§ 7.26 p.m.
§ Sir Geoffrey Howe (Surrey, East)
I think that I am right in saying that if the Minister who has just come into the Chamber succeeds in catching your eye, Mr. Speaker, the speech that he will make will be the first that he has made in a full daylight debate since his appointment giving him special responsibility for the disabled. I have already welcomed his appointment, not just because the hon. Gentleman is a constituent of mine, but because of the importance of the opportunity that it offers him in dealing with the problems of the disabled.
Sir Harmar Nicholls (Peterborough)
And of the work that he has done in the past.
§ Sir G. Howe
As my hon. Friend the Member for Peterborough (Sir H. Nicholls) has pointed out, we welcome it, too, as recognition of the work that he has done in the past for the disabled.
In the previous Conservative Government I was a co-ordinating Minister with responsibility that attempted to reach out into other Departments in Whitehall than my own, and perhaps I may pass on the assurance—if I may so call it—that the hon. Gentleman will not find that the difficulties of co-operation will all melt away merely by virtue of his appointment. I wish the hon. Gentleman more power to his elbow. I expect that he will have to keep at it with his usual tenacity.
The hon. Gentleman may not find it easy to achieve as much as I am sure he would like to do, in the context of the social policy of the Government of which he is a member. Both sides of the House accept that there are inevitable constraints on expenditure on the social services in the present situation. There always have been and probably always will be. Equally, the House accepts that the disabled have a special call on the community for understanding and practical help. Nevertheless, the necessity for choice is imposed by the facts of the world in which we live. The fear of hon. Members on this side of the House is that the present Government have already made, or are making, 1233 certain choices in the broad sectors of social expenditure that, regrettably, may preclude the opportunity of giving to the disabled the priority that we believe they should have. I urge the Minister, with his personal responsibility towards the disabled, to see, so far as possible within this Government, that that does not happen.
I suggest that the questions the Minister should be asking are whether it is sensible in the interests of a balanced social policy, to commit such large sums of money to indiscriminate food subsidies, to commit in advance such a significant sum of money to the pledge to abolish prescription charges, and to commit a significant sum of money to the total standstill on all rents. Those sums already add up to approximately £620 million.
For the purpose of illustration, I suggest that it was wrong of the Government to commit themselves so readily and swiftly, without, apparently, overt pressure or representation, to refund a sum as large as £10 million—a most significant sum in the social services field —to the trade unions which did not register under the Industrial Relations Act.
I do not intend the remainder of my speech to be tendentious; nor do I intend those observations to be tendentious, because they are important when trying to assess the framework of the Governments social policy as a whole. The object of this debate at this time is to give the House an opportunity in the short time available to influence the Government's thinking on this subject. Some hon. Members have suggested that the opportunity has arisen almost too early, but experience of a debate on this subject in another place suggests that that will not turn out to be the case, and I hope that the Government will profit by the observations of my hon. Friends, who seem to outnumber Government Members.
I begin by expressing thanks on behalf of the whole House to Lady Sharp for the care and thoroughness with which she prepared her report on this subject. Even though not all hon. Members will agree with the whole structure of her argument, it presents an essential and invaluable framework for informed discussion.
1234 The first question arising is that with regard to cars or "trikes", and it is manifest that cars are preferred, partly because they are safer—I shall have more to say about that—and partly because they are available for passengers as well as drivers. Finally, but by no means least important, they are manifestly cheaper.
Questions of eligibility arise, but if the fundamental case is accepted, that cars are preferable to "trikes", one asks the Government whether it is not possible to start soon, shortly—indeed, almost now —in relation to the new applicants, on the use of cars rather than "trikes". One would like to know how far any shortage of suitable cars is likely to inhibit such a change of policy. I understand that that is not likely to be the case.
The second point, even if the first choice is made in favour of cars, is about the overall future of "trikes". Should they remain as an option available to the disabled? There seems to be a good case for saying that they should be so available, for example, to the 16-year-olds. Perhaps the Minister will tell us how many disabled drivers fall into that category.
It is also desirable, surely, that they should remain available as an option for those who would actually prefer "trikes" to cars, perhaps because the car is impossible to adapt, although I should be interested to know how far the Minister agrees that adaptation is an impossibility. Much opinion now argues that there is no vehicle that cannot be sensibly adapted for a particular driver.
If "trikes" remain an option, has the Minister any idea of how many disabled people would still want to exercise the option in their favour? What then would be the effect of retaining them as optional, but for a much smaller number of people, on the unit cost of the "trikes"?
These are among the points made by the Joint Committee on Mobility for the Disabled, whose chairman, as the Minister knows, is a fellow constituent of his in my constituency, but the central point I am making is to ask whether there is any reason why the disabled should not continue to have a choice as between a "trike" and a car if safety is of no real concern.
1235 That brings me to the next topic with which many people have been concerned—the subject of safety. I appreciate that this is a sensitive subject, because observations by the Secretary of State and one of my hon. Friends are now the subject of investigation by the Parliamentary Commissioner, and I have no wish to do anything that will increase concern about this topic if and in so far as such concern is unjustified. The Minister will appreciate that concern continues to be expressed.
Strong language expressing concern was used in another place and it has certainly been used by the Disabled Drivers' Action Group. The Minister himself has voiced such concern in the past. Moreover, the Motor Industry Research Association reports, if I read them correctly, show that an unmodified "trike" falls short of existing or draft requirements in at least two respects apart from the much discussed question of performance in high winds.
I read the observations by the Minister's noble Friend in another place, but I have two questions to put to him. First, are newly issued "trikes" being modified to eliminate all the shortcomings disclosed in the MIRA reports? Secondly, will the Minister, if it is not pressing him too hard—in view of his past observations his words on this subject will have authority that should command respect—give the House his assessment of the question of safety so as to inform and reassure opinion on this subject so far as, but no further than, reassurance is justifiable? It is not satisfactory that this important question should rest, as it seems to continue to rest, between well documented and apparently responsible allegations on the one side and unpublished and incomplete reports on the other. I make that point is no tendentious sense, but because this is an important subject.
I turn now to eligibility. It is clear that the proposed extension to passengers, outlined by Lady Sharp, and which we regard as desirable as soon as it can reasonably be achieved, will add significantly to demand, to take-up and, therefore, to cost. Therefore, it is easy to understand why Lady Sharp suggested different criteria to keep the additional cost down to the £3 million that she mentioned. The House will recall that 1236 the criteria put forward by Lady Sharp broadly involve eligibility for those who need a vehicle for getting to work, for getting to a place of further education or training, or for looking after a household. Acceptance of those criteria and of the whole of Lady Sharp's report would involve withdrawal, when existing vehicles became unusable, of vehicles from about 13,500 people who are now entitled to them. I agree with the Secretary of State in regarding such an outcome as unacceptable.
If we reject that restriction completely, so as to admit for cars a whole new group of disabled passengers, significant extra cost would be incurred. Has the Minister any better idea now of the additional numbers likely to be involved on that basis and of the extra cost? Is there any reason to disagree with the £12 million which appears to have been accepted by both sides in the debate in another place?
If so, it is worth keeping in perspective just what that £12 million amounts to, particularly in the context of this Government's pattern of social spending and priorities. Although on one view, in the hard-pressed social services sphere, it is a large sum of money to find, it is less than the amount to be spent on subsidising bread and cheese in 12 months and less than one-tenth of the cost of subsidising the price of pint of milk by 1p. That is the basis upon which we urge that high priority should be given to the disabled.
Many other important questions arise. some of them matters of detail. For example, there is the question of responsibility between the Department and local authorities for the operation and servicing of vehicles for the disabled. The House will recollect that Lady Sharp concludes that the responsibility should remain that of the Department. I should be interested to know what, if any, conclusions the Government are moving towards on that subject.
There are other detailed questions—for example, exemption from vehicle excise duty and the requirement that a vehicle should be conspicuously and permanently adapted. That gives rise to certain difficult borderline cases. We should, therefore, like to know how far that requirement is likely to continue.
1237 There is the question, increasingly important in the light of rising fuel costs, of the adequacy of existing cash allowances where such are being paid.
There are larger questions which will require further consideration. In principle, should provision for the disabled in this sphere be by means of cash or by a vehicle? I can certainly see the attraction, not least because it opens up a range of options, of dealing with this matter by a cash payment, but I can also see some of the difficulties that would be involved in that approach.
There is another large question: how far is it right for provision in this sphere, whether by means of a vehicle or of cash, to be means tested? I see, and, indeed, have argued this evening, the need for social policy in all areas to be so designed that, so far as we can, we bring most help to those in greatest need, but I am reluctant to accept the argument for another means test. I should prefer curtailment of other indiscriminate benefits and to bring help without a means test to the whole effective category of the disabled if that is possible within financial limits.
I should be interested to know whether the Minister is in a position to advance the Government's thinking on this subject any further than was vouchsafed in another place. We have only an abbreviated time for this debate. Its function is to give the House an opportunity to express its views so as to influence the Government's thinking on a subject which is not contentious between the parties. I hope that the Government will study all the points that I have mentioned. They are by no means exhaustive. I shall certainly consider what my hon. Friends and other hon. Members say in the debate.
Meantime, I repeat my hope that an early start will be made, ahead of the main review of provision for the disabled which will come forward in the autumn. I think that the argument for some progress and change is already accepted. For example, is it possible to switch to the provision of cars now in place of "trikes"? Would it be sensible to start, so far as additional provision is contemplated for disabled passengers, within the criteria suggested by Lady Sharp in her report, not by way of curtailment, I hasten to add, but by identification of additional groups in the passenger rather 1238 than the driver class as an area of first sensible priorities?
