DISABLEMENT COMMISSION BILL

HC Deb 28 March 1969 vol 780 cc1990-2033

Order for Second Reading read.

1.30 p.m.

Mr. Gordon Campbell (Moray and Nairn)

I beg to move, That the Bill be now read a Second time.

The Bill is a short one, and it sets out simply to establish a small advisory commission consisting of between four and six members who would consider the whole subject of disablement and then make recommendations on changes and additions to pensions and benefits for the disabled. The Bill does not seek to deal with the pensions, benefits or conditions of the disabled. All that it seeks to do is set up a commission which would then carry out certain tasks.

Those who have followed the subject will know that this short simple Bill is a further stage in what I and some other right hon. and hon. Members have been trying to do over a period of two or three years. I have been fortunate in two Ballots. I was first fortunate in a Ballot for Motions which meant that, a year ago, I was able to have a day's debate on the subject on the Floor of the House. Now I have been successful in the Ballot for Private Members' Bills and so have been able to bring in this Bill.

While disability of all kinds and of varying degrees raises problems, I have concentrated on the categories of the very severely disabled who at present fall outside our systems. We have systems for dealing with the war disabled and the industrially disabled, and we in this House are very much concerned to see that those systems operate efficiently, just as we are concerned about the adequacy of the pensions and benefits involved. But there are these other categories, most of them very severely disabled persons, who have been disabled either from birth or from early youth and, therefore, have never been able to work. They have never been employed or self-employed. For that reason, they have never entered the National Insurance system. They have never been contributors, and the Government have no record of them. If they were in the National Insurance system there would be records, so that the Government would know more about them, how many there were, and where they were in the country.

Similarly, another important group consists of housewives who have never been in paid employment, who have never been in the National Insurance system, and who have been struck down by some paralysing illness or other incapacity which makes them unable to look after their houses and families. This is another category of person who is not catered for in the present system.

Two years ago, I was pressing hard for a survey to be carried out with a view to compiling a register for the whole country of those who have been missed out of the system. It was not with a view to criticising. The National Insurance system and the National Health Service have been operating for over 20 years. Historically, when the National Insurance system was brought into existence, it was based on the Beveridge Report, which had employment and unemployment as the major factors in the background. It set up a system to assist people when they were out of work.

When one remembers the 1930s and the percentages of unemployment which Lord Beveridge would have been considering when compiling his Report during the war, it is not surprising that the system, whether for sickness benefits or retirement pension, was based on persons receiving benefits when they were out of work. Those who, for one reason or another, could never have been in employment were not catered for. That, basically, is the gap which has appeared in the system 20 years later.

When I was pressing for the survey, I put down a battery of Questions and raised the matter in other ways, and I succeeded in getting a statement in reply to a Question which I asked on 23rd October, 1967, that the Government's Social Survey was to start a study throughout the country in order to gain information on this subject. I can do no better than read what the Minister said in that reply: The Government's Social Survey will undertake next year a study of adults living at home who are substantially and permanently handicapped by limitations in their movements. The survey will show the extent to which they receive and need help from local authority services and will assist in the development of those services."—[OFFICIAL REPORT, 23rd October, 1967; Vol. 751, c. 1332.] That study is going on, and I shall be glad if we can have from the Government the latest estimate of when it will be completed and the results made public.

In paragraph 91 of the White Paper on National Superannuation and Social Insurance, the Government stated that the action to be taken on the groups who were outside the National Insurance system must await the result of that study. In other words, all future action on this by the Government has to await the result of the study by the Government Social Survey, which I greatly welcomed when it was first announced in reply to my Question.

In a slightly different form, this Bill was introduced by the hon. Member for Stoke-on-Trent, South (Mr. Ashley) last summer. He introduced it under the Ten Minute Rule procedure, and he had supporters from all parts of the House. I was one of its sponsors. The hon. Gentleman has done a great deal for and on behalf of the disabled, and I am sorry that he cannot be here today though, of course, he is a supporter of my Bill. We all congratulate him on the way in which he has overcome his own disability and decided to stay in the House. We have all admired his decision and the way in which he has been so successful in carrying on.

Last summer, a crowded House gave the hon. Gentleman leave to bring in his Bill. There was a very full Treasury Bench that day. On that occasion and after it, the Government gave every impression that they were in favour of the Bill. When I was successful in the Ballot later last year, I thought that, in taking up and presenting it, I was bringing forward a non-controversial Bill which would be welcomed by the Government and by everyone else who was concerned about the plight of these disabled groups.

In the form in which the hon. Member for Stoke-on-Trent, South brought it in, the Bill could get no further. Under the Ten Minute Rule procedure, there was no possibility late in the summer of it's going through its stages and being completed before the end of that Session. Therefore, it was not surprising that I or some other Member who was successful in the Ballot should have brought it forward. Again, I have sponsors from all sides of the House for the Bill.

I made some changes to the context, because I wanted to make it, as a Private Member's Bill, more easy acceptable to the Government. For example, I took out that part of the Bill which would have cost money, because that was not necessary. I also consulted the Government to see whether there were any other ways in which I could make the Bill more easily acceptable to them.

Another point is that the Disablement Commission is entirely advisory. It will not take any decisions about pensions, benefits or conditions concerning the disabled. It is purely advisory to the Government. There is no question of it taking away decisions which rightly are those for the Government of the day to take. That is why it was surprising when the Government suddenly declared their hand and came out against the Bill. I hope that they have changed their mind today. But I must record the fact that, when I consulted them about it, they eventually told me that they could not support it. This surprised not only me but everybody else who had been working in this sphere.

An advisory commission of this kind would be able to help the Departments by studying the special problems of the disabled and making recommendations. The Government appeared to be presenting two faces: the one they presented last summer when the Bill first appeared with the general acclamation of this House, but which could go no further; and the other which they presented when my Bill appeared and they had to decide what they thought about it. It was a shock, in particular, to the organisation known as D.I.G.—the Disablement Income Group—which had been working very hard to bring to public attention the plight of these groups of severely disabled about whom I have been speaking.

In the last two years I have frequently been asked by the Press, in particular, and also on radio and television, why these problems have arisen now and why they did not arise earlier during the 20 years of the National Insurance system. I believe that one reason is that the persons involved are physically helpless individuals, most of whom are out of touch with each other. They are the very opposite of a pressure group. In the past it has been impossible for them to make known their existence even to the Government, because the Government still do not know in what numbers they exist or how they are dispersed throughout the country. It was extremely difficult for them to get together into any kind of organisation until the formulation of the Disablement Income Group.

Some of the people most concerned with the Disablement Income Group are themselves very severely disabled. It is remarkable that people in wheelchairs or from hospital beds should be able to organise a group through the post or by telephone. D.I.G. is particularly shocked at what apparently has been the Government's attitude to my Bill. I hastily add that I hope that the Government, on reconsideration, will have second thoughts today.

As I have mentioned, these people are either bedridden or have to spend their time sitting in chairs or wheelchairs in their houses. I am talking about the very severely disabled. Life for them can be very grim. Many of them have to be in hospitals or institutions being looked after, because there is no one outside who can give them the necessary help. Others are able to live outside because they are helped voluntarily by their families or others. It should be our intention to encourage as many as possible to live outside hospitals and institutions and to enable them to get the help that they need to live as normal a life as is possible.

The reason given by the Government in January when they informed me that they could not support what I thought was a non-contentious Bill was that Ministers and officials did not need the advice which this advisory commission would produce because they had to do the job and they knew all about the situation. I submit that they cannot know enough about it. I have already pointed out that because the particular groups about whom I am concerned are not in the National Insurance system, there are no records. The Government have had to start a study to try to find out where they are. There is a great deal more to be known about the different kinds of disability and how these people should be treated and helped. I am sure that this information is simply not available to the Departments.

In former existences I have been both a Minister and an official. I am well aware that Ministers and officials are very busy getting on with their jobs. They have a lot of work to do and they are busy doing it. Therefore, it is not easy for them to sit down and consider the whole sphere of the disabled and their disabilities in the way that the Commission which I propose would.

I should like to give one example of the difficulty of Ministers. In the debate on the White Paper on Proposals for Earnings-Related Social Security on 6th March this year, there was an exchange between my hon. Friend the Member for Hertford (Lord Balniel) and the Secretary of State for Social Services which I should like to read: Lord Balniel: If I understood the right hon. Gentleman aright, it applies to the short-term sickness benefit—it cannot apply to a long-term civilian disabled pension, for which I was asking. Mr. Crossman: It will apply to long-term sickness and long-term unemployment, as is stated briefly here. It is in that context that we are prepared to consider the problems of disability. Lord Balniel: Yes, but the right hon. Gentleman is well aware that long-term sickness benefit applies only to people in the insurance scheme and the civilian disabled housewife who has never been in work is not in the insurance scheme."—[OFFICIAL REPORT, 6th March, 1969; Vol. 779, c. 729.] Here is a major debate on the Floor of the House with the Minister concerned not recognising that the very groups about which we were talking were not in the National Insurance scheme. That was the whole point. All that the right hon. Gentleman was saying about disability benefits and allowances being considered in the short-term or the long-term sickness benefit had no effect on the people about whom I am talking. They could not benefit from that scheme because they are not eligible for sickness benefit whether in the short term or the long term. I found that exchange a real illustration of what I can only describe as the ignorance which can exist, and it shocked me.

