§ 7.8 p.m.
§ BARONESS PHILLIPS rose to ask Her Majesty's Government whether they will consider amending the Chronically Sick and Disabled Persons Act 1970 so as to include persons of severely restricted growth. The noble Baroness said: My Lords, I beg leave to ask the Question standing in my name on the Order Paper. In doing so, I proudly declare an interest. I am President of the newly formed Association for Research into Restricted 877 Growth. I warned some of my guests this evening that they might see the House peopled only by the Minister on the Front Bench and myself on this side of the House. I am happy to see that a few noble Lords have remained and I thank them for this. I hope that the lack of attendance does not in any way reflect your Lordships' interest in the subject.
§ I think that we must ask, first of all, who are the people of restricted growth. Throughout history we have heard stories, either fictional or factual, about dwarfs and midgets, and we have been conscious of people of small stature who move in our own society. I think noble Lords who saw the very sensibly produced film by the noble Earl, Lord Snowdon, on Monday evening on the Independent Television channel, called Born to he Small, will have realised, probably for the first time, that people of small stature are not people confined to the stage or the circus; that there are people who are carrying out all kinds of highly responsible work —manual work and professional work—and are, just as the rest of the community, engaged in making contributions of varying kinds. They will have also seen that small people are the size that they are for differing reasons, none of which I will go into this evening, because I am not sufficiently medically informed to do so.
§ I am more concerned with the disadvantages that come from being of small stature. I am 5 ft. 3 in., and I stand just above this Despatch Box. I should like your Lordships to imagine, if it is possible, what life can be like if you are 4 ft. 3 in. or even less. Public transport will present great difficulties. As one of our members described to me in graphic terms, the only way she can get on a bus is to lie on her "tummy" and be helped up by kindly people who are sitting inside the bus. This is an adult. Can your Lordships imagine the difficulty and humiliation of a situation like that? Of course, if one has enough money, one has one's own vehicle, but if you have a car, obviously it has to be adapted to your size.
§ Can your Lordships conceive of not being able to reach the balustrades in a public place if you want to go up the stairs? Can you conceive of not even being able to reach light switches, door 878 handles or even lavatory facilities? When it comes to clothing, one is faced by two alternatives—and this applies both to men and to women: either you find someone who will make it for you, often at high expense, or you search around until you find someone who makes clothing to suit your size. It is all too easy to say: "They can always wear children's clothing." If you are an adult, the size may be right, but obviously the style will be completely unsuitable. Shoes and furniture, again, are all designed for an average-sized person, though over the years I have begun to doubt what an average-sized person is. I remember that the gown manufacturers seemed to work on the extraordinary idea that a woman rose two inches on the hips every time she rose two inches on the bust. This has been proved to be biologically quite incorrect. No doubt males suffer from some of these peculiarities as well. Indeed, we may well ask: what is an average-sized person? But what we do know is that the person of small stature will not come within the recognised range of clothing that is available.
§ At present, the help which the small person can get is dependent on the sensitivity of individuals in the health and welfare fields; and this is not a satisfactory basis for them. That is why this evening I am asking the Minister whether he will consider amending the Chronically Sick and Disabled Persons Act to enable the Act to cover the small person, who might be described as disadvantaged—a rather ungainly and ugly word, but I have so far been unable to discover a better one. Your Lordships will recall that splendid piece of legislation, which was introduced into this House in 1970. It covers not only the provision of welfare services if a person is disabled, but matters concerning the changing of housing, public sanitary conveniences, access to vehicles; indeed, everything that may now affect the small person adversely, although at present these people cannot benefit because they are not all—in fact very few are—disabled, but are people in full health.
§
The small person moves self-consciously in an unfriendly world of derision and indignity. If your Lordships doubt that, I would ask whether you noticed the way in which The Times,
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which considers itself to be a newspaper of quality, announced the programme to which I have referred. It said:
Gape as you will at the midgets".
§ To me that is shocking and something to be absolutely deplored from any paper, but particularly a paper of this character. I remember when the noble Baroness, Lady Wootton of Abinger, chose the title for her book, In a World I Never Made. If you are of small stature you truly do wander lonely and afraid"in a world I never made". The fact that these people with whom I have the pleasure and the honour to work have surmounted the incredible difficulties which confront them says a great deal for their character and their endurance. But there must be many who still have neither the skill, the intelligence nor the ability to do these things for themselves. We do not even know how many people would come within this particular group. May I give the noble Lord notice that if, by good fortune, he is going to agree this evening to an amendment of the Act, he will bring great joy to many people; but if he cannot do this, I give him notice also that I shall return again and again with my request. I beg to ask the Question on the Order Paper.
§ 7.16 p.m.
