CHRONICALLY SICK AND DISABLED PERSONS ACT

HC Deb 18 December 1970 vol 808 cc1788-809

Mr. Speaker

We now come to the next debate, and we are a little ahead of time. The subject of the debate is, if I may say so, one that is dear to my heart, if anyone can say that Mr. Speaker has a heart, but it must finish at four o'clock.

3.2 p.m.

Mr. David Weitzman (Stoke Newington and Hackney, North)

May I first say how grateful I am to you, Mr. Speaker, for having selected this subject for debate. My hon. Friend the Member for Manchester, Wythenshawe (Mr. Alfred Morris) rendered immense service to the cause of the chronically sick and disabled when he first introduced and then piloted his Measure with great skill on to the Statute Book. It was supported by all parties, but one is pleased to refer to the debt we owed to Ministers in the previous Administration who did everything they could to assist in this direction. I am proud to know that it was a Labour Government who took steps to see that the Measure was enacted before the General Election.

The Act has been called a charter for the chronically sick and disabled, but I remind the House that however beneficial its provisions are they are futile unless they are implemented, and at the base, as it were, of such implementation is the bringing into effect of Section 1.

Section 29 of the National Assistance Act, 1948, empowered a local authority … to make arrangements for promoting the welfare of persons … who are blind, deaf or dumb, and other persons who are substantially and permanently handicapped by illness, injury, or congenital deformity or such other disabilities as may be prescribed by the Minister. Section 2 of the Chronically Sick and Disabled Persons Act puts on a local authority the duty to assess the requirements of such persons, and to provide them with such things as practical assistance in the home, wireless, television, library or similar recreation facilities, telephone, work at home, holidays, meals and other matters. In order to do that it must know who are the disabled persons to be assisted.

Section 1 of the Act therefore provides the machinery for obtaining this information and for communicating knowledge of the services provided to the disabled. It requires a local authority to inform itself of the number of persons within the area and to make known to them what services are provided. In other words, there is a duty on the local authority to compile and keep a register of all disabled coming within the words of Section 29 of the National Assistance Act, 1948.

However, more than three months after the Act came into force, so far as is known only 600,000 persons are registered as disabled. In a recently published book by Sally Sainsbury, entitled "Registered as Disabled", the numbers per thousand of the population of those registered as physically disabled in 1965 and 1966 were given for a considerable number of local authorities. For instance, for Merioneth, Kingston upon Hull, Bath and Preston it was between 7 and 10; for West Bromwich, Cardiff and Salford it was between 5 and 6 while in the North Riding of Yorkshire, Swansea and Chester it was as low as .7 and 1.9. The number on the register in my own borough of Hackney is 3,200. It is estimated that there will be an increase of no less than one-third and possibly more when full publicity is given to the Act.

It is clear from these statistics and from inquiries and from information given to the Central Council for the Disabled and other bodies that there are at least 1 million more disabled than those appearing on the register. The first and perhaps most fundamental step, therefore, is to identify those who are not on the register and to find what some organs of the Press have called the missing million. But this can be done only if the provisions of Section 1 are effectively carried out.

I have said that the Act came into force on 29th August. More than three months have elapsed since then, but there is still remarkable ignorance of the Act and its provisions, particularly of the services to be provided as set out in Section 2. In "Contact", the organ of the Central Council, there are a number of extracts from letters and I draw attention to a few. One reads: The Medical Officer of Health of … considers the telephone a luxury which cannot possibly be supplied by the local authority but offers the names and addresses of charities to which the very severely disabled person might apply herself. Another says: I have been to my local welfare office and they said they have never heard of the Act. Another reads: Will you please send me a copy of the Chronically Sick and Disabled Persons Act as no one here seems to know anything about it. There are many other letters in a similar vein with which I have been supplied by the Central Council for the Disabled.

But it does not stop there. There is a similar ignorance among the staff of the local offices of the Department of Health and Social Security. I have been shown letters from the managers of two such offices addressed to the Central Council. The first, dated 12th November, 1970, reads: I understand you have recently published a pamphlet explaining the provisons of the Chronically Sick and Disabled Persons Act, 1970. I shall be obliged if you will be good enough to let me have three copies for the information of the staff of this office. The other said: Further to an inquiry from a chronically sick person, I have been asked to obtain a copy of the leaflet which was mentioned in …evening paper. I would be grateful therefore if you would forward a copy to the address above as soon as possible. My hon. Friend the Member for Wythenshawe wrote to the Department of Health and Social Security about this ignorance and he received a reply from the Ministry on 3rd December, a fortnight ago, saying: Arrangements are in hand to send each local office a summary of the provisions of the Act and they are being advised to put enquirers in touch with local authorities who can best help them". Why was this not done before?