In closing, I make no apology for concentrating on the question of mobility. There are many other equally important aspects, some of which were touched upon in Lady Sharp's report, but as The Times, in a leading article on 26th March, observed,among the many needs of disabled people their own transport should come very high on the list of priorities. It can be decisive in enabling them to earn a living and to preserving their self-respect. It can make all the difference between a life of isolation and an active rôle in the outside world.It is upon that basis that I justify having concentrated on that part of the subject in my few observations this evening.
§ 7.44 p.m.
§ The Under-Secretary of State for Health and Social Security (Mr. Alfred Morris)
I thank the right hon. and learned Member for Surrey, East (Sir G. Howe) for his warm and sincere words of welcome to me on my appointment. This is my first opportunity to welcome him in his new appointment. I say little more now than that the right hon. and learned Gentleman always looks happier on the Opposition side of the House. It is a mark of my good will to him that I trust that felicity and function will continue to march together. That will enable the right hon. and learned Gentleman, as my Member of Parliament, the better to look after my interests in the House and help me with all my personal problems.
One of my main problems now is that I may have to wait for the conclusion of the debate to answer all the points of detail which the right hon. and learned Gentleman raised.
I join the right hon. and learned Gentleman in congratulating Lady Sharp on her lucid and well-argued report. She dealt with both indoor and outdoor mobility. I shall concentrate on the latter, as it has been of the greatest interest to right hon. and hon. Members.
Lady Sharp deserves the thanks of us all for setting out the issues so clearly and succinctly. We may not accept all her conclusions, but it seems to me that her terms of reference required her to do the impossible. She was asked to propose a comprehensive and satisfactory package without using the resources needed to do so. I am told that that 1239 is a ploy familiar to keen students of the last administration, but it is one which my right hon. Friends do not propose to adopt.
It may strike hon. Members on both sides as odd that the Opposition, having failed to publish the report after it had been in their possession for nearly five months, are now so enthusiastic to debate this important document. I remind the House that we published the report within weeks of taking office.
Similarly, the previous Government were unwilling to publish the reports of the Motor Industry Research Association on the tests carried out on a three-wheeler. In fact, they were more than unwilling; they said that it could not be done. We did it. My right hon. Friend the Secretary of State and I were anxious to publish the MIRA reports in full, but we were reluctantly obliged to accept that the report on side-wind tests could not be published without breach of commercial confidence. Therefore, we made the other reports available to hon. Members as fast as we could, and with them provided a synopsis of the side-wind tests which left out nothing concerning the Model 70 tricycle.
If any hon. Members wish still to dispute that the course of events in connection with the publication of the MIRA reports was otherwise than I have briefly recounted, let them say so now. I shall make available for their inspection the correspondence between my right hon. Friend and the Director of MIRA. That correspondence belies beyond any shadow of doubt the contention that my Department could have published details of the side-wind test in full if it had wished.
The Conservatives were fully aware when in office of the figures of incidents involving three-wheelers, yet did not regard them as being of sufficient consequence to justify taking speedy action to withdraw or modify the vehicles, a fact which I trust will be borne in mind in any consideration of the safety of the three-wheeler. As the Minister of State of my Department in the previous Government, Lord Aberdare, frankly admitted in another place during a debate on the subject on 10th April, the whole subject of the vehicle service is one of extreme complexity, and it has difficult financial implications.
1240 As my right hon. Friend explained in the statement she made contemporaneously with the publication of the Sharp Report, the Government are now in consultation with a wide range of organisations representing disabled people—those in medical and social work and other professions—and the local authority associations. We are consulting them on the issues raised by the report, both specifically and in the context of the wider question of the priority to be assigned to the various needs of the disabled, of which mobility is one. The Government have also made clear that they are not only considering Lady Sharp's recommendations but are making a study of cash benefits for the disabled, which will form the subject of an announcement at the time of the October review.
It follows from what I have said that I am not in a position today to declare my right hon. Friend's intentions about the future of the vehicle service and about such important matters as whether contributions should be made by recipients, how we should select priority categories, and whether cash grants would be preferable to cars. I am aware that certain organisations favour the provision of grants rather than cars to enable the disabled to exercise a choice on the way in which they meet their transport needs.
There are cogent arguments both for and against a system of cash grants—arguments that were briefly mentioned by my noble friend, Lord Wells-Pestell, in another place on 10th April. All I can say now is that the Government could not accept Lady Sharp's proposal —which, as I have said, I feel was made in the context of an impossible remit—to disentitle a substantial category of disabled people. Even with the transitional safeguards proposed, those disentitled would probably be the most disabled of those now eligible. That is one of the many factors we are taking to account in our overall consideration.
I can assure the House, as my right hon. Friend and I have done before, that in circumstances of this kind we intend to make a practice of taking decisions in the light of the views of disabled people themselves. We wish to act with them and not exclusively for them. While we must allow time for full consultation on the report, we do not intend 1241 to allow this to delay action on issues on which it is clear that there is universal agreement.
If we were to do everything that we should like to do, we should face a high level of expenditure on the vehicle service. It can be reasonably argued that it is illogical to make care available without making provision for disabled passengers. Lady Sharp suggests that to do so, employing present criteria, might triple the present net cost of supplying vehicles or allowances to NHS recipients. This excludes first issues to anyone over 70 years of age. If passengers are to be eligible, can we justify treating those over 70 differently? Can we seriously contemplate taking away a vehicle when the eligible person reaches that age?
If we entitle everyone eligible on present criteria, whether drivers or nondrivers, we shall be talking of much greater expenditure even than Lady Sharp's £12 million, which she suggests could be a considerable under-estimate. We must not forget that prices have risen considerably since Lady Sharp made her calculations. I must admit that, unfortunately, any estimates still involve a large amount of guesswork. There are unavoidable difficulties in the way of getting firm and consistent figures. One of the main problems is that while we might make a rough estimate of the number of disabled non-drivers who could be eligible—and if no regard is paid to age the possible total is formidable—we can have no idea of the number who could find someone to drive a car for them.
All that we can be certain of is that the additional expenditure would be large. The root of the problem, therefore, is one of financial priorities. This is the most important of the matters we have specifically asked the organisations to consider.
The Government have also to examine the report with their review of cash benefits for the disabled undertaken under Section 36 of the Social Security Act 1973. This review has to be completed by the autumn, and it is for that reason that we hope to get the views of all interested organisations on the vehicle service as soon as possible. There are many other problems, apart from the basic one of the availability of cash. There are, for instance, questions related 1242 to the continued production of the three-wheeler for those who are or feel unable or unwilling to use a car. There is also the equally difficult problem of the administrative apparatus required for a much larger and more complex service.
I want to develop the question of the retention of the three-wheeler. I do not want to be misunderstood in what I shall say. It is fully accepted that the three-wheeler has shortcomings. We must not for a moment pretend that in general it is preferable to a small car. I would much rather see disabled people with mobility problems but who were able to manage a small car being given the opportunity of doing so. Many who have been in touch with me have said that they cannot manage a small car. If the Government were to decide to change to small cars tomorrow, the supply position, as Lady Sharp notes, would make it impossible to replace all the three-wheelers for some time. Thus, it is inevitable that the three-wheeler will remain with us, albeit in reduced numbers, during the immediate future.
My right hon. Friend and I are therefore vitally concerned about its safety. We have accordingly ensured that everything that could be published on the subject has been published. The point about the three-wheeler is that it is necessarily a functional vehicle, incorporating many features specifically designed to meet the needs of the most severely disabled. It is these features that have largely given rise to criticisms by drivers accustomed to more conventional vehicles.
No one can argue that the three-wheeler is the best possible answer, and we have constantly improved it. It provides a means of mobility for severely disabled people and has done for a long period. Many users are now fearful that because of the strong pressure for its immediate withdrawal they will be left without any means of transport after having driven a three-wheeler quite safely for a number of years.
Many, because of their particular disabilities, would be unable to drive a car. Others would not want to. Many, having mastered the three-wheeler, would not want to learn to drive a car and take another test—even assuming that they had a qualified driver who could accompany them until they had become sufficiently proficient to pass the test. To do away 1243 with the three-wheeler entirely would mean that the severely disabled school leaver would be rendered immobile at an age when mobility was of special importance, because a 16-year-old can drive a three-wheeler but he must wait until he is 17 before he can drive a four-wheeled vehicle. I do not have the detailed information requested by the right hon. and learned Member for Surrey, East, on this point. Later in the debate, however, I shall attempt to meet the request which was quite legitimately made for full information. I would not wish hon. Members to think that I was in any way complacent about the general question of safety. The House will know that I am not complacent.
My Department asked for certain tests to be undertaken, and the results of these are available to all hon. Members. Quite a number of disabled people have taken the trouble to write to Ministers categorically dissociating themselves from the criticisms published and expressing fears that they may be deprived of a vehicle which they regard as eminently suitable for their personal needs. I know how strongly many disabled people long for a car so that they can be like anyone else and take their families with them when they go out. I know what a difference it would make to the lives of so many even more seriously disabled people if a car could he provided for the households in which they lived.
Mobility is a priceless asset, which perhaps only those who have lost it can fully appreciate. That is why I would not agree to any solution which involved withdrawing vehicles from any of those already entitled to them. There is no escaping the consequence which clearly emerges from Lady Sharp's report, namely, that a move towards cars will involve substantially increased expenditure. That does not mean that it cannot be done. It means that it must be weighed against other claims upon resources and, in particular, the claims of the disabled themselves. In any case, quite apart from the priorities, it seems right to look at the question of vehicles and cash provision.
I recognise that there is an argument for treating the development of the vehicle service as something quite distinct from the development of a proper structure 1244 of cash benefits for the disabled. This distinction may not be wholly realistic. Disabled people span a great range of ages, types and severity of disablement and areas of need. The Government have to look at the whole range of their social responsibility and also at the priorities for development of help for any one broad group.
