THE ATTENDANCE ALLOWANCE BOARD

HC Deb 15 July 1970 vol 803 cc1610-32

Mr. Alfred Morris

I beg to move Amendment No. 9, in page 4, line 28, at end insert: 'and shall include at least one person with experience of work among and of the needs of the chronically sick and disabled and in selecting any such person regard shall be had to the desirability of having a chronically sick or disabled person'.

The Temporary Chairman

We shall consider at the same time the following two further Amendments:

No. 10, in page 4, line 30, after 'be', insert: 'and of those two one should be employed in social work among disabled persons'. No. 11, in page 4, line 30, leave out 'and those two or either of them may be'.

Mr. Morris

This is a group of constructive Amendments designed to ensure that there shall be at least one member of the Attendance Allowance Board who knows something of the realities of life for the severely disabled. Amendment No. 9 is in wording identical to provisions made in the Chronically Sick and Disabled Persons Act, 1970.

There are, of course, people who feel that the disabled are not competent to discuss matters affecting their welfare, their housing and their status in society. By enacting the Chronically Sick and Disabled Persons Act, we have laid down that, where the interests of disabled people are under discussion, there should be at least one disabled person present.

I am sure the Under-Secretary of State will want to give a favourable response to this group of Amendments. The organisations representing the disabled, in particular, the Central Council for the Disabled and the Disablement Income Group, are most keen that those who know where the shoe pinches should be present when policy discussions take place.

I need not speak at length. The Amendments are introduced with serious intent. It would be illogical not to adopt them when we have made similar provisions, of identical wording, in other legislation. My hon. Friend the Member for Stoke on Trent, South, who cannot be present this evening, feels, as a disabled person himself, that this group of Amendments is extremely important. I am sure that the Attendance Allowance Board would benefit from the presence of at least one member who knew the problem of the disabled at first hand and I commend the Amendments to the Committee.

Mr. Carter-Jones

I strongly support what has been said by my hon. Friend the Member for Manchester, Wythenshawe (Mr. Alfred Morris). It is appropriate that he should have referred to my hon. Friend the Member for Stoke-on-Trent, South (Mr. Ashley), in whom we have a classic example of a disabled person working as a Member of this House, doing so very efficiently, and, what is more, enabling the House to understand something of the problems of disabled people. [HON. MEMBERS: "Hear, hear."] His disability helps us to understand these matters better.

My hon. Friend the Member for Stoke-on-Trent, South made a notable contribution on the Chronically Sick and Disabled Persons Bill.

Dame Irene Ward

Hear, hear.

Mr. Carter-Jones

I am glad to hear the hon. Lady endorse what I say, for we worked together very happily on that Bill. It was much to my hon. Friend's credit that not only was he able to tell us something of the problems of those who are completely deaf, but he took up the special needs of the deaf-blind and spoke also of the problem of dyslexia and the reading difficulties suffered by children. Because of his disability in one sense, he was able to speak with conviction and authority on those other afflictions.

Those of us who served on the Standing Committee on that Bill, introduced by my hon. Friend the Member for Wythenshawe—there are some present now—derived a tremendous amount of information and inspiration from the disabled people who attended upon us. Indeed, we used to have our little private "Whips'" meetings downstairs. I warn the Government of the danger of that sort of thing spreading. Hon. and right hon. Members from both sides used to assemble in one of the rooms downstairs, where we would be given a very good briefing from disabled people about their needs and their problems. As time went on, we acquired considerable understanding and knowledge.

If the Attendance Allowance Board does not, under Statute, have disabled people upon it, it will miss something of great value. From time to time, we consider matters in the House somewhat in isolation, without personal knowledge of the problems involved. The Board would be in a much better situation if it insisted on the presence of a disabled person. The dilemma is that such boards can easily be manned, because large numbers of people like to serve on them, and the right hon. Gentleman will be faced with a problem of choosing. Having to choose from a wide range of people, he will say that the disabled person does not matter. I am sure that the Disablement Income Group, the Disabled Living Foundation or the Central Council for the Disabled would at any time recommend first-class people who are disabled themselves and could speak with authority and conviction for the disabled.

I hope that the Minister will accept the Amendment.

8.0 p.m.

Dame Irene Ward

I hope that the Government will accept the Amendments. I feel very strongly about the matter. In view of all the consideration that has been given to the production of the Bill, those members of the Government who were concerned with it might have had the idea contained in the Amendments themselves to ensure that the Board would have adequate representation from the Disablement Income Group or any of the other groups which represent the disabled.

A couple of days ago my hon. Friend the Member for Melton (Miss Pike) made a most interesting speech on participation. She spoke at great length and in great depth, with particular reference to the social services stressing how important it was that the country should be given the widest possible participation in the work being done through Parliament to improve conditions. She did not tell us how she thought that that participation could become effective. I may be wrong, but I have a feeling—because the grapevine is pretty effective in this House—that her speech stemmed from my Government. Then I suddenly realised, reading the Bill in depth, that the first opportunity to take advantage of the ideas put forward by my hon. Friend, who has now been elected the chairman of our Social Services Committee, has not been taken in the Bill. This annoys me very much. I hope that when creative ideas are put forward my Government will have enough imagination to make use of them if they are practical.

