§ Motion made, and Question proposed, That this House do now adjourn.—[Mr. Speed.]
§ 12.35 a.m.
§ Mr. Michael Meacher (Oldham, West)
A fortnight from Midsummer Day may not seem the most appropriate moment for raising the issue of heating allowances as of right for the elderly and the disabled. I believe, however, that, if anything is to be done about this need before next winter, now must be the time for planning rather than later. Moreover, for many of those for whom I make this plea the requirement of adequate heating and the necessary costs are not. unfortunately, limited to the winter time but extend throughout the year.
I am asking for heating allowances as of right for the elderly and disabled, subject only to a medical certificate of need, because the present system of means-tested discretion is patently failing miserably. Only about 2 per cent. of the 7 million elderly or disabled persons receive any special assistance with heating costs. The Under-Secretary is not a hardhearted man, and I am sure that he would concede that nobody could deny that this is a mere drop in the ocean of need.
At present specific assistance with fuel costs is given to elderly or disabled persons only through supplementary benefit 1299 offices in one or both of two ways. First, weekly additions may be given for extra fuel costs where, for example, a man or his wife on supplementary benefit is housebound or cannot leave the house frequently because of advanced age or chronic poor health or because the accommodation is damp or otherwise difficult to keep adequately warm. Second, exceptional needs payment may be made in the form of a lump sum to meet fuel expenses.
For several reasons I believe that the present framework of assistance is utterly inadequate. One central reason is that much less than half the total number of retirement pensioners receive supplementary benefits and probably ½ million who are entitled to claim because of low income do not do so and are thereby excluded from any special assistance with heating costs. To that extent I believe that it is no use the Under-Secretary replying that the present system of help through supplementary benefits is satisfactory because the supplementary benefits scheme is a flexible instrument for channelling extra assistance to those in greatest need. It is not, and it does not do this.
I will quote a current example, for the details of which I am grateful to the organisers of the National Campaign for the Young Chronic Sick, as I am grateful to them for details of other cases:This lady is aged 70, living on a £5 a week pension. Although entitled to supplementary benefits, she will not accept what she feels is charity. She has a high ceilinged, two-roomed flat with a gas fire in one room. She allows herself doses of heat but for the main sits in the extreme cold.Another example is quoted by Help the Aged in March of this year as follows:A Cheshire widow aged 64 with a pension of £5, has only £2.75 to pay all her bills after her rent has been paid. Her electricity has been cut off since September"—that is, for six months throughout the winter.
Apart from those who are entitled to claim but do not, there is an unknown, though undoubtedly substantial, number of retirement pensioners and disabled persons who are living only slightly above the supplementary benefit entitlement level but are thereby rigidly excluded from receiving any special help 1300 with heating costs. How are they to be assisted, in view of the 10 to 15 per cent. increase in gas and electricity charges over the last year?
It is no use the Minister arguing that they will be taken care of by the £1 rise in pension this September, partly because the increase in the real purchasing power over the value at the time of the last rise will be eroded, as he well knows, in a matter of a few weeks, but chiefly because to argue that heating costs of £2 a week or so are taken into account in a pension of £6 is just absurd.
Nor do I believe that the special help which is at present given for heating is other than utterly inadequate. The number who receive a weekly addition for extra heating needs—151,000 a year, according to the latest figures—is minute in relation to the extent of the real need. Nor is the amount given more than a token pittance. Hitherto, the average amount has been 20p a week, and 40p in more serious cases. The sheer inadequacy of these sums is glaringly revealed by an item in a recent report by the secretary of the National Campaign for the Young Chronic Sick:I visited a young disabled widow last winter who was trying to manage with two children on supplementary benefit. I found her huddled over her gas fire, almost in tears from the cold. Not so long ago she had applied to the local branch of the Department of Social Security for a heating payment and was given an extra 20p a week.That is the normal amount.She uses more than this in one day, and even in the middle of summer often has to use the fire".I am aware that, following the announcement by the Secretary of State on 27th November last year, these rates have now been raised to 25p, 50p, and in rare cases—they certainly are rare—75p. These are not exactly massive increases to meet a massive need. Yet the Under-Secretary of State felt able to write to me, nevertheless, on 2nd March this year,We consider that where there is a need for extra heating among supplementary pensioners, the new rates will adequately cover the extra cost.What sort of world does the hon. Gentleman live in? Such statements roll too easily from the air-conditioned centrally-heated offices of Whitehall. The reality for hundreds of thousands of retired and disabled people is very different.
