HC Deb 10 December 1970 vol 808 cc805-16

Motion made, and Question proposed, That this House do now adjourn.—[Mr. Clegg.]

10.17 p.m.

Mr. Peter Hordern (Horsham)

I wish to talk about my constituent, Mr. Paul Bates, and, in particular, about the strength of his case for a vehicle suitable to his condition. Paul Bates is a well-known Horsham figure. His courage and determination to lead a normal life have long been a source of inspiration to his many friends and to all those who have come across him—and especially to those who are disabled.

Paul Bates is a respiratory tetraplegic. He was struck down while on active service in the Armed Forces in Malaysia in the 1950s, and is effectively immobilised. He is, therefore, classified as a war disabled pensioner, and there is no dispute about this classification.

For many years war disablement pensioners who qualify by reason of the severity of their disablement have had the benefit of the use of the Minister's discretion, exercised under successive Royal Warrants since 1946, of providing them with a vehicle. This vehicle has usually taken the form either of a saloon or an estate vehicle in which these pensioners can be driven. It is accepted that there is no absolute right to these vehicles but, equally, there is no known case in which any such pensioner who was qualified has not had a vehicle if he wanted one. This was confirmed by Mr. Kenneth Robinson when he was Minister of Health in a statement to the House on 15th February, 1967.

This service has been a humane and generous action for those who have become severely disabled on active service for their country. What is more, the generosity does not stop simply at the provision of a car. Free road fund licences are issued, and insurance is also provided free. Further, an allowance is given towards the running costs of the car, and I understand that this amounts to between £50 and £100 a year. The vehicle itself is regularly replaced after a period of about five years. The Minis- try will even adapt the car to reasonable modifications.

There is no dispute about the extent and generosity of the service that is provided. It is one of which the country can justly be proud. Where disabled pensioners have lost the use of both legs, they rightly deserve, and are getting, the best treatment the country can give.

My constituent, Paul Bates, has been offered one of these vehicles. Unfortunately, he is too disabled to be able to get into it. For this reason, and seemingly for this reason alone, he has been refused an alternative vehicle. It is true that he has been offered a grant, amounting to £120 a year, towards the running costs of a suitable vehicle, but that in no way approaches the extent of the benefits provided to those who are less severely disabled.

I repeat what these benefits are: a vehicle costing about £1,000 replaceable every five years or so; a free road fund licence; free insurance; and a running allowance of at least £50 a year. Against this, Mr. Bates has been offered a flat allowance of £120, and, of course, he is expected to provide his own car. This is an obvious anomaly and one which simply cannot be tolerated.

There would seem to be two courses open to the Minister. One is to provide a grant which would be comparable in money terms to that now given to these particular war pensioners who qualify, and the other is to provide a vehicle of comparable cost with the same services as are being offered. I recognise, of course, that these vehicles are not provided as of right. But it is a fact that they are provided to those who have lost the use of both legs. It is extraordinary to say the least, that they should not be provided to those who are even more disabled than those to whom they are provided.

What sort of proposition can it be that a certain service is given to those who are badly disabled but is not given at all to those who are even worse disabled? I cannot believe that there are many in this category. This small band of war disabled pensioners—I emphasise the word "war"—are so badly disabled that they cannot use a Ministry vehicle. Perhaps the Minister will tell me how many of them there are and what cost would be involved in paying them a grant instead of providing them with this service.

However, this is not the only alternative. The other is to provide another kind of vehicle. I understand that this has recently been done with a Triumph Herald, fitted with a special door. My constituent wants something like a Commer 2000 van or another vehicle which would be comparable in cost to the cars which the Ministry now provide.

The remarkable thing about this case is that Mr. Bates has never been asked what sort of vehicle he would like, or whether the vehicle he would like is in any way comparable in cost. When one considers that the whole service is discretionary anyway, it is odd that his request should simply have been refused without a further inquiry.

I hope that the Minister will not rely on the argument which was used by his predecessor, Dr. Dunwoody, the then Parliamentary Secretary. Dr. Dunwoody wrote to me on 18th May last as follows: One difficulty about changing the arrangements in this way is that it cannot be viewed in isolation from the needs of National Health Service patients. If more money is to be injected into the invalid vehicle service it is essential that priority be given to those groups with the best claims whether they be war pensioners or National Health Service patients. I am sure that my hon. Friend would never he guilty of talking that kind of nonsense because the fact is that Mr. Bates has a much stronger case than all those who now receive these benefits.