I do not think that my hon. Friend the Under-Secretary of State or my right hon. Friend could under any circumstances reject the Amendments, to two of which I have added my name. I, too, had wanted to table an Amendment on the question of having too many medical people on the Board, but I was told that another hon. Member had already put down such an Amendment and that I could only add my name to it. However, I find that I could have put it down myself, but I am delighted to support the hon. Member for Manchester, Wythenshawe (Mr. Alfred Morris). I only hope that the two Amendments to which I have added my name will be accepted by the Government.

I should like to deal first with the words that imply that the whole Board could be composed of members of the medical profession. That is not a very good idea. My hon. Friend may say that provision has been made for advisers. I know that, but my experience is that any committee listens politely to what people have to say and then pays no attention to them. This has happened on the consumer committees for the nationalised industries. I am sure that the Board would listen very politely to the advisers and to any information put forward by those actively concerned with the chronically sick and disabled, but when the advisers had left it would take its own decision, and there would then be nobody to fight the case on the Board. It is all very well being able to offer advice, but one must have fighters on the Board to see that one's advice is accepted.

I do not like the arrangement proposed. It is most unfortunate that the Board could be composed entirely of members of the medical profession. The medical profession is absolutely first-class, and I am sure that the people appointed to the Board will be proud and honoured to serve on it. But the medical profession does not know everything, and every now and again its members would get on much better if they would take a little advice from people with the experience and knowledge of the kind of thing being discussed.

I absolutely support the hon. Member for Wythenshawe in his suggestions to which I have added my name. I do not want a Board consisting entirely of medical people. They have all sorts of wonderful knowledge, but they are not necessarily always so good at the grass roots. They have not the experience of what a constant attendant has to do, the help that has to be given and what has to be provided inside a household. The Amendments are most practical, and I cannot see any reason why my hon. Friend cannot rise straight away to say that he accepts them.

The hon. Gentleman's Act would not have been the same without the enthusiasm, experience and knowledge of disabled people from which the committee which helped to support it benefited. We also benefited from all the inspiration and humanity they brought into discussing the problem, and the reception the Bill received from Ministers when the present Opposition were in government. They took infinite care to try to make the Bill as practical as possible and we who were then in Opposition did our best to support them in every possible way.

It would be extraordinary if the medical profession had to have all the places on the Committee. If this is the case, it is a funny thing that the medical profession did not see that an Act helping the chronically sick and disabled reached the Statute Book before it was left to the hon. Member for Wythenshawe to produce it.

People who have tremendous knowledge, as the medical profession has, naturally want to use it to the best of their ability, but members of the medical profession do not understand about Parliament and how to pressurise Governments, whether Conservative or Socialist. They do not have a chance to pressurise a Liberal Government.

The assumption that a constant attendance allowance board should be composed wholly of members of the medical profession is intolerable. I am grateful to the hon. Member for Wythenshawe, who has put his proposals in much less rough terms than I have used in supporting them, for the assumption behind the Bill as it stands is intolerable.

The Under-Secretary has a deep knowledge of these matters and I am sure that he will agree with me. If he has been pressurised by the medical profession, I hope that he will become unpressurised and will allow the disabled to be represented on the board and not to act merely as advisers. The representatives of the disabled would be able to keep the country in touch with what was going on.

The Conservative Party believes in participation by those who have the knowledge to participate. There is no one in the Committee who does not know of the hard work and enthusiasm of the disabled in legislation now on the Statute Book and without their help we would not have got as far as we have with this Bill. We want participation at the highest possible levels so that the disabled may argue their case as full representatives on the board and not merely as advisers who may be politely heard but whose views may be disregarded by members of the medical profession, who rather hang together. If we believe in participation, here is an opportunity to take the first step.

It would be unfortunate if the doctors were able to fill the board with medical people. I should like the board to include representatives of the Chartered Society of Physiotherapists and the Royal College of Nursing, for example, but there must be at least direct representation of the disabled.

If my hon. Friend was thinking of finding charming reasons for turning down the Amendment, he should tear up his notes, speak his heart and take his advice from those of us who want the Bill to be a great success, those of us who want the disabled to have a chance to participate so that they may be proud of what they have started in the way of a proper service for the chronically sick and disabled.

8.15 p.m.

Mr. John Golding (Newcastle-under-Lyme)

We on this side of the Committee are very pleased that once again the hon. Lady the Member for Tynemouth (Dame Irene Ward) has joined us in battling for the rights of the disabled. I rise to ask my hon. Friend the Member for Manchester, Wythenshawe (Mr. Alfred Morris) to press the Amendment and not to be persuaded to withdraw it. Whatever the intention of present Ministers, we know only too well from experience that good intentions may be quickly forgotten if the Amendment is not made.

The first of my two arguments for supporting the Amendment has already been made by the hon. Lady. Doctors should not have a monopoly of representation, or even form the majority, on the constant attendance board. Increasingly the function of the doctor is to look after the medical needs of the sick. The doctor sees a disabled person as a patient, as someone whom he is trying to keep alive, to keep out of pain, as someone he hopes one day to be able to cure. The doctor sees a disabled person as a medical case, but a disabled person is more than that.