I note that there are already no fewer than six—there may be more—advisory committees on health and social security, but the Ministers do not object to them. They do not seek to abolish them on the basis that Ministers and officials already know enough. These advisory committees cover other spheres. There is no committee dealing with the disabled and the problems which I have raised today.

If the Disablement Commission were set up as proposed in the Bill it would be in existence in time to help with the consideration of the results of the Government's Social Survey. If the results of the study became available towards the end of this year, the Commission would be established and ready to go ahead to help the Government sift and consider the information which would become available. I make it clear again that the Commission itself would not take decisions. It would merely make recommendations.

I should like, also, to make it clear to the Government that there is a lot of money to be saved in this business. By helping the disabled to live normal lives, or nearly normal lives, and so far as they can to do useful work, which is possible in many cases, a great deal of money could be saved. A little money thoughtfully spent in keeping a severely disabled person out of hospital could result in a great saving. If someone is in hospital permanently he costs very much more to public funds, and also uses a much needed bed and hospital resources.

We all know examples of very severely disabled persons who have been able to overcome their disabilities, but they need help and encouragement. At the moment not enough is being done for what are described as the civilian disabled. They are not being given the encouragement they need.

The Bill gives the Commission the duty of reviewing pensions and benefits and making recommendations. In order to do that properly, the Commission would have to go into all these matters. It would study how very severely disabled persons could be assisted. In this way they could come out of hospital and live in their own homes, and would be able to pay for the help which they need, which may mean for two or three hours a day. In that way people would be able to be outside a hospital or an institution, instead of being permanently inside it.

The Government surely cannot object to the Bill on the grounds that it would add to public expenditure. The Minister will have seen that it is proposed that the members of the Commission should be unpaid. That is one of the changes which I made from the original Bill. I did sc because my inquiries showed that then; was no shortage—and I assure the Government of this—of qualified persons who would be only too glad to give their services part-time on this Commission. Any other expenditure which would arise under the Bill would be derisory—purely small administrative expenditure.

If the Government feel that the task of the Commision should be better described, I am not wedded to the wording of the terms of reference. If the Government accept the principle of an advisory Disablement Commission, the terms of reference could be spelled out differently if the Government so wished.

The Minister will also have noticed that in the Bill the Chancellor of the Exchequer is very much brought into the picture, as is the Secretary of State for Social Services. This recognises that anything done to help these people is something with which the Treasury must be concerned, because eventually if benefits and pensions are to be affected the Chancellor of the Exchequer will have the last say. Both these Ministers will be interested in reducing the burden on the hospital services.

The burden on the National Health Service and on the hospital services can be reduced if there is a more progressive attitude to the severely disabled in our community. Ways of enabling the disabled to fend for themselves, and enabling them to pay the comparatively small amounts which may be needed for other people to help them in their own homes, are matters which ought to be looked into but about which too little is being done. If such help were given, it could lead to a considerable easing of the burden on the National Health Service

I should like to ask the Minister about the Government's Social Survey. Paragraph 91 of the White Paper suggests that the Government have in mind some kind of supplementary benefit for the very severely disabled who are not in the National Insurance Scheme. Supplementary benefit is the old National Assistance benefit, so it is clear that in the Government's view as set out in the White Paper these people would not be part of the National Insurance Scheme, and they may never have contributed to it.

The statement in paragraph 91 is extremely vague and those bodies outside the House who are working on behalf of the disabled are worried about the vagueness of it. The main categories of people outside the National Insurance Scheme are those who have been severely disabled from birth or youth and housewives who later in life have been struck down with incapacity. Do the Government intend to compile a register from the results of the Social Survey? The Minister may say that the study is not to be comprehensive and therefore will not produce all the facts and figures for the country. In that event will the Government take any further steps to compile a register for the whole country?

Questions which I and my hon. Friends have put down over the last two or three years have revealed that some local authorities try to keep records of the disabled in their areas. There is no obligation on them to do so, and therefore the only picture that we can get is that of the situation in some areas. The Government might have been able to produce the figures themselves if these disabled people had been in the National Insurance Scheme because there would then have been records for them.

As there are no Government records, what do the Government intend to do about compiling a register? So far I have been unable to get this information. I continue this questioning of the Government whenever I get the opportunity, and gradually I manage to extract information. The Government have moved gradually, otherwise we should not have the Social Survey going on at the moment, but, looking to the next stage, I hope that today the Minister will say that it is the Government's intention to have a proper register.

As I said, the Government's attitude to the Bill in January caused great dismay, because it was compared with their apparent support for it when it was introduced by the hon. Member for Stoke-on-Trent, South in the summer. The Government's attitude has caused disillusionment and I therefore ask the Minister to change his mind, if he has not already done so. While the Government are awaiting the results of the study, and while they are later considering them, which will take some time, the Commission could be being set up.

It would be the one action which the Government could now take which would be very heartening, not only to the severely disabled but to all those who are working on behalf of them, and to the bodies who represent them. This action would not involve any public expenditure but it would show that the Government meant business. It would demonstrate to the country and the world that this Parliament and the Government wish to be fully informed and to make progress in dealing with this important subject.

2.0 p.m.

Mr. David Gibson-Watt (Hereford)

The Bill which my hon. Friend the Member for Moray and Nairn (Mr. Gordon Campbell) has introduced should have the sympathy and understanding of hon. Members on both sides of the House. It reflects an anxiety which many people have in respect of one of the many problems of the disabled. In the past other hon. Members have introduced Bills of various sorts in this connection and it is to be hoped, following what my hon. Friend has said, that the Government will tell us the results of their survey and what they intend to do on the lines suggested by my hon. Friend.

I support the Bill wholeheartedly, and hope that it will receive a Second Reading. I hope that my hon. Friend will forgive me if I go on to say that I shall ask him to extend the Bill to cover other aspects of the problems of disabled people. My hon. Friend normally speaks for Scotland. I normally speak for Wales. On a Friday we can all speak as private Members on a matter which is relevant to all parts of the United Kingdom—England, Scotland, Ulster and Wales.

In dealing with this problem we are dealing not only with the war disabled and the industrially disabled but also with the mentally disabled. I should therefore like to see an increase in the size of the Commission suggested in the Bill. If it is limited to six members I do not think that it will be able to deal with those other problems of the disabled that I want the Bill to cover.

I say this for two reasons. Estimable as is my hon. Friend's Bill in bringing to the fore the plight of the disabled—in the home and in institutions—I doubt if the country appreciates the size of the problem and the numbers involved, it would be possible to extend the Bill's provisions to those who are also mentally disabled.

Only yesterday we heard a very unpleasant and significant report on the Ely Hospital in Cardiff. In introducing the report the Minister made no bones about the conditions in the hospital and the failures of those responsible. He said: Responsibility for serious deficiencies in the standards of medical and nursing services and of administration is attributed to the senior staff of the hospital, to the Hospital Management Committee and to the Welsh Hospital Board."—[OFFICIAL REPORT, 27th March, 1969; Vol. 780, c. 1809.] I do not wish to take up too much time of the House on this Welsh matter and I hope that I may be forgiven for referring to it but the deficiencies mentioned in the report show a state of affairs which is far from happy. I wonder what the Welsh Hospital Board and the hospital management committee will do. They should examine their own positions. Will any of their members resign? Many people in Wales feel ashamed of what has happened in that hospital.

This touches upon the fact that many people, especially in their old age, go to this type of hospital. Some of the people are disabled and some are purely geriatric cases. Today I shall not go into the question of the provision which Governments of all hues have made in respect of old people's homes and sheltered accommodation outside hospitals. I still think it is insufficient. This is one reason why so many geriatric patients are in these institutions today. It greatly complicates the job of those who have to look after people in institutions, hospitals and homes of this sort, and whose work and care for them is so praiseworthy.

I hope that my hon. Friend will forgive me for saying that I hope that the scope of the Commission's work can be extended. If such a Commission had been in existence some years ago it is possible that the conditions which prevailed in Ely Hospital in Cardiff would never have occurred.