It is true that a joint circular of the Department of Health and Social Security, the Ministry of Housing and Local Government, the Department of Education and Science and the Ministry of Transport setting out the purposes of the Act appears to have been published on 17th August of this year. It purports to be addressed to local authorities. Either it has not reached them or it has been dismissed as of little importance. It was certainly not followed up or impressed on the authorities, judging by the ignorance and lack of action.

Section 1(3) of the Act states that it comes into operation on such date as the Secretary of State may by order made by Statutory Instrument appoint". My hon. Friend the Member for Wythenshawe tabled a Question asking if: the Secretary of State for Social Services … will make a statement on the coming into effect of Section 1 of the Chronically Sick and Disabled Persons Act, 1970; and what action he is taking in preparation therefor. In a Written Answer of 7th December, the Minister replied, and I ask the House to note the terms of this Answer: I expect shortly after 1st April to make an Order bringing Section 1 of the Chronically Sick and Disabled Persons Act into force at a time when the new local authority social service departments are in a position to carry out their duties under it in the right context. Section 1 (1) requires authorities to inform themselves of the numbers and needs of substantially and permanently handicapped persons in their areas, and I have asked the Office of Population Censuses and Surveys to help with the preparation of guidance for local authorities on the use of survey techniques. I expect this to be available after the summer. Section 1 (2) requires authorities to make known the services they provide under Section 29 of the National Assistance Act, 1948, both generally and to persons using any one of them. I am considering"— note these words— whether further guidance to local authorities is necessary on the discharge of this duty. Note the delay; no order until after 1st April, 1970, a delay of seven months, and possibly more, from the date of the Act coming into force, with a further delay because the surveys of the Office of Population Censuses and Surveys are expected after the summer, whatever that might mean. Then there is the last phrase in that Answer: Whether further guidance to local authorities is necessary on the discharge of this duty." —[OFFICIAL REPORT, 7th December, 1970; Vol. 808, c. 57–8.] The problem is acute. This means so much to every chronically sick and disabled person.

There are, no doubt, authorities which are aware of the Act and which are doing something about it. For example, I am informed by the Town Clerk of Hackney, my borough, that preparations are in hand for the necessary increase in staff and for the provision of further finance for expenditure on welfare services under the Act. Also provision has been made for assisting certain categories of persons in obtaining telephones and in regard to housing, the council has in mind the specific requirements of the physically handicapped.

There are, however, many councils which have already prepared their budgets for 1971. If the Order is made on or after April, 1970, what chance will these authorities have to obtain the necessary finance and have it available; in other words, to provide the services set out in Section 2?

I criticise the Ministry for the delay. It contrasts badly with the eagerness of the last Administration to assist. This matter is so important that there should be the utmost publicity. Local authorities and disabled people, mentally as well as physically disabled—and I remind the House that people affected mentally are included in the definition of "disabled" in the Act—should have their attention drawn in no uncertain way to the duties and their rights under the Act. The Minister, possibly with the assistance of my hon. Friend the Member for Wythenshawe, should publicise on television and radio and through the Press what the Act does; he could do no better thing in the interests of the disabled, for whom I am sure he cares. Registration can be done at a small cost, possibly on a regional basis. Voluntary help can be employed. I am sure that the Central Council would assist, and I believe that there would be no shortage of volunteers.

If it is said that the expenditure of money would be involved, I remind the Minister that £60,000 was spent on publicising pensions for people over the age of 80. This is no less worthy an object, yet no money appears to have been spent on publicity to inform the disabled about the provisions of the Act.

This matter calls for immediate action, not the delay foreshadowed by the Minister in his Written Answer. I earnestly urge the right hon. Gentleman, in the interests of thousands of these people, to take action immediately.

Mr. Deputy Speaker (Miss Harvie Anderson)

May I draw the attention of the House to the fact that a number of Members wish to take part in this debate. If speeches are short, it will be possible to call all of them.