For many disabled people the disability is the least of the medical problems. Disabled people are worried about isolation, loneliness, frustration. They generally receive more help from the health visitor, the social worker and the people around them than from the doctor. The doctor spends little time with patients of this sort whom he has often written off as incurable. Because they spend so little time with them, the doctors never come to understand the total problems of such people; other people do.

The one category of person who understands most clearly is the disabled person himself. I agree with my hon. Friend the Member for Eccles (Mr. Carter-Jones) that while we were all grateful for the talented leadership of my hon. Friend the Member for Wythenshawe during the passage of his Bill, a substantial part of the practical guidance came from the disabled themselves. We were indebted throughout the proceedings to the National Council for the Disabled; to the Campaign for the Young Chronic Sick, which stemmed from personal family experience; and to members of another place, one of whom was sent there specifically to speak on behalf of the disabled. We also received great assistance from hon. Members disabled in one way or another. However well intentioned they may be, those who have not been disabled do not have the sympathy and understanding which the disabled share.

For these reasons, I hope that my hon. Friend will press the Amendment to test the Government's attitude to the disabled on this point, and I strongly support him.

8.20 p.m.

Mr. Kaufman

I would like to support my hon. Friends and the hon. Member for Tynemouth (Dame Irene Ward), perhaps more in the first part of her speech, dealing with her positive points of participation rather than with what she said about the medical profession. I press this point for two reasons. First, the inclusion of such an Amendment in the Bill would give confidence to those involved with making sure that their situations are understood. The understanding of the problems by a participant is always far greater than the understanding of problems by a sympathiser who can never understand them in the same way. My hon. Friend the Member for Manchester, Wythenshawe (Mr. Alfred Morris) in his Act has already made provision for this situation, and in my view this kind of legislation can revolutionise the situation of the disabled.

If we take an example of those making applications for housing, covered by my hon. Friend's Act, people without legs, and people who have chronic asthmatic conditions, sitting on a housing committee are able more easily to understand the problems of people similarly placed and making applications to that Committee. In my constituency I have people in this situation who find it difficult to get suitable accommodation from the local authority. If there were someone, as I hope there will be, sitting on such committees they would be able to press those in authority in a way that sympathisers who have not experienced these matters could not.

In addition to the confidence that this would provide, such an Amendment would give hope to the disabled. There is a danger that disabled people may feel set aside from life. There is a danger that they will feel psychologically inferior as a result of their physical disability. This Amendment recognises that the disabled and chronic sick are part of society. If it is accepted it will give them extra confidence and even pride as citizens of the community. That is why I very much hope that the Government will find it possible to accept the Amendment.

8.25 p.m.

Mr. McGuire

I, too, support this Amendment. The Under-Secretary will know that there is a payment known as the constant attendance allowance, payable for industrial and war injuries. Can he tell me in what way the powers of this board will differ from the powers of the authority which awards such an allowance? I ought to know the composition of the existing constant attendance allowance board but I do not and I would like enlightenment. All I know is that those who wish to qualify for the allowance have to overcome a pretty stiff hurdle. There has been the McCorquodale Commission, which made amendments to the subject of severe disablement and attendance allowances. I know that severe disablement alone does not qualify a person. When my hon. Friend the Member for Eccles (Mr. Carter-Jones) mentioned my hon. Friend the Member for Stoke-on-Trent, South (Mr. Ashley) I was delighted. When I learned of my hon. Friend's disaster I sent him a letter saying that he, more than anyone else, could bring the problems of the disabled before the House. I told him that they needed a champion here who could speak about what it was like to be disabled.

I have a boy who is very severely disabled. He has two artificial legs, and that is why I asked a question about the entitlement. It was said that severe disablement would mean a double amputation. I wanted to say then that the hon. Gentleman should not mislead the Committee into thinking that this would qualify a person for the constant attendance allowance. We need someone who suffers from a disablement such as we are talking about in the House. We want people on this board who can participate in the decisions and have a voice in the debates.

The Minister has left himself with two options. The Bill says that two places can be filled with doctors, but if we are discussing constant attendance allowance I do not see how such a person can make a useful contribution. We need someone who is the wife or husband of someone receiving such an allowance. We are not talking about an ordinary disability. We should not think that by getting someone disabled, such as my hon. Friend the Member for Stoke-on-Trent, South—useful as he would be in this context—upon such a board we have achieved everything. We do not want someone who is himself or herself disabled; we want, rather, the husband or wife, or other relative, of a disabled person, who will know at first hand what is involved.

8.30 p.m.

Mr. O'Malley

The Amendment has been pressed hard by hon. Members from both sides. The disabled whose case may be before the Constant Attendance Board and organisations representing the disabled should have confidence in the organisation and should be able to hope that all the factors which seem relevant will be fully considered.

The Bill which set up the board said that its composition should be between four and nine members—that remains in this Bill—and that each member of the board must be a medical practitioner. The previous Bill went further only in this respect, saying that the board, not the Secretary of State could appoint persons as advisers on matters which the board thought needed special qualifications.

This is how matters stood before the National Superannuation and Social Insurance Bill went into Committee. In Committee, an addition was made to those provisions by a Government Amendment, which is now subsection (3) of this Bill. It says that the Secretary of State, not the board, can appoint others, but not for a medical adjudication, when the board was acting in its advisory capacity, since it was held that the Board had two clear functions—medical adjudication and an advisory capacity.