Mr. Gordon Campbell

My hon. Friend has mentioned his desire to extend the provisions of the Bill to cover mental disability. He will see that at the end of Clause 4 disability is defined as being mental as well as physical. Severe disability of a mental kind as well as of a physical kind would be included.

Mr. Gibson-Watt

I am very grateful to my hon. Friend for pointing this out. To that extent I do not seek to extend the facilities provided by the Bill.

This fact is important, because in many cases the difference between physical disability and mental disability are not easily definable. This is a huge subject. The unemployment figures for South Wales, under any Government in the past, are higher than the national average, and this reflects the high percentage of industrially injured people. This applies to any other coalfields area. That is one of the factors that we are up against all the time, and shows how these areas have suffered.

My hon. Friend was right in what he said above Beveridge. It is now widely recognised that conditions have changed, but that we have not yet got away from the old concept. We have to recognise the fact that Beveridge was based upon the unemployment figures of the 'thirties. We have not yet sufficiently understood the change that has taken place, and that this should be reflected in a change of approach to our social problems.

It is not my habit to make a long speech, but debates on Private Members' Bills on Friday mornings produce the sort of atmosphere in which it is possible to discuss the problems of this sort concerning the disabled. This is a good Bill. I hope that the Government will accept it and that I shall be honoured to serve on the Committee. The Bill should receive the wholehearted support of hon. Members on both sides of the House. I hope that the Minister will accede to my hon. Friend's request that the Government should tell us the results of the survey to which he has referred, and that the Government will give the Bill their support.

2.10 p.m.

Mr. Ben Whitaker (Hampstead)

I want to give all-party support to what has been said, because I believe this is one of the subjects which should be taken out of party politics. It is a more important matter than party politics. That view is widely shared by the public generally. The massive abstentions which we saw in yesterday's by-elections reflect the disillusionment with all three parties, and in particular it can be traced to the fault of politicians in so often trying to make party capital from real problems. One of the problems, not only of Governments but of all parties in the past, has been neglect of the conditions for mental health patients and for our disabled people.

This is no fault of these disabled people. They have no sponsored Members to speak for them. It therefore behoves us who are lucky enough not to be disabled to act as their trustees and to be both doubly conscientious and doubly active. And I say "active" because they need action, not platitudes which they have received from politicians of all parties for so long. The disabled are one of the groups in our society, like the mentally ill, who can exert no powerful pressure at election time. Unlike the B.O.A.C. pilots or the dock workers, they cannot form a pressure group. Recently, largely thanks to the efforts of Mrs. Du Boisson, they have started a nucleus of an organisation, the Disablement Income Group. This has been helped by hon. Members of all parties, including my hon. Friend the Member for Plymouth, Sutton (Dr. David Owen), the Under-Secretary of State for Defence for the Royal Navy, who I am glad to see is here, and my hon. Friend the Member for Stoke-on-Trent, South (Mr. Ashley) who is not, unfortunately, able to be here today.

We should not shield from the public that what is necessary is a considerable injection of money to right the conditions for disabled people which they suffer through no fault of their own. We also need a massive amount of money to rectify the years of neglect of the mentally disabled. It is the job of all of us, and the Government, to persuade public opinion—who are fortunate enough not to share these disabilities—to make sacrifices instead of, as is so often the case, leaving the disabled out of sight and out of mind, like the mentally ill, until there is some shocking exposure of a scandal like yesterday's report on Ely Hospital which reactivates public concern momentarily. When it comes to voting taxes, so often people tend to ignore issues like this which should be real priorities.

2.15 p.m.

Mr. John Astor (Newbury)

I should like to congratulate my hon. Friend the Member for Moray and Nairn (Mr. Gordon Campbell) upon introducing this Bill. I apologise to him for missing his opening remarks. Since I have spoken on this subject on a number of occasions, I will not speak at great length or repeat what I have said.

I agree very much with the hon. Member for Hampstead (Mr. Whitaker) that this is in no way a party political matter. All parties have been guilty, over the years, of neglecting the needs of the disabled. I hope that there will not be a party vote on this Bill; I hope that it will be supported on all sides. I was rather disappointed, when my hon. Friend brought it forward in late January, that it was refused a Second Reading. I was surprised because the hon. Member for Stoke-on-Trent, South (Mr. Ashley) had introduced a similar Bill during the summer which had been received with great enthusiasm in all parts of the House.

With all respect to my hon. Friend this is a rather modest Bill, but modesty has certain virtues. One is that it is not expensive, and the Bill would not involve any additional cost to the Government. Even if it is only modest, we should welcome anything which will help solve the problems of disabled people. I understand that one of the arguments against the proposed Commission is that the Minister already has a number of advisory bodies giving him all the advice he wants. I am sure that many people are always prepared to give advice to Governments. However effective these advisory bodies may be in certain areas, it is clear that the disabled have been neglected.

One of the reasons always given for not taking more prompt action to help the disabled is that not enough is known about the extent and scope of the problems. In the past there has been a great lack of information. This advisory body can help fill that gap. But for the efforts of disabled people it is probable that this problem would not be so prominent and attracting so much attention. The person who inspired the Disablement Income Group is a disabled person. When she came face to face with the problems she was appalled to find this gap in the welfare services. This Group has done a tremendous amount to educate the public and to persuade hon. Members and members of the Government to help. It is unlikely that the welcome announcement in the recent White Paper about an attendance allowance would have been introduced but for the fact that the Group was able to present its case to the Government, which took note of it.

Mr. Gibson-Watt

In my speech I omitted to refer to the excellent work that the British Legion has done in this sphere. Would my hon. Friend agree that they have played a great part in putting forward the case for the disabled?

Mr. Astor

I entirely agree. The British Legion has done a great deal, but my thoughts are oriented more to the civilian disabled. The Commission would not usurp the Government's responsibilities. It would be able only to give advice. It could analyse the many and varied problems associated with disablement. Some of the more obvious are the need for extra electricity to keep people warm, attendants to look after them and telephones in case of emergency. Often it is a matter of life and death. They may be dependent entirely on a machine. What happens if it breaks down? Unless someone is there with a hand-pump or a standby plant is available, a few minutes electricity cut could have disastrous effects.

There are many such problems, and every disabled person has to meet a different problem in his individual family circumstances if he is to continue living at home. It is important that, wherever possible on medical grounds, disabled people should be able to continue living at home with their families. They need a tremendous amount of courage to overcome their handicaps, and they can be greatly helped if they are surrounded by the love and affection of their families.

This is not a one-way traffic, because the disabled person also contributes to the activities of the family. I know of a severely disabled mother of two children who is permanently confined to bed, but she has played a vital part in keeping the family united and bringing up her two sons. My hon. Friend mentioned that it is much more economical for people to live at home rather than to be cared for in an expensive hospital bed.

I understand that the results of the Government survey will be coming out fairly soon. This Commission should reinforce any evidence in it and give valuable advice. I therefore hope that the Government will accept the Bill as a step forward and a real contribution to helping the disabled.

2.21 p.m.

Mr. Marcus Kimball (Gainsborough)

I add my congratulations to my hon. Friend the Member for Moray and Nairn (Mr. Gordon Campbell) for his continued attack on this problem. There seems to be a theory that a Private Member's Bill succeeds at the first attempt, but in earlier years many took several debates and several years to go through. My hon. Friend's attacks are certainly consistent and he has proved himself a skilful manager of the Order Paper by the fact that, although in bottom place in the Ballot, he has gained a Second Reading debate for the Bill. I hope that we will shortly see it in Committee.

When, on 21st February, the Government rejected the Disabled Persons' Pensions and Miscellaneous Provisions Bill, the Parliamentary Secretary told us the numbers of people involved—170,000 sick and disabled under pension age, 412,000 war wounded and 219,000 industrial injured. He went on to say that in the Government's opinion, the services which these people got from local authorities were just as important as cash and supplementary benefits.

One of the most worrying things is the varying standards of local authority services. In the County of Lindsey, the welfare services for the disabled are as good as in any other county in England because, in a large rural area, we are fortunate in having a large number of people who can give voluntary time and help. But one of the most disturbing facts brought out by the Local Government Commission a few years ago was the differences in local authority services, which it used to back up its argument for some change in local government boundaries.

The important thing about the Bill and the reason that it is better than the Bill which the House rejected on 21st February, is not only that it will not cost the taxpayer much but that it will reinforce work now being done by the advisory committee which the Government set up to consider the health and welfare of handicapped people. The Commission which the Bill proposes will have power to recommend an annual review of pension levels for the disabled.