3.17 p.m.

Mr. James Hill (Southampton, Test)

It is with pleasure that I speak in this debate. I was extremely pleased to hear that both sides of the House concur on this matter.

I wish to direct my remarks particularly to Section 3 of the Chronically Sick and Disabled Persons Act, 1970, which requests all housing committees to look to their future needs in housing accommodation, with particular emphasis on the chronically sick and disabled.

The jobs starts with the architect's department. The city architect, who is in a very specialised profession, must consult the disabled people's groups. One of the most chronically disabled persons is the housewife who must not only run her home but look after her family and herself. The city achitect must look to the planning of her kitchen and her environment in the home.

A report called the "The Disabled Housewife in the Kitchen" was published by the Disabled Living Foundation as a result of three conferences held in June, 1969—one in Glasgow, one in Birmingham and one in London. The report stressed the importance of flexibility and adjustability to both the disabled and the able bodied. A home, certainly a council house, should be adapted to the needs of a disabled person. In other words, the heights of shelves, storage facilities, the design of kitchen equipment, the level of cookers, low-level preparation tables and other safety features should be adjustable to the needs of a disabled or an able-bodied person. Kitchen storage facilities are generally out of reach of the disabled person.

Housewives dependent upon crutches, and unable to reach for the shelves, or the normal points at which normal controls usually are—for water, electricity, gas, windows—need those controls where they can reach them. It is of the utmost importance for the architect to get them right. He should consider that the husband will be at work and the housewife unable to put coins in an electricity or gas meter. The housewife needs these means for keeping her home going and preparing for the return of her family. Too often I find that gas and electricity companies place meters in totally inaccessible positions. How many accidents have been caused, not only to the disabled, but to the elderly, by their trying to reach meters by climbing stepladders, or trying to reach meters under the stairs? Should not a percentage of the houses which we are building for our council tenants be purpose-built to incorporate special rooms such as those required for kidney machines and other appliances?

Mr. Ernie Money (Ipswich)

There is one further category I would seek to add to those my hon. Friend has mentioned, and that is picture windows, admirable things in themselves, but for the disabled almost impossible to open or shut.

Mr. Deputy Speaker (Miss Harvie Anderson)

Order. I would draw the attention of the House to the fact that the discussion is mainly on Section 1 of the Act.

Mr. Hill

It is not only the houses which we are going to build in the future that are important but also converted accommodation which disabled people are using. A case was brought to me some 12 months ago of a man with no legs, for they had been amputated, and who lived on the 14th floor of a multistorey block of flats. It is a case of that sort which local authorities must watch for, and they should give great publicity in order to bring disabled people on to the register. In converted accommodation there must be hoists for baths and beds; there must be special doors wide enough for wheelchairs; there must be special facilities for toilet needs; there must be switches at low level; and there must be a warning system, so that if there is an accident in the home the woman, for instance, who is on her own can at least give an alarm, and so there should be an alarm system. I concur completely with the hon. and learned Gentleman that the telephone is a necessity in every one of these homes occupied by persons registered as disabled. Another factor, they must have a garage adjacent to their home for their invalid chair.

If I am in order I will just say a word about Section 10, the appointment of one or more persons with knowldge of the problems of the chronically sick and disabled to the Central Housing Advisory Committee. Should that be written in? This should be common sense and should be applied at local level.

Mr. Arthur Latham (Paddington, North)

On a point of order. May I point out, Mr. Deputy Speaker, a point which you have yourself just made, that we are discussing in this Adjournment debate our concern with Section 1 and the non-implementation of what is on the Statute Book. It is almost inhuman to list many other things which might well have been suggested on Second Reading or Third Reading of the Bill or in Committee on the Bill. What this debate is about is getting implementation of that which is already law.

Mr. Deputy Speaker

Yes, but I think that, perhaps, the hon. Member does not further his own case as he hopes. The fact is that, as he rightly says, we are having an Adjournment debate. There- fore, there is the possibility of covering matter further to that which, for the convenience of the House, is notified on the Order Paper. Nevertheless, I have tried to restrict the debate in the interests of the House. Technically, however, the hon. Member may stray rather more widely.

Mr. Hill

Thank you, Mr. Deputy Speaker, for your indulgence in this matter.