During the debate at that time, Mr. David Ennals said: There may well be occasions on which the voice of someone speaking directly for the disabled, either through personal experience or through close involvement in an organisation working for the disabled, should be heard through membership of the board, or as an adviser. The Amendment"— now subsection (3) of the Bill— to allow the Secretary of State to add additional advisory members to the Board, with the power already in the Bill for the Board itself to appoint advisers, secures that all the necessary expertise can be brought to bear where and when needed."—[OFFICIAL REPORT, Standing Committee F, 30th April, 1970; c. 1155–56.] I am clear that my hon. Friend the Member for Manchester, Wythenshawe (Mr. Alfred Morris) wanted a member on the board to help in its advisory capacity, but I am not sure whether he and other hon. Members who support him had envisaged the presence of a chronically sick or disabled person to deal with a question which at least mainly, if not entirely, was a question of individual medical adjudication.

Although I recognise that other factors than medical will need to be taken into account, all hon. Members would like the Under-Secretary to be forthcoming about the Government's intent in respect of these suggestions. The point raised is an important one. It would be helpful to the board if a representative of the chronic sick or disabled—or a chronically sick or disabled person himself or herself—was a member of the board, at least in respect of part of its role.

I now turn to Amendments Nos. 10 and 11, which are also being discussed. During the Committee stage of the previous Bill on this subject the Under-Secretary—then in opposition—took the view that the adjudication of claims was not entirely and exclusively a medical matter. He pointed out that decisions would be taken by doctors at local level, so that the board, or some members of it, would review a medical decision that had already been taken. He was therefore in favour of representation on the board—at least in respect of adjudication—by someone who was not necessarily a qualified medical practitioner but was a recognised social worker.

In response to the representations made by the hon. Gentleman—now the Under-Secretary—Mr. David Ennals said that he would consider the point, but he took the view, as the Government did, that this was exclusively a medical matter. The medical profession would regard the question of appointments to the Board—as it has done in the past on a number of occasions—as entirely a matter for the profession, and would take the view that non-medically qualified people had no rôle to play in such appointments. On considering the matter I have come to the view that the Under-Secretary was right in the view that he then expressed.

But when individual claims are raised it is not merely a matter of medical consideration. The Government Amendment makes it a possibility, but no more, that some members of the board, in terms of its adjudicatory functions, need not necessarily be medical practitioners. But that does not go far enough. It is very cautious drafting. We understand the reasons for it. The medical profession is not the easiest one in the world to deal with. Nevertheless, hon. Members opposite have already found that they need not give that profession everything it wants—except during election periods. Once they have gained office it becomes a different matter. I therefore hope that the hon. Member will feel able to accept Amendments Nos. 10 and 11. They seek to make the provisious of the Bill a little firmer—to give the Government support when they tell the medical profession that some members of the board will be experienced in social work among disabled persons. Since I am taking the line that the Under-Secretary took only a few months ago I hope that he will feel able—I am sure that he will; he cannot do anything else, with his history in the matter—to accept the Amendments.

Mr. Dean

This has been an extremely interesting debate on a very important subject. I say right away that there is no difference between us as to the aims and intentions that we wish to see achieved. I shall start by examining the composition of the board as laid down by the Bill, after which I shall expand a little on the precise way in which we propose that the powers should be used.

The composition of the board is laid down primarily in Clause 5(1). Under paragraph (a) the board has a duty to determine whether the medical conditions for an attendance allowance, as laid down in Clause 4, are satisfied. That is the specialist medical function.

The second function, in paragraph (b), is to advise the Secretary of State on questions he refers to the board regarding the working of the provisions, including the advisability of amending the provisions. This is a comprehensive function, in which we envisage that not only medical expertise will be of value but also non-medical expertise, that of social workers who know social needs and of people who know nursing needs, will be of value. This second function will, of course, be a very important one. One envisages that, as we gain experience of the working of attendance allowance, that experience will suggest various changes.

In deciding what changes may, in the light of experience, be made in the future, we shall need as comprehensive advice as possible from full members of the board—and I emphasise to my hon. Friend the Member for Tynemouth (Dame Irene Ward) that they would be full members of the board who would be exercising this function. They would not be exercising the narrower, specialist, medical functions, but they would be full members of the board for this all-important function of advising what changes should be made in future in the light of experience.

The third main function is to exercise any other functions …. that the Secretary of State may determine. Here, too, all the members would be concerned, and they would be equally members of the board in giving advice in this respect.

As the hon. Member for Rotherham (Mr. O'Malley) conceded, since this matter was discussed in the last Parliament we have gone rather further. We have now laid down quite specifically that two members need not be medical practitioners, and in that sense I think we have gone a great deal of the way to meet the points which have been made for both sides of the Committee today. I hope that that helps with regard to the main functions.

Now I turn to subsection (3)—

Mr. O'Malley

The hon. Gentleman said, quite rightly, that the Government have come some way, because they have said that two of the members need not be medical practitioners. On reflection, would he think it would be a better situation if the Government were to say that two members should not be members of the medical profession?

Mr. Dean

I will come to that in a few moments. I should like to get it clear to the Committee exactly what the functions of the board are to be, and then I will come to the point the hon. Gentleman has raised.

