HC Deb 20 March 1970 vol 798 cc876-83
Mr. Arthur Latham (Paddington, North)

I beg to move Amendment No. 1, in page 1, line 8, leave out 'such steps as are reasonably practicable' and insert 'the steps necessary'.

Mr. Deputy Speaker (Mr. Harry Gourlay)

I suggest that it would be convenient for the House to consider at the same time the following Amendments: No. 2 in line 14, leave out 'they consider' and insert 'the Secretary of State considers'.

Amendment No. 3 in line 15, leave out 'general' and insert 'all'.

Amendment No. 4 in line 17, leave out 'in their area' and insert 'nationally'.

Amendment No. 5 in line 18, after 'area', insert: ', such information to cover all relevant aids and appliances available from the local authority or the National Health Service'.

Mr. Latham

My hon. Friend the Member for Manchester, Exchange (Mr. Will Griffiths), in whose name these Amendments stand, has unavoidably been prevented from coming to the House today.

This group of Amendments seeks, consistent with the general intentions of the Bill, to strengthen certain aspects of the Measure, and I am sure that there will be virtually no difference between hon. Members about the general desirability of these proposals.

It is unfortunately a fact that, when the Bill becomes law, practice may vary according to the degree of enthusiasm of those whose job it will be to implement its provisions. This is inevitable, however we draft the Bill. Nevertheless, this group of Amendments will have the effect of minimising, as far as that is possible, this variation of practice.

Amendment No. 1 proposes to substitute the words "the steps necessary" for the phrase at present in the Bill: … such steps as are reasonably practicable …". As drafted, the Bill leaves open to question one's interpretation of the steps which can be regarded as "reasonably practicable". Perhaps what one authority considers practicable and reasonable, another will consider quite differently.

The Amendment would indicate that all necessary steps should be taken, so that there would be a comprehensive register of all disabled persons. It should be considered in conjunction with Amendment No. 2, in which we ask that instead of each local authority considering what form of publication is appropriate, there should be uniformity of practice by all local authorities charged with responsibility under the Bill. The only way of achieving that objective would be for the Secretary of State himself to determine and to make clear to each local authority the precise form in which the information should be available.

That leads me to Amendment 3. I am a little puzzled why the word "general" ever appeared in the Bill, because it can have many interpretations. One might publish the minimum or the maximum of information. That being so, those who have tabled the Amendment are quite correct in suggesting that in order to avoid ambiguity, and the variations in practice to which I have already referred, the use of the word "all" would be much stronger and clearer.

I turn to Amendment No. 4. The Bill at present asks local authorities to publish information about the services available within their own areas. That expression may have a very real meaning to those well versed and practised in local government, but the average member of the public is often in difficulty in knowing where the area of one local authority ends and that of another begins. If local authorities are merely to publish information about what happens in their own areas it will not only deny information to someone living close to or just across a local government boundary but will omit from the information published the services provided under the National Health Service. As the House well knows, there is no coincidence between regional hospital board and local authority boundaries, while the hospital management committee catchment areas cut completely across existing local government boundaries.

Amendment No. 5 seeks to ensure that the published information is as compre- hensive as possible so as to make known to disabled people all the aids appliances and services available from any branch of the National Health Service and any any part of the country. If one is to tackle the problem wholeheartedly, it is sensible to make sure that a disabled person should be aware of everything that is available to him, no matter in which part of the country he may live or to which he may travel, and no matter which authority is responsible for providing those services. I hope that the House will accept that the purpose of the Amendment is to give to disabled persons a far wider and more comprehensive service than seems practicable under the existing provisions.

Dr. John Dunwoody

The intention of this group of Amendments seems to be to extend in some ways the scope of action to be taken by local authorities in providing information about their own services and, perhaps, to restrict their discretion in doing so. That raises some difficulties and problems, although I accept, as is implied in the Amendments, that in this situation it is not easy to spell out clearly exactly what one wants to achieve.