For some disabled people mobility is not the most immediately pressing need. For others, as Lady Sharp has said, help in respect of mobility is not necessarily best provided through developments within the vehicle service. She took a very great interest in the provision of satisfactory housing for disabled people. Whatever view one takes it must be sensible to develop our proposals for cash benefits with Lady Sharp's report in mind and to consider our policy on the proposals in the report in the light of the structure of cash benefits which we see emerging. Certainly progress has been made in the past by a piecemeal approach. It would be unrealistic to expect to achieve everything desirable in one leap. Nevertheless, a coherent strategy is needed and we are determined to achieve it as quickly as is humanly possible.
I opened by saying that I was not sure what had prompted hon. Members opposite to initiate a debate on this subject at this juncture. I close by saying that I hope it was to inform rather than divide the House. I know now from the speech of the right hon. and learned Member for Surrey, East, that the former was his intention.
I welcome the debate as giving hon. Members an opportunity to express their views on Lady Sharp's report—views which the Government will consider very carefully no matter from which side of the House they may come. The House as a whole, regardless of party, has shown a deep and abiding interest in problems affecting disabled people. I shall listen closely to the points raised by hon. Members during the debate and, with permission, will hope to deal with them in replying.
§ Mr. Deputy Speaker (Mr. Oscar Murton)
Before I call the next speaker I should draw to the attention of the House the fact that a considerable number of hon. Members desire to make 1245 contributions to the debate. It would be helpful if Members confined their speeches to a maximum of 10 minutes, if possible.
§ 8.3 p.m.
§ Mr. Neil Marten (Banbury)
The Minister for the Disabled and I, and one or two others, have always tried to keep party politics out of this subject, I think rightly. Therefore, I shall not tease him about his speech being "poacher turned gamekeeper" in one or two respects. We welcome the report as a basis for a good discussion, and we thank Lady Sharp for having made it. Those of us who gave evidence to her would like to thank her particularly for her personal kindness in listening to our views, and also for the fact that she heard, took, or read evidence from over 200 sources. This was not a committee but one person. It was a creditable performance.
I take this opportunity of thanking my right hon. Friend the Member for Leeds, North-East (Sir K. Joseph) who set up the Sharp Committee. We ought to pay tribute to him. I regretted the delay in the publication of the report. I congratulate the Government on their speedy publication.
This debate is premature, however, because quite a number of us have not even had a chance to see some of the disabled groups who are very much concerned with this matter. As chairman of the all-party disabled drivers' group in the House, I should like to give a slight plug: for next Wednesday, on the all-party Whip, hon. Members will see that there is to be a meeting with the disabled drivers' organisations. If anyone present wishes to attend, he will be very welcome.
I shall not deal with the safety aspects of this matter. I want to concentrate on the question of the vehicles. It is quite clear that the three-wheeler is on its way out for those who do not want it, but will, I hope, be retained for those who do. The report has given the Government the basis on which to make two main recommendations on two broad issues. The first is whether there should be a three-wheeler or a four-wheeler. That is obvious and is fairly well accepted; it is now hardly an issue. The other is as to whether the Department should provide the car or the cash on a capital grant system. This is an impor- 1246 tant matter on which hon. Members should give their views.
On the question of criteria, we shall always argue about eligibility for a car or a three-wheeler, or whatever it is. It is an extremely complicated issue. It is a question of getting the line drawn right. I should need to make a long speech to deal with that matter. But, wherever the line is drawn, it must include the disabled passenger.
I should like to sound a note of warning. In the past, some of the estimates, often given in good faith by the Department, have proved to be too great and the take-up has not been anywhere near the estimate. I hope that that will be borne in mind when the Government come to make estimates.
In this short debate there is no time for any of us to tell what I call rather moving stories about individual cases. All of us who are interested in this subject now know the problem. Most of us have driven these vehicles, and so on. Members of Parliament as a whole know of many tragic cases from personal experience.
My preference is for the cash grant system, with a reasonable maintenance allowance, and bits and bobs such as the licence, and so on. I see that this was rejected by Lady Sharp. But it has four advantages. It could certainly operate quickly as a scheme once the criteria have been agreed and the organisation has been set up. I was rather terrified by paragraph 96 of the report, in which Lady Sharp gave four to five years as being the time required for the changeover to four-wheelers. But if we have a cash grant system allowing the person to buy the car which suited him best, we could operate this scheme much more quickly.
The second advantage of a cash grant is that the disabled can have a car of their choice, within the cost bracket of the grant. I hope that people can get away from the idea that all the disabled want Minis. Everyone talks about Minis. But there are fat disabled for whom a Mini is too small, and there are disabled with large families who want a large car. There are disabled who are single and want a small car. There are disabled with differing disabilities. It is much easier to get into certain types of car—not, perhaps, including a Mini. Some 1247 even want a van with a ramp at the rear. So the idea of choice by cash grant has many advantages in that way.
The cash grant also has the advantage that it gets the Government and the civil servants out of the rather fussy involvment with day-to-day responsibility for all the problems of the vehicles. The cash grant has a fourth advantage, with which all hon. Members may not agree, in that it can much more easily be means-tested. I understood my right hon. and learned Friend the Member for Surrey, East (Sir G. Howe) to say that he did not agree with means testing on this issue. But I do not think that we should object to it. It is an absurd waste of resources to give a grant to a wealthy person who does not need it when that grant could be spread to people who may be on the margin. So it should be means tested, but fairly means tested. Any cash grant and maintenance grant should also be regularly reviewed, particularly in these days of inflation.
My final point is the main one that will face any party which has to deal with this matter—the overall amount of money which is to be put into this project. One always returns to the slice of the cake argument, and that always brings one back to the Treasury. I mean nothing offensive to the Treasury officials, but they have the governmental responsibility for husbanding resources. The Treasury rather tends to squeeze on this matter. Its past attitude has been that, if a vehicle or the vehicle service is unsatisfactory, some people will never bother to apply and, therefore, it is cheaper. I hope that the Minister will agree with me when I say that that attitude is utterly deplorable. The House of Commons must say tonight, "We shall have no more of that attitude from what we call the Treasury".
What hon. Members want is not just a fair deal for the disabled but a good deal for the disabled. The disabled want to play as active and normal a part in life as possible, and Parliament should see that they are given every help to do so.
Most Members of Parliament would disagree on the question of the slice of the national cake and how it can be carved up. The Minister has already staked his claim with the Chronically Sick and Disabled Persons Act, which 1248 now stands on the statute book in his name. He has always been a great campaigner for expenditure on this matter. But on this question of vehicles for the disabled we are dealing not exclusively with the mobility of one person but possibly with the more social aspect of the mobility of, perhaps, a family, and it needs an attitude that is entirely different from the previous attitude, which was about a vehicle for one driver. I believe that the public would give their wholehearted support to a large expenditure on this matter.
One of the main reasons why many of us are in Parliament is to do what we can to uplift the lot of the less fortunate in life. I hope, therefore, that Parliament as a whole, when the time comes for decision on the Government proposals, wherever they may be—I hope it will come in a debate later this year—will vote against anything which is less than really generous to the disabled and, for once, will unanimously demand that the disabled are given a good deal.
§ 8.13 p.m.
§ Mr. Lewis Carter-Jones (Eccles)
I wish to deal with mobility in three aspects. The Sharp Report is clearly headed "Mobility of Physically Disabled People"—in all its aspects. First, however, I wish to welcome my hon. Friend the Under-Secretary to the Government Front Bench. He really is an honourable friend. I hope that my pursuit of technology for disabled people does not cause me to lose his friendship. I am sure that it will not. I should like him to take up many of the causes that I have been pushing for a long time. I must refer also to the hon. Member for Banbury (Mr. Marten), whom I regard as my friend in this sense.
If we look at this matter carefully, we can prove that maximum aid to disabled people can also be economically sound. From three points of view, it is possible, by providing mobility, and where the motivation is right, to get disabled people into employment, making their contribution, and to enable them to be independent. It is possible also, where they are severely handicapped and young, to educate them so that, again, they can be independent and earn their living.
Isolation is a terrible state. It is terrible to be immobile. I quote from the book 1249 written by Philip Nicholls, who is the director of Mary Marlborough Lodge:Mobility is often, the key to the whole programme of rehabilitation of the severely physically disabled.We should tackle mobility in all its aspects. If we do not provide mobility where it is possible to do so, Parliament is guilty of keeing people unnecessarily in prison.
The Sharp Report dealt with the subject of three-wheelers. We tend to spend a great deal of our time on the question of long-distance mobility, and we forget that a substantial number of people merely want to have the opportunity to move around in their own immediate environment. They want to go to the shops or to the park, and therefore an appropriate wheelchair would be helpful.
A person's immediate environment, in which mobility involving five steps can get a disabled person to the toilet and in that way give him independence, takes some planning. It is, perhaps, unfortunate that in the publicity given to the Sharp Report a great deal was said about three-wheelers and not enough about toilets. This aspect of the subject is of particular importance to somebody who is immobile, and it has been dealt with in the report on the crippled child and in the Amelia Harris Report. There are 1½ million people who could be given mobility quite simply by being provided with aids in the home. I saw Lady Sharp this afternoon, and she said, "It is all in the report The trouble is that society and the public are not aware of this aspect, which is of extreme importance to those concerned.
I welcome what was said by the right hon. and learned Member for Surrey, East (Sir G. Howe) from the Opposition Front Bench. It seems that every time I get up to speak in Parliament we have the same questions with different people asking them—
§ Mr. Carter-Jones
Yes, and sometimes the same answers. At least, I hope for better things from the Minister of State.