1301 Here is another typical example:The husband has advanced multiple sclerosis. 50p is allowed per week for heating which in fact costs £2.40 per week. So on their social security, which is already strained, they have to find almost an extra £2 a week".That example is important for this reason. For a disease such as multiple sclerosis, a constant temperature has to be maintained because the patient is highly vulnerable to pneumonia. The consequent cost of heating for such families is very high, summer and winter, and particularly where they live in cold, draughty accommodation with high ceilings and large rooms, as, unfortunately, it seems, too many of them do.
The other form of special help with heating which is given to the elderly and disabled is the lump sum exceptional needs payment. Here again, the measure of assistance is miniscule. The number of grants given exclusively for fuel costs alone in the last year for which figures are available was 197,000, and the average value of exceptional needs payments at only about £6, if not exactly derisory, is utterly inadequate.
Here is another illustration on this point:Miss T is in her late 30s and is severely disabled with polio, being completely paralysed from the neck down. Due to impaired circulation, she is always cold, and even on hot days during the summer I have never failed to see her in a bulky knit cardigan. She lives in a large house which is hard to keep warm and has an electric fire on all day long. The last electricity bill was £33.That is, for one quarter.
I believe that the seriousness of this situation is most vividly and cruelly demonstrated by the figures for deaths from hypothermia due to shortages of heating. On 2nd February, the Under-Secretary of State for Health and Social Security stated in the House:In 1969. the last year for which detailed figures are available, the deaths of 155 people of 65 years and over were attributed to excessive cold, hunger, thirst and neglect in which hypothermia was a contributory or underlying cause."—[OFFICIAL REPORT, 2nd February, 1971; Vol. 810, c. 1438–39.]Dr. Geoffrey Taylor, who has made a special study of this problem, has drawn attention to the fact that a better indicator of the effects of shortage of heating lies in the fact that 90,000 more elderly people die in the winter months than in 1302 the summer. Whatever is the truth between these contrasting figures, a current Brunei study by Malcolm Wicks will, I believe, throw some light on the problem in the near future. What is disturbing from the point of view of the debate is that when I asked on 15th February in how many cases of the 155 deaths attributed to hypothermia was the person concerned receiving extra financial assistance for the purpose of heating, the answer was that the information was not available.
In view of the appalling state of affairs which I have described, I am asking that the Government should begin now to plan and put into operation for next winter a heating allowance as of right amounting to £1 a week for each week for the six winter months and 50p for the remaining months to all those retired or chronically disabled persons whom their doctor indicates by medical certificate need extra heating. I believe that in the most serious cases the doctor should also have the right to recommend a discretionary extra 50p for the winter months, making a total of £1.50 per week in the cases of most exceptional need in winter.
Since the Government have already refused any concession over rental charges for gas and electricity, for which, absurdly, many elderly single people living alone can pay double the cost of the units of fuel consumed, the only alternative, without the deterrent of means testing, to assist elderly and disabled people is through heating allowances as of right realistically geared to today's inflated fuel prices. I regard it as a measure of the Government's commitment to the needs of the elderly and the disabled that some definite action should be taken now along the lines of these proposals.
§ The Under-Secretary of State for Health and Social Security (Mr. Paul Dean)
I am grateful to the hon. Member for Oldham, West (Mr. Meacher) for raising this important subject, but I am surprised that, with his knowledge of and great interest in it, he should make a suggestion which is so impracticable and so indiscriminate. He asks that all pensioners and disabled people should have a heating allowance, subject to a medical certificate of need. I should like to explain what are the main weaknesses of his proposal and then state what the 1303 Government are doing to meet this problem.
