§ 4.47 a.m.
§ Mr. J. P. W. Mallalieu (Huddersfield, East)Keeping the Under-Secretary of State out of bed at this late hour in the morning is a very poor return for the courtesy which both he and his Department have shown me in recent weeks over the very important matters which I want to raise.
The first matter affects people who are suffering from muscular dystrophy or those who are born thalidomide babies. At present the Department provides for these sufferers an unpowered chair which can be used in the home but cannot be used outside. This means that many of them, perhaps most of them, are virtually confined to their homes or to their gardens if they have such. These chairs have to be pushed. In some families there are two sufferers, and it is difficult to find people who could take them out and push two of them.
The price of these chairs is about £150 each. There are available on the market powered chairs costing about £190. If the Department could provide one of these for these sufferers, the opportunities for enjoying leisure in what for some of them unhappily is bound to be a fairly short life would be greatly expanded. Unhappily, the Ministry has so far failed to provide such powered chairs, and one of my purposes in raising this matter now is to ask the Under-Secretary to think again.
My second main point concerns disabled people who have retired from work. In the debate on 21st February this year, the Secretary of State said:
There has so far been no campaign for the elderly disabled, and yet they are just as poignant as the disabled of working age and disabled children".I agreed, and I am gratified, as, I am sure, the whole House was, that the Secretary of State decided that people who were unable to work because of chest or heart complaints would in future be allowed to retain their vehicles even after they 296 had stopped work. That was a great help to some of the elderly about whom the right hon. Gentleman spoke so movingly.But, unfortunately, in the same debate the Secretary of State announced another move which has brought despair to another section of the elderly. He said:
Vehicles will continue to be issued to people with some, though severely limited, walking ability if they need them to get to full-time work, but on cessation of employment the vehicle will be surrendered instead of, as hitherto, left with a person permanently once he has qualified for it."—[OFFICIAL REPORT, 21st February, 1972; Vol. 831, c. 924–35.]I regard that as a bad decision. It is rather like giving a man an artificial leg while he is at work and then taking it away when he retires. The withdrawal of these vehicles affects his opportunity for enjoyment in leisure retirement, and that opportunity for enjoyment in leisure retirement is, in my opinion, at least as important as the opportunity which the vehicle gives him to go to work.To deprive these people of vehicles to which they have become accustomed during their working time is to sentence them to confinement in their older years, and, indeed, in many instances to make their retirement a misery.
I could just understand the decision if there were a shortage of such vehicles. But I gather that the shortage is not of vehicles but of money. I do not believe that the Under-Secretary, the Secretary of State or any of the civil servants in their Department wanted to take that step. I genuinely believe that their concern is to do the best they possibly can for the disabled. But I suspect that they have been told that if they give with one hand they must take away with another.
These Treasury dictates are, as I well remember, a commonplace of Government, and sometimes they may be justified, though I wish to goodness that, when Cabinets find themselves faced with a global sum for total expenditure, they would not try to match the difference between that sum and the estimates they receive from Departments by telling them all to cut by a flat rate of, say, 10 per cent., which, unhappily, is what happens much too frequently.
Those Treasury dictates are sometimes understandable and correct but this one, 297 if it is a Treasury dictate, certainly is not correct. I understand that Baroness Sharp is at the moment looking into the workings of the Department, especially in this area, to see what anomalies there are, to find out the gaps and deficiencies. She will eventually make recommendations and I hope that her report will be published. I hope, too, that before the report is written the Under-Secretary will make it his business to point out to Lady Sharp at least the two aspects I have mentioned tonight.
In any event I press him to go back again on this to the Treasury if he cannot give a favourable answer tonight. I am quite sure if he does that he will get the most wholehearted backing from all hon. Members.
§ 4.57 a.m.