I want to refer to an extract from another letter which has come into my hands. It was written last February by the then Joint Parliamentary Secretary to the Department of Health and Social Security. I ask my hon. Friend to rely on this letter rather than on the letter I have just quoted. The final paragraph in reply to a civilian body which sought parity with war pensioners reads: One final point I would like to make is that of the difference in treatment, so far as the vehicle service is concerned, between the war pensioner and the National Health Service applicant. The statutory powers for the provision of cars for war pensioners stem from successive Royal Warrants and the aim has always been to acknowledge the self-sacrifice of the war pensioner in defence of his country as well as to restore his mobility. This is in accordance with the well established principles in other fields and, I am sure, continues to command general support. I trust and hope—indeed, I am confident—that my hon. Friend will carry out the spirit of that undertaking. I am sure that he will agree that Mr. Bates has a very good case and that it would be wrong that the present very generous system should be brought into disrepute because of what looks like an administrative oversight.

The point is very simple. How can it be justified either in equity or logic that a service can be provided to a category of disabled war pensioners but not at all to war pensioners who are even more severely disabled? How can it be right to select a service to apply to one small band of war-disabled pensioners but not to those who are even more disabled than those to whom it has been provided?

10.27 p.m.

Mr. Lewis Carter-Jones (Eccles)

I am grateful to the hon. Member for Horsham (Mr. Hordern) for giving one or two of us a chance to comment on this case. Paul Bates is well known to those of us on both sides of the House who have an interest in the disabled. This is a nonpolitical matter, and I appeal to the Under-Secretary of State to tell his civil servants, who are often very understanding, that in this case they look like making themselves appear rather foolish.

This is the case of a man who contracted polio in Malaya. He is 6 ft. 4 in. in height, but basically he has to lie in a horizontal position and use a respirator. If he were not so disabled the Department would provide him with a car, because his case would not then present a problem. As it is, Paul Bates presents a problem. I say to the hon. Gentleman "Solve it. Be flexible. Be useful. Be understanding. Be compassionate".

The guy is only asking for a van. It will not cost any more. I must say that I let the Department off the hook in this matter, but I accuse the Treasury of always talking about value analysis. I keep saying, whether I am dealing with a Conservative or a Labour Government: "If you deal properly with this case you will find that in the long run the money will be very well spent and you will, in fact, save a considerable amount".

We are talking about a man with a severe disability who, in a state of paralysis and from a horizontal position, is making his contribution to our economy by exporting beds all over the world. If he had gone into a home and had not made this effort the State would over 15 years have paid out £75,000.

We are asking for a vehicle for Mr. Bates which costs less than the one which the Department is normally prepared to provide. I ask the hon. Gentleman to use his influence. Let him get hold of the very good men he has in the Department and insist that they show common sense and provide the vehicle which is, after all, this man's right.

10.30 p.m.

Mr. Neil Marten (Banbury)

As this may well be the last small debate for some time on disabled drivers in the broader sense, I think it appropriate for me, as chairman of the all-party Disabled Drivers Group, to pay a tribute to Mr. Speaker, who has told us today that he is soon to leave. Mr. Speaker has for a long time been Vice-President of the Disabled Drivers Association, and I know how extremely interested he is in these matters and how much he has done to help with disabled drivers' problems. I am sure that the whole House wishes to acknowledge his support for that cause.

The case of Paul Bates is an extreme example of a rigid attitude maintained all along the line, whether in the Treasury or in the Department of Health and Social Security I do not know. That line simply must be broken. Mr. Bates wants a van. Why should he not have a van?

It comes back to a question of flexibility, as the hon. Gentleman the Member for Eccles (Mr. Carter-Jones) said. I know that my hon. Friend the Under-Secretary of State has a flexible mind. He has told me that he is going deeply into the whole question. Yesterday we had an all-party meeting with all the various disabled drivers' associations upstairs in a Committee Room. When I threw the meeting open to the guests, the disabled drivers, the very first point which was raised came from a Miss Felicity Lane Fox, who had been one of my constituents but who now lives in London. She said that she had had a vehicle and help from the Ministry. She had suffered polio. Then her paralysis became too bad and she was unable to drive any longer, and from that moment onwards she got no help at all.

We come back to what we have been campaigning about for so long, the need to recognise the disabled passenger, the person so disabled that he or she cannot drive himself or herself.

I know that my hon. Friend the Under-Secretary is a sincere man. He is going into this matter, and he wants time, but I hope that by, let us say, early or late spring next year he will be able to announce to the House some radical reappraisal of the whole problem of help to disabled drivers. He has the political will. It will be done. He can do it. It is up to him.

10.32 p.m.

The Under-Secretary of State for Health and Social Security (Mr. Michael Alison)

I hope that my hon. Friend the Member for Horsham (Mr. Hordern) will excuse me if I gallop along rather, because I want to cover as much ground as possible in the time remaining to me.

