done all they could in the time available, and in the financial situation, to meet the points that have been raised. There are no doubt matters which we should have pressed still harder (if there had not been the question of time, there was one this afternoon), but I need not go into them now. There will, I am sure, some time or other—and I hope sooner rather than later—be another Bill. Meanwhile there will be a duty on the Government, which I hope and believe they will fulfil, to interpret this Bill as humanely and liberally as possible, and there will be a duty on everyone else to exert a constant and legitimate pressure and to educate public opinion. However, all that lies in the future. Sufficient unto the day is the good thereof. I believe that there is great good and great hope in this Bill, and I believe that the whole House can rejoice in its passing.

On Question, Bill passed, and returned to the Commons.