HC Deb 15 February 1967 vol 741 cc523-31

10.5 a.m.

The Minister of Health (Mr. Kenneth Robinson)

With your permission, Mr. Speaker, and that of the House, I wish to make a statement about the provision of vehicles for the disabled, and I should like to apologise for its length.

My right hon. Friend the Secretary of State for Scotland and I have been reviewing the provision of invalid vehicles for the disabled and the associated benefits. We have taken into account all the representations that have been made during the last two years for the provision of types of vehicles different from those at present supplied, for the extension of classes of eligibility and for the provision of additional benefits.

Under present arrangements a single-seater invalid tricycle may be provided for disabled persons who qualify under one of the three categories of eligibility used for this purpose. The alternative choice of a small four-seater car has been available for some years to war pensioners and, since July, 1964, without specific authority under the National Health Service Acts, to two members of the same family who are both entitled to an invalid tricycle, and to a husband and wife one of whom is eligible for a vehicle and the other is blind.

Many hon. Members have urged upon me on many occasions that the choice of a small car instead of a tricycle should be more generally available. We have examined the possibility of extending the present provision and we have considered the claims to priority of various classes of the disabled. I am glad to be able to tell the House that we have decided to make cars available to three further groups.

A member of the first group would be a disabled parent who had lost his or her spouse and had been left alone to care for the child or children of the marriage. If such a parent is entitled to a tricycle, he or she will be offered the alternative of a car for as long as he or she is responsible for a child. Members of the second group would be two relatives in the same household not necessarily man and wife, of whom one is eligible for a vehicle and the other blind. Members of the third group would be two relatives in the same household both eligible for an invalid vehicle, one of whom is under 16 years of age and therefore unable to hold a driving licence.

People in these three groups will qualify for a car as long as they meet the conditions and provided they are able to drive themselves. We estimate that there are about 1,600 households that will benefit from these additional provisions and we will deal with their applications as promptly as we can. The initial capital cost will be about £600,000 and the annual maintenance cost about £150,000.

This is as far as we can go without specific statutory authority. My right hon. Friend and I intend, however, to find a place in the timetable for amending legislation that would enable us to do more for the disabled driver as resources permit. Very large sums would be involved if it were decided to provide a car for all those now eligible for a tricycle. This is not so much because a car is rather more expensive than a tricycle, which is not a cheap machine, but because of the numbers required; there are many thousands of people who would qualify under our present rules of eligibility who have not applied for a tricycle but who would certainly be expected to ask for a car.

Progress in the direction I have indicated will have to be made by stages, as, indeed, has been the case in the past. The rate at which we shall be able to move forward must be determined by the economic circumstances of the time, the amount of money that can be made available for the National Health Service and the competing claims of many other desirable improvements in the Service. At each stage, we will have to consider the need and convenience of the disabled in relation to those other competing claims which may be no less urgent. Subject to this and armed with new powers, it would be our intention to take a substantial step forward as soon as practicable following legislation.

We propose to introduce some other immediate improvements. The small saloon cars now supplied are not entirely convenient for a minority of the disabled and we have decided that in exceptional circumstances where a real medical need exists we will supply the estate car model instead.

We are also proposing to introduce a scheme whereby those who become entitled to the supply of a car may receive a course of driving tuition from a recognised school of motoring at Exchequer expense. It has long been the practice to provide driving instruction for those who receive invalid tricycles, and I am sure it is right that those who receive a car should be given similar facilities.

One of the conditions of supplying a car is that proper garage accommodation should be available. This requirement entails difficulty for some and in future they will be entitled to apply for half of their first year's maintenance allowance in advance to help them to provide a suitable garage.

I am sure the House will welcome these immediate improvements. I am sure, too, that we are right to announce our intention to legislate for further advances to be made. At the same time, I must emphasise the necessity of phasing further progress so as to reconcile the claims of the severely disabled with the urgent need for improvements in other sectors of the National Health Service.

Mr. Dean

I am sure that the whole House will welcome the right hon. Gentleman's statement, although it has been a long time in coming. Is the right hon. Gentleman aware that there will he disappointment that the step forward which he has announced is so extremely limited and involves only about 1,600 households? We shall, of course, wish to study the statement with care—it is a complicated one—but may I ask the right hon. Gentleman one or two questions.