No one who has listened to my hon. Friend speak about the severe disabilities suffered by Mr. Paul Bates, his struggles to come to terms with them, and his eventual triumph over adversity—as the hon. Member for Eccles (Mr. Carter-Jones) pointed out—could fail to be emotionally and personally involved in the case. I add my tribute to this brave young man, and I assure the House that all the officers of the Department of Health and Social Security who have come into contact with Mr. Bates—and there are many of them—have nothing but the greatest admiration for his spirit and sense of determination, which, I may add, has brought him to the very considerable position of, as it were, viability which he enjoys today.

As my hon. Friend explained, Mr. Bates sustained his disability while serving in the Forces in Malaya. He is a disabled war pensioner and as such is eligible for, and receives, help from my Department with his personal transport.

Under existing arrangements, we provide small cars for eligible disabled war pensioners. At present just over 6,500 such cars are being used by war pensioners in Great Britain; that is to say, by war pensioners who have a certain degree of mobility, and disablement of 20 per cent. or more, and who are able to enter and leave one of these small cars without difficulty. I should add that the cost of these cars is only about half the figure of £1,000 suggested by my hon. Friend. No Triumph Herald, incidentally, has been supplied by my Department, though it may have been supplied by some other Department.

There are other war pensioners eligible for help with personal transport who prefer to use their own cars rather than have one of the Department's small cars, and there are still others who are eligible for help but who are unable to enter and leave a car within our range. Both these groups provide their own vehicle, the first from choice and the second of necessity, and we pay them an annual allowance towards the maintenance of their own vehicle.

Mr. Bates comes within the second group, and we have for a number of years paid him a maintenance allowance for his specially-adapted, privately-owned van. There are about 150 war pensioners in a similar situation, namely, who cannot use our vehicles but get a maintenance allowance. Most of them are not so severely disabled as Mr. Bates, it is true, but all are in the same position of being unable to use our small cars and, therefore, having to provide—and replace as necessary—their own vehicle in respect of which they are paid an allowance from my Department.

There are, in addition, some 25 or so war pensioners about as severely disabled as Mr. Bates who at the moment do not seek any help from the vehicle service. Had they purchased a special vehicle, they, likewise, would be eligible for our allowance, and, no doubt if a special type of vehicle in which they could be accommodated were to be provided by the Department or a grant of equivalent value had been payable as suggested they would apply for one or the other.

It has been asked why we do not extend the range of vehicles we provide for war pensioners so that all those eligible for help may have their vehicle supplied by the Department. The answer to this is that money for the vehicle service is not unlimited and we must use what we have to the best advantage. If we were to extend the range to provide not only the larger cars which would satisfy the needs of some of the pensioners who at present have to buy their own but also to include special vans, Dormobiles and ambulance type vehicles which the most severely disabled would need, the cost for war pensioners alone would be perhaps an additional £20,000 a year.

In itself, this is not a very large sum of money, but it would be wrong, in my opinion, to limit this extension, if we made it to war pensioners. Although the disabled war pensioner still rightly enjoys a measure of preference in the help he receives with personal transport over his equally disabled National Health Service counterpart, I feel sure that the general feeling is that the amount of preference is just about right and that it would be wrong to upset the present balance.

I ask hon. Members to bear in mind that this is an area of delicate sensitivity. Nobody has any doubt that the war pensioner whose injury was sustained in the pursuit of active service, such as Paul Bates in Malaya in the emergency, is in one category, but there are patients in the National Health Service who feel that a young man of 18 who today loses a big toe when on a short service engagement in the Forces and who becomes a war pensioner, because of the paradox that technically the war is not over, is in a different category. Consequently, there are people who become classified as war pensioners, with all the special advantages of that, who have been rather remote from the hazards and personal suffering of active service.

All I am saying at this point is that this is the nexus of the relationship between the privilege granted to war pensioners and Health Service patients and one must be careful to preserve a balance which is acceptable to public opinion.

Any improvement in the present war pensioner scheme would need to be accompanied by similar concessions for the Health Service patients, of whom there are many more thousands. It should be remembered that the Health Service patient who is unable to use the type of vehicle which we provide does not at the present time have the war pensioner's alternative of an allowance towards the maintenance of his privately-owned vehicle. He is precluded from receiving any help from the Department, and it is, therefore, for consideration whether, if extra money could be found for the vehicle service, it would be proper to give more to those who already receive help rather than to those who at present receive no help at all. The same objections apply to giving a grant equivalent to the cost of supplying a vehicle.

Mr. Carter-Jones

What I ask is: why not supply a van, which would be much better than the car we provide?

Mr. Alison

I will come to that.