The intention of Amendment No. 1 appears to be to restrict the discretion of the authority. There is in the Amendment a minor drafting problem, and acceptance would make the Clause read somewhat inappropriately. Even if the Amendment were aptly drafted, its intention seems unlikely to be achieved, as no very great change in meaning can be attributed. The steps which are necessary in an area are, it can be argued, those which are reasonably practicable, and vice versa.

If one used a more limited interpretation and the word "necessary" was taken to have objective force, we could find ourselves in a somewhat anomalous situation because within the present local government structure there are very different local authorities with very different problems and resources. A situation could be created in which, for example, Rutland would have to deploy the same resources as might be available in the West Riding of Yorkshire or in Lancashire or, and perhaps more serious, the West Riding of Yorkshire or Lancashire might have to content itself only with standards that Rutland could afford.

The circumstances of local authorities vary—distances, communications, density of population, standard of development, resources, and the like—and what strikes me as I go round the country is that there are very different problems in different areas. One area has a special problem in regard to one form of chronic illness which may not present much of a problem in another area. That circumstance underlines the wisdom of allowing local authorities discretion in dealing with what, in the country as a whole, may not be a problem. There is much to commend an approach that allows local authorities freedom to judge from time to time, knowing their own problems in their own areas, what may be reasonably practicable.

Somewhat similar considerations apply to Amendment No. 2. The Secretary of State would be put in a position of having to set a general standard which would be beyond some authorities and too low for others, and it would be disastrous if we took steps which held back the front runners. Many hon. Members' interest in the Bill has been stimulated by the fact that their own local authorities are, and have been for many years, very progressive. It would be disastrous if we did anything to limit the activities of these front runners. One therefore wants to leave this degree of discretion. A much more serious consideration is that it could conceivably be that a Secretary of State might in future set standards practicable only for the poorest and most backward authorities, and such action would hold back not only the front runners but those areas with ample provisions.

In referring to Amendment No. 3 my hon. Friend mentioned the possible ambiguity in the use of the word "general". It is always difficult in legislation to find just the right word, but I think that, in the circumstances, the word "general" is the more suitable. There are two objections to the use of the word "all". First, the totality of the word would mean the provision of a lot of information about which, frankly, I do not think the supporters of the Bill are concerned about. Things like organisation and staffing, and many other aspects, are irrelevant and uninteresting in this context, and not the sort of information which they want to see provided.

Secondly, in relation to the services to be given to individuals—and I am sure that this is what is the concern of hon. Members—the word implies a great deal of detail, and there is a danger that this could defeat the object. Publicity is intended to attract, but most of us already get criticism about the voluminous provision of information which so submerges the unfortunate individual that he cannot pick out the particular bits he wants. What is required is what I think the Clause as it stands asks for. That is information which will plant the idea of a range of helpful services for people with individual problems in the public mind and leave those individuals to make further inquiries and to use those services appropriate to their particular problems and needs.

1.30 p.m.

I think there is a slight misunderstanding over Amendment No. 4. I do not think the Clause is as restrictive as my hon. Friend appeared to think. There is a little ambiguity about the possible meaning of the word "nationally". If it means "available from a central source" it presumably refers to the Secretary of State and is limited in effect to what from time to time he may do. His activities do not extend to the provision of any local service. On the other hand, it may mean "available in every area", which might have a limiting effect on the more advanced authorities. This Amendment, I think, does not achieve the aim which the mover intended.

Amendment No. 5 uses the word "relevant". We are in some difficulty as to the precise meaning of the word, but I think the effect is to impose a duty on the local welfare authority and therefore when the Seebohm legislation—the Local Authority Social Services Bill—becomes law, as I hope it will, it will place a duty on the successor social services department. In the circumstances this may be difficult and impracticable. The Secretary of State informs all general practitioners through the drug tariff of the items which they may prescribe. He informs hospitals of items on central contract.