The Government rejected the earlier Bill because they felt that the economic circumstances did not justify it, but those very circumstances make it even more urgent to do something for disabled people. If the disabled, by help and supplementary payments, can continue to lead a normal life at home, this is very expensive, for instance, in housing, because the house must be adapted with a lift or some other device, there must be wide doorways and slopes instead of stairs. It is also expensive in transport, whether through the specialised adaptation of a motor car or simply because they have to use public transport and avoid the rush hours. It is also expensive in clothing. So there is a real case for this Commission looking annually at the plight of the disabled and advising the Government at what level their pensions should be made.

Several hon. Members, including the hon. Member for Hampstead, Mr. Whitaker) have paid tribute to the tremendous amount of work which has been done by the Disablement Income Group and it is significant that we have had two debates in private Members' time on this subject already this year. This shows how public opinion is at last being awakened to this problem. It is significant, perhaps, that there is some small improvement in the Government's White Paper on superannuation. However, I hope that today we will have an indication of one other success in the mobilisation of public opinion through the Disablement Income Group when the Parliamentary Secretary says that he will accept my hon. Friend's Bill.

2.27 p.m.

Mrs. Jill Knight (Birmingham, Edgbaston)

In supporting the Bill warmly and commending the speech of my hon. Friend the Member for Moray and Nairn (Mr. Gordon Campbell) I also support the plea of my hon. Friend the Member for Hereford (Mr. Gibson-Watt) that more people should be put on this Commission. The problems and difficulties of the disabled are not covered by pensions and benefits. There are many more problems. Since this Commission will be looking at these problems, it should open up and recognise the other problems.

I want to give three short examples of ways in which it is necessary for this provision to be opened up. The first relates to taxation. I find it extraordinary that, if a man has a disabled wife who is totally incapacitated, he can claim a tax allowance for a housekeeper, but that if the positions are reversed, if it is the husband who is totally disabled and the wife who must go out to work to support them both, she can claim nothing.

It is not always recognised that the disabled have a particular difficulty in some areas. One instance is the care of deaf children, the situation of which in Birmingham is severe. I am sure that this is not the only area where this applies. I should like the Commission to examine what facilities are available in that area for afflicted persons and try to see that something is done, or at least that the problem is posed.

Disabled people suffer many difficulties. For instance, a great difficulty for some of them is access for their wheelchairs in various cities. These people have a wide range of problems in which, if it is set up, the Commission should interest itself, but a Commission quite as small as that suggested might not be able to study the full range.

It should be made clear that attendance in the Chamber today is not indicative of the House's support for this principle. We all know that hon. Members often face great difficulties on Fridays—constituency arrangements cannot always be altered—and the public might imagine that small attendance meant a lack of interest by the House. That is certainly not the case on this occasion. Hon. Members on both sides and of all parties have a great interest in this subject.

We cannot continue merely paying lip-service to the needs of this group, and the Bill has been framed in the most general way in order to cover the various difficulties which the Government might find themselves facing. My hon. Friend has leant over backwards to make the Bill acceptable to the Government. I warmly support him, and I hope that if the Bill goes to a Standing Committee all the points that have been mentioned in this debate will be most carefully considered.

2.32 p.m.

Mr. William Molloy (Ealing, North)

The Bill deals with a very poignant subject, and I very much agree with the hon. Lady the Member for Birmingham, Edgbaston (Mrs. Knight) when she says that Parliament has a responsibility. The fact is that Parliament has shown its concern for the disabled perhaps more in the past few years than for many a year before, and for this the Government can claim great credit.

We should acknowledge that much of what has been done has its roots in the National Health Service. I was born in an area afflicted by great industrial upheavals such as mining and shipping disasters in which people were disabled and left incapable of following their normal employment. In addition, there were those more gruesomely afflicted by being born disabled. One of the brutal blotches on our pre-war society was that no one seemed to care; that no one was concerned. The country did not appear to want to be involved in the problems of the disabled until the advent of the National Health Service. From that time on, we have made remarkable progress.

I cannot agree with the hon. Lady, though I do not think that she really meant it in this way, that we have been paying only lip-service since the war. In the last four or five years we have done much more than that, though I confess that the progress so far made does not satisfy me. But the contribution of our people via this House has been not; inconsiderable. The introduction of various supplementary benefits has made a marked contribution to the lives of disabled people, and particularly to their families.

In all the sad and poignant story, I am desperately concerned about the situation of the disabled mother. In what might be called the ordinary working-class family, the rôle of the housewife with, perhaps, half a dozen children can be pretty grim, but when that same woman is disabled, life indeed becomes very grim. I have such mothers in my constituency.

One can only marvel at their courage in combating their affliction, and at the wonderful example they show to others in caring for their families, moving around in a wheelchair from kitchen to living-room. Various rooms have to be altered in order to eliminate steps and enable the wheelchair to be manipulated. They are, indeed, proud of their ability to manipulate their wheelchairs. Yet we have not so far taken real cognisance of the fact that these people bear an additional burden. A mother so afflicted is often compelled to seek additional help in running the home. We should concentrate some attention on this aspect.

I know the feelings of the hon. Member for Moray and Nairn (Mr. Gordon Campbell). I have had the privilege of sharing with him platforms, if that is the word, at demonstrations to call attention to the plight of the disabled. I know that he will agree with me that the work that has been done by the Disablement Income Group is quite remarkable. It is a comparatively new group, but it has certainly made its mark. It has been led by a remarkable woman, Mrs. Du Boisson, who has been its inspiring force. Those who previously had no interest in the disabled now have an interest because of this lady's determination and charm. She herself is disabled. If a permanent Commission such as that envisaged in the Bill should ever be established, I see no reason at all why someone with such remarkable and specific knowledge should not be a member.

The Government outlined their intentions in the White Paper "Proposals for Earnings-related Social Security", and legislation on those lines will further assist these people. In the past four or five years, hon. Members of all parties have done much to support various organisations seeking to put the case of the disabled on the agenda of our political hares, and I have been proud to associate myself with their endeavours.

2.40 p.m.

Mr. Paul Dean (Somerset, North)

I join the congratulations to my hon. Friend the Member for Moray and Nairn (Mr. Gordon Campbell) on his luck in the Ballot and on his persistence in this subject for many years. I suppose that I should declare a marginal interest in that I am in receipt of a war disability pension and am also a member of the British Legion. I am glad that the British Legion has been mentioned, but the House will, I am sure, also wish to pay tribute to the other organisations, both statutory and voluntary, which do so much good work in social service.

I am sure that the Under-Secretary of State will be as struck in this debate as in the previous debate, which we had only on 21st February on a Bill introduced by my hon. Friend the Member for Lowestoft (Mr. Prior), by the unanimous opinion of all the speeches on the need for action, and early action, on this issue. It is equally striking that, as shown both today and on 21st February, there is the growing view not only in the House but outside that, in modern conditions and with the knowledge which we have about the disabled, we need to look increasingly to the extent of the disability rather than to the cause if we are to deal with the gaps which exist and to try to overcome the anomalies of which we are all well aware.

I was sorry, as I am sure were many hon. Members, that, on the last occasion, there having been an almost unanimous view in favour of the Bill presented by my hon. Friend the Member for Lowestoft, it was voted down and did not have a chance to be considered in detail in Committee. I hope that that will not be the fate of this Bill, which was introduced so eloquently by my hon. Friend the Member for Moray and Nairn. As my hon. Friend mentioned, the Government gave every indication last summer, when a similar Bill was introduced, that they were interested in the proposal and, indeed, welcomed it. I hope that we are not to be disappointed again today by the Under-Secretary of State's reply.

There is disappointment not only in the House about the Government's apparent change of attitude. Our disappointment is shared by those outside who are particularly interested in this matter. This morning I received Newsletter No. 11 from D.I.G. referring to correspondence which it has been having with the Secretary of State about the proposed Commission. The Newsletter said: … to our surprise and disappointment, Mr. Crossman set his face resolutely against any Disablement Commission or advisory body, declaring that he and his colleagues are 'responsible for ensuring that the right things are done for the right people at the right time and in the right way'. We find this a curious declaration of paternalism when in so many public utterances Mr. Crossman comes out strongly in favour of participation". The Newsletter goes on to say that D.I.G. hopes that the right hon. Gentleman will change his mind. I am sure that the House hopes so, too.

I will give briefly some of the reasons, in addition to and in amplification of those given by my hon. Friend, why I believe that the Bill, with its proposal for a Commission, is so valuable and timely. In saying this, I show no disrespect to any of the organisations which already exist—for example, the Advisory Committee on the Health and Welfare of Handicapped Persons. We know that it has done a splendid job. As my hon. Friend the Member for Newbury (Mr. Astor) said, it is significant that the committees which advise the Minister have not been able, possibly because they have not had time, to focus attention on this problem. It has been done only when organisations like D.I.G. have done it.