As I was about to say, under subsection (3), which is a very important subsection, the Secretary of State may appoint as additional members of the board people whom he considers specially qualified, whether or not they are medical practitioners. These additional members will not, of course, take part in the purely medical decisions, but they will take part in the other decisions. Thus, one has a picture of a board with two members who need not be medical practitioners and additional members, either medical or non-medical, who can exercise the all-important advisory function.

I wonder whether the Committee has fully appreciated that we have, in my judgment, gone almost all the way to meet the points put forward from both sides of the Committee. I very much hope that hon. Members will feel on reflection that what they have been asking for is here in the Bill, and that it will not be necessary to take this question to a Division.

Mr. Alfred Morris rose—

8.45 p.m.

Mr. Dean

I have not finished yet. I still have some things to say which I hope will be helpful.

Much of the debate has concentrated on Amendment No. 9 in the name of the hon. Member for Manchester, Wythenshawe (Mr. Alfred Morris), supported by my hon. Friend the Member for Tynemouth. The Amendment adds the words: and shall include at least one person with experience of work among and of the needs of the chronically sick and disabled …". That is the firm intention of the Government. The medical practitioners appointed to the board will include people with experience of work amongst and of the needs of the chronically sick and disabled. For example, many of the people who will make successful claims will be elderly people, so that it will be necessary to have on the board one or more medical practitioners with experience of geriatrics. These medical practitioners are likely to be people who know geriatrics from the hospital end and also from the community end, from the homes and the hostels in which the geriatrics live. We have in mind as wide a range of experience as we can possibly get for the non-medical functions. This wide range will be essential if the board is to command the respect and gain the confidence of those for whom it is working, and if the Secretary of State is to have the most comprehensive advice available. I think the point is met in the wording we now have.

The second part of Amendment No. 9 deals with the desirability of having on the board a chronically sick or disabled person. A person with direct knowledge of disability from personal experience is clearly the sort of person who would be carefully considered in deciding the composition of the board, but I am advised that the wording of the Amendment might not achieve the object which both sides of the Committee wish to see achieved.

My final point is a plea to maintain maximum flexibility. We are venturing into a new area. None of us knows how it will work out. We know the types of expertise that we want, but if we are to get on the board the people who are necessary to make it successful, the Committee will recognise that we must first consult those most concerned about the precise composition of the board. If at this point the Committee tries to tie us down with wording which may not achieve what we all want to achieve, it might be much more difficult to get the people we want and for them freely to give us advice.

I hope that I have convinced the Committee that we are all after the same ends. It is merely a question of how they can best be achieved. In the judgment of the Government and from what we have heard so far, the objectives which have been suggested from both sides can best be achieved under the wording of the Clause as it stands.

Mr. Carter-Jones

I must press this point. I am sure that we would all pay tribute to bodies like the Disablement Income Group, the Disabled Living Foundation and the Central Council for the Disabled. I know that the hon. Gentleman has a great respect for the medical profession, a respect which I share, but those of us who worked on the Chronically Sick and Disabled Persons Act are convinced that there is no greater fount of knowledge than lies in those organisations. This should be written into the Bill so that this knowledge should not be squandered.

[Miss HARVIE ANDERSON in the chair]

Dame Irene Ward

I am disappointed with the Under-Secretary's reply. He has charmingly and delightfully set out his arguments in detail, but I cannot see why he has any objection to these Amendments.

Does my hon. Friend consider that all the tests for the award of vehicles for the disabled are satisfactory? I have talked to people who have knowledge of this matter and they certainly are not satisfied. The fact that the Clause says that the Board should include two members of the medical profession does not satisfy me. I have no intention of supporting the Clause without amendment. That does not mean that I will vote against it, but I cannot support my hon. Friend on this matter.

The requests which have been put forward have been most reasonable. We have never discussed numbers, but I gather that the Bill makes provision for a board of between four and nine members. If the Under-Secretary cannot get all the people he wants on the board within that number, then I despair.

He has not said a single word about participation which was mentioned in the speech of the hon. Member for Melton (Miss Pike). It was a wonderful speech, but she gave no indication of now she saw it being carried out. Had she been here to listen to this discussion she would have pounced on what has been said as being a wonderful opportunity.

Mr. Marks

Words not actions.

Dame Irene Ward

I am a Member of Parliament who likes action. The Under-Secretary of State has put his case in a nice and friendly way and no doubt hopes that everybody will be satisfied. But I am not satisfied. I am sorry that I should have to dispute with him of all people, but I feel that these two Amendments are reasonable. It is a pity that if the Conservative Party are keen on participation they do not take the first opportunity to demonstrate that they mean what they say.

I can only hope that the Under-Secretary will say that he will consider the matter on Report because we could have a Report stage. Between now and then my hon. Friend could meet those of us who feel strongly on these matters so that we could perhaps convince him instead of his trying to convince us.

Mr. Alfred Morris

The Committee is now in some difficulty. I listened carefully to the terms of the Under-Secretary's reply. If it is his firm intention to meet the spirit of Amendment 9, hon. Members rightly want to know why it is not possible to include the wording of that Amendment in the Bill?