I make the point to my hon. Friend, who rightly points out the fantastic anomaly, that there is a whole band of National Health Service patients, thousands of them, more severely disabled than those who qualify for vehicles. We face this frankly, and our logical justification for this is that the National Health Service three-wheeler is in our view basically a kind of artificial limb. It really is applicable only to those who have this special limited limb disability. It is an extension of an artificial limb, and those who have not got this limb disability do not qualify for it. It is the only way we can justify the fact that there are thousands of people extremely disabled, more so than those who have a vehicle, who are automatically debarred.

For this reason we have reluctantly come to the conclusion that we cannot accept the suggestions made by my hon. Friend. We could not in fairness provide something for Mr. Bates without being prepared to make a similar provision for a very large number of other war pensioners and patients.

Mr. Bates' own van is almost worn out and he would like us to buy him another. He contends that to buy and modify a van which could accommodate him in his special bed and the other special equipment which he needs to carry with him would cost no more than one of the cars we can provide; but this is not so. A suitable vehicle for Mr. Bates would cost at least twice that of one of our cars.

Although we have made no detailed investigation recently of Mr. Bates' precise vehicle needs, we are well aware of his disabilities and what he will require in the way of a vehicle.

Hon. Members, particularly my hon. Friend the Member for Banbury (Mr. Marten), will recall an Adjournment debate we had two weeks ago today. There were very determined suggestions that we should give cars instead of three-wheelers to haemophiliac users, that we should give some sort of outdoor vehicle to quadriplegics who get no help at all, that we should help what was termed the disabled passenger and that we should give cars to disabled mothers with young children.

I mention all these potential improvements to stress that there is no lack of suggestions for bettering the invalid vehicle service. Some want those that are already helped to get improved help; others want those that get no help to be given some. The common theme is that all the suggestions would cost more and would create fresh base lines from which campaigns for still more concessions would be launched.

We are urgently reviewing the invalid vehicle service. I assure my hon. Friend with all the sincerity I can command that there is a problem here with all the anomalies and paradoxes, and we want to see whether we can deal with it within the review. I am sure it would be quite wrong to make piecemeal changes, including increasing the financial assistance to those who run their own vehicle.

I do not want it to be thought that the Department is seeking to discriminate against this gravely disabled young man. Let me say that while we feel we cannot in fairness to others give Mr. Bates more help under the vehicle service at this stage, there is certainly no lack of help forthcoming from the Department in other ways. Indeed, Mr. Bates receives from the Department a very large cash sum free of income tax, in the way of war disability pension, additional comforts allowance, constant attendance allowance, special allowance to pay for him to be cared for in his own home rather than in hospital, and maintenance allowance for his van.

In addition, he is provided with respirators, suction apparatus, special bed and mattresses, a hoist and many items of medical and home nursing equipment. All these are supplied, maintained and replaced as necessary, and we maintain the electronic equipment which enables him to use the telephone and to type.

I know my hon. Friend is concerned here with principles and it is to these I have addressed myself. Although it is not relevant as a point of principle, nevertheless as a matter of fact my hon. Friend will to glad to know that considerable financial help towards the cost of a new vehicle has been offered Mr. Bates from non-statutory resources. If Mr. Bates accepts this help and buys a new van, we will continue to pay, in addition to all these other sums, an annual maintenance allowance for his vehicle.

10.45 p.m.

Mr. Alfred Morris (Manchester, Wythenshawe)

This is a very important case. The hon. Member for Horsham (Mr. Hordern) brought a compelling case for reconsideration by the Department of the problem facing Mr. Paul Bates. The Minister has reminded us of the recent debate on the problems of haemophiliacs. I am very glad that he recalled that debate and the part played by the hon. Member for Banbury (Mr. Marten).

The Prime Minister, at a recent confrontation with the Haemophilia Society in Bexley, said that he understood that the society wanted action on the question of replacing the three-wheel vehicle with a four-wheel vehicle. I know of the hon. Gentleman's interest in the problems of disabled people who require help with transport, and I am very pleased to learn that there is now proceeding a review of the whole question of the supply of vehicles for the disabled. I can see no reason why we should have the old division between the war-disabled and the peacetime-disabled. It is utterly wrong that there are people who are more disabled than others whose transport requirements are met much less satisfactorily than they should be. I hope very much that this year and next year will see further steps forward in improving the mobility of disabled people.

Mr. William Molloy (Ealing, North)

The hon. Gentleman mentioned the cost of the aid to Mr. Bates, but if Mr. Bates were in hospital the cost would inevitably be more, and this could apply to thousands of others. By helping them with vehicles we are helping ourselves economically as well as raising their status as individuals.

Mr. Morris

I hope that the hon. Gentleman is looking into the whole question of cost-effectiveness. There are many disabled people who—

The Question having been proposed after Ten o'clock, and the debate having continued for half an hour, Mr. DEPUTY SPEAKER adjourned the House without Question put, pursuant to the Standing Order.

Adjourned at thirteen minutes to Eleven o'clock.