Another very good reason is that it is generally accepted that we must get the health and welfare services locked in very much more closely together and that we must get a complete picture of the needs of the individual and his family. Nowhere is this truer than in the case of disablement where, as my hon. Friends the Members for Gainsborough (Mr. Kimball) and Birmingham, Edgbaston (Mrs. Knight) pointed out, such a wide variety of the services is required by disabled people.

In the first place, the whole family is inevitably affected. It may well be that another member of the family who would otherwise be earning has to stay at home in order to look after the disabled person. Many of the health and welfare services are affected. The severely disabled are in close touch all the time with their family doctors, with the supporting services provided by the local authorities—home nursing, home helps and the rest—and with similar services provided by voluntary bodies, and they also need the services of the hospitals on many occasions. The first important thing which such a Commission could do is help to see the picture as a whole. It could equally help to supplement our knowledge. Some of the gaps are being filled but many are still left in our knowledge as to the extent and causes of disability and the best and most economic way in which we can help the disabled.

The third and one of the most important reasons is that new information is coming forward on the problems of the disabled. We are soon to have the Government's Social Survey. Indeed, if I recall correctly, we were told on 21st February that it was coming in the spring. I need not remind the Under-Secretary of State that it is now spring. The weather does not suggest it, but it is nevertheless spring. I hope that he will be able to tell us when the Survey will be available to the Government, so that the Department can start work on it, and when it will be published and available to the House. The Commission can assist in assessing the implications of the new information coming forward and could help the Government in deciding what action is required.

Another reason is that the administration of the social services as a whole is very much in a state of flux. We have the Department of Health and Social Security. We had a Green Paper on the structure of the National Health Service which, we understand, is being withdrawn, with another to take its place. We have the Seebohm Report on Local Authority Personal Services. We have the Royal Commission on Medical Education, with important implications particularly for the rôle of the family doctor. Finally, we have the Maud Commission on Local Government. Thus, all the administrative aspects which are of interest and relevance to the disabled are in a state of flux, and that is surely another strong reason for having the Commission proposed.

The final reason, referred to by my hon. Friend the Member for Hereford (Mr. Gibson-Watt), is the disturbing report which came out yesterday about Ely Hospital, Cardiff. One of the points of interest in this discussion is the attention which it draws to the need for having integrated services for the mentally subnormal, and what the Report says with regard to (the mentally subnormal is equally important in our dealings with disablement. Paragraph 456 of the Report said: Our conclusion—which lacks any novelty by now—is that the present tripartite administrative structure of the health service has not, so far as Ely is concerned, done enough consciously to encourage a more integrated service and pattern of care for the mentally sub-normal. Despite the best efforts of those concerned to interlock their activities, the gaps and the difficulties remain. A final solution will only be found within a new and more closely integrated administrative structure. The same arguments which come out in that Report and which the Secretary of State welcomed yesterday apply to the disabled and constitute another compellingly good reason for a Disablement Commission, a Commission which can view the picture as a whole, which can advise and recommend, and whose reports can be available to Parliament.

My hon. Friend the Member for Moray and Nairn made it quite clear that he is asking for a very modest step. The Bill would involve no Government expenditure and would commit the Government to nothing. Surely that is not too much to ask, particularly as these reports which are coming forward require to be examined from the point of view of people whose job it is to try to see the whole picture concerning the disabled.

I want briefly to ask the Government whether they will take this opportunity to tell us a little more about their intentions, both on the Bill and on the issues with regard to benefits which arise under the Bill. We welcome, as we have welcomed before, the proposal for a constant attendance allowance. This seems to us to be the first and most urgent step to assist the very severely disabled. We recognise, and again welcome, the fact that under the proposals which the Government have put forward this will cover wives on their husbands' insurance; and because it will be available under the Supplementary Benefits Scheme, it will also cover those who are not actually in insurance.

I hope that the Under-Secretary—I pressed him on this point on 21st February—will be able to tell us a little more about when the constant attendance allowance will be introduced. He hinted broadly on that occasion that there would be no need for this scheme to wait until the introduction of the earnings-related scheme in the Spring of 1972. I hope that he will be able to be a little more specific and to tell us at least when the Government propose that this new constant attendance allowance will be introduced. I appreciate that the hon. Gentleman probably will not be able to tell us today at what rate it will be or exactly who will be covered. He will want time to study the result of the Government's survey. Surely he should now be able to tell us when it will be introduced. I press him particularly on this because since the last debate, when the hon. Gentleman was not able to give us an indication of the time, we have had a clear indication from the Government that pensions will be increased in the autumn.

Although we welcome the constant attendance allowance, it will cover only a very small number of the disabled, so that there is a need to take the matter forward to a disability pension. I am sorry to say that it looks as though the Government have rejected the concept of a disability pension to cover all the groups about whom we are concerned in this debate. The White Paper on the earnings-related scheme says that long-term sickness benefit will be, in effect, an invalidity pension. My hon. Friend the Member for Moray and Nairn quoted the exchange which took place on that matter in the debate on 6th March.

This is not an invalidity pension. This is playing with words, because, first, the invalidity pension as the Government appear to be envisaging it would exclude those very two categories which my hon. Friend mentioned—those two categories which are not covered by the National Insurance scheme at present. The hon. Member for Ealing, North (Mr. Molloy) mentioned one category, namely, the disabled housewife. It is clear from the proposals in the White Paper that the disabled housewife will be excluded and that those who are disabled from birth will be excluded. It also appears that the so-called invalidity pension will not take into account the degree of disability.

It is not good enough to say that long-term sickness benefit is in effect an invalidity pension, when it excludes two categories about which we are most concerned and when it takes no account of the degree of disability involved. I therefore hope that the Government will think again about this, or at least that they will keep open minds until they have had an opportunity to study the result of the social survey due in the spring—in other words, due new.

Another point which the Under-Secretary will no doubt make, as he did on 21st February, is that the cost of a disability pension would be very substantial. It would depend upon the rate of it, on who was covered, and on the degree of disability which was eligible. Whatever decisions are made on details, there are the offsetting factors which have been mentioned time and time again in this debate. For want of an adequate disability pension, many disabled housewives are in hospital at the cost of possibly £50 a week or more. Many children who are in care at the cost of £10 a week or more for want of that additional cash support would probably be able to keep the family together in the home. When we are considering these matters we must take into account the total cost of disability to the community at present.

There is also the social and psychological cost involved in splitting up families and in removing them from the community. If the statement on the Ely Hospital did nothing else, it emphasised the need to keep down the numbers of people who are in long-stay hospitals and to avoid those hospitals being overcrowded.

I believe, then, that the debate, which has shown the unanimous view of both sides of the House, is one which the Government must heed. I give the Government credit for wanting to take action to deal with disability. I believe that they want to do so. However, it is disturbing that they appear to be changing their mind; they appeared to welcome a Bill very much on these lines last summer but now appear to be rejecting it. This is bound to be disturbing and it does not do the Government credit when they put themselves in a position of that kind.

The Bill, as my hon. Friend the Member for Moray and Nairn said, is modest. It would cost nothing. It merely asks the Government to accept some expert advice. It would not even commit the Government to be bound to carry out the recommendations which the Commission might make. It merely asks that a Commission of this kind should be made available to the Government of the day. Surely that is not too much to ask, particularly at a time like this, when the social survey is coming forward, along with new information about the disabled! Surely no government, if they are wise, will reject the possibility of advice in this all-important sphere.

3.0 p.m.

Mr. Alexander W. Lyon (York)

One of the saddest things I ever had to do when I was at the Bar was to interview a client who had been severely injured as a result of a serious accident and made into a paraplegic. He was virtually a human cabbage. There was difficulty in his corresponding with the members of his family, because he had virtually lost the power of speech. He was incontinent, he found it difficult to have any interest in anything, and reading was fearfully difficult for him. The result was that this put an enormous strain upon his wife who had to give him devoted attention in the home.

The alternative was that he should go into some kind of long-stay hospital, perhaps of a geriatric nature, where he would be in the company of people considerably older than himself. We decided that it was a kind of case in which we might be, able to get damages and we took it to court. There were some weaknesses in the case and, in the end, it was compromised. As a novel departure for pleading in such a case, I decided to try to evaluate what would be the cost of giving him the services which would enable him to live in his own home and to enjoy, as far as he could, the fullness of life. I had the solicitor instruct an architect to draw up plans for the kind of house suitable for a man of his nature to move about in, so that he could propel himself, to the lavatory, for example, and so that he would be able to be as independent as was possible, given his disability.

Advice was sought from electricians who manufacture aids for the disabled, to find out what would be the cost of fitting out this house to ease the difficulties with which he was faced. The total cost of such a house amounted to a little less than £10,000. This was a man living in a normal semi-detached house which, in that part of the country, was costing, then, something like £3,500. The disparity between the two figures is an indication of the additional cost which falls upon the disabled if they are to try to live anything like a normal life, a cost falling upon them as a result of their disability.