§ Mr. David Crouch (Canterbury)I shall not take more than a minute in intervening in the debate. I stayed on to do so because, like other hon. Members, I have a special duty towards the disabled in as much as I am an officer in Kent of the Disabled Drivers' Association. I am constantly reminded of my duty because of the many disabled drivers I meet, and I congrateulate the hon. Member for Huddersfield, East (Mr. J. P. W. Mallalieu) on raising this important subject, even at this late hour. The Government are facing crises on the economy, on industrial relations and on civil disorder in Northern Ireland, but they are also faced with the human problem which is the subject of the debate. The Government have a good record in recognising how vitally important this matter is to the disabled, and in looking after them it has done much in the last two years in the allocation of vehicles.
There is one area in which I hope the Under-Secretary will press on the Secretary of State the need for further consideration and further generosity, and that is in the allocation of four-wheeled vehicles to some disabled persons. This applies particularly to mothers who need to have their children or some other person to accompany them when they go to work or go shopping and when they take the children to school. That is one area where the Secretary of State should continue to battle for greater generosity from the Treasury.
§ 4.59 a.m.
§ Mr. Tom Normanton (Cheadle)I, too, offer my congratulations to the hon. Member for Huddersfield, East (Mr. J. P. W. Mallalieu) on initiating the debate. The Under-Secretary granted an interview to two of my constituents 10 days ago. They were two children, one aged six and the other 12, named Felicity and Stephen, both suffering from muscular dystrophy. To see the way those children were able to lead a fuller, richer life within the limitations imposed upon them by an ill stroke of fortune was an inspiration and encouragement for all who saw them. Those two children were running up and down on the Terrace of this House and around the building. With their electrically-powered chairs they were able to do what many fully fit people might find it difficult to do.
The point is that the number of cases which fall into the category to which the hon. Member for Huddersfield, East has referred is not great. It is believed to be of the magnitude of about 10,000. As the hon. Gentleman pointed out, this is not a matter of there being 5,000 new cases every year; that is the measure of the total requirement for chairs as far as can be anticipated.
The requirement is clearly for the provision of a chair with three basic essential requirements. First, it must be collapsible and capable of being carted about both in a car and about a building or house; secondly, it must be transportable and capable of being lugged by hand by perhaps one or two people; thirdly, it must be rigid, rugged and stable.
I realise, as my hon. Friend did when he saw the two children to whom I have referred in their invalid vehicles, that there will never be the possibility of providing a perfect vehicle. There will always be some technical problem which will prove insuperable.
Although Baroness Sharp is conducting these investigations, I hope and pray that time will not be lost in making provision always on the basis, "We must find something still better", all the time losing something which is priceless to these sad and tragic cases. The big contribution we can make to these cases in the short space of life left to them is the opportunity in their own ways to be free from the inhibiting influence of being 299 utterly and completely dependent upon parents. The provision of a stable, power-operated chair—the kind which my hon. Friend saw in this House only 10 days ago—is also a considerable contribution to the long suffering, tragic cases of the parents. Neither parents nor children in this case should be overlooked.
I earnestly hope that my hon. Friend will press the Treasury as hard as he possibly can to make such provision for these sad and tragic cases.
§ 5.3 a.m.
§ The Under-Secretary of State for Health and Social Security (Mr. Michael Alison)I am glad that the hon. Member for Huddersfield, East (Mr. J. P. W. Mallalieu) has succeeded, albeit at a latish hour, in raising a very important subject, as is witnessed by the presence of my hon. Friends the Members for Canterbury (Mr. Crouch) and Cheadle (Mr. Normanton) who took part in the debate.
I am obliged to the hon. Member for Huddersfield, East for his courtesy and the tone in which he spoke tonight, and I hope he will allow me at the outset to dispose of one point which my hon. Friend the Member for Canterbury raised. I am not certain whether my hon. Friend spotted that my right hon. Friend, when he announced the new scheme on 21st February, included in paragraph 6 a new category: that mothers who qualify for a vehicle will be able to have a car instead of a three-wheeler if they have the care of young children. The requirement that they must be in sole charge of the children will be removed. Therefore, we have made an improvement specifically in the direction my hon. Friend was seeking.