I must emphasise that we do not envisage the adjudication of medical points by non-medical people. The Explanatory and Financial Memorandum makes it clear that there will be non-medical members serving on the Attendance Allowance Board. It says: The Board … will consist preponderantly of medical members, though clause 5 (2) gives the Secretary of State power to appoint not more than two non-medical members to the Board. The Board will also have the duty of advising the Secretary of State on such matters concerning attendance allowance as he may refer to them; for this purpose the Secretary of State can appoint additional members, whether medical or non-medical, to the Board. This debate emphasises the concern of hon. Members on both sides of the Committee that, on the Attendance Allowance Board, there should be at least one severely disabled person. The disabled want nothing more than to make their proper contribution to society. They resent condescension more than anything else, and that is what this Clause is about. It is concerned with avoiding condescension towards disabled people.

In Amendment 9, we are seeking to emphasise that the disabled man or woman is the best possible representative of disabled people. We are testifying to our belief in the abilities of the disabled. There are some very bright intellects locked in crippled bodies. Even some of the most severely disabled people are extremely able when it comes to stating their case and explaining their problems. We must reject condescension because disabled people are in revolt against condescension. We must ensure that they are directly represented on any board, committee or council where their interests are discussed.

In the Chronically Sick and Disabled Persons Act, 1970, we have provided that there shall be direct representation for the chronically sick and disabled on the Central Housing Advisory Committee, on the Youth Employment Executive, and on all kinds of consultative committees concerned with such matters as the uses of electricity, gas, coal and so on.

Thus it would be in keeping with what was done in the last Parliament for the Government to approve the Amendment.

I admired the strength with which the hon. Lady the Member for Tynemouth (Dame Irene Ward) said that she would support the Amendment. Since it is the Government's intention to accept the spirit of Amendment No. 9, I trust that they will accept the wording. I am being pressed by hon. Members on both sides of the Committee to divide on this matter. All concerned would welcome the addition of Amendment No. 9 to the Clause, and I trust that the Under-Secretary will be able to give an assurance to include not only the spirit but also the wording of Amendment No. 9, if not now, at a later stage in the Bill's consideration by Parliament.

9.0 p.m.

Mr. O'Malley

The Under-Secretary will appreciate the strength of feeling that has been aroused in discussing this series of Amendments. I recognise that he has tried to meet the demands that have been made in connection with Amendment No. 9. Hon. Members on both sides want a chronically sick and disabled person on the board. This is the whole argument.

The Government say that members of the board may be medical practitioners. We say that they should not be medical practitioners. This arises under Amendments Nos. 10 and 11. Unless the Under-Secretary can say that at a later stage some further amendment of the Bill will be made to meet the spirit of these Amendments, I shall have to advise my hon. Friends to divide the Committee on Amendment No. 9.

I appreciate that as the Report stage will follow immediately the Committee stage, it is impossible for the Under-Secretary to undertake to introduce an Amendment between now and Report. If he will undertake not only to accept the spirit of these Amendments but to amend the Bill accordingly at a later stage, in another place, substantially to meet the demands that have been made, I shall be able to advise my hon. Friends to leave the matter there. However, unless he gives this categorical assurance, I shall have to advise my hon. Friends to divide the Committee.

Mr. Dean

I will try to help the Committee a little further. I tried earlier to explain fully the functions of the board and how important will be the advisory functions in which the non-medical element would play a critical part in advising my right hon. Friend, in the light of experience, as to any changes that may be made.

I should like now to deal with one or two specific points, and particularly with the point made by the hon. Member for Wythenshawe (Mr. Alfred Morris) in his second speech, when he appeared to be under the impression that Amendment No. 9 refers only to the additional members of the Board. As I understand it, it refers to the full members, so in that sense it ties down the Secretary of State in respect of the composition of the Board more than the hon. Member himself would wish. He may not have fully appreciated that point, which he might himself regard as one of the perhaps not entirely satisfactory features of the Amendment.

The hon. Member for Rotherham (Mr. O'Malley) asked for an assurance that a chronically sick or disabled person would be a member. That, again, would be to go further even than the wording of the Amendment. One would expect, as I said earlier, that someone who had direct knowledge and experience of disability would be valuable in this work, but one could not be sure that at any one time an individual who was right and appropriate would be available for the job. I am sure that the hon. Gentleman is not saying that we must have a disabled person on the Board—full stop—but only that this should happen if there were someone in that category obviously suitable for the work. Here, again, there lies a danger of our being tied down rather too much.

I would not be frank if I were to tell the Committee that we will have time to consider the matter further between now and Report. The House, I know, is anxious that the Report stage should

follow at once, so that further consideration is not practicable.

Equally, it would be wrong of me to say that it might be possible to introduce an Amendment in another place. The Committee knows very well that we are anxious that the Bill should reach the Statute Book as soon as possible, so that pensions for the over-80s can be paid in November as planned, so that the preparatory work for paying the widows' pensions and, above all, so that the enormous amount of preparatory work we have to do to put this provision into operation, shall be done at the earliest possible time. So it would not be frank of me to hold out hope there.

I ask the Committee to take us on trust on this point. I have given an assurance that what has been said will be very carefully considered, and that we do intend in spirit, without all the disadvantages I have mentioned of being tied down, to put into effect the valuable points that have been made in the debate. That being so, I hope that we shall not have a Division.