I will not prolong the debate any longer Local government must educate the public and the relatives of the disabled about the registration of disabled persons, and funds should be available for national advertising to this effect.

3.25 p.m.

Mr. Jack Ashley (Stoke-on-Trent, South)

I appreciate the opportunity afforded by my hon. and learned Friend the Member for Stoke Newington and Hackney, North (Mr. Weitzman) to make a brief intervention in the debate. The House will agree that he has successfully made his case for the urgent implementation of Secton 1 of the Act. My hon. and learned Friend put forward a convincing case, and I think both sides of the House will endorse all that he has said.

My intervention is designed to draw to the attention of the Minister two points: first, the letter of the Act, and, secondly, the spirit of the Act. If they are not careful, the Government will lay themselves open to the charge of being dilatory in the implementation of the Act. I know that the Minister personally is not dilatory, and that he is as anxious as anyone else to implement the Act, but I understand that there are problems which must be dealt with by the Government.

The Act deals with a group of people who do not have time on their side and, therefore, a sense of urgency in the implementation of Section 1 is all the more imperative. I plead with the Minister to show a great sense of urgency, and to cut whatever red tape it is necessary to cut to ensure that official action is taken at the highest level. By taking this action and implementing the Act, he will win the appreciation of millions of disabled people.

Will the Minister consider the issue of an interim circular to local authorities urging on them the need for urgent action before his official implementation of Section 1? Such nudging, pushing and elbowing by the Minister would have a considerable effect on local authorities. So much for the letter of the law.

As to the spirit of the law, many local authorities should be able to take action without implementation. I do not want this to be taken as an excuse for not implementing Section 1; implementation is the first priority; but in the meantime local authorities can take valuable direct action. There are Members on both sides of the House who will welcome voluntary action by local authorities and be prepared to harry remorselessly those local authorities who refuse to take action.

I highly commend the Sunday Times for listing local authorities who are prepared to act while awaiting the Minister's implementation, and local authorities who are being dilatory. The Sunday Times, and other newspapers which are prepared to follow its lead, will find that the House will endorse this method of persuasion of members of local authorities who are evading the spirit of the Act.

In conclusion, may I take this opportunity, as the chairman of the all-party group on disablement, to say this to Mr. Speaker on his last day in the Chair. Many hon. Members are concerned with disablement, and an increasing number are becoming actively concerned. All this support is warmly welcome to Mr. Speaker, who was active in helping disabled people, particularly disabled children, long ago when it was unfashionable. His efforts on behalf of disabled people before the Act, and other Meassures, are greatly appreciated. One can now safely say that the implementation of Section 1 and the actions which will follow are in part a result of the work which was put in by Mr. Speaker years ago.

Several Hon. Members

rose—

3.30 p.m.

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

I do not want the fact that I rise at this point in any sense to curtail the debate. In any case, it would be impossible for me to do so, as there is a set time scale today. In view of the number of hon. Members who wish to speak it is rather difficult for me to judge the right point at which to intervene, but I am most anxious that the hon. and learned Member for Stoke Newington and Hackney, North (Mr. Weitzman) should get a proper reply without any pressure, as it were, from the clock. I shall listen with great interest to the contributions we shall have from hon. Members on both sides after I have sat down.

I am extremely glad that the hon. and learned Gentleman has chosen this subject for debate. It is a subject extremely close to my own interests and sympathies, as it is to those of my Department, and the debate undoubtedly serves a useful purpose in focusing public attention and that of the Departments upon the urgent priority which should be given to this historic Act. I shall spend most of my speech on Section 1, since this was highlighted by the hon. and learned Gentleman. That is not to say, however, that I did not listen with interest and attention to the remarks made by my hon. Friend the Member for Southampton, Test (Mr. James Hill), which will find their place on the record and will be pondered in my Department.

Section 1 requires local authorities to carry out two distinct but related tasks. First, it requires them to inform themselves of the numbers and needs of substantially and permanently handicapped persons in their area; secondly, to make known the services they provide, under Section 29 of the old National Assistance Act, 1948, both generally and to persons using any one of these services at a particular moment in time. I want to examine both these obligations. When Section 1(1) is in force, it will impose a duty on local authorities to find out the numbers of persons with disabilities at a certain level and the kind of services which should be provided for those persons. In other words, it places on the local authorities the general duty to inform themselves of the local situation so that they can make adequate and relevant plans to meet the needs.