I welcome the Sharp Report, for its attitude on the question of four-wheelers represents a step forward. I share the 1250 view of the hon. Member for Banbury (Mr. Marten) that we must decide on the type of vehicle to be used. The hon. Gentleman and I agreed that we would not discuss cases. He is the chairman of my group, and I am the secretary, and together we could produce thousands of cases that have come to our notice.
I shall refer to one person only to illustrate the theme. Given the application of advanced technology, it is possible for a quadriplegic to drive his own vehicle. Indeed, it is not only possible. It is a fact. Mr. Paul Bates of Horsham, who contracted polio as a soldier in Malaya, is a living example of this fact. For Paul the vehicle required is a milk float, for in that vehicle he can become a spectator at a rugby football match.
I agree with the Member for Banbury that the type of vehicle must be suited to the person's needs. I congratulate the Disabled Drivers' Action Group on its campaign against the three-wheeler. However, there was a slight element of overkill in that campaign. Its backlash is now being felt. I have had some sad letters from people saying, in effect, "If you take my three-wheeler from me, I shall die". That is not the language of an emotional Welshman from the Rhondda; it is the language of people who have written to me and said, "I am passionately fond of my three-wheeler". The choice, obviously, must run from a milk float to the existing three-wheeler. The chances are that the Mini or the Daf from the production line may fill the need in the majority of cases.
I am deeply concerned about the fact that 13,500 people may lose their vehicles. [Interruption.] One of my hon. Friends seems to disagree with that remark, but, if the Sharp Report is accepted, the 13,500 people who find themselves in that situation will still be there in 20 years. It may be that in that period the figure will be 13,900 or 13,200, but that group will still exist. This is one part of the Sharp Report which must be totally rejected.
§ Mr. Raphael Tuck (Watford)
I think that my hon. Friend is under a misapprehension. The Minister said that he did not accept that part of the report—in other words nobody who has a vehicle at present will lose it.
§ Mr. Carter-Jones
I am grateful for that intervention by my hon. Friend the Member for Watford (Mr. Tuck). I hope that, if that proves not to be so, he will come with me into the Division Lobby. The category to which I refer must not be neglected.
The next group with which I wish to deal is the group of people who are so severely handicapped that they cannot drive. The answer sometimes is a nominated driver, but a nominated driver is not always convenient. If the Minister wants the names of people who can help to provide vehicles for the severely handicapped, I assure him that I can provide —I think this applies also to the hon. Member for Aylesbury (Mr. Raison)—the names of technologists who can help him to defeat this problem. If it cannot be done by advanced technology, then it must be done by a substantial mobility grant. There are many people—such as the Mary Greaves of this world, a past honorary director of DIG—who want to go out only occasionally but find it extremely expensive. We should think in terms of providing money for private hire cars or taxis.
Since I promised to be brief, I shall cut out my remarks on the problems of wheelchairs. I believe that there is a good case for producing a powered, stable, safe wheelchair for use on pavements. We must discover what is the best wheelchair to be used, and this applies to powered chairs as well as ordinary wheelchairs.
I end by stressing the problems of the disabled person who faces the task of getting from the living room to what we in Wales call the ty bach, the toilet, or to the kitchen. Here, I should like to see my hon. Friend spend money on assessment centres and rehabilitation units. Almost incredible work is done at Mary Marlborough Lodge, Oxford, where 20 per cent. of patients have bowel and incontinence problems and yet, with care and advice and without much technology, can gain their independence provided that they can walk a short distance.
I hope that the three aspects of mobility will be taken into account. Having said that, I end with the plea that I always make in this House. I wish to God that someone would get hold of the Treasury knights and bang their heads 1252 together to make them realise that there are two sides to a balance sheet. If they concerned themselves less with the expenditure side and tried to realise how they can make savings by encouraging people to work if they want to work and by keeping people out of hospital if they do not want to go to hospital, there would be additions on the plus side. I hope that my hon. Friend will do something about this. I assure him that the all-party group will give him every possible support whenever he wants to take on the Treasury—and God bless him.
§ 8.36 p.m.
§ Mr. Christopher Woodhouse (Oxford)
I join in congratulating the Minister on his first major speech following his appointment and in expressing warm appreciation of the work which Lady Sharp put into her report. She produced it with remarkable speed. I am sorry to say that that speed was somewhat inhibited in the latter part of last year. She wrote a most incisive and readable report and made a great many recommendations with which I heartily agree, especially on the importance of suitable designs for houses for the disabled and on the need for more attention to be given to the use of wheelchairs for short distances.
I warmly commend and am glad that the Minister has accepted Lady Sharp's plea that there should be no discrimination against the disabled non-driver. I assume that the hon. Gentleman will also give a sympathetic hearing to her recommendations for greater flexibility in the administration of the service. Having listed those and other points in which the report deserves wholehearted commendation, I join with other hon. Members in saying that it is also open to very serious criticisms.
The first criticism is that Lady Sharp brushes aside in a somewhat offhand manner the dangers of the three-wheeled vehicle. It is understandable that she should have wished to postpone consideration of this matter until the MIRA report was available. Again, I congratulate the Minister on his decision to publish as much of that as was possible in March.
I am sure that the hon. Gentleman has also given attention to other documents which were not available to Lady Sharp, 1253 such as the report by the Research Institute for Consumer Affairs on the three-wheeler and the article on that report published in the magazine Which? during March. But Lady Sharp should have considered what advice she would offer if the MIRA report proved to be damaging with regard to the dangers of the three-wheeler vehicle—and it has proved to be damaging. This should have been considered, especially because the report estimates that it will take four or five years to replace the three-wheeler completely.
The MIRA report shows that the standard P70 vehicle which was tested in August last year failed basic safety tests and only passed them when it was modified substantially and re-tested in September. It is a very important point that all the P70 models on the road at present are of the type that was tested with unsatisfactory results in August last year. There are none adapted in the manner of the model that was tested in September.
There is also the very disquieting feature of the MIRA report about the wind test. I accept the Minister's good faith when he argues that it was literally impossible to publish the result of that test in full, though I put to him the question which has been put to me on behalf of disabled drivers. Why was not it possible to publish the details identifying the other vehicles tested only as A,B,C,D, etc., as has been done with other tests on vehicles published by MIRA?
All of this was unknown to Lady Sharp at the time she wrote her report. But the reason why she included the dangers of the P70 was not that the investigation by MIRA was still in progress. She decided, in her own words, quite early that the three-wheeler would be replaced by a car in any case as soon as possible. In my judgment, that was a precipitate and unwise conclusion. I recall my own experience over the 10 years that I have been agitating on this subject. I came quite early to the same conclusion, but I very soon went back on it in the light of experience for the reasons instanced by the hon. Member for Eccles (Mr. Carter-Jones).
1254 Lady Sharp's report admits in paragraph 34 that some disabled people can drive the three-wheeler who would never be able to drive a car. That is a very different matter from another way that Lady Sharp expresses this distinction in other paragraphs when she talks about some people "preferring" the three-wheeler or about the three-wheeler being "a better bet". I find it very difficult to imagine anyone preferring a three-wheeler if they had a free choice between a three-wheeler and a car and if also they could handle a car. It can be assumed, virtually without exception, that those who choose the three-wheeler are making Hobson's choice.
Lady Sharp admits that some will suffer if the three-wheeler disappears. We do not know exactly how many but there is that very alarming figure in paragraph 139 which gives the estimated number of those who would be deprived if all the various categories were added together—those unable to use a car instead of a three-wheeler, those not of age to drive a car, and those who would be disqualified by Lady Sharp's new criterion of need.
The total figure is 13,500. However, the Minister has told me already that this is in the nature of an estimate which he could not confirm without a great deal of research. I must remind the House that that figure of those who would lose all means of transport under Lady Sharp's proposals includes a small but significant number of war pensioners—according to paragraph 79, more than 250 of them. The report is very ambiguous and even confused in its treatment of war pensioners.
I shall not go into this matter in the detail that I might have done if we had had more time, but I ask the Minister to compare paragraph 141 in the Conclusions—which appears to state that war pensioners should continue to enjoy preferential treatment—with paragraph 83 in the main body of the report, which appears to say that war pensioners should not continue to enjoy preferential treatment with regard to the criterion of need. Whether Lady Sharp means that they should or should not have preferential treatment, it must remain true that some war pensioners, who are unable to drive cars and. therefore, can use only tricycles, 1255 are bound to be among the 13,500 who would be deprived of all mobility under her recommendations, along with thousands of National Health Service applicants.
Such deprivation of mobility for thousands of people I know that I only reiterate what has been said already, but it cannot be said too emphatically—whether on the ground that a particular vehicle which is the only one suited to them is to disappear, or that they cease to be qualified by the criterion of need, would be inhumane. It would also be intolerable on grounds of safety if, during and after the transition period—which itself will be at least five years—increasingly obsolescent vehicles were allowed to run on the roads until they either fell to bits or became involved in fatal accidents.
The Secretary of State has already said, and the Under-Secretary of State has confirmed, that that is unacceptable. It follows, therefore, that the three-wheeler must continue to be manufactured, and inevitably its unit costs are bound to increase as the demand for it diminishes. The question is whether there is any way out of this dilemma.
The Disabled Drivers' Action Group has made two suggestions in a document which I received today. The first is that much more attention should be given to trying to solve the problem of adapting the four-wheeled car, aimed eventually at eliminating all need for the three-wheeler. This would be an enormously expensive process, and, as it approached successful completion, unfortunately the unit costs of the three-wheeler would continue to rise astronomically as long as anybody needed it. I am afraid that that merely substitutes another dilemma.
The second suggestion is that cars should be provided as of right, with the alternative choice of a cash allowance towards a tricycle—in other words, a combination of the two alternatives which Lady Sharp advocates. However, the allowance would have to be much higher than the cost of the car and, once again, there is no escape from the dilemma of cost.