Question put, That the Amendment be made:—

The Committee divided: Ayes 127, Noes 179.

Division No. 5.]	AYES	[9.10 p.m.
Allaun, Frank (Salford, E.)	Eadie, Alex	Judd, Frank
Allen, Scholefield	Ellis, Tom	Kaufman, Gerald
Bennett, James (Glasgow, Bridgeton)	Evans, Fred	Kerr, Russell
Booth, Albert	Fitch, Alan (Wigan)	Kinnock, Neil
Broughton, Sir Alfred	Fletcher, Raymond (Ilkeston)	Lambie, David
Brown, Hugh D. (G'gow, Provan)	Fletcher, Ted (Darlington)	Lawson, George
Brown, Bob (N'c'tle-upon-Tyne, W.)	Ford, Ben	Lee, Rt. Hn. Frederick
Buchan, Norman	Forrester, John	Lomas, Kenneth
Buchanan, Richard (G'gow, Sp'burn)	Freeson, Reginald	McCann, John
Callaghan, Rt. Hn. James	Gilbert, Dr. John	McCartney, Hugh
Carter, Ray (Birmingh'm, Northfield)	Golding, John	McGuire, Michael
Carter-Jones, Lewis (Eccles)	Gourlay, Harry	Mackenzie, Gregor
Clark, David (Colne Valley)	Grant, George (Morpeth)	Maclennan, Robert
Cocks, Michael	Griffiths, Eddie (Brightside)	Mallalieu, E. L. (Brigg)
Cohen, Stanley	Griffiths, Will (Exchange)	Marks, Kenneth
Coleman, Donald	Hamilton, William (Fife, W.)	Mason, Rt. Hn. Roy
Concannon, J. D.	Hardy, Peter	Meacher, Michael
Cox, Thomas (Wandsworth, Central)	Harper, Joseph	Mellish, Rt. Hn. Robert
Crawshaw, Richard	Harrison, Walter (Wakefield)	Millan, Bruce
Cunningham, Dr. J. A. (Whitehaven)	Hattersley, Roy	Morgan, Elystan (Cardiganshire)
Davies, Denzil (Llanelly)	Heffer, Eric S.	Morris, Alfred (Wythenshawe)
Davies, G. Elfed (Rhondda, E.)	Hooson, Emlyn	Morris, Rt. Hn. John (Aberavon)
Davies, Ifor (Gower)	Houghton, Rt. Hn. Douglas	Murray, Hn. Ronald King
Davies, S. O. (Merthyr Tydvil)	Hughes, Robert (Aberdeen, North)	Ogden, Eric
Davis, Clinton (Hackney, Central)	Hunter, Adam	O'Halloran, Michael
Deakins, Eric	Janner, Greville	O'Malley, Brian
Dempsey, James	Jeger, Mrs. Lena (H'b'n & St. P'cras, S.)	Palmer, Arthur
Doig, Peter	Jenkins, Rt. Hn. Roy (Stechford)	Pannell, Rt. Hn. Charles
Dormand, J. D.	John, Brynmor	Parry, Robert (Liverpool, Exchange)
Douglas, Dick (Stirlingshire, E.)	Johnson, James (K'ston-on-Hull, W.)	Peart, Rt. Hn. Fred
Douglas-Mann, Bruce	Jones, Dan (Burnley)	Pendry, Tom
Duffy, A. E. P.	Jones, T. Alec (Rhondda, West)	Pentland, Norman
Prentice, Rt. Hn. Reg.	Skinner, Dennis	Watkins, David
Prescott, John	Smith, John (Lanarkshire, North)	Wellbeloved, James
Price, J. T. (Westhoughton)	Spriggs, Leslie	White, dames (Glasgow, Pollok)
Reed, D. (Sedgefield)	Stallard, A. W.	Williams, Alan (Swansea, W.)
Roderick, Caerwyn E. (Br'c'n & R'dnor)	Steel, David	Wilson, Alexander (Hamilton)
Rodgers, William (Stockton-on-Tees)	Stewart, Rt. Hn. Michael (Fulham)	Wilson, William (Coventry, S.)
Rose, Paul B.	Stoddart, David (Swindon)	Woof, Robert
Ross, Rt. Hn. William (Kilmarnock)	Strang, Gavin
Sheldon, Robert (Ashton-under-Lyne)	Swain, Thomas	TELLERS FOR THE AYES:
Sillars, James	Torney, Thomas	Mr. Ernest Armstrong and
Silverman, Julius	Wallace, George	Mr. William Hamling.
NOES
Adley, Robert	Hannam, John (Exeter)	Peel, John
Alison, Michael (Barkston Ash)	Harrison, Col. Sir Harwood (Eye)	Percival, Ian
Archer, Jeffrey (Louth)	Haselhurst, Alan	Pike, Miss Mervyn
Atkins, Humphrey	Havers, Michael	Pink, R. Bonner
Awdry, Daniel	Hawkins, Paul	Pounder, Rafton
Baker, W. H. K.	Hayhoe, Barney	Prior, Rt. Hn. J. M. L.
Barber, Rt. Hn. Anthony	Hicks, Robert	Proudfoot, Wilfred