There are a number of ways in which the authorities might seek to discharge their duties under Section 1(1) specifically. One way suggested is to compile a complete register of handicapped persons and to assess individually the needs of the people appearing on it. I have a great deal of sympathy with the feeling of those who advocate this course—total compilation. But, in practical terms, I do not think that it would be really reasonable for the Government to encourage it.

First, while complete registration of the handicapped would probably achieve the objects of Section 1(1), I am convinced that the cost of the effort of doing it would be so great a diversion of resources, in terms both of manpower and money, particularly manpower, that the whole point of the task would be nullified. There would be nothing left over, as it were, to meet the needs of those registered. That is not the only argument. Secondly, I cannot believe that it is right that all handicapped persons should be required to register whether they like it or not. Almost certainly many of them prefer not to reveal their handicap or do not wish to receive or have no need of the services. In any case, a quite arbitrary definition of the level of disability which entitled a person to be registered would have to be introduced; it would have to be measured in some way. Then we should encounter the old problem of the borderline, when people who needed services might lie just outside the legislation and suffer undue hardship.

Compulsory notification of disabling diseases would not be a suitable alternative as these are mostly of long duration, fluctuating courses and, in the early stages at least, difficult to diagnose. To define them in relation to the point in their history when they must become notifiable would be very important.

In addition to this, there would be a large increase in the number of cases which would have to be examined and assessed, with relatively little return in the form of people who would benefit from the services. I should like to suggest what seems a more realistic and practical approach to the implementation of Section 1(1). The first need of authorities is to assess the overall size and nature of the demand for services under the Act. This can be measured with a fair degree of accuracy by the use of sampling and survey techniques. A number of authorities have already carried out, or are carrying out, local surveys of various kinds designed to help them in planning services for the future.

Mr. Lewis Carter-Jones (Eccles)

Sampling techniques would give some idea of the number. The point made by my hon. and learned Friend was that he does not want a rough idea of the number but he wants to identify the people. A sample will never identify the people. Section 1 is about people.

Mr. Alison

That is not the whole story. Certainly identification and discovery is a crucial part. Total discovery for that identification would need such a massive diversion of resources, simply for that operation, that those left over to meet the needs of people so discovered would correspondingly be reduced. There is an advantage in the sort of surveys which I have suggested, and I hope and believe that authorities will attempt more widely to establish accurately the needs and priorities in their areas by this technique, so that they can set about meeting them in a practical and economic way One has to have some idea of the numbers, even by this technique of surveys of samples, in order to make an assessment of what the budgetary obligations are likely to be. To assist authorities in this my Department has asked the Office of Population Censuses and Surveys to help with the preparation of guidance on the employment of survey techniques which the O.P.C.S. is now using. We hope that this will be available by next summer, when the O.P.C.S. survey will be completed.

This will not solve the whole problem. Authorities will still need to establish contact with individuals. I should like to see them doing this by basing their visiting services in the first place on information already available to them about individuals, of which there is already much available. This means that there must be an adequate exchange of information, obviously within the proper limits of confidentiality, between departments and services which are in contact with people in need of help.

I emphasise the valuable part which voluntary effort can and does play in making such contacts with individuals, as the hon. Gentleman noted; and it may often be that efforts to expand services can best be begun in areas where voluntary help is particularly active. It is clear that a massive increase in the provision of services cannot be produced overnight; for one thing, it takes time to recruit and train the staff who are one of the essentials of services of the kind we hope to provide. It is no good adding handicapped people to a list of those in need of services, and thereby raising their expectation of help, when there is no hope of being able to meet that expectation for a considerable time to come. To do this is cruelty. We all know that services could be better—indeed, there is almost no limit to developments which could be made—and we all intend that they shall be better. But we must be realistic. If the development of services is started in the way I have suggested, on the basis of lists of known individuals, it can be continued by adding to those lists at a rate commensurate with the growth of resources.