There are about 8½ million people within the range which he mentioned, and they are a very large and varied group. Even within the group of the disabled, there are many, thank goodness, including hon. Members, who are able to live active lives and to earn their own living. Within the group of retirement pensioners, there are many with very substantial resources. Even millionaires are pensioners.
Second, the hon. Member singles out one need for special treatment. Our climate makes heating very important for a large part of the year, but it is only one need amongst others, like food, housing, clothing and light. The cost of those items, like that of fuel, is taken into account in the Index of Retail Prices, which we use to measure variations in the cost of living. These variations in turn have an important bearing on the periodical adjustments to contributory National Insurance benefits and supplementary benefits. That is the main weakness in the hon. Gentleman's argument. He has not sufficiently taken into account the fact that those items are considered in deciding the level of the benefits.
In addition, there is the extra help available based on the particular needs of the recipient as individually assessed. Here again there is a long list, such as rent and rate rebates, payment of rent, with supplementary benefit, allowances for special diets, lump sum payments for major household essentials and sometimes for clothing, and special additions for fuel.
The next practical point is the medical certificate of need. On what basis would doctors decide whether a certificate should be issued? Everybody needs heat, and it may be that as general categories the old and chronic sick are rather more hit than most other people, apart from the very young. But is it not imposing an impossible burden on the medical profession to expect its members to distinguish within those categories the ones who need extra money for heating from those who do not? For example, do they give a certificate to a rich old man living in a country house who also needs lots 1304 of heat for medical reasons? Do they refuse a certificate to a man of modest means living in a modern centrally-heated council flat? Do they take means into account as well as medical need? If they do, at once we are in the area of asking the medical profession to do something outside the medical needs of the case. But if they do not, we get into the ridiculous position where a rich man with a medical need will get a certificate whereas a poor man with less medical need will not. So the hon. Gentleman's suggestion does not stand up.
§ Mr. Meacher
Does the Minister not think it reasonable that even people with means should receive the assistance subject to a medical certificate of need, on the basis of the principle the Government have accepted that people over 80 should receive a special pension simply because they are over that age, even if they are rich?
§ Mr. Dean
It is a reasonable and fair assumption that need will grow as people become older, and the chances are that in the vast majority of cases the resources people over the age of 80 will need for the business of living will be greater than for younger people. The hon. Gentleman is saying that we should have indiscriminate resources available to the category of people of whom he has spoken, whether they need them or not. That would be a very bad use of scarce resources and contrary to the selective approach which the Government have adopted.
What are the Government doing to see that the old and the sick have adequate warmth? There are many ways in which we are taking positive steps to alleviate the problem. There are the heating additions allowed by the Supplementary Benefits Commission, which are available to the most vulnerable section of the community who have special heating needs because of illness or bad accommodation. Help in this way goes to those who need it most. Scarce resources are thereby concentrated where they will do most good. We estimate that about 290,000 supplementary pensioners and a further 60,000 younger people, many of whom are chronically sick or disabled, will be covered by the improved additions 1305 we have introduced well in time for the coming winter.
In addition, of course, there are the substantial increases in pension and supplementary benefits which come into operation in September. Not only are these by far the biggest increases in money terms but they will more than cover the price increases. I assure the hon. Gentleman that there is no question of these new benefits being eroded in a matter of weeks. There will be a substantial increase in real value.
Over and above that, there are selective improvements for the over-80s, the chronic sick and the disabled. Very elderly people are obviously at risk and the 25p age addition to the retirement pensions for all pensioners over 80, with complementary provisions in the supplementary benefits scheme, will enhance the position of the over-80s and bring benefits therefore to the whole population over that age. There are the four new allowances which will help many of the chronic sick and disabled—the invalidity allowance, the improved earnings rule for the wife of a disabled person, the higher allowances for the children, which come in in September, and, of course, the attendance allowance, which begins in December. All these are substantial improvements on the cash side, but, of course, that is not the only side which is necessary.
