§ Motion made, and Question proposed, That this House do now adjourn.—[Mr. J. E. B. Hill.]
§ 10.25 p.m.
§ Mr. Ness Edwards (Caerphilly)
I was moved to request this Adjournment debate by an incident which happened to me some months ago, when a lady visited me to talk to me about her son. Her son had had a brilliant career in the grammar school. He had reached the age of 19, and he then contracted poliomyelitis. After some time we were able to do something for him. We were able to get him a tricycle and get him a job. This had gone on for about two years.
The lady told me that the boy was her only child. She said that when he goes out he has to go out alone. He makes no social contacts. Sometimes when he is sitting in the house she says to him, "Why do you not go out?" She says that the boy looks at her as if he is reproaching her for having brought him into the world.
That brought home to me the tremendous tragedy which exists in the case of people disabled in this fashion. This is a young man, with the limited facilities which the present Minister provides for him, who is doomed to travel life alone. With all these shouts of, "You have never had it so good", it is a hollow mockery to treat the boy in the way he is being treated.
Having had that experience, I began to look at the problem on a wider basis. I asked the miners' secretary in South Wales, Mr. Dan Evans, to tell me what the position was about the men injured in industry. He told me that about 100 miners in South Wales alone are using these wretched tricycles. Some of them are "Bevin boys". They did great work for the country during the war. They did what we wanted them to do, and they are now condemned to 1236 these wretched tricycles, to travel alone, to travel not in safety but in very great danger.
I was reminded by the secretary of the South Wales miners of the plight of Evan Morris, a famous fighter, who was injured in the pit and whose tricycle caught fire on a mountain road. If no one had come along, he would have been burnt to a cinder, as the tricycle was burnt to a cinder. He was saved from it by passers-by.
I have noticed men sitting in these shabby, cheap-looking tricycles, which are about the cheapest thing we could provide for them, on the lonely mountain roads, by themselves, absolutely cut off from social contact It is about time we did something about it. The Minister himself has sparked off a new agitation by his decision to provide two-seater cars for the war disabled and replace the old tricycles. One applauds this decision. Why cannot this be extended to other classes of persons in the same category?
Why is it that the man who was disabled as a soldier is to have different treatment from the person who worked in London on war work and who often suffered greater danger from bomb damage than some people in the regiments? Why is he to be excluded from this beneficial step taken by the Minister? During the war we were all on war work. Those of us who had to live in London during the war and come to the House know the dangers to which we were exposed. They were far greater than those of some people in other parts of the country on Service work. Yet those injured during the bombing of London or Coventry or other cities are to be excluded from this advantage which is now conferred by the Minister.
I went into St. James's Park at lunch-time. In the park I saw one of these wretched tricycles. It was black with a varnished sail cloth, a cheap-looking thing. I saw the man being helped out of the tricycle in order to sit on a deck chair. What about the man who has no one to meet him in the park or assist him from his tricycle? I wish the hon Lady would keep this very much in mind. I know she has great qualities. I am wondering why she has allowed this condition to continue for so long.
1237 What prevents her from doing this? Is it a question of cost? On merit there can be no question. I notice that the cost spread over a number of years would be an additional £2½ million. I find that the additional annual cost, once the change had been effected, would be roughly £1 million a year. Those are figures she has given. I should have thought cost was not an insuperable barrier. I found the Minister's reply much more explicit than that of the hon. Lady. The hon. and gallant Member for Norwood (Sir J. Smyth) said:The Parliamentary Secretary has consistently replied to questions on this subject by saying that she was debarred by the terms of the Act from treating such people in the same way as the war disabled.The Minister replied:I do not think that my hon. Friend has ever said that it was an insuperable barrier.He was most complimentary and said:What she has done, with her customary candour and conscientious clarity, has been to point out that there is a possible legal difficulty which relates to the question whether a small car which can take passengers and which can be driven by somebody else can properly be said to come within the wording of Section 3 (1, b) of the National Health Service Act. that is to say, within:'medical, nursing and other services require at or for the purposes of hospitals …"' —[OFFICIAL REPORT, 2nd May, 1960; Vol. 622. c. 694.]Is it a legal difficulty which the hon. Lady has in mind? The Minister is much more careful in his use of language. He says there is only a possible legal difficulty. When he, a trained lawyer, a barrister I believe, says there is only a possible legal difficulty, does that not raise the presumption that he really does not feel the legal position is preventing him from doing what we request him to do?