I conclude that there is no easy and cheap solution to this problem. That is an obvious conclusion. Therefore, the 1256 Secretary of State has no choice but to take the difficult and expensive solution —that is, the course of making cars the standard issue and keeping the three-wheeler in production for those who can use nothing else, despite the rising cost. Having been committed to this view for at least the past 10 years, I can only say that there is nothing in the Sharp Report which has caused me to change my mind.
§ 8.38 p.m.
§ Mr. Raphael Tuck (Watford)
I congratulate my hon. Friend the Under-Secretary of State on his maiden speech at the Dispatch Box, and my right hon. Friend the Secretary of State and my hon. Friend on the speed with which they have brought forward this report. It is something that is vitally necessary. I am glad that it has been brought forward today, and that we have had an opportunity to discuss it.
The House may know that in Watford there is a colony—Kytes Drive—of bungalows for disabled people who cannot walk and who are in wheelchairs. I have visited the colony and have been to all the bungalows. Without one exception, the conversation has always turned within three or four minutes to the three-wheeled vehicle. These disabled people are all—again, without exception—dissatisfied with the three-wheeled vehicle, for three main reasons. They say, first, that it is unsafe, secondly that if they take it to a garage to be serviced the garage "just don't want to know", and thirdly, that they cannot take their wives and their children, if they have any, with them on their journeys in their three-wheeled vehicles.
I associate myself with all the remarks made by the hon. Member for Banbury (Mr. Marten), by my hon. Friend the Member for Eccles (Mr. Carter-Jones), and by the hon. Member for Oxford (Mr. Woodhouse). Let me deal first with the safety aspect of these vehicles. The Motor Industry Research Association report states:As tested the Invacar model 70 tricycle did not meet the requirements of EEC regulations concerning steering system penetration when subjected to a 30 mph frontal barrier impact.Additionally, the requirements of the draft regulation on fire risks were not met, due to excessive fuel leakage from the fractured frontally mounted petrol tank.1257 It is generally agreed by the people who use these cars—and they are, after all, the people to be considered—that they are unsafe.
I need not stress the point about the garages not wanting to know. But there is the point of the drivers being alone. Loneliness or isolation is a terrible thing. Perhaps three times a week I go down to my constituency by car. When my wife cannot be with me I have an hour's journey there and an hour's journey back alone. I feel the loneliness just for those two hours.
I ask hon. Members to picture a man who has to be lonely all the time he is driving. The loneliness and isolation may drive him practically insane. My right hon. Friend and my hon. Friend are both compassionate. Look at the speed with which my right hon. Friend acted to rectify the matter when she found today that I could not act for two people in Watford before a tribunal because of a regulation. They will both understand the plight of people who are lonely and who are in their three-wheeled vehicles without either wife or children.
Next, there is one part of the Sharp Report that causes me grave concern. In paragraph 180 Lady Sharp divides people into three categories. The first two categories embrace those who virtually cannot walk at all. The third is those who are in employment but who cannot walk.
In paragraph 46 Lady Sharp says:It can be argued—and it has been argued to me—that every person who is so severely disabled that he or she is virtually housebound without a car, needs one just for the freedom it gives to get out. That would mean admitting all, or possibly all under a certain age, whose disability is sufficiently severe—on whatever test of this is adopted—who can either drive a car or find somebody to drive it.… I have not thought it possible to accept so wide a plea.In paragraph 51 Lady Sharp suggests:the disappearance of the present categories 1 and 2 of those eligible for assistance (i.e. those whose claim rests solely on the fact that they can virtually not walk at all); and the enlargement of category 3 (i.e. those with very limited walking ability who need a vehicle to get to and from work or to carry out the duties of a household).In paragraph 135 Lady Sharp goes on to say,Cars should be withdrawn when the purpose for which they are supplied no longer applies: e.g. when a car was supplied to enable 1258 a disabled person to get to work but he or she has ceased to work.I do not think Lady Sharp can be aware of what it means to be unable to get about. I am glad my hon. Friend has stated that he does not accept that part of the report. It would actually prevent disabled people who had previously had cars from having cars once their vehicle was finished and once they had ceased to work. I am glad to know that my hon. Friend does not accept that part of the report. It is not compassionate at all. But that still leaves people who are not yet in the category of disabled persons, but who became disabled, who want a vehicle, who are not working, who have no family, though they may have a wife, and who would be totally immobilised if Lady Sharp's proposals were put into effect.
Unfortunately, I have on my car a disabled person's sticker. I have painful arthritis of both hips and the spine. But I am lucky enough to be able to afford a car—perhaps I should say still to be able to afford a car—and I can use that car with my wife and get around when I want to. I depend entirely on it. I cannot walk very far without it, and if I did not have that car I should be practically housebound.
I do not think that Lady Sharp realises what it means to be housebound without the possibility of moving about. I am lucky now in that I have a job. I am a Member of Parliament and therefore I do not come into Category 1 or Category 2, but if I get worse and I cannot discharge my duties as a Member of Parliament, I shall have to retire. If I had no money, I should be housebound without a car.
This kind of thing can be frustrating; it can drive somebody almost mad. I cannot help thinking that if it had been Lady Masham who wrote the report instead of Lady Sharp, this provision would not have been inserted, because Lady Masham knows what it is to be immobilised, for she goes about in a wheelchair.
I ask my hon. Friend to consider this matter very seriously and not to accept that part of the report which dispenses with Category 1 and Category 2, because if he accepts that, he will be penalising many deserving people. They have no other life, they will be housebound and 1259 able to do nothing whatever. All the hope they have is to get about in a car. If that car is taken from them, we shall be very guilty indeed.
§ 8.47 p.m.
§ Dr. Michael Winstanley (Hazel Grove)
I hope that the hon. Member for Watford (Mr. Tuck) will forgive me if on this occasion, in the interests of brevity, I do not follow his interesting remarks. Nor will I deal with some of the points made by the hon. Members for Banbury (Mr. Marten) and for Eccles (Mr. Carter-Jones), with whom I have had the pleasure of working on this subject in the past and with whom I so strongly agree on this subject and, sometimes, on others.
On this occasion I can absolutely guarantee that I will not make a long speech. I am suffering from a minor disability—a complaint called phlebitis. I mention that to show that doctors are just as delighted to talk about their ailments as anybody else. But the medical advice I have received is to avoid long periods of standing. I shall follow that advice and sit down quite soon, but perhaps I might say in passing that an occasional intervention might not be unwelcome.
§ Mr. Raphael Tuck
Surely if the hon. Gentleman has phlebitis it would be in order for you, Mr. Deputy Speaker, to allow him to sit down while he is making his speech.
§ Dr. Winstanley
I prefer not to have any special dispensations on this occasion.
I join hon. Members in welcoming this report and this opportunity to make some progress on what is an important and difficult matter. I join other hon. Members in thanking and congratulating Lady Sharp on her report and thanking all others who have given her advice and assistance in compiling the report. We all await the Government's proposals.
In that connection I quote the right hon. Lady's statement to the House on 25th March, when she said that the Government willconsider the recommendations in the report alongside their study of cash benefits for the disabled.She went on:we will discuss the questions raised by the report as well as the wider questions of the 1260 priority to be assigned to the various needs of the disabled of which mobility is one, with organisations representing the disabled, as well as with local authorities, the medical profession and others interested."—[OFFICIAL REPORT, 25th March 1974; Vol. 871, c. 31.]We are some of those others interested. I hope that in due course it will be seen that the Government's final proposals owe something to what we say here this evening.
I want to say a few words about the philosophy which should underly our thoughts on matters of this kind. Our aim should be, not to compensate the disabled person for his disability, not to award him a car as some kind of bonus so that he will not feel quite so bad about being disabled, but as far as possible to neutralise his disability so that he seems almost to be without it. Mobility is crucial to normal life and our aim, therefore, should be to enable the disabled person to move about his home, to travel to and from work and at work, and to get around the district in which he lives for leisure and recreational purposes as well.
§ Mr. Ernle Money (Ipswich)
Does the hon. Gentleman agree that all of this of its nature must be only a step on the way to a full disablement income?
§ Dr. Winstanley
I agree with that, and we have heard one or two things already that suggests that perhaps we shall take certain steps along that road, and I would certainly accompany the hon. Gentleman along that road myself.
The provisions of the Chronically Sick and Disabled Persons Act—I am proud to have been one of its sponsors with the Under-Secretary—are slightly different. For example, we award a telephone to a disabled person, not for the disabled person to be able to summon aid in some terrible emergency but to enable him to widen his horizons and improve the quality of his life. Here we are enabling a person to move around who could not otherwise do so, and we are thus enabling a person to live a normal life rather than compensating him for not being able to do so.
I turn now to some details of the report. First, the proposal that cars should replace the three-wheelers is obviously right. The reasons given by the noble Baroness are that cars are 1261 cheaper, safer and, to most people, preferable. It will be costly, and it will take time. We should, therefore, encourage people, where possible, because of the time factor to take advantage of the proposal in paragraph 136 of the report to take a cash allowance for the conversion and running of their own cars. That right—and I hope it will become a right in the fullest sense—must he made widely known. I shall turn to the question of publicity later.
The Automobile Association has published a report today saying that the cost of motoring in this type of car is roughly £800 per annum, so we are not discussing a very generous provision.
I come to the consequential question of what to do with the tricycles. Obviously they must be phased out in part as they are replaced by cars. I say in part, because there are some who will still wish to keep their tricycles. On the question of safety, my personal observations tell me whatever may be said by some other distinguished observers, that in the way in which these tricycles are used, the kind of people who use them, the circumstances in which they use them and the places in which they use them, they can sometimes be regarded as safe.