In order to clarify the main point at issue raised by the hon. Member for Huddersfield, East—the problem of the disabled who cease work—it will be helpful if I first remind the House of the basic principles of the scheme my Department administers to provide personal mobility for those whose ability to walk is severely restricted.
According to the nature and extent of the disability and some other related factors, those who qualify for invalid three-wheelers or cars, or the new £100 allowance, as the case may be, fall into one of three basic categories.
300 The first category consists of those who have had both legs amputated, at least one of them above the knee. The second category is made up of those who are virtually unable to walk. Here I should like to leave for a moment my main theme to elaborate a little about this category: the significance of my doing so will be apparent a little later on.
Prior to the new scheme which my right hon. Friend the Secretary of State introduced in February of this year, when he announced a number of improvements in the arrangements we are discussing, this second category consisted solely of those who could not walk because of a locomotor disability—that is, something which mechanically in the back and locomotor mechanism prevents any sort of movement—a disability sustained, for example, as a result of polio, paraplegia or rheumatoid arthritis. Those disabled by a non-locomotor condition—for example, a weak heart—who none the less were handicapped to a precisely comparable degree, were totally excluded from this second category. The reason was quite uncomplicated: simply that the money resources available would not permit their inclusion—not that the claims of the non-locomotor disabled were any less deserving than those suffering from a locomotor disability.
Although I am very much obliged to the hon. Gentleman for sparing us in the Department of Health and Social Security the thunder and lightning he brought down on the Treasury, there is a real problem of priorities in this area of financial resources, because by the peculiarities of the way in which the provision of mobility for the disabled has grown in this country in rather a Topsy way, we must always bear in mind when making further financial provisions available for those whose mobility is very restricted that we make no provision for those who are totally immobile, perhaps like the blind or the completely paralysed, or those whose disability is so extreme that they can make no pretension to be able to control a vehicle. Anything we do for the less disabled places in even more stark isolation those whose disability is so total that they cannot come into the category of even a pretence at mobility. This is why we asked Baroness Sharp to look at the totality of the question rather than going on building piecemeal on this 301 narrow element of partly disabled, partly mobile.
I return to my main theme. The third category of disabled people we help are those who can walk a moderate distance but need a vehicle in order to get to and from work, and this is the group with whom we are particularly concerned tonight. Here I might mention in passing that the majority of those who qualify for our help are found to be within the first or second category, and for them the work criterion is not relevant. For those who are eligible, in category 3, a vehicle to get to work must be necessary. Several groups—those, for example, who work from home—cannot be eligible because their need is not for a vehicle to get to work.
It has never been the specific intention that a person should continue perpetually to enjoy the benefits of the invalid transport service regardless of whether or not the conditions giving rise to eligibility remain unchanged. In some cases, including obviously all those in the first category, there can be no such change and, in very many others, change—that is, improvement—is unlikely. But where a change has taken place and the individual concerned has brought this to the Department's notice—and the most obvious example here is the category 3 person who ceases to follow employment—the benefit has been reviewed. I use the word "reviewed" rather than "withdrawn" because one must bear in mind that in many instances the walking ability of a disabled person found eligible in category 3 will inevitably deteriorate to the point where the person becomes eligible in category 2. Very often disabled people start in category 3, but before the vehicle comes to be removed when they cease employment they have already, alas, deteriorated to category 2, and so keep the vehicle. In these sad cases of further deterioration there is naturally no loss of benefit in the shape of the vehicle.
There are two reasons why, following the review of the invalid transport service which preceded the changes announced in February, it was decided that the Department should itself initiate action to check that the conditions of eligibility continued to be satisfied rather than to leave the initiative to come from the disabled person.