Perhaps the hon. Lady will take this into account. If under that form of words it is possible to provide a three-wheeled vehicle and a three-wheeled vehicle is provided, why is it impossible to add another wheel? Is it less of an appliance because it has four wheels? If she finds that a difficulty, does it become less of an appliance if it has two seats instead of one? I am afraid that the hon. Lady has been relying upon a barrier which does not exist.
I find that when we have sought to raise this matter in the past we have 1238 been told that it would mean a change of legislation. It does not mean that at all Even the Minister does not say that it means that. He says that it is only a possible legal difficulty. He did not say in his reply that it required a change of legislation, but the hon. Lady in an Adjournment debate last November seemed to rely upon that completely. It would perhaps have been far more honourable if the Minister had himself come here to defend his position rather than the Parliamentary Secretary, and I am not saying that with any disrespect to the hon. Lady.
The situation is a national disgrace. There are 6,000 people who are disabled is such a way that they have not the means of locomotion, and we have condemned them to travel alone in what I regard as the cheapest form of transport that the Minister could find.
The Minister has at last succumbed to the pressure that has been brought upon him from both sides of the House to do something for the war disabled. But have we not reached a strange position when one man with one type of disablement is told, "Because you got it in such a way you shall have a car", but another man with exactly the same disability is told, "Because you got it in a different way while serving your country you shall not have it"? There is no humanity or justice in this.
I warn the hon. lady, and she can warn her right hon. and learned Friend, that they will get no peace until this position is put right. We shall come back to it time after time to see to it that the disabled people of the country are treated decently. At the moment they are being treated on the cheap. I beg the hon Lady to do one of two things, to provide either a two-seater tricycle or a two-seater car for every one of the persons in this condition.
My right hon. Friend the Member for Warrington (Dr. Summerskill) has been pressing for this for a very long time, and I am sure that in what I say I carry with me her and my other right hon. and hon. Friends and most hon. Members on the other side of the House. I hope, therefore, that we shall get a reply from the hon. Lady which will give us some hope. I repeat my warning: we shall come back 1239 to this time after time until we have made the Ministry bend and do the decent thing.
§ 10.39 p.m.
§ Dr. Edith Summerskill (Warrington)
I support what has been said by my right hon. Friend the Member for Caerphilly (Mr. Ness Edwards). There is surely an anomalous position here. During the war the late Mr. Ernest Bevin equated certain men in industry with men in the Armed Forces by saying that if they were prepared to do certain jobs they would be exempt from military service.
My right hon. Friend has mentioned the miners. The miner has one of the dirtiest jobs in the country. He works in dark, confined conditions and is vulnerable to nystagmus, pneumoconiosis and injury in the pits. If a miner is severely injured in the pits he is denied a car, whereas if a Service man, perhaps stationed in a pleasant country town or district, is injured, not by a bomb but perhaps in an accident with a motor lorry which he is driving during his war service, he is entitled to a car. It is a most curious position, inhuman, unjust, and quite illogical.
My right hon. Friend mentioned the fact that this man was punished because he had to be alone, and because when he went out he could not take anyone with him. I would remind the House of the man's wife. This woman has been called upon to work much harder than she would have done if her husband had not been injured. She has been called upon to be a housewife and nurse for the rest of her life, and has been confined to the house much more than she would have been had her husband been normal. She is just the wife who needs a little relaxation, some holiday, some change from the appalling conditions which she has to suffer day after day for the rest of her life. When there is an opportunity of some holiday at present, she, who probably needs it more than any other member of the household, apart from the invalid, is condemned to stay at home. I ask the hon. Lady to consider that.
I remind my right hon. Friend that the point I pressed was cars for men disabled in the Services, but equally I join my right hon. Friend in his plea for the other disabled.
§ 10.41 p.m.
§ The Parliamentary Secretary to the Ministry of Health (Miss Edith Pitt)
In reply to this debate, perhaps I may briefly explain that the service transport for disabled people ranges from the provision of chairs, of which there are about 57,000 on issue in England and Wales, to powered tricycles and cars. This matter is not often discussed in the House, and so I am very happy to reply to the debate which the right hon. Gentleman the Member for Caerphilly (Mr. Ness Edwards) has raised tonight. When I say the matter is not often discussed, I must add that I am, of course, aware that there is considerable interest in it among hon. and right hon. Gentlemen. I know that from the volume of correspondence which comes to me about their constituency cases.