It may be said that what I have suggested is simply to allow authorities to avoid their responsibilities, and the hon. Gentleman has also suggested this by his reference to some local authorities in particular parts of the country. It is suggested that some of them will make no effort to add to the number of handicapped people known to them. I hope that this will not be so; I state that firmly. We shall certainly be watching their performance in that respect. We expect the report of the national survey of disability, which the Office of Population Censuses and Surveys is now completing, to appear in the late spring next year, and this will give us a very good estimate of the number of people there are with varying levels of handicap in the country as a whole. We shall then be able to compare the number registered with authorities with the number of people who seem to be registrable, and we shall have a clear idea of how large the gap is, and both we and they will be able to form a good idea of the size of the problem facing them in the future demand on the resources.

I ask hon. Members to await the publication of the survey before they start talking about "the missing million". That is mentioned in the article to which the hon. Gentleman referred in the course of his speech. It must be remembered that many people are receiving services for which they do not need to be registered. That would bite considerably into the so-called "missing million".

Although there is room for development, I do not suggest that most authorities are not doing all that they can with the resources at their disposal, on which there are a great many heavy demands at present, or that this is a problem which we are leaving the authorities to face alone. To assist local authorities in improving services which we specially wish them to develop, including those referred to in the Morris Act, the amount of relevant expenditure on the health and welfare services ranking for rate support grant was increased by £5 million in the 1971–72 and £6 million in the 1972–73 rate support grant negotiations over and above the sums already settled in the latest negotiations.

I turn now to Section 1(2) of the Act, which comes within the ambit of the hon. and learned Gentleman's Adjournment Motion. Section 1(2) falls into two parts. The first seeks to ensure that local authorities do what is necessary generally to publicise the service which they provide for substantially and permanently handicapped people so that those who might benefit from these services, and their families, should know what is available to them. This object was one on which the hon. and learned Gentleman touched. The second part seeks to ensure that, when a person receives any single service, he should be told of others that are likely to be helpful to him.

The second of these tasks presents relatively few problems. Once one is in touch with a handicapped person and providing him with a service, it is not too difficult to tell him about other services. However, there are a number of considerable difficulties attaching to the first requirement. It really amounts to making sure that the right kind of information about a wide range of services is available continuously to those who may be in need of help in such a way that they can make use of the information and the services at any time when they are required.

Such a problem can be attacked at several levels. At the national level, there is already a general booklet called "Rehabilitation and Care of the Disabled in Britain", published by the C.O.I. However, this is not primarily designed for disabled people themselves, and it is not confined to those services with which Section 1 of the Act is concerned. I am asking my Department to look at the need for a general booklet aimed more specifically at the needs of the disabled and their families.

I am pleased to recognise the work of voluntary bodies in this sphere. There is, for example, the very useful "Guide to the Social Services" put out by the Family Welfare Association, in the preparation of which Government Departments have annually given a good deal of help. The Central Council for the Disabled has done much to make known the services provided by local authorities, especially those provided under the Alf Morris Act. I understand that the director of the Central Council for the Disabled is also participating in a commercial enterprise to produce a handbook for the disabled and those working with them. I ought to refer as well to the extremely useful Information Service for the Disabled run by the Disabled Living Foundation.

The offices of local authorities and my Department's branch offices have some of these semi-official or voluntary publications emanating, for example, from the Central Council for the Disabled. We want to see what is being produced by voluntary organisations so that we know the extent to which it must be supplemented by official publications.

Mr. Latham

I am sorry to have to tell the hon. Gentleman that my own correspondence and experience very much matches that recounted by my hon. and learned Friend the Member for Stoke Newington and Hackney, North (Mr. Weitzman). It cannot be explained away by saying that those officials want to inquire what publicity material is available. I have a file of letters which, if necessary, I can make available to the hon. Gentleman, giving details of cases where local authorities have denied knowledge of the Act. One county council, Glamorgan, has sought to shield behind the lack of a date for the implementation of Section 1 in order to postpone the implementation of Section 2. In another case, a lady in Exeter saw a social security officer who denied that the Act had become law. I hope that the hon. Gentleman will not labour under the misapprehension that this is an inquiry concerned with lack of information. We are asking the hon. Gentleman to see that all his officials and local authorities are informed by the Department; not leave it for occasional inquiry as to what is being published.

Mr. Alison

I have listened closely to what the hon. Gentleman has said. I hope that he will write giving me a summary of the communications which he has received and perhaps highlight those which he regards particularly suspect and liable to be interpreted as exposing ignorance on the part of the statutory body. The hon. Gentleman will know that my Department published—"published" is not the right word—prepared and circulated a substantial departmental document on the Act dated 17th August, which was widely disseminated among local authorities.