It is this disparity which is at the root of much of the objections to the present rate of compensation by State allowances of one kind or another. The State allowances are designed, imperfectly as we all know, to bring up the level of income to something like the level of earnings of a person before he met the disability. The same thing is true of pensions and sickness. Under the scheme which this Government have introduced these allowances are now much more in line with normal earning capacity. The difficulty about the disabled person is that he wants, not simply to be brought back to the level of income that he had, but he has to be taken to a level of income greater than he had ever hoped to achieve. It is this that is the real difficulty, if he is to maintain anything like a viable and full life. My sympathies are very much with the disabled.

Mr. Molloy

Would my hon. Friend not agree that, in his example of a person who was severely disabled, his requirements to live as near to normal as possible are much more expensive than those of a normal person? Would he not further agree that, for a housewife, who may never have been gainfully employed, merely to carry out her functions as a mother, if she has children, and as a housewife, for which there is no comparable job in industry, it is much more expensive?

Mr. Lyon

I agree. It is the point to which I was coming, that if a housewife, for instance, is not equipped with modern labour-saving devices when she suffers disability, the supply of those modern labour-saving devices to give her any kind of hope of independence is to put on her a burden which normally she would not have thought of shouldering. That simply underlines the point I was making, that this is a burden over and above the normal burdens of normal, everyday life. In this sense disability is different from retirement; it is different from sickness; it is different even from redundancy. Those are difficulties which can be compensated to the extent of raising incomes to the normal level of earnings, but that is not so with disability. Disability is a greater burden on the individual, and it is this which is really at the crux of the whole problem.

How are we to determine how much of the nation's resources ought to be channelled to help those who are disabled, as against the amount to be channelled into all the other items of public expenditure? I hope I have indicated sufficiently my sympathy with the plight of the disabled. In my view, a society which is as rich as ours, whatever its balance of payments difficulties, whatever the economic future, ought to be able to provide efficiently and well for disability. When one recognises the standard of living which most of us enjoy, so much higher than the standards of living enjoyed by two-thirds of the world, we ought to be able, out of that munificence, to provide for people of this kind who have fallen on times not only of difficulty but of added burdens which otherwise they would not have had to shoulder. I believe passionately that society ought to do just that.

Before we can do it we are going to have to take out of the pockets of the private consumers that amount which is required in public expenditure. This is the real moral question for the House. This is why this side of the House constantly says that it is desirable to increase public expenditure, and this is why we are attacked constantly by the other side of the House, which says that we should cut public expenditure, we should leave as much as can be to the private consumers to provide for themselves. If we were to pursue that philosophy of social action the result would be that the disabled would never get the standard of living to which they are entitled. Once we face up to that central fact of this social problem we do not need a Disablement Commission to decide it.

I listened with great interest to the hon. Member for Somerset, North (Mr. Dean) declaiming the virtues of this Commission. I wondered if he had read the Bill. From what he was saying it would seem that this Commission is to investigate ways in which disability should be lightened, the ways in which the disabled could take advantage of the new technology to overcome their disabilities, the ways in which they suffer by disability and could be helped by Government advice.

None of that, as I understand it, is within the remit of this Commission which is proposed in this Bill. All that is proposed, as the duty of this Commission, is that it should keep under continuous review all pensions and benefits for the disabled and make appropriate recommendations to the Chancellor of the Exchequer and the Secretary of State for Social Services. If that be the case, all that we are talking about is a group of wise men who are likely to tell the Chancellor how much he ought to be giving to the disabled. That is taking the matter no further.

Mr. Dean

The hon. Gentleman is under-emphasising the importance of Clause 2(1)(b) which refers specifically to: … any changes or additions to the existing system …

Mr. Lyon

I am not only under-estimating it, but I have read on a little further to the words: … the existing system of pensions and benefits for the disabled … We are talking about money and not about aids, services, advice, techniques. The money situation is a constant moral and economic problem for any government and for the country at large. What are the priorities for public expenditure? If we say that the disabled are entitled to the relief which I believe they need, and which it is our moral obligation to give them, and if we are to continue with the present level of public expenditure, public expenditure must increase. If it is not to increase by constant economic growth, which we have not so far achieved, then it must be increased by taxation, either by contributions to National Health Insurance or by contributions in Income Tax and other forms of direct and indirect taxation.

If the country faces up to that problem, then the debate will be a valid one. To think that the country can achieve the suggested living standards for the disabled by simply tinkering about with a few men on a Commission which will cost nothing is to pursue a hypocritical line of reasoning. I do not mind facing my electorate and telling them that they must pay more to help the disabled, but I am sick of these constant debates on Fridays when back benchers opposite, who did nothing about it in the 13 years of the Tory Government, tell us what we ought to do about increasing benefits, while at the same time decrying the Government because the present level of public expenditure is too high. Once it is admitted that this is the central dilemma, then progress might be made.

I believe there is a case for increasing public expenditure, and it does not need three wise men or anybody else to tell the Chancellor of the Exchequer that. We should review our present system of public expenditure and decide whether there is room for the relief of the disabled. At present there is very limited room. If the present state of the economy allows of no increase in consumer purchase for the next year or so, which is the Chancellor's analysis with which none of us disagrees, and if the prospect for growth can come only by limiting public and private expenditure over the next year or so, then the possibility of early relief is limited. The Government are doing all they can in the promises which they have made in the White Paper about constant attendance allowances and invalidity pensions to contribute to the relief which is required.

When it is possible to increase public expenditure, when priorities can be reviewed, when there is constant economic growth and when there is a hope of using public expenditure for other purposes, this issue must be decided, and must be decided in favour of the disabled. With all that I know about the economic situation, I cannot urge upon the Government that they should deal with this as a matter of early priority. At the moment, none of us is in an easy position to urge increases in public expenditure. However, as soon as the economic situation permits, this should be one of the top priorities, if not the top priority.

Since the introduction of the National Insurance Scheme in 1948, the disabled have had the rough end of the stick. They have been fobbed off with all kinds of excuses. They have been provided with different standards of recompense for their disability, according to how the disability was caused. But it does not matter whether a disablement has been caused by an accident at work arising from the negligence of an employer, by an accident at work not due to an employer's negligence, by an accident on the road, or by normal debilitating disease. The fact is that a person has been disabled. He has been robbed of the chance of living a full life. Every member of the community has a moral obligation to see that he can live as full a life as possible. When it becomes possible to review the limits of public expenditure—and I believe that it will not be long—there is a very strong case for seeing that relief is afforded to the disabled.

3.16 p.m.

Mr. Eddie Griffiths (Sheffield, Brightside)

I should like to pursue the line which my hon. Friend the Member for York (Mr. Alexander W. Lyon) has taken. The problem of the handicapped and disabled is not solved by giving them a few extra shillings in pension or even by introducing a new pension scheme. What we as a nation have to consider is how we can bring the handicapped and disabled back into normal society by providing them with modern aids so that they can lead a full and useful life in the community.

I want to illustrate the point by citing three examples. The youth officer in my constituency is a blind person. At the Young Socialists' conference, which is to be held over Easter weekend, he will be moving a motion drawing the attention of the Government to the problems of the handicapped and disabled. Hon. Members will be interested to know that this young man has been accepted into Sheffield University to pursue a degree course which is to begin in the coming October. I think that his case illustrates the fact that, with modern techniques which are available and others which may be developed, there is no reason why a blind person should not be trained to pursue a normal job and to play a full part in society.

My second example illustrates the neglect and double-thinking on the part of the authorities. A disabled person is provided with a three-wheeled carriage. If his wife is also disabled, I gather that, as an alternative, he is entitled to a normal car in which he can take a passenger. I put a case to the Minister some time ago concerning the case of a disabled man and his disabled sister. He is not allowed a four-wheeled vehicle in which he can take her as a passenger.

My third example concerns a housewife who is confined in the main to a wheelchair. Generally speaking, local authorities have been slow to provide suitable accommodation with adequate access for wheelchairs to flats and bungalows. Such a person needs equipment in the home at such a level that she can manage the cooker, the washing up and so on from her wheelchair.

There is much which could be done to improve the lot of the disabled and handicapped, not only by increasing their pensions but by adopting the techniques which have been developed. When we consider that there is an Early Day Motion congratulating Russia and America on their exploration of space and congratulating this country and France on producing such a wonderful aircraft as the Concorde, it seems extraordinary that we cannot apply some of these advanced techniques in technology to providing the disabled and the handicapped of this country, and indeed of the world, with the means to come back into society and lead a normal useful life.