First, are all those war pensioners who are now qualified for cars in receipt of them? Secondly, when does he expect the cars for these three additional categories of people to be made available to them? Thirdly, the right hon. Gentleman says that he intends to introduce legislation which will do more. Can he say whether this will deal with matters other than the provision of cars? For example, will it deal with the different rates of help which are available, depending, for example, on whether a person buys a car with automatic transmission for which not much help is available at the moment? Finally, can he say whether in the meantime he is taking some steps to try to help with the problem of repair difficulties, particularly at weekends, when many people find themselves in an embarrassing situation because they cannot get repairs to their tricycles carried out speedily?

Mr. Robinson

I am grateful to the hon. Gentleman for the general reception he has given to my statement. He said that there would be disappointment that we had not been able to go further immediately. I would remind him that a similar review was carried out by my predecessor, the right hon. Member for Altrincham and Sale (Mr. Barber), the results of which were announced just before the General Election preceding the change of Government. These changes produced cars for only 300 additional persons. The steps which I have proposed will bring in 1,600 persons, more than five times as many.

The hon. Gentleman asked whether all war pensioners entitled to cars were in receipt of them. I understand that they are.

The hon. Gentleman also asked when these additional categories would get the cars. I think I made it clear in my statement that it would be as soon as we can manage it, as promptly as possible.

On the question of legislation, it will be our intention to include this legislation in other legislation relating to the National Health Service, so it will not deal specifically with this matter, but it will give us statutory authority to do things which hitherto we have been able to do only extra statutorily.

I take the hon. Gentleman's point about repair difficulties. I should be glad to look into any particular case, but we are seeking all the time to improve repair facilities.

Mr. Ogden

Is my right hon. Friend aware that his statement will be given a wholehearted welcome on this side of the House? The help which he is giving to these 1,600 families will be greatly appreciated, and we realise that there are statutory limitations to the help which he has been able to give. Can my right hon. Friend assure the House that he will endeavour to introduce this legislation during this Session?

Mr. Robinson

The timing of the legislation is not a matter for me. I do not think that it will be possible to do it in this Session, but we shall have to see, in consultation with my right hon. Friends, when it can be introduced. I am grateful to my hon. Friend for his reception of my statement.

Sir J. Langford-Holt

Many of us have been trying to get not only this Government but the previous one to do something in this direction. Will the right hon. Gentleman bear in mind that he has not covered the most important sector, namely, those ordinary people who are disabled and who, because they cannot take a person with them, are completely immobilised unless they can get somebody to help them at both ends of the operation?

Secondly, will the right hon. Gentleman look into the design of the present tricycles to see whether they can be made into two-seater tricycles? The tricycles are uncomfortable, draughty and extremely badly designed. Will he look into this question again, and what consideration did he give to the alternative provision of cars, which is to provide disabled persons with an allowance equivalent to the difference in cost between running a tricycle and running a car? This presumably would not have involved legislation, or would it?

Mr. Robinson

On the last point, this is a matter which we considered, but we did not feel able to go any further at the moment. I appreciate that the hon. Gentleman pressed his own Government, as he has this Government, to extend the provision of cars and facilities for the disabled. I think that the kind of extension to which he referred at the beginning of his question is of a major nature and something which can only follow legislation.

I do not accept the hon. Gentleman's criticism about the design of invalid tricycles. This is a reliable machine, and it has been specially designed for the disabled driver. It can be extensively modified to cover particular conditions of disablement, and indeed frequently is, but certainly there is room for further improvement, and we are continually improving it.

Mr. Bob Brown

My right hon. Friend's statement will be welcomed throughout the country, though with some regret that it does not go quite as far as many of us would have hoped.

Mr. Speaker

Order. Question.

Mr. Brown

May I ask my right hon. Friend whether he is aware that many of these unfortunate people are living on borrowed time? Time is not on their side. When he is considering further legislation, will he not await general legislation in connection with the Health Service, but deal with this serious problem as early as possible by means of simple amending legislation?

Mr. Robinson

I am not sure that the legislation will necessarily be as simple as that, but it will not be held up on the ground that it might be included with other matters.

I appreciate that my hon. Friend, and many others, would have liked me to go further. I would have liked to go further, but, for the reasons which I have given, this is as far as I can go for the immediate present.

Sir R. Russell

Will the right hon. Gentleman say what is the purpose of the restriction about garage accommodation? Is it to help preserve the car, or to prevent obstruction on the roads?