The care services are equally important—provided by the family, by statutory bodies and by voluntary bodies. It is sometimes alleged—the hon. Gentleman referred to this—that 60,000 or even 90,000 old people a year die of hypothermia or through cold. This is a distortion of the statistics which were compiled by Professor Dennison of the Centre for Environmental Studies. He said that deaths in the six colder months of the year averaged 60,000 more than in the warmer months, and that in the winter of 1962–63 they rose to over 90,000. He was doing no more than state the obvious—that more people die in winter than in summer, largely due to increases in respiratory diseases and not that anything like that number die of hypothermia. Unfortunately, the figures have been misunderstood and misquoted in such a way as grossly to exaggerate the problem and create quite unnecessary alarm. 1306 In fact, in 1969 the deaths of only 155 people aged 65 or over were attributed to excessive cold, hunger, thirst and neglect, in which hypothermia was a contributory or underlying cause. Poor heating was not the only factor responsible since some of the deaths occurred in the summer part of the year. Of course this is still too many such deaths. But the matter was put in perspective by Mr. M. R. F. Simson, Secretary of the National Corporation for the Care of Old People and a much respected authority on these matters. As he pointed out in his article in the British Hospital Journal and Social Service Review of 8th May:Money is important to some degree, but it will not always buy what the existing circumstances demand. The fact is that the old need help of all kinds from all those willing and able to give it.For example, cases are known where fairly well-off people have suffered simply by insisting on an unheated bedroom. Elderly people often run risks like this because they are not fully aware of the dangers to them of an inadequately heated room. I still work on the principle of "cold stable, healthy horse". That may be all right for people of our age but it can be dangerous for these elderly people.
Then there are the elderly who are unable to cope with preparing and lighting a fire. What they need as well as sufficient money is a friendly visitor or home help prepared to come in each day to light the fire and perhaps help in other ways.
The answer may be some small aid or adaptation which helps the person concerned to look after himself in a better fashion. Landlords and local authorities have in some cases undertaken to replace open coal fires with electric or gas fires or central heating, or made it easier for the bed-ridden to operate a switch that turns on the electric fire. Sometimes sheer apathy or depression causes an otherwise healthy old person to sit, cold and alone, when what is required is something to spark his interest in the outside world and overcome his sense of loneliness. For example, arrangements for him to attend an old persons' club or fixing up for transport to take him regularly to a day centre will increase his social contacts and at the same time deal with the problem of keeping him warm. 1307 The problem of inadequate heating is thus a complex one which can often be tackled most successfully in intricate ways, according to the overall health and social needs of the individual. My Department issued a circular in November of last year to local health and welfare authorities about the risk of hypothermia in the elderly and home-bound, reminding them of the need for preventive and precautionary measures to deal with it. It also advised them of the help available through supplementary benefit. The Supplementary Benefits Commission has also told its local offices to watch out for old people who might be at risk, and to co-operate with local authority staff to ensure that heating arrangements are adequate for the old people they visit.
To sum up, we are providing, next September, before the cold weather returns, for large cash increases in pensions and other benefits which raise them
1308 to highest-ever levels in real values. In addition, we are providing extra cash benefits for the very old and chronic sick. Where heating problems are concerned cash alone is not enough. The need is also for regular visiting and supervision of the cases most at risk and for close co-operation between the statutory and voluntary health and social service agencies to ensure, through education and vigilance, that everything is done to reduce the danger of suffering through cold.
I am glad that the hon. Member has raised this subject, and I hope he will feel that, through the various measures I have outlined, the Government are as concerned as he is about this important matter, and that we are doing our utmost to help.
§ Question put and agreed to.
§ Adjourned accordingly at three minutes past One o'clock.