Last November my hon. Friend the Member for Plymouth, Devonport (Miss Vickers) raised on the Adjournment the matter of the supply of tricycles, and we had a full discussion on the service and the criteria we use. For that reason I shall not take up time tonight with the criteria, except briefly to say that a disabled person, whether war disabled or under the National Health Service, may be eligible for a power-propelled tricycle if he has suffered amputation of both legs, at least one above the knee, or suffers such defect of the locomotor system as to all intents and purposes to be unable to walk, or is similarly but slightly less severely disabled, with very limited walking ability, and needs a machine to get to and from work.
On cars, which is really the subject of the debate tonight, only war pensioners get cars. Up to now only the most severely disabled have been eligible for them under the scheme introduced in 1948. My right hon. and learned Friend announced on 4tlh April his decision to extend the war pensioners car scheme, and we hope that the additional cars will begin to be available in a month or two's time. At present nearly 1,800 war pensioners have cars and over 1,700 have tricycles.
When we come to the National Health Service—
§ Mr. Ness Edwards
Would the hon. Lady inform the House on what authority the Minister of Health provides these cars for war disabled people?
§ Mr. Ness Edwards
I do not want to take the hon. Lady's time, but I want to say that we have made reference to the Library and the research department there, to try to find out from the Ministry this information, and we have been able to find no authority at all for what the Minister is doing, except under the National Health Service Act.
§ Miss Pitt
I do not think the Royal Warrant specifically says "cars", but it is very wide in its terms, and it is under that power that my Minister, and his predecessors, including those of the party of the right hon. Gentleman opposite, have provided cars for the war disabled.
As I was explaining, when we come to the National Health Service the figures are very much greater than the number of war pensioners affected, as one would naturally expect.
A total of 12,773 National Health Service patients in Great Britain have tricycles and the number has risen steadily over the years. The annual cost of the tricycle service in England and Wales, excluding the cost of salaries of staff, is now about £1¾ million. The tricycle has often been criticised, perhaps by those who tend to overlook what it is designed to do and concentrate their criticism on what it does not do. It has been described in the House as "very antiquated" and the right hon. Member for Caerphilly has referred tonight to "wretched" tricycles, which I think a most unwarranted criticism. The machines have been improved over the years and are efficient machines for their purpose.
The old open "motorised invalid chairs" have been superseded by all-weather machines which are, in effect, small saloon cars with steel or glass fibre bodies, hydraulic brakes and controls, efficient engines and modern suspension units. They are specially designed to give adequate space for the driver and for a folding push-chair, and 1242 for ease of control and of access. Frequently they are specially modified to meet individual needs.
The right hon. Member for Caerphilly mentioned two specific cases which he kindly told us about two days ago and I have looked them up. One was the case of Mr. Morris who had a fire in his tricycle in 1952. It was caused by a split petrol feed pipe, which could have occurred in any motor vehicle. He suffered shock but not physical injury, and a few days later he asked for a replacement, which shows that he was not afraid of using a tricycle again. He was issued with a new tricycle and he used it until he died.
The boy whom the right hon. Member mentioned was Geoffrey Powell, who was supplied with a new tricycle in 1956, enclosed but with a soft top. In 1958 he complained of inadequate weather protection and asked for a tricycle with a hard top. It was found that the reason why the rain came in was that there was a large hole in the rear window. This was repaired and the tricycle is still in use. We have no record of recent complaint, but if the right hon. Gentleman wants me to look into this case I will.
§ Mr. Ness Edwards
I am not complaining about this particular tricycle and I am sorry that the hon. Lady has mentioned a name, but I complain that he has to travel by himself even if the tricycle is perfect.
§ Miss Pitt
The right hon. Gentleman is very critical, but I am sure that he agrees that the tricycle gives a valuable service to the disabled man. The chairman of one of the organisations which is interested in bigger machines recently told me that the tricycle service here had no parallel. In a supplementary question on 14th December, the hon. Member for Southampton, Itchen (Dr. King) referred to the Invalid Tricycle Association's tremendous appreciation of the benefits conferred on its members. The right hon. Member for Caerphilly says that these people are cut off, but in fact the tricycle provides them with some mobility. They are able to go out to football matches, to work 1243 and to maintain their contacts. But the tricycle is not designed to carry a passenger who could give help and companionship and I realise that that is a point which the right hon. Member has very much in mind.