302 The first is on grounds of equity. This can best be illustrated by a simple example. A person, say, aged 50, could be found fully eligible in category 3, including being in full-time paid employment, and could cease to be so employed a month later and never resume work. Under our former arrangements, he might well have continued to benefit by way of a vehicle or car allowance until death, perhaps in his later 60s, several or many years later. An exactly similar individual even possibly marginally more disabled, but not employed and never able to get a job, applying for a vehicle just shortly after he had ceased employment, perhaps through retirement, would be ineligible at the outset and remain so. Here would be two people of precisely comparable degrees of disability, one just qualifying before he stopped work and able to keep his vehicle indefinitely, and one disabled just after retirement and not getting a vehicle. It was an inequitable situation from the start.
Such an inequitable situation cannot be justified. We had to face up to the stark choice. We either found the resources by a cutback elsewhere, dropped the employment condition altogether and simply extended the service to embrace the less severely disabled people in category 3, or withdrew benefit when employment ceased. In considering the allocation of resources, the question we had to face all the time was that we were thinking of making marginal improvements in the range of those who are really comparatively mobile, less seriously disabled, in all three categories, whilst behind the most seriously disabled category there are the great mass of people such as the blind and the totally paralysed who are usually well behind in terms of the allocation of vehicles and other appliances.
The second reason was the need to use our resources to the best advantage. I am sure there is agreement in the House that, regrettable as this may be, the many deserving claims for help inevitably are greater than the resources at our disposal to meet and that it is therefore essential that we should channel our resources to those whose need for assistance is greatest. Admittedly, this is not always an easy undertaking. In reviewing the invalid transport scheme, we were conscious of a number of anomalies including the 303 specifically limited ambit of the second category of eligibility.
The significance of my earlier remarks will now be apparent. Purely for financial reasons and no other, severely disabled people unable to walk could come in or out of category 2 simply by reason of the nature of their disability rather than from limitations which resulted from it. In order to remedy, especially this, but also other anomalies, we had to find extra money. At the same time, we were quite certain in our own minds that it would be a wrong order of priorities to devote more resources to this particular service—the narrow range of transport service—pending the outcome of the more fundamental review which Lady Sharp is now undertaking.
Accordingly, the changes announced by my right hon. Friend in February included a number with the aim of achieving some savings in order to help finance the very worthwhile extensions. One of these was the more systematic check that people in category 3 continue to satisfy the criteria for that category if they are to continue to derive benefit.
Although it is an over-simplification, for the balance sheet is rather more tentative and complicated, the withdrawal of benefit from category 3 people who have ceased to be eligible for help has helped to finance the extension of the service to the non-locomotor disabled in category 2—heart and lung cases—who, in equity, ought always to have been helped. Simply stated, we are helping more of those who cannot walk at all rather than those who can walk a modest distance but no longer need a vehicle to get to work.
The other point that I should like to make, apart from the specific question of deterioration, is that the circumstances of 304 individual cases will be taken fully into account before a decision to withdraw benefit is reached. We shall do so with the utmost care, attention and sympathy, and stretch as many points as we can, within the regulations, to avoid unnecessary hardship and duress. If, for example, an unemployed person clearly has reasonable expectations of very quickly resuming full-time paid employment, benefit will not be withdrawn. Incidentally, retirement, as such, is not the determining factor; it is ceasing, for whatever reason to follow full-time paid employment. The aim will be to administer the check in a considerate manner and with maximum sympathy. I will gladly review the circumstances of any case brought to my notice where there appears to have been any failure on the Department's part to do so. I shall always be glad if my hon. Friends will bring individual cases like this to my attention. Nevertheless, I would not wish to seek to hide the fact that in some instances benefit will, quite properly in the circumstances, be withdrawn. The decision to take this course was not reached lightly but in all the circumstances it was clearly the right and proper one to take.
I am sure that Members on both sides of the House will agree that our record in this field—as my hon. Friends the Members for Canterbury and Cheadle have said—is one of steady progress of which we can be justly proud. To mention one or two developments—
§ The Question having been proposed after Ten o'clock on Monday evening and the debate having continued for half an hour, Mr. DEPUTY SPEAKER adjourned the House without Question put, pursuant to the Standing Order.
§ Adjourned at seventeen minutes past Five o'clock.