I hope that the debate will prove to the nation that it is not sufficient to say, "We feel very sorry for you because you are blind or deaf or confined to a wheelchair, but we want to lock you away in a home which caters for this type of disability." Our main object should be to bring them back into society. We should not say to our disabled and handicapped, "For the rest of your life we want you to work in a workshop making wicker baskets or making brooms." If we get to the disabled or handicapped person at an early age and train him, I feel certain that he can be brought back into society and can lead a full and useful life.

3.21 p.m.

The Under-Secretary of State for the Department of Health and Social Security (Mr. Norman Pentland)

The hon. Member for Somerset, North (Mr. Dean), said, quite properly, that this is the second debate that we have had in recent weeks on the problems facing the disabled. This in itself is an indication of the serious concern shown by hon. Members on all sides of the House towards the problems facing the disabled in this country.

I begin my speech with two rather intimidating disadvantages. The first is that, as the hon. Member for Moray and Nairn (Mr. Gordon Campbell) has ably shown, there are attractions in the idea of a Disablement Commission, and objections to the idea might seem to stem simply from a fear that the Commission's advice might be unpalatable.

My second disadvantage is that my right hon. Friend's views on the proposal to set up a Commission have already received some Press publicity, and some hon. Members may be more ready to expect a negative reply from me than to listen to the reason.

I should like to look in some detail at what the job of the proposed Commission would be. Here I agree with my hon. Friend the Member for York (Mr. Alexander W. Lyon), who has unfortunately had to leave the Chamber. I follow the line that he took in his description and understanding of what is embodied in the Bill.

The Commission's job is described in the long title as … to review pensions and benefits for the disabled and to make recommendations on changes and additions. The disabled are defined as those who suffer from a long-term defect, medically ascertainable, which prevents them doing normal work, substantially reduces their ability to do normal work, or involves them in significant extra expense in order to do normal work. Normal work as such is not defined. I must point out that by limiting the Bill to people of working age the old are forgotten.

As the hon. Member for Moray and Nairn explained, the benefits which such disabled people may receive at the moment are benefits under the War Pensions and Industrial Injuries Schemes, National Insurance sickness benefit, unemployment benefit, widow's benefit, retirement pension, and so on; and benefits under the Supplementary Benefits Scheme. I think it is important to recognise that the disabled are not in a ghetto, to be treated in isolation or ignored in isolation. They are spread among the population, and their circumstances are even more diverse than their disabilities. In passing, I note that the hon. Member's definition of disablement is essentially a loss of earnings definition. Those of us with experience of disablement in industry may have reservations about how comprehensive and satisfactory this definition is.

Reviewing existing benefits for the disabled is therefore a matter of looking at virtually the entire range of our social security provisions and saying whether the rates of benefit are high enough and whether we are spending enough money on them. I am glad that the hon. Member has not followed the suggestion that I have seen made elsewhere, and it has been made again today, that a new advisory body should be made responsible for the health and welfare provisions for the disabled as well as the cash benefits. We already have expert bodies to advise us on those other matters. I have always been led to understand that expertise is concerned with a specific subject, and I confess at once that I have a certain suspicion of universal experts.

However, the absence of an advisory body on the level and range of cash benefits is not accidental. I should be surprised if any Government felt able to welcome the setting up of a body with the specific function of telling them how to spend several million £s of public money, and, in effect, what their public expenditure priorities should be. And if the Government had to take their own decisions in the light of very much wider considerations than the advisory body could properly apply itself to, as they certainly would, I see little point in setting up the advisory body.

I suspect that the Disablement Commission Bill was a more forthright Measure when it appeared in its earlier guise as the Disablement Income Commission Bill. The change of name is a perfectly fair way of making it more difficult for the Government to object to the Measure, and I do not criticise that, but it masks to some extent the fact that the underlying aim is to provide a new special cash benefit for the disabled, and to achieve this by imposing upon the Government something called an advisory body but which would in fact be a pressure group.

I have put this bluntly, but I ask the House to consider whether supporters of the Measure, including those outside the House, would be interested in having a special body which supported the existing rates and range of benefits, or even contented itself with proposals no more generous and radical than those the Government could be expected to make in any case, of its own volition. I am afraid that in switching the emphasis from looking at the possibility of a new benefit, to looking at the level of existing benefits, the sponsors have made the Bill much more unrealistic. If ever there was a decision which a Government must take on the strength of its own responsibility to the country as a whole, it is in respect of the amount of an uprating of social security benefits.

I have recently re-read the speech made by the hon. Member for Moray and Nairn on 21st February during the Second Reading debate on the Disabled Persons Pensions Bill. I note that he seemed to envisage that a Commission would help to end what he described as the present "piecemeal and haphazard" way of dealing with the disabled. I, and others, would be interested to know whether it is correct to interpret this as meaning that the Commission would be expected to consider winding up the War Pensions and Industrial Injuries Schemes.

Mr. Gordon Campbell

The Minister should realise that I was speaking about the groups which are outside the National Insurance Scheme. I was not referring to the industrially injured, but to the anomalies which the Government agree exist in the present system, and which the White Paper says the Government will do something about in the future.

Mr. Pentland

Ironing out the alleged "anomalies", "arbitrary provisions", "piecemeal arrangements" as they are variously termed, must mean either treating everyone in the same way as disabled people are treated under the special Schemes or else simply taking away all the preference enjoyed to varying degrees by the war and industrially disabled. I should be interested to know how it is proposed to administer or pay for the one course, or defend the other.

In rejecting one way of making progress, I fully accept that we are in duty bound to find another. Like my hon. Friend the Member for Ealing, North (Mr. Molloy), I suggest that judged by the measures we have already taken, which benefit the disabled generally, and by the further measures we have proposed, our record as a Government is not one of which we need be ashamed. The level of cash benefits has been maintained and improved; earnings-related short-term sickness and unemployment benefits have been introduced; there is a new Supplementary Benefits Scheme. Our review of the health and welfare services is designed to ensure a better, and a better co-ordinated, service for disabled people and everybody else too.

Finally, in the recently published White Paper we have outlined proposals for a number of radical improvements, including a new attendance allowance for the very severely disabled, and we have promised biennial reviews of rates of benefit. Public opinion has undoubtedly played a part in all this.

In reply to the hon. Member for Somerset, North who asked me a direct question on the constant attendance allowance, I am afraid that at the moment I cannot go any further than the White Paper. However, I can assure him, as I did in the debate on 21st February, that the Government recognise that there is a widespread desire for this change to be introduced at an early date. Naturally the Government and particularly my right hon. Friend will take this into account.

The hon. Member for Moray and Nairn asked me about the survey, and when we might expect its results. We shall be getting results from the major survey of the disabled during the course of this year, though the full results will not be generally available until next year. This will give us a much better idea of the total number of disabled people in the country, the range of severity of disablement, the financial position of the disabled, and how far the health and welfare services are measuring up to the needs they are there to meet. We shall be studying carefully the implications of the results as we get them, and in total. To a much greater extent than any previous Government, we have been ready to call in independent experts either on an ad hoc basis or as members of a team working with professional civil servants.

Mr. Gordon Campbell

Is it the Government's intention—this was my question as well—that a register should be started once these results have come in?

Mr. Pentland

I apologise to the hon. Gentleman. I took a note of that. I have made some investigation. The survey is a sample survey, so a complete and comprehensive register could be compiled only by making it compulsory for people to put forward their names. Compulsion is hardly possible, but we hope that the publicity accompanying the attendance allowance will be adequate enough to encourage people to claim it.

As research develops, we are very ready to make use of the research facilities offered by the universities. This exchange of ideas is very healthy, and in opposing this Bill we are certainly not refusing to listen to people who are able to help us. The point I am making is simply that it is no good asking people, whose time is valuable to them and to the community, questions which are so highly charged politically, economically, and socially, that they can only be answered by Ministers.

I note that the Bill seeks to involve the Chancellor of the Exchequer as well as my right hon. Friend. I hope I am not being too critical if I suggest that both these Ministers have to take into account a very wide range of considerations, among which the very natural and proper sense of priorities of those concerned with the problems of disablement is only one. Equally, hon. Members would still have their own views about the level of public expenditure, the proper priorities within public expenditure, and the most pressing needs in the social services, whatever a Disablement Commission might have to say about these matters.

Quite frankly, on a question such as whether the basic rate of national insurance benefit for sick and disabled people should be £4 10s. or some other figure, I personally would respect the views of an hon. Member who knows his constituents at least as much as the views of any outside expert. I am sure my right hon. Friends would feel the same.

I respect the hon. Member's keen and continuing interest in the survey, and the sympathy and concern for justice which has prompted this Bill. But we cannot see that the idea of a Disablement Commission makes real sense; and the Government is unable to give support to this Bill.