Benyon, W.	Higgins, Terence L.	Pym, Rt. Hn. Francis
Biffen, John	Hiley, Joseph	Ramsden, Rt. Hn. James
Biggs-Davison, John	Hill, J. E. B. (Norfolk, S.)	Rankin, John
Blaker, Peter	Hill, James (Southampton, Test)	Redmond, Robert
Boardman, Tom (Leicester, S.W.)	Holland, Philip	Reed, Laurance (Bolton, East)
Boscawen, R. T.	Holt, Miss Mary	Rees, Hn. Peter (Dover)
Bowden, Andrew	Hornsby-Smith, Rt. Hn. Dame Patricia	Renton, Rt. Hn. Sir David
Boyd-Carpenter, Rt. Hn. John	Howell, David (Guildford)	Rhys Williams, Sir Brandon
Braine, Bernard	Howell, Ralph (Norfolk, North)	Ridsdale, Julian
Bray, Ronald	Hunt, John	Roberts, Michael (Cardiff, North
Brinton, Sir Tatton	Hutchison, Michael Clark	Roberts, Wyn (Conway)
Brocklebank-Fowler, Christopher	James, David	Rodgers, Sir John (Sevenoaks)
Brown, Sir Edward (Bath)	Jessel, Toby	Rossi, Hugh (Hornsey)
Butler, Adam (Bosworth)	Joseph, Rt. Hn. Sir Keith	Rost, Peter
Carlisle, Mark	Kellett, Mrs. Elaine	St. John-Stevas, Norman
Chapman, Sydney	Kilfedder, James	Scott-Hopkins, James
Clarke, Kenneth (Rushcliffe)	Kimball, Marcus	Sharples, Richard
Clegg, Walter	King, Evelyn (Dorset, South)	Shaw, Michael (Sc'b'gh & Whitby)
Cockeram, Eric	Kinsey, Joseph	Shelton, William (Clapham)
Cooke, Robert	Kirk, Peter	Simeons, Charles
Coombs, Derek	Knight, Mrs. Jill	Skeet, T. H. H.
Cooper, A. E.	Knox, David	Soref, Harold
Cormack, Patrick	Legge-Bourke, Sir Harry	Speed, Keith
Curran, Charles	Longden, Gilbert	Spence, John
Dance, James	Loveridge, John	Sproat, Iain
Dean, Paul	McAdden, Sir Stephen	Stanbrook, Ivor
Deedes, Rt. Hn. W. F.	McMaster, Stanley	Stewart-Smith, D. G. (Belper)
Dixon, Piers	Madel, David	Stoddart-Scott, Col. Sir M.
Dykes, Hugh	Maginnis, John E.	Stokes, John
Edwards, Nicholas (Pembroke)	Mather, Carol	Sutcliffe, John
Elliott, R. W. (N'c'tle-upon-Tyne, N.)	Maude, Angus	Taylor, Edward M.(G'gow, Cathcart)
Eyre, Reginald	Mawby, Ray	Taylor, Robert (Croydon, N.W.)
Farr, John	Maxwell-Hyslop, R. J.	Tebbit, Norman
Fell, Anthony	Mills, Peter (Torrington)	Thatcher, Rt. Hn. Mrs. Margaret
Fenner, Mrs. Peggy	Miscampbell, Norman	Thomas, John Stradling (Monmouth)
Fidler, Michael	Mitchell, Lt.-Col. C.(Aberdeenshire, W)	Tilney, John
Finsberg, Geoffrey (Hampstead)	Moate, Roger	Trafford, Dr. Anthony
Fisher, Nigel (Surbiton)	Molyneaux, James	van Straubenzee, W. R.
Fletcher-Cooke, Charles	Money, Ernle D.	Vaughan, Dr. Gerard
Fookes, Miss Janet	Monks, Mrs. Connie	Vickers, Dame Joan
Fortescue, Tim	Monro, Hector	Waddington, David
Fowler, Norman	Montgomery, Fergus	Warren, Kenneth
Fox, Marcus	More, Jasper	Wells, John (Maidstone)
Fraser, Rt. Hn. Hugh (St'fford & Stone)	Morgan, Geraint (Denbigh)	Whitelaw, Rt. Hn. William
Gilmour, Sir John (Fife, E.)	Morgan-Giles, Rear-Adm.	Wiggin, Jerry
Goodhart, Philip	Morrison, Charles (Devizes)	Wilkinson, John
Gorst, John	Mudd, David	Wolrige-Gordon, Patrick
Gower, Raymond	Murton, Oscar	Worsley, Marcus
Green, Alan	Nabarro, Sir Gerald	Wylie, Rt. Hn. N. R.
Gummer, Selwyn	Normanton, Tom	Younger, Hon. George
Gurden, Harold	Oppenheim, Mrs. Sally
Hall, Miss Joan (Keighley)	Osborn, John	TELLERS FOR THE NOES:
Hall, John (Wycombe)	Owen, Idris (Stockport, North)	Mr. Bernard Weatherill and
Hamilton, Michael (Salisbury)	Page, Graham (Crosby)	Mr. Victor Goodhew.

Clause 5 ordered to stand part of the Bill.

Clauses 6 to 9 ordered to stand part of the Bill.