Recognising this, we said in our manifesto:Those disabled in the service of our country will remain the subject of our special care. Particular attention will be given to providing more suitable vehicles for the badly disabled.This passage has been misinterpreted by many to mean that it was intended that all disabled persons, war pensioners and National Health Service patients, should have more suitable vehicles.
§ Miss Pitt
If the sentence is read in its context the meaning is clear. Successive Governments are agreed that war pensioners should have preference and priority in our social services. The right hon. Member for Caerphilly said that all should be treated alike. The right hon. Lady the Member for Warrington (Dr. Summerskill) said it was inhuman, unjust and illogical not to give the same benefits to all disabled people. But, as I have explained, it was their own party and their own Minister of Pensions who, in 1949, decided that certain war pensioners should have cars, in other words, continuing the preferential treatment which successive Governments have given.
On 4th April, my right hon. and learned Friend announced that he and the Secretary of State had decided to implement the promise to provide more suitable vehicles by providing small cars for those war pensioners disabled in the service of their country who are eligible for Government power-propelled tricycles. Answering a Question on 2nd May, my right hon. and learned Friend estimated that the additional capital cost of the proposals would be about £200,000, and the additional maintenance cost would be about £80,000 a year over the years. The figure of capital cost takes account of the cost of the tricycles we would otherwise have to buy over the years to replace the tricycles now in use.
I think hon. Members will be interested to know that in our calcula- 1244 tions in regard to war pensioners, we assumed that some would prefer to keep their tricycles, and the replies we are receiving to our letters inquiring whether war pensioners want cars indicate that some would rather not have them.
I come now to the legal powers, to which the right hon. Gentleman referred. War pensioners, as I have said, have their vehicles under the Royal Warrant powers. There has been a good deal of discussion in exchanges on supplementary questions in the House about the power to provide cars under the National Health Service Act, and that is one of the main points tonight. The right hon. Gentleman quoted what the Minister said in answer to a supplementary question, and I shall not take time by repeating it. The view taken by the legal department of my Ministry is roughly this. With some straining of the language of the Section, it can be held that a tricycle has a connection with hospital treatment and that its provision is a hospital purpose. It can be regarded as an appliance for a disabled man receiving hospital services, akin to artificial limbs or crutches.
It seems to us, however, that there is a great distinction between an invalid tricycle and a car in the context of Part II of the National Health Service Act. The use of a car would, in substance, be a welfare service not limited to medical needs or the treatment of the patient himself. It would provide not merely transport for the patient but transport for his family and friends as well. Sympathetic though one may be, we do not think that this is covered by the present powers. This is not insuperable, as my right hon. and learned Friend made clear, if Parliament decided that such a service should be provided, but it would probably need amending legislation.
There are subsidiary legal points to be taken into account, but I certainly have no time to develop them now. The question of legal powers is only part of the problem. As I have said, there are differing views, but it is not for the House to decide what a Statute means once it is enacted. That falls within the province of the courts. The question whether cars should or should not be provided for the disabled generally is, however, a matter for Parliament to discuss, and. as my right hon. and learned Friend has said, 1245 if it were necessary so to do, it would be possible at some time to amend the statutory provision.
The main question is whether the provision of vehicles for the disabled generally is a development which is desirable and of sufficient priority. It would be a costly development, as the right hon. Gentleman said. He quoted the figures which my right hon. and learned Friend gave to the House. Those were based on assumptions which it was not possible to develop fully in a supplementary answer. Various assumptions were made in the figures, which were a broad estimate and did not take account of the eventual and uncertain returns from the sale of old cars. A scheme introduced now would be spread over eight years to get full value from existing tricycles, and the capital cost would be greater if the period were short and usable tricycles had to be scrapped. There are many other points which arise on this question of cost but, plainly, I have not time to develop them.
I am not without sympathy for the point which has been raised. There is a 1246 legal difficulty. There is the matter of cost and there are the other claims on the Health Service. There must be few who would not wish us to widen our categories of eligibility for tricycles, though I think that hon. Members do not always appreciate the financial implications of the requests they make. To provide cars for the disabled generally is a development which would have to be considered in the context of its initial and continuing cost against all the other claims for the development of our services. It would be a major development, and, while we fully understand the case for making it, we have made no commitment beyond the commitment in regard to war pensioners, and it is a development which we have not felt able to contemplate.
§ The Question having been proposed after Ten o'clock and the debate having continued for half an hour, Mr. SPEAKER adjourned the House without Question put, pursuant to the Standing Order.
§ Adjourned at five minutes to Eleven o'clock.