Mr. Robinson

It is mainly to help preserve the car, to protect what is, after all, public property.

Mr. Brooks

Will my right hon. Friend accept that both sides of the House will give a very sincere cheer for his announcement, indeed they will give two sincere cheers, but that there is disappointment that he has not been able to go further? Will my right hon. Friend confirm that the figure given to the House last year that about £40 million would be involved over an eight-year period in supplying cars to all these categories of disabled people who might be eligible for them is still a firm figure, and will he say whether there is no more than a financial obstacle to the introduction of amending legislation to enable such cars to be provided?

Mr. Robinson

The obstacle is statutory in the first place, and then we will have to consider the rate at which we can move forward in connection with the resources available and with the competing claims on the Service.

We have now made a more accurate estimate of the cost which would be entailed in supplying cars to all those who are now eligible for invalid vehicles. We believe that the initial capital cost will be about £30 million, and that maintenance and replacements costs will eventually be about £15 million a year. This is rather more than we thought earlier.

Mr. Marten

I am sure that the Minister regrets as much as I do the fact that we cannot do more. Is he now bumping up against the statutory limits to which he referred? Looking backwards, can he explain why in 1966 there were 172 fewer four-wheeled vehicles supplied than in 1965? It seems to be a curious thing.

Mr. Robinson

I should like notice of the last question. Did the hon. Member refer to invalid vehicles or cars?

Mr. Marten

Cars.

Mr. Robinson

The bulk of the cars go to war pensioners. I cannot explain offhand why the number was fewer last year, but there has been no change in the arrangements to explain it. I do not know whether it is correct to say that we are bumping up against the statutory limits now. I think that we have been bumping up against them for some years past.

Sir G. Nabarro

I welcome any measure which will improve transportation for the war disabled, but is the Minister aware that it took me eight months to wring from his Department, reluctantly, a mechanically-propelled invalid carriage for a 100 per cent. war disabled constituent of mine, a Mr. Victor Cleaver of Bretforton, Worcestershire. As there are widely differing views about amending legislation, will the Minister talk to the Leader of the House about providing Parliamentary time before legislation is brought forward, so that room can be made for a non-party political debate in which Members can relate the experiences they have had in the last twenty years of helping war disabled men?

Mr. Robinson

I should welcome a debate on this matter, but that is not a question for me. I do not know whether a debate would be necessary for the purpose of framing statutory provisions. We know what we want in the way of powers to do what we hope eventually to do. I hope that the hon. Member for Kidder-minster——

Sir G. Nabarro

Worcestershire, South. You are out of date.

Mr. Robinson

Out of date. I beg the hon. Gentleman's pardon. I hope that the hon. Member for Worcestershire, South (Sir G. Nabarro) will not assume that the delay in the provision of one of these vehicles was the result of bureaucracy. These are medical decisions as to the eligibility for vehicles. There may be complicated medical decisions in a particular case. I shall look into the case mentioned by the hon. Gentleman again. but I would guess that probably it was a medical matter rather than an administrative matter which led to the delay.

Dr. Winstanley

May I add a warm welcome on behalf of my party for the statement made by the Minister of Health? It will be warmly welcomed by the disabled, by the doctors who have to deal with them, and surely by everybody else. What steps will the Minister take to publicise the new arrangements, especially among those in contact with the disabled, and the disabled themselves? Secondly, in computing the cost of further steps, will he also take into account the substantial economic benefits which can accrue from making the disabled more mobile?

Mr. Robinson

The last point raised by the hon. Gentleman is one that we take into account. One of the three categories of disabled is specifically linked with the ability of a disabled person to get to work. I hope that my statement will receive full publicity and anything that my Department can do to publicise it, it will do

Mr. Fortescue

Is the Minister aware that frequently in the last year I have asked him if he will consider a scheme whereby people entitled to a tricycle but who have a car should be allowed to pay the difference themselves? He has always told me to await his statement. I have now heard his statement, but there is no reference in it to the point that I have raised. Would he clarify the position?

Mr. Robinson

This is a difficult matter because, as I tried to explain in my statement, the arguments against going further than we have at the moment do not rest to any great extent on the difference in cost between the provision of an invalid tricycle and the provision of a car. The difficulty is that once one offers a car, or the equivalent of a car, or the difference between an invalid tricycle and a car, one widens the demand very considerably. We have to take that question into account.

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