3.39 p.m.

Mr. Lewis Carter-Jones (Eccles)

I apologise for intervening late in the debate. What worries me as an economist is that the Treasury seem to take only one side of a balance sheet and to say. "It costs us so much". Regrettably, they do not look at the other side and say, "We save this much."

For the last 18 months I have been studying the question of technological aid for the disabled. At no time have I found evidence to show that this aid to the disabled costs the country money. On the contrary, all my studies nave revealed that aid in terms of technology given to disabled people results in the country being saved money.

I appreciate that to pursue this line one must have opinion on one's side. I also appreciate that we are in an extremely difficult economic situation. However, in discussing this matter with hon. Members generally I have found it hard to persuade them that if only one will look at the matter in terms of pure economics, one can see how great savings can be made.

I could give many examples of what I have in mind. Instead of delaying the House, I will cite only two. First, a man contracted polio in Malaya 15 years ago. Being a compassionate society, we provided him with a respirator, since he cannot otherwise breathe. There is an incision in his throat and he is permanently horizontal. If this man goes into hospital he will cost the State between £80 and £100 a week. As a result of technology being brought to his assistance, he is able to pay Income Tax. That one example shows that the sooner we get down to conducting a survey into the concept of what the Disablement Commission should be doing, the better.

My second example is of a spastic who seemingly could not communicate. This man, aged 34, is unable to speak and merely shakes. By the compassionate use of technology, however, he has obtained his first job. He is now a programmer earning £30 a week.

I have great respect for the House of Commons, but I get the impression when speaking on this subject that hon. Members think that people of this type are exceptional. They are not. It is simply a problem of communication and technology can allow these people to help themselves.

The trouble is that the Treasury always want to look at only one side of a balance sheet. Perhaps our entire public accounting system is wrong, but I should be out of order in going into that. After closely examining about 400 cases in 18 months—the Ministry is welcome to my casebook—I have yet to find evidence that the disabled cost the State anything; that is, unless we want to be extravagant and do not want to help them to help themselves.

It is the easiest thing in the world to shed tears when examining a problem of this type. I belong to one of the most emotional races under the sun. We shed tears at the drop of a hat. The disabled do not want our sympathy. They want help to help themselves and there are three main ways in which we can help.

The first is to give them the right to gain and sustain independence; no more and no less. People get hooked on drugs and cigarettes. I am completely hooked on the application of technology to this type of person, for it can enable them to earn their own livelihood. If people in the Ministry say that it cannot be done, they are deluding themselves. These people can earn their living, and they should be given the chance to do so.

I have quoted the case of a man who has suffered from the results of polio for 15 years. Intensive care and treatment would have cost the State £100 a week, and £100 a week for 15 years is a lot of money. The State is prepared to spend that amount, but what the man wants is his independence. I can produce case after case of people who can earn their living if they are allowed access to proper technology.

There is a second side that concerns me intensely. On Monday I received a letter from my hon. Friend's Department saying that it did not want any value analysis studies made. Why? It is because the Department is completely convinced that the disabled should be given help without regard to value analysis. My right hon. Friend gave an open-ended undertaking. I am convinced that what I suggest is not extravagant, but that, with its proper application, we can save money.

I am quite delighted to see on the Front Bench today a representative of the Treasury—an old friend of mine. I hope that I can convince him, too, that if we use these schemes wisely the State saves money. The most expensive form of care for the individual today is to put him in hospital. That costs a lot of money. Therefore, any device that can be used to keep him out of hospital—and I hope that the proposed commission would investigate that type of case—is from, the Treasury point of view, a net saving, but the difference for the individual is quite incredible.

I am a rugby enthusiast. Last Saturday, I wanted to see on television the match between Scotland and England. A consultant whom I know has multiple sclerosis. He spent all his working life up to the age of 53 caring for children. He is paralysed, and in a wheelchair. When I visited him, I said, "I can't stay long—I must see the match." He replied, "You can see the match here." I was with a completely paralysed man who yet was able to turn on his television, and tune it in, and let us see the match. Incidentally, the match was between England and Scotland, but he is an Irishman and I am a Welshman and I must say that neither of us thought much of either side.

The great tribute to technology is that that man had recovered some of his self-respect. He felt independent, and no longer had to send for his wife to turn on the television——

Mr. Molloy

Perhaps I can say——

Mr. Speaker

Order. If one hon. Member wishes to address another hon. Member, he should do so through the Chair.

Mr. Molloy

I beg your pardon, Mr. Speaker, if I turned away from the Chair. I am very interested in my hon. Friend's argument, and I certainly meant no discourtesy to you.

I have been particularly interested in the problem of the housewife, whose work cannot be evaluated in industrial terms as a fitter, or a designer, or the like. Her job is bringing up the family. My hon. Friend spoke of someone who now did not need to ask his wife to turn on the television for him, but I know of many housewives who could not have turned it on, because they, too, are paralysed. If the same technological efforts could be made to help those housewives to move around the home that, too, would be a great contribution.

Mr. Carter-Jones

I am grateful to my hon. Friend, because he has anticipated the third part of my argument. My argument is that, first, we should let the disabled earn a living. Let us not waste our sympathy or shed tears. Let them earn their living, because it can be done. Secondly, give them a sense of independence and enable them to stay out of hospital.

Thirdly, the whole of my research started because of the circumstances of a fit man, working in a mine, who had been married for 23 years. His wife contracted multiple sclerosis, and he said, "I shall not have her go to hospital. I will leave work and look after her."

The point he made to me was, "If my wife goes to hospital, it will cost the State £30 per week. I am prepared to look after her for half that sum of money." But, of course, we cannot do that because we are not flexible enough.

What I found so incredible was that, when I spoke about this matter to a technologist, he said, "But this is stupid. The man will have to go shopping at some time. He will have to be away from home for half-an-hour or more. By the help of a simple device on a telephone, the wife can communicate with her husband if there is need". It was explained to me that one can have a device which operates every half-hour unless the wife wishes otherwise. We breathe about 15 times a minute. Our heart beats about 72 times a minute. This woman would be happy, I was told, to knock off the control every half-hour. If she did not do it, then her husband would know that she was in need of help.

The concept which the hon. Member for Moray and Nairn has is wonderful, but we do not appreciate what is involved. I believe that the present Government have done more financially for the disabled than any other Government of all time. I stick to that view. But I am appalled by the failure to use so much that is known, so much that could be exploited without a great deal of further finance in order to give comfort and independence to the disabled; to give comfort and independence to those dependent upon them; and, finally, by its application to hospitals, to help in the use of our scarce resources of skilled physicians and skilled nurses and to enable them to receive communication from the disabled rather more freely. I associate myself most strongly with the hon. Member for Moray and Nairn.

Question put, That the Bill be now read a Second time:—

The House divided: Ayes 24, Noes 28.

Division No. 137.]	AYES	[3.55 p.m.
Astor, John	Drayson, G. B.	Russell, Sir Ronald
Atkins, Humphrey (M't'n & M'd'n)	Grant-Ferris, R.	Scott, Nicholas
Biggs-Davison, John	Gresham Cooke, R.	Sharples, Richard
Body, Richard	Gurden, Harold	Sinclair, Sir George
Boyd-Carpenter, Rt. Hn. John	Hunt, John	Thorpe, Rt. Hn. Jeremy
Carter-Jones, Lewis	Iremonger, John	Whitaker, Ben
Channon, H. P. G.	Kerr, Russell (Feltham)	TELLERS FOR THE AYES:
Crouch, David	Knight, Mrs. Jill	Mr. Gordon Campbell and
Dean, Paul	Page, Graham (Crosby)	Mr. David Gibson-Watt.
NOES
Beaney, Alan	Fletcher, Raymond (Ilkeston)	Rees, Merlyn
Blenkinsop, Arthur	Griffiths, Will (Exchange)	Reynolds, Rt. Hn. G. W.
Booth, Albert	Howie, W.	Richard, Ivor
Boston, Terence	Lee, Rt. Hn. Jennie (Cannock)	Roebuck, Roy
Brown, Rt. Hn. George (Belper)	Lever, Harold (Cheetham)	Rogers, George (Kensington, N.)
Coo, Denis	Luard, Evan	Silkin, Rt. Hn. John (Deptford)
Davidson, Arthur (Accrington)	Mikardo, Ian	Skeffington, Arthur
Delargy, Hugh	Molloy, William
Dickens, James	Pavitt, Laurence	TELLERS FOR THE NOES:
Dunwoody, Mrs. Gwyneth (Exeter)	Pentland, Norman	Mr. Brian O'Malley and
English, Michael	Perry, George H. (Nottingham, S.)	Mr. Ernest G. Perry.