Mr. Latham

Will the hon. Gentleman read to the House that section of the circular which deals with registration? My recollection is that it specifically advises local authorities that they are not expected to achieve 100 per cent. regis- tration, and this is leading to dilatoriness in implementing the Act.

Mr. Alison

I hope that the hon. Gentleman appreciates that registration is not a prerequisite for benefiting from the services under the Act. The purpose of registration is to carry on the original statutory duties of local authorities to register those who apply for services. A person does not need to be registered to secure services under the Act. When he applies for services under the Act he is automatically registered.

Mr. Latham

The people have to be found.

Mr. Alison

I agree that discovery is one of the crucial problems. Full 100 per cent, discovery could divert enormous resources, both of manpower and money, not only from the implementation of the services which we hope to provide under the Act, but possibly from other services as well.

Mr. Weitzman

Will the Minister deal with the suggestion about publicity by which the Minister, on radio, television and in the Press, should make the facts of the Act known to the disabled.

Mr. Alison

As the hon. and learned Gentleman has made the point so forcefully, I will carefully consider it without committing myself. I appreciate that there may be substance in this point, but it is extraordinary how some things which appear on television nevertheless totally fail to register and often miss some of the people one is most anxious to help.

Nevertheless, as useful as national information of this kind is—this is where the television angle might have some bearing—I feel sure that it is only valuable in so far as it is supported by very full local information. This is the importance of the locale of publicity.

Many local authorities already publish booklets which describe their own services, and I am anxious to encourage efforts of this kind. But even here there is a big problem. Even assuming that one has discovered a person who may at some time be in need of services, or of the services provided under the Act, and has put in his hands a guide, written in simple language, about the services available, how does one ensure that he will consult it when the need for services arises? All too often the information with which somebody is provided in written form, at a time when he does not require services, disappears from his camp.

My Department has these problems very much in mind, and we are considering whether there is any need to issue guidance to authorities on the narrower point of publicity. But there is no single or simple solution to publicising the Act. What is needed is publicity of numerous kinds from numerous sources put across in a variety of ways. Local authorities will need the co-operation of local newspapers and radio stations—I take the hon. Gentleman's point—in making their services known and in supplementing authorities' own leaflets and guides.

Local authority staff are increasingly being attached to general practitioners. This will help to bring people into contact with local authority services. I attach great importance to the value of attachment to local authority health centres. I believe that this may be one cardinal area in which the general dissemination of information about these extra services can be spread.

I must once again refer to the important part which voluntary effort can play in supporting and supplementing the work of local authorities. Many people have a general practitioner and they have a broad idea of the kind of services which the family doctor provides, but general practitioners have been working in a community for centuries while the social services are latecomers to the scene. Obviously, we cannot wait for centuries before these services sink into the public consciousness. We can all play a part in helping to make them known to those who need them.

Above all, it is the quality of the services provided which determines the extent to which they will be talked about in the community and thus become known. The quality of the service is a vital factor in spreading the good news of its existence. The better a local authority's services are, the more likely it is that they will be known and talked about and will come to the awareness of those who need them and at the time they are needed. It is our intention to support local authorities in the efforts which, I know, they will make to develop their services and to ensure that they are made widely known so that they can be used to the best possible advantage.

The implementation of section 1 of the Act requires an Order made by Statutory Instrument. It is my right hon. Friend's intention to make such an Order shortly after 1st April next year, when the new Seebohm departments of local authorities will be in existence and can take on the problem in the context of the responsibilities which the Section imposes upon them.

I must refute the allegation that the present Government, in contrast to the last one, are being dilatory in that respect. The Alf Morris Act specifically wrote in a flexible time scale for implementing the important Section 1. We have no doubt whatever that local authorities are in a state of ferment and upheaval as a result of the profound reorganisation which was imposed upon them by the Local Authority Social Services Act. To bombard them now with supplementary memoranda, guidance and letters in addition to the very large numbers which they are receiving bearing upon the Local Authority Social Services Act would merely gum up the machine and, I believe, be counter-productive. We hope that the new Seebohm departments—they will not be long in coming—will provide just the springboard that is needed to get the Alf Morris Act really into orbit and benefiting the global scene, as we hope that it will.