I agree that we should do nothing to deprive anyone who now has a vehicle of a vehicle. But, if it suggested that these tricycles are not safe in all circumstances, we should be starting to do something now to make them safe by attention to steering and to the petrol system. We should also start to pioneer and develop a new and wholly safer model. There will always be room for a vehicle of that kind for some people who would prefer it.
Another matter, which has been responsible for most of the resentment and frustration, is the category of entitlement. At present one cannot talk about widening the category, and I accept what has been said about priorities, but within that context we must underline the provisions for disabled passengers. These unfortunate people are unfit to drive but are fit to work. They have failed in certain cases in the past to obtain any kind of provision merely because they are too severely disabled. We have to deal as firmly as we can with these people.
1262 Within the context of those brief remarks I move on to mention two needs which may seem to be contradictory. There is, first, the need to spell out clearly whatever are ultimately to be the categories decided upon. In my experience a great deal of unhappiness results from people misunderstanding the categories, people applying who should not have applied and who are ultimately disappointed, and people who are led on to a path that they should not have embarked upon at all.
We are now recognising that we must explain people's rights to them. I speak from personal experience. We see changes in other Government Departments—for example, changes with regard to supplementary benefits. At long last, we explain the entitlements to people.
In that connection, the House may be interested to hear a quotation from a letter written by a distinguished previous Minister of Health, Mr Kenneth Robinson. to the former Member for Orpington, Mr. Lubbock, as he then was. This was on the question of making known the categories of entitlement, and these were Mr. Kenneth Robinson's words:The conditions of eligibility are not set out in a document issued to the general public. Ultimately eligibility depends always upon the clinical decisions of medical specialists. The wide variety of physical conditions and other factors that might influence eligibility would call for a document of such complexity that potential beneficiaries would be confused by them.Times have changed. We must risk the confusion and make the categories utterly clear to people so that those who might benefit indeed do ultimately benefit and so that they do in fact apply. That is one of the needs—to spell out clearly what are to be the categories so that there can be as little doubt as possible.
Having said that we must spell out the categories clearly, I say also that there is a need to provide for discretion. I believe we cannot define these categories so exactly as to avoid the possibility of injustices and hard cases. I believe that there has to be a discretionary element if the whole scheme is to work fairly. I know that the hon. Gentleman's Department recoils from being given the responsibility of exercising discretion, but I believe that on this occasion it has to 1263 accept that responsibility, because I think that it will prove to be necessary.
Finally, on priorities, there is obviously a need for some limitation. But are we to limit by restrictive categories or otherwise? My view is that we should keep the categories as wide as possible but also have regard to the whole social background of the case. Many who qualify may not need help and they should not have it forced upon them if they do not ask for it. People should not be encouraged to have vehicles if they do not ask for them. I think that the disabled should aim at being, and believing themselves to be, wholly normal Therefore, it is perfectly right in this field to look at the whole social background to each case. It seems that we may be beginning to think about that, and doing that may move this whole business rather more to the social security side of the hon. Gentleman's Department than the health side.
That brings me to some anxieties which have been expressed to me by medical colleagues working in the disabled vehicles service. They apparently fear that the whole invalid vehicle service is to be handed over to the social security branch of the Department, to the War Pensions Branch at Norcross. Indeed, I am told that a circular letter to that effect by Dr. Seelig of Roehampton has been sent out. It may be that if the criteria are to be kept wide, or even to be widened, regard will have to be paid to the whole social background. Therefore, the right hon. Lady's social security branch may be the right people to do that. But the doctors and the health department will inevitably have to play a very large part in assessing individual cases. I hope, therefore, that the right hon. Lady will be able to reassure the doctors and others who now work with the artificial limb and appliance centres that they will still have a major part to play in this important work.
I am very glad to join hon. Members on all sides of the House in welcoming this report and in urging some speedy progress on it.
§ 8.58 p.m.
§ Mrs. Elaine Kellett-Bowman (Lancaster)
I am very glad that the noble Lady, Lady Sharp, was wise enough to 1264 make full use of the very wide discretion given to her in her terms of reterence to deal with many aspects of disablement which have received far too little attention.
The part of the report relating to vehicles has received by far the greatest publicity, but I personally attach enormous importance to her section on mobility in the home. It is not just a question of building new homes for the disabled, although local authorities now have a statutory obligation to include reference to this aspect in all new housing projects put before the Minister. The problem looms large also in the adaptation of existing houses, as people with advancing years acquire new disabilities. Often the adaptations need be only slight.
I have been startled at the number of people coming to my surgery whose only requirement is that they should be able to get to the toilet. There are people with circulatory disabilities who have become double amputees and have to wear heavy trusses and cannot get to the toilet as it is at present. There are people living in older properties, which are about to be modernised, who can get to the toilet where it is now, but who will not be able to get to a "loo" upstairs. These may seem small details, but they make all the difference between enabling a man or a woman to feel independent, and on the one hand, almost as a child in the household, on the other.
There is, too, the important question —important in my constituency with its many steep streets—of ramps up steps leading to houses, whether council or private. It is important that further research should be made into electrically-powered wheelchairs without an attendant, for use outside. I have seen many of these chairs in action inside and have been much impressed by their present state. I am convinced that, with a little modification, they could be used to give much greater independence to people who cannot use a car.
Like most reports, the Sharp Report is a bit like the curate's egg, because there are parts of it that I dislike intensely. One part which I dislike is in paragraphs 45 and 46, which would restrict the category of those eligible to have a vehicle. If that provision were adopted, it would be a deplorably retrograde step. 1265 I welcome the provision to allow a disabled non-driver to have the mobility that would be given by a vehicle, but I also believe that we must not allow the "trike" itself to go into disuse.
I have had a number of teenage children—I hardly dare mention the number after World Population Year—and I know only too well how much mobility matters to youngsters of 16. They can be inhibited for life if they cannot be mobile at a time when their friends are leaving school, going to parties, social clubs and so forth, and are caged within the walls of their house or dependent on older relatives to take them around. I think it extremely important that we should retain the tricycle for youngsters of 16 or those who have not, perhaps, the confidence to pass the test for another vehicle.
But I welcome the report in general, and trust that the House and the country will be generous in its implementation. Personally, I would rather see the money used specifically to help the disabled than go towards taking 5p off the price of cheese. We could implement this report twice over in that way, and I believe that we have got to get our priorities right and give to those to whom life has dealt a hard blow a chance to take their normal place in the community, as all of us here are fortunately able to do.
§ 9.4 p.m.
§ Mr. George Rodgers (Chorley)
Lady Sharp is to be congratulated on the clarity and precision of her report, the more so since the necessary background information was not always available. It still astonishes me that there is no precise record of the number of disabled people in the country, and it is apparent from the report that a number of people entitled to provision under the existing Act were not aware of the situation.
However, to admire the quality of the report is not necessarily to approve of its conclusions and recommendations. I cannot accept or approve of the paragraph referred to by other hon. Members in the conclusions, which says:Severe physical disablement should not in itself entitle any NHS applicant to a car. This should depend, in addition, on the need of the disabled person for a car in order, broadly, to maintain him or herself and the family or to contribute to their support.1266 To implement that proposal would be to deprive many, who are already the victims of very tragic circumstances, of their lifeline—very often a lifeline to dignity and normality. That criterion is narrow and without vision, and is almost commercial in its concept.
It has been suggested that individual cases should not be mentioned, but disability is what the discussion is about, and I hope that hon. Members will forgive me if I refer to one gentleman in my constituency who has suffered amputation of both legs. He has had 48 operations, and as a result of his severe disability he is not able even to wear artificial limbs.
The position in that household is that the wife is a nurse and works permanently on nights in order to maintain the family. The total income of the family, incidentally, is less than £23 per week. Because one of the lunacies of the family income supplement scheme is that the male of the household must be the wage-earner, the wife, whose circumstances force her to take on this responsibility, did not qualify for this supplement.
That is the situation. The man is without legs. The family has a very modest income. There are two children to provide for. The husband can make no contribution financially. He cannot even take part in the decorating of the house or the gardening. The one consolation in these bleak circumstances is that the Ministry has provided a car, which enables the family to venture out occasionally. Obviously, they cannot do that very frequently, but it enables the man occasionally to savour some dignity and responsibility.
If Baroness Sharp's proposal were accepted, even that tiny area of consolation would vanish along with the vehicle. How can we measure a loss of this nature? I do not know. Certainly, a car can provide those intangible aspects such as simple happiness, and freedom to move about. This must be a powerful factor in our considerations and calculations.
Too often, it is not just the disabled individual who suffers but the whole family. In fact, stress and depression are the constant companions both of the parents of the disabled child and children of disabled persons. Last week, I came across such a case quite incidentally in 1267 my constituency, when a youngster, certainly no more than 13 years of age, unburdened herself to me, a complete stranger. She described how her father was suffering from a wasting disease, a terminal complaint. She was upset because her mother had been angry with her father, and occasionally her father was vexed with her mother. Of course, this happens and, of course, the tensions spread to the children. We have no right to assume that, because people are disabled, they are saints or heroes. They are subject to all the pressures and stresses that this unhappy situation brings about. I am grateful for my hon. Friend's response to that suggestion in Lady Sharp's report. We must, in fairness, bear in mind that Lady Sharp was restricted by her terms of reference.
I appreciate that, if we are to make wide provision, there will have to be substantial expenditure. I could suggest economies in directions where money is lavished and where disablement might well be a consequence of that extravagance. But even if the programme is to be financed by more orthodox means, if it means a penny on a pint or a copper on income tax, this is surely a triviality to anyone who is fortunate enough to enjoy the luxury of good health and reasonable wealth. It should, indeed, be a privilege to contribute towards relieving the burden on our less fortunate brethren.
I believe that people are reasonably decent, and, if they are approached, consulted and advised, they would respond and be prepared to pay to meet this situation. I honestly think that we should be astonished and delighted at the response that such an attitude would bring.