§ THE MINISTER OF STATE, DEPARTMENT OF HEALTH AND SOCIAL SECURITY (LORD ABERDARE)My Lords, it is a great pleasure to be debating for a second day running with the noble Baroness. Yesterday we were discussing the problems of the low paid, and to-day we are discussing the problems of persons of severely restricted growth. While it may well be that we were concerned with a greater number of people yesterday, and it is also true that there were more noble Lords present yesterday, it is right to emphasise, as the noble Baroness did in putting the Question, the great importance of both these debates to many of the citizens of this country. As the noble Baroness explained at the start, she speaks with great authority as patron of the Association for Research into Restricted Growth. The number of persons of severely restricted growth is fortunately small—there are, I believe, not many more than 2,000 in this country 880 —but their particular problems are none the less important.
The noble Baroness has raised the point of statutory provision of services for persons of severely restricted growth. She assumed in her Question that as a class these people fall outside the scope of services provided by the relevant legislation, and has asked us to amend the Chronically Sick and Disabled Persons Act 1970. Our view is that this amendment is not necessary. In the context of this debate, the Chronically Sick and Disabled Persons Act is mainly relevant in connection with social services provided by local authorities. In particular, Section 2 of that Act places a duty on local authorities with regard to certain of their services provided under Section 29 of the 1948 National Assistance Act. Section 29 covers persons who are blind or deaf and
other persons who are substantially and permanently handicapped by illness, injury or congenital deformity.People of small stature suffer from this condition either as a result of illness or of congenital deformity. There is no simple definition of "handicapped", but if in any respect a person of severely restricted growth is handicapped, he is covered not only by Section 29 of the 1948 Act but also by Section 2 of the 1970 Act. I am not talking here just of those who are also physically handicapped, but of those whose small stature is in itself the cause of handicap. It follows that if any of the services provided by local authority social services departments could benefit a person in this category, he or she would be eligible for that service—without further statutory provision being necessary.My Lords, I hope that that is a satisfactory answer to the noble Baroness, but perhaps I may be allowed to add a little more about the practical problems, some of which she has mentioned, that are faced by persons of restricted growth. I have had the advantage of seeing a copy of the Report of Inquiry into the Incidence and Problems of People of Small Stature prepared by the National Council of Social Service in 1969, which led to the setting up of the Association of which the noble Baroness is President. The problems identified were in three main groups: social, personal and 881 occupational. The social problems arise because those of small stature are sometimes regarded as the object of mirth or of entertainment, as permanent children or as if they were mentally retarded. Although serious problems are created as a result of these attitudes, they cannot be solved by the provision of services alone. It is a matter of changing the climate of public opinion, and although such a change can only be gradual, I hope that it may be helped by public debate such as we have had to-day and perhaps also by the television programme on Monday, "Born to be Small" to which the noble Baroness drew our attention.
The second group of problems are personal, and include problems of mobility and transport, as well as those of clothing, furniture and aids and adaptations to the home, which were mentioned by the noble Baroness. She also mentioned the difficulty and embarrassment that may be experienced by these people when they have to clamber on to a bus. In so far as smallness of stature may be associated with severely restricted ability to walk, the Government are often able to assist by the provision of an invalid vehicle. These vehicles are provided not only for those who have actually lost legs, but to those who are accepted medically as having equivalent difficulty in walking.
Another aspect of mobility is access to buildings, which may be difficult where there are steps to be climbed. This should become less of a problem in future, as under Section 4 of the Chronically Sick and Disabled Persons Act, new buildings to which the public has access will have to include provision for disabled persons. Ramps and lifts provided for wheelchair-users to comply with this requirement will also help meet the needs of persons of restricted growth. So far as other personal problems are concerned, the local authority social services are already available to these people if they need them. These may include the support and advice offered by social workers, as well as the provision of aids or adaptations to the home. I have no reason to doubt that local authorities generally already do all they can to help in these ways, and I am sure that this debate will have the effect of again drawing the matter to their attention. I will, however, consider whether there is 882 a need for any particular action on our part, including drawing to their attention the Report of the National Council of Social Service, and perhaps the noble Baroness would like to have a further word with me about that aspect of the matter.
The third group of problems are occupational. Again there are difficulties because of prejudice, but quite a number of persons of small stature are engaged in full-time employment. A person whose small stature substantially handicaps him in obtaining or keeping employment or in working on his own account would be eligible for registration under the Disabled Persons (Employment) Act 1944 and for the facilities provided under it. These include courses of industrial rehabilitation and vocational training, and, when necessary, special aids to employment or employment under sheltered conditions.
The educational placement of children who arc of small statute is a matter for each education authority to decide. Each child needs individual consideration. The general policy is for these children to be educated so far as possible in ordinary schools, and returns made by local education authorities in 1969–70 show that 250 children with some retardation of growth were being educated in these schools. Some children may need, at least for a time, the more sheltered environment of a special school because of emotional difficulties associated with their small stature or because of other disabilities.
In conclusion, I should like to say two things: first, to repeat that so far as the services which already exist are concerned, persons of restricted growth already have access to them without the necessity for further legislation. I would not claim that these services are universally perfect, but they are there and they are developing. Secondly, improved services are not going to solve all the problems. These are largely intangible and depend on social attitudes: changes in the climate of public opinion will not come suddenly, but the noble Baroness has done a considerable service to-day in drawing public attention to the problems of persons of restricted growth.