3.52 p.m.

Mr. Lewis Carter-Jones (Eccles)

I shall be brief because many hon. Members, on both sides, wish to speak. I regret that the Minister had such an unimaginative brief, because he is a charming man and I think that he would like to implement the Act. It should be made known to his Department that the Act was put upon the Statute Book not only by the efforts mainly of my hon. Friend the Member for Manchester, Wythenshawe (Mr. Alfred Morris), but by the efforts of hon. Members on both sides of the House, and that there was never a Division upon it. The only division which is now creeping in is the result of the Department's being dilatory. It could quite easily have come forward with a compromise. My hon. Friend the Member for Stoke-on-Trent, South (Mr. Ashley) clearly said, "Very well. If we cannot have full implementation, let us have an interim implementation." There was absolutely no response from the Minister to that reasonable request.

I am very glad that on the benches opposite we now have a friend in the hon. Member for Ipswich (Mr. Money), who is lucky enough to have an enlightened medical officer of health who is prepared to implement the Act. My hon. and learned Friend the Member for Stoke Newington and Hackney, North (Mr. Weitzman) pointed out, however, that the implementation of the Act varies from one area to another. Some areas want to help, some do not. Some want to hide behind a cloud of regulations. The Department should clearly give a lead to all local authorities that they must implement the Act.

I was astounded that the Minister's Department should have talked about a statistical survey. We are not concerned about a statistical survey. We are concerned about people. What we are after is not a random sample, but a person in reality, not a cipher. First, it is necessary to assess the disabled, whether for environmental control, access to buildings, mobility or communication. Having assessed them, we must give them whatever we can to enable them to live a normal life. But how can those two long processes be carried out until those coming under Section 1 have been indentified?

I ask the Minister to tell his Department that it was the unanimous view of the House that the Act should be implemented. That was the view expressed in the last Parliament, and it should be implemented under this Government. I hope that the hon. Gentleman will assert his authority and insist that it be done.

Mr. Money

rose—

Mr. Laurie Pavitt (Willesden, West)

rose—

Mr. Speaker

Order. I thought that the Opposition Front Bench speaker was to interevene. We must finish this debate at four o'clock. Mr. Morris.

3.55 p.m.

Mr. Alfred Morris (Manchester, Wythenshawe)

I am extremely grateful to my hon. and learned Friend the Member for Stoke Newington and Hackney, North (Mr. Weitzman) both for his extremely kindly remarks and for helping to create this opportunity to discuss a very important, not to say fundamentally important, Section of the Chronically Sick and Disabled Persons Act, 1970. The timing of the debate is also extremely felicitous. The book published yesterday by Miss Sally Sainsbury, which is called Registered as Disabled, documents again the extremely serious problem of how we treat our disabled fellow citizens.

Much of the publicity about the Act has been undertaken by the organisations working for the chronically sick and disabled. I hope that there will now be more official publicity about its provisions. We want the implementation of Section 1 not just for reasons of administrative tidiness but because it concerns a deeply serious human problem. It has to do with some of the poorest and most needful people as well as with preventable suffering.

I accept what the Secretary of State said to me when I, together with the Earl of Longford, met him recently. He said that the Act represents a major change in the law to which local authorities will need to adjust; and he put it to us very strongly that they will need time to implement the Act fully. I fully appreciate that, but there is increasing pressure from the organisations representing disabled people, as well as many other organisations, for the quick and effective implementation of Section 1. For it is about the crucially important problems of finding out where disabled people are and of ensuring that they receive information about the services available to them.

There are examples of boys with muscular dystrophy whose parents have been unaware of the availability of ripple cushions. This means that the boys concerned suffer highly serious and very painful pressure sores. I have seen examples of this; and it would be very instructive for anyone who obstructs the passing of information to disabled people to see the effect of this on the boys I have mentioned.

To some extent this debate is a reunion of those who worked with me in passing the Act. Again, I pay warm tribute to them. I know that all of them attach great importance to Section 1.

There is obviously a wide chasm between the number of severely disabled people known to public authorities and the actual incidence of severe disablement. I ask the Minister, who I know to be very deeply concerned about the problems of disabled people, now to do everything he possibly can to see that the Section is implemented at the earliest possible date.

It being Four o'clock, the Motion for the Adjournment of the House lapsed, without Question put.

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