I do not think we can make it the duty of a non-medical local authority to provide public information in a meaningful manner about medical services. Nor, since consultants are entirely free to prescribe outside the contractual range for a particular patient's needs, is it likely that they could readily ascertain with the certainty required by a duty what is available. This is the possible restrictive element in the Amendment.

There are probably two underlying assumptions to this and some other Amendments. The first is that the sick and handicapped need to be in a position to—"demand" is perhaps too strong a word—request any service. This is a concept about which one has to be a little cautious because the rôle of professional workers, particularly the increasing rôle of social workers, is very importnt. This sort of situation could be disruptive of professional work and certainly wasteful. In some cases it could be positively harmful to the patient or clinet.

I know from professional experience before I came to the House that while it is right and proper, and indeed desirable, that an individual should be able to express a view, it also requires someone with a professional background and experience in dealing with the problems which the individual has to link an individual with the service, aid or system most appropriate to his particular need. We do not want to lose this very important rôle which the professional worker fulfils. This is equally important in the social work as in the medical context.

The other assumption underlying the Amendments is that the respective authorities and medical staffs are insufficiently informed about each other's services to be fully helpful to patients or clients. If that is so, it is a problem of communications. It is something which could be, and should be, looked at very thoroughly when the social service departments are well-established after the legislation now in Committee comes into force.

I hope that I have given sufficient reasons to show that I see a number of practical difficulties in these Amendments, why I have considerable doubt about whether they might achieve the aims of the mover of the first Amendment, and why I feel fairly certain that there may be certain respects in which at least some of them could be limiting and potentially harmful.

Mr. Latham

Will my hon. Friend at least have a further look at Amendment No. 2? I should have thought that the substitution of the words proposed would mean that the Secretary of State would take account of the local circumstances and local needs. Will my hon. Friend have a look at the implication of the Amendment? One of the intentions is not to restrict the most forward-looking authorities but to ensure that the authorities are obliged to do this work to a minimum standard. It asks that discretion should not remain entirely with the authority but should remain with the Secretary of State.

Dr. Dunwoody

I understand what my hon. Friend is trying to achieve, but I think there are real difficulties. In this exercise we are producing legislation. It is not sufficient merely to have the intention of achieving certain objects. We have to spell out legislation which will achieve them. I see the very real danger here that a Secretary of State at some time could set standards which would have the practical effect although this may not be his intention and certainly is not the intention of any of us, of holding back local authorities which in some cases have outstanding records in pioneering work.

The Amendment as worded gives rise to difficulties. It would certainly be the intention of my right hon. Friend before making an appointed day Order under subsection (3) to discuss with the authorities the range of and practical solution to particular problems in their areas. I hope that my hon. Friend will feel able to agree, for there are considerable difficulties in the Amendments as they stand.

Mr. Fred Evans

I assure my hon. Friend the Under-Secretary that on Second Reading and certainly in Committee the problem of permissive legislation was dealt with extensively. I feel that areas of permissive legislation are undesirable.

I am sure that I speak for most hon. Members who were on the Committee in saying that when we raised this question with the Under-Secretary, time and again we were satisfied with his explanations. The explanation given today should give the assurance for which my hon. Friend the Member for Paddington, North (Mr. Latham) asked. It emerged in Committee that the Under-Secretary has very extensive pressure points which he can exercise through the Department. He can keep a very close watch on recalcitrant authorities and ginger them up when necessary.

Mr. Latham

I hope that if I seek to withdraw the Amendment my hon. Friend will undertake to give further consideration to the points which have been raised so that in another place some more suitable form of drafting can be considered. I accept that the undertakings were given in Committee, but I do not feel happy about the Department always having sufficient power to apply sanctions when authorities are not facing their responsibilities. If my hon. Friend will undertake to look at the matter in this way, I think the original sponsors of the Amendments would agree to their being withdrawn. I therefore beg to ask leave to withdraw the Amendment.

Amendment, by leave, withdrawn.

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