§ 9.10 p.m.
§ Mrs. Lynda Chalker (Wallasey)
I welcome this opportunity to add to the comments and congratulations on Lady Sharp's far-reaching report. It does have some drawbacks, to which reference has already been made. I think that the hon. Member for Eccles (Mr. Carter-Jones) probably put it most forcefully when he talked about the potential removal of eligibility from the 13,500 people today, next year, the year after and so on, who might lose their vehicles and their entitlement.
1268 We often talk about the possibility of life after death. I hope that there is a life after retirement. But for disabled people there will not be a life after retirement if they do not have their cars. I know that many of my constituents who are getting on in years still get around remarkably well with the help of their "trikes". Work is practically their only outside contact. They beg me to go and see them more regularly, because it means a friendly face for them to see. I am sure that this happens throughout the country, week in and week out.
I sincerely hope that, if these vehicles were removed at all, they would not be removed from retired people. That would be to deny a life after retirement for a large section of our population who still have much of the life and good will in them that keep other younger disabled people going, and who have shown the way on so many occasions.
When I spoke in the House six weeks ago, I spoke very critically of the "trike", and I still am exceedingly critical of that vehicle, if it can be so called. Research into a new car needs to be speeded up if we are to continue to have a smaller vehicle specially designed.
But I welcome Lady Sharp's recommendation to move to the conversion of other cars, and not only to the Mini. There are many people, not necessarily large, but with particular hip disabilities, who simply cannot swing a leg into a car unless the door is sufficiently wide. Not only have we to adapt these cars for the people who so badly need mobility, but we have to improve forthwith, not waiting for a Government report, the safety measures on the P70. As many hon. Members have done, I have sat in one, started to drive, and been too frightened to go ahead.
Those are the problems of the "trike". We have heard a lot tonight about this aspect of physical mobility, but I want to turn to other aspects which, I regret, are mentioned only briefly in the report—mobility in the home and mobility for the housewife. Only four paragraphs under the heading of "Housing" in the main report really refer to this aspect.
During the last few months, I have become more and more familiar with the problems of disabled housewives simply 1269 in going into a kitchen and not being able to come out of it forwards, but having always to reverse out because there is no room to turn round the wheelchair. It may be due to the siting of domestic appliances, but in the main it is due to the type of property. If such disabled housewives are in council property, it is sometimes possible to move them to another place. If they are in their own property, which is often the case when they have become disabled later in life, a move is usually not financially possible.
We come, then, to one of the most tragic situations today—the problem of alterations to existing homes to accommodate people who become disabled after moving in. It is particularly acute where it is their own home. It seems to me utter nonsense, although I welcome and will always push for home improvement grants—I hope they continue at the 75 per cent. level—that a family who are able-bodied get an improvement grant whereas, to convert some part of a house for somebody who is disabled the money available is usually very much smaller. It is exceedingly difficult to get the large grants which are sometimes needed for alterations to existing homes. I am speaking here particularly about toilets.
If the toilets are outside—meaning on the ground floor—they are nearly always up a step, or they may be down the back steps. Such steps are probably steep and unable to take the normal ramp because of their height. That problem can sometimes be skilfully overcome by borough architects. But often there is no provision or no possibility of having a ground-floor toilet or washing facilities such as a shower.
Money should be turned to the provision of a mini-elevator on the stairs. I know that it is not a cheap appliance, but I believe that it would enable some of the disabled to lead a more normal life, when they could sit on a little seat and be hydraulically drawn up the stairs, actually sleep in a normal bedroom and go into their bathrooms on the higher floor. It would probably work out cheaper than the conversion of a ground floor room or an extension built on to a house to enable the disabled to look after themselves with due care, but without all the strains imposed by their present 1270 mode of life. Finally, on the subject of housing, I want to comment on the placement of disabled and handicapped persons, and the chronically sick as well, in public authority housing. Parking distances from front doors are often a source of considerable fear and a problem for disabled persons. If their vehicle has to be left any distance from their front door, if it is not kept in a secure garage or is where they cannot see it, problems arise.
Most local authorities attempt to house disabled persons on the ground floors. In public sector housing there tend to be a lot of children playing in the area, and I regret to say that many children today have no respect for anything, let alone a disabled person's vehicle. Many of my disabled constituents are suffering from increasing vandalism, for they cannot put their cars anywhere near their own front doors because of local authority restrictions.
I hope that the Under-Secretary will find a way to influence local authorities to give the disabled more mobility from their front doors. The siting of disabled people's homes and the provision of home amenities are only part of the story. The disabled must be able to get about locally. They must be allowed to live as normal a life as possible. The intentions on both sides of the House are the same. I hope that we make sure that we have no idiotic schemes of spending that prevent our giving the maximum encouragement to disabled people to live their lives to the full.
§ 9.18 p.m.
§ Mr. Sydney Tierney (Birmingham, Yardley)
This is the first time that I have had an opportunity to speak in a debate on this subject, and I say straight away that I am impressed with the concern and sincerity shown on both sides of the House.
We have a controversial report before us on a controversial subject. It must be controversial because of the many needs of the disabled. There are many arguments and many interests which tend to indicate that there is no overall single solution to the problem and that there is something to be said for the various representations made by the interested parties about their needs.
1271 There is evidence available that ordinary cars—four-wheelers——adapted as necessary for use by disabled drivers should now replace three-wheelers. I agree that ordinary small cars ought to be introduced for those who want them and are able to use them. Apart from any other factor—safety, for instance, which, although important, must not be exaggerated—the ordinary small car has advantages in that it would carry passengers, which is most important, whilst for the disabled who cannot drive and do not want to drive the ordinary car offers a chance of extended mobility.
Although adaptations can be made to the ordinary small car at a cost, I am convinced that if three-wheelers were withdrawn, even gradually, a great number of disabled people who are mobile at present would be deprived of this facility. If vehicle provision were to be generally extended as it should be, the ideal situation might well be that the provision of ordinary small cars and three-wheelers would grow in numbers. One of my constituents tells me that at the moment he cannot envisage an ordinary small car being more advantageous to him in a situation where he uses a chair to get him in and away from his three-wheeler vehicle. No doubt there are many others.
One of the arguments in favour of the ordinary small car is that the user will be less conspicuous. Another of my constituents tells me that recognition, or being conspicuous, is important, especially when police allow him to drive into shopping precincts and park whilst he goes into the shop, in areas where other vehicles would not be allowed. He believes also that an ordinary small car would not meet the requirements the three-wheeler affords him at present in sliding-door and sliding-seat facilities.
The arguments go on, they are varied, and decisions will have to be made. I believe that it will be fatal to insist that the provision of the ordinary small car is the complete answer to the problem. The three-wheeler will continue to meet the needs of many. I am glad that there appears to be general agreement on that matter.
I am concerned about the servicing, maintaining and adapting of invalid car- 1272 riages. At present there are about 130 approved repairers in this country who are all agents to the Department. There is a danger that large car manufacturers will begin to distribute the four-wheelers and eventually to service and maintain them. If this happens there is every possibility that many repairers will become commercially unviable. This could result in a severe curtailment of servicing facilities for those who would still have to drive invalid carriages and for the many thousands of invalid chair users. Obviously this is a danger.
Over the years the approved repairers have built up considerable expertise, not only in the technical aspects of the trade, but in their human relationships with the disabled. They know the personal needs of those with whom they deal. Such specialist knowledge of the requirements of disabled people is of paramount importance to the well-being of the Department's patients.
There is general agreement that changes must occur, but, because of the introduction of the four-wheeler, I hope that the present system of repair, servicing and adaptation is not disturbed to the extent that many disabled persons will be seriously inconvenienced in their desire to be mobile. My hon. Friend the Member for Watford (Mr. Tuck) said that the ordinary run of garages do not want to know when it comes to servicing the type of vehicle with which we are concerned.
It is important that the skill and techniques, in both technical and human terms, of employees in the trade should not be lost to the Department. It is also important that the service be retained to avoid the dislocation and possible loss of jobs in the existing repair service.
I know that my hon. Friend the Under-Secretary of State with special responsibility for the disabled will give serious consideration to all the points that we make in the debate.
§ 9.25 p.m.
§ Mr. William Ross (Londonderry)
The Sharp Report is, on the whole, a wise and constructive statement of the problem—a problem that the average person notices only when he meets a wheelchair on the footpath or sees a three-wheeler on the road. The general public are also 1273 only made aware of the problem at a time such as the publication of this report.
I agree with the conclusion that mobility, although important, is not necessarily the most pressing need of the disabled person. A house—indeed, a whole environment—properly designed, would be a far greater boon to the majority of the handicapped. More must be done in that direction. However, I agree with the conclusion that progress has been made, and is being made. There is no doubt about the finding of the report that houses which are suitable for the able-bodied as well as the disabled are possibly the cheapest and easiest way around the problem in many cases, but by no means all.
Sliding doors would be an advantage to housewives in wheelchairs, as would windows with catches low down so that they could open them, and cupboards at a reasonable height. I know one lady confined to a wheelchair all her life who manages to provide bed and breakfast in her bungalow. She is to be commended.
In paragraph 103 of the report there is a reference to the difficulty in recruiting skilled staff, such as physiotherapists, to deal with the problems of the disabled. A standard of pay in Keeping with the skill and training of such staff would go a long way towards solving the problem.
The powered wheelchair could have a ides application than it has now, urge the Minister to have a close look at this means of keeping the disabled mobile.
Speaking of mobility, I must confess to being rather startled to find that it is reckoned that about 13,500 people at present receiving three-wheelers would be left out in the cold under the report. We should try to keep disabled people mobile and not restrict them to fireside chairs. I trust that that part of the report will not be accepted.
I am also concerned that no grant is payable to those who w[...]sh to convert their own car. Such people are generally those who have a job and who wish to continue with their work, and they generally fall into Category 2 or 3. I press on hon. Members the needs of these industrious but unfortunate members of society, and ask that such people should receive a grant for conversion. They 1274 generally need hand controls which are rather costly, to say the least, but those controls cost a great deal less than the car which would be supplied to those people if they did not have a car of their own.
No one will quibble if those who can drive without conversion to their vehicles receive £125 rather than £100 plus vehicle excise duty, but that sum should be increased in view of the greatly increased costs of motoring, and should be reviewed at frequent intervals.
The help available to the disabled should be given wide publicity, so that those who are eligible know of it. It is evident from the report that many people who are entitled to help do not receive it, because they do not know of their entitlement.
Some people are putting forward the claims of the 850 c.c. Mini automatic or the small Daf for the use of the disabled. I drove a Daf once; a fellow was trying to sell it to me. I cannot offer an opinion on its suitability after one trial. In any case, I prefer British cars, because they are much easier to come by, and spare parts are always available. But in my experience the 850 c.c. Mini automatic seems to spend all its time changing up or down. Not everyone lives in a flat part of the country. We should opt for a rather larger engine.
The care and maintenance of all vehicles used by the disabled should be undertaken only by garages of the highest standards of competence. We dare not have low standards of workmanship on such vehicles.
I agree with the hon. Member who said that vehicles for the disabled should be recognisable on the road. That is essential.
In so far as some people have to carry their wheelchairs with them, perhaps examination should be made of the possibility of using small vans or vehicles of the station wagon type rather than cars, as they might be more suitable for carrying a wheelchair.
We should give our disabled folk as much help as the financial state of the nation can allow.
Like the hon. Member who spoke earlier, I have a constituent and personal friend who lost both legs and who has had 50 or 60 operations. He also lost two fingers. Such severely disabled 1275 people should be an inspiration to other members of the community, because we do not hear the disabled moaning about their condition. They are usually cheerful people, who do the best they can. They deserve the support and sympathy of this House.
§ 9.30 p.m.
§ Mr. Ernle Money (Ipswich)
I am grateful for the opportunity of contributing to the debate, if only briefly. I apologise to the Minister for having missed his introductory remarks. I wish to make only two points.
The whole House accepts that it is a major breakthrough to have got this far. We all pay tribute to people like my hon. Friend the Member for Banbury (Mr. Marten), who battled so long and so stalwartly on this subject. The one thing which gives cause for concern to all of us who have watched the broadening of the categories involved is the uncertainty which exists about the position of a disabled individual or disabled family in respect of their entitlement.
We have broken through from the days when only the war disabled were entitled to four-wheeled vehicles. We have come slowly through to the development of certain categories of disabled employment. A major battle was won on behalf of haemophiliacs by my hon. Friend the Member for Oxford (Mr. Woodhouse). Even today the situation is exemplified by the urgent pleas from all quarters of the House concerning those disabled people who still need the three-wheeler and the position of the disabled passenger.
Every hon. Member knows how agonising it is when a disabled family comes to a surgery and ask why they are not entitled to the form of mobility that will make all the difference to them. My plea is that, when legislation is brought forward on the basis of Lady Sharp's report, or based on the conclusions which the Department reaches, the categorisation of those who will be entitled to help should be made very clear. If it is not, there will continue to be uncertainty and misery will be caused to large numbers of people who do not know where they stand. Many hon. Members will have found one of the most shocking things in the entire report to be the fact that at 1276 present many of those entitled to claim for help do not do so because they do not know of their entitlement. Can the situation be made abundantly clear?
I echo the moving pleas made by my hon. Friends the Members for Lancaster (Mrs. Kellett-Bowman) and Wallasey (Mrs. Chalker) about mobility in the home. Although this takes up only a small number of paragraphs in the report, I know that it is given great weight by Lady Sharp. In many ways she regards it as being among the most important of the tasks she had to consider.
I know that the Minister has this point in mind because he has discussed it with the all-party parliamentary disablement group and other groups. I know that he wants to improve existing facilities for home mobility and to co-ordinate them with building styles and techniques so as to mould these facilities together. We are all aware of the problems of many of our constituents with electric plugs that are not within reach and baths that are impossible to get into. These are the things that make it impossible for disabled persons to lead the normal life to which they are entitled and which with a little thought could be provided.
§ 9.34 p.m.
§ Mr. Timothy Raison (Aylesbury)
In spite of the doubts expressed by my hon. Friend the Member for Banbury (Mr. Marten) and the Minister, we can claim that this debate on this brilliant but in some respects rather controversial report has been fully justified. It is fair to say that every speech has contributed something worth while and has helped to establish some kind of consensus which I am sure the Minister will find of real value. It is true that we have elicited nothing from the Minister so far in terms of solid commitment or promise on the topic of the report.
The Minister argues that the whole question should be tied up with the question of the overall cash aid to the disabled. As I understand it, he will be making an announcement taking these two things together in due course. I am not sure that I fully accept his logic, and I do not think that Lady Sharp accepted it. There are indications in the report that she regarded the question of the 1277 mobility of the disabled and the disability income as being separate. In paragraph 68, she said:If the disabled have a case for help in meeting travel costs, it seems to me part of the case for disablement income which is a separate matter.In other words, she seems to indicate that there is a division between the two. I am not sure that I do not agree with her. Nevertheless, we respect the right of the Minister and the Government to bring forward their proposals together.
There is only one point on which I would cavil at the attitude of the Minister. It is about the terms of reference. The Minister said that in his view the limitations imposed on Lady Sharp in the terms of reference caused her to have an almost impossible task. That is not fair. The terms of reference said that she should have regardto the help in cash or kind which the available resources permit or could permit from the various agencies with responsibilities for such persons.In other words, she certainly was asked to consider the resources situation. But I do not believe that it ever does any harm in any of these problems to bear that in mind. After all, we can perfectly well say that Lady Sharp's view on how resources can be best used is not acceptable to us, but that she has given us the facts and the argument which can provide the basis for our judgment. So on that point I do not agree with the Minister. But it is fair to say—I believe that the Minister will accept this—that the House is forming a general view about the Sharp Report.
I should like briefly to pick up what seem to me to be some of the principal ingredients in this matter. The House is unanimous in being attracted by Lady Sharp's idea of there being a need for non-drivers equal to that for drivers. That point has been accepted by all. Equally, the House is not happy about Lady Sharp's restriction in the criteria that she put forward. Speaker after speaker in the debate has expressed his or her unhappiness about the idea that we should say to people who have vehicles that they can no longer have them or, indeed, perhaps, that their successors in similar circumstances will not be able to have them.
1278 I am not quite sure how far the Minister's pledge on this matter goes. He says that no one will lose his vehicle. I am not quite clear that he extrapolates that into the future. I am not clear whether he is saying that no one in future will be limited by the criteria that Lady Sharp laid down. I shall be grateful if the hon. Gentleman will clarify that point.
What of the other points which came over strongly? One or two hon. Members—certainly one of my hon. Friends—raised some doubt about whether it needs to take quite so long to provide cars as Lady Sharp seems to indicate. She said that it would take four or five years, or even longer, to produce 40,000 small cars. She also points out, very fairly, that adaptation would take time. But I wonder whether it would take as long as that and whether it is beyond the capacity of our admittedly somewhat erratic motor-car industry to produce this number of vehicles. We should take note of the question whether the cash alternative might be used to accelerate the provision of these vehicles.
There was naturally much concern about the proposal to cease the supply of three-wheelers. Among some of the experts there is still a big difference of opinion on this matter, but I largely agree with the Minister on this subject. I think that the whole House agreed with him. My hon. Friends the Members for Oxford (Mr. Woodhouse) and Lancaster (Mrs. Kellett-Bowman) put forward very strongly the case that it would be quite wrong to cease provision of the three-wheeler. It was said with great force that it would be a great hardship to 16year-olds who are at present able to drive to work with the aid of these vehicles and who would not be able to do so in future.
There is a serious fear on the part of some who have these vehicles about the consequences of being deprived of them. I want to quote a few lines from a letter on this subject which was sent to one of my hon. Friends by someone who falls into this category:The report on Mobility of Physically Disabled People came to me as a great shock. While it is indeed good to consider replacing the three-wheeler with a four-wheel car, it is a dreadful thought for those who will not be eligible for such a car, that their present three-wheeler will he phased out. To many of us these tricycles are a lifeline, giving us the 1279 means to live a normal life and integrate into society. Only those who have experienced being housebound will know fully what this means. I am sure that if such a retrograde step be introduced mental illness among those affected will increase dramatically, thus causing more expense to the State than would the provision of a motorised vehicle.That letter sums up a view which has come over strongly in this debate.
Also, we must ensure that if cars are provided, they should be provided in such a way that they will fit all shapes and sizes of people. This point was well made by my hon. Friend the Member for Wallasey (Mrs. Chalker). I recently met a disabled constituent who is 6 ft. 2 ins. tall and finds it hard to squeeze himself into his Mini. I suppose he is lucky to have a car, but he experiences difficulties each time he wants to go out. Therefore, the question of the size of vehicles should be examined.
The debate has touched upon the question whether a car should be provided or whether there should be a cash alternative. My hon. Friend the Member for Banbury strongly argued the case for a cash alternative. He said, quite rightly, that the system would be quicker to operate, it would help to meet the need for different shapes and sizes of people, and it would keep the Civil Service out of the operation. He also argued—though perhaps more controversially—that this is a more easily means-tested way of operating. I do not agree entirely with my hon. Friend on his last point, but I believe that there is a strong case for preferring a cash alternative if it is remotely possible.
I do not think the doubts put forward by Lady Sharp in paragraph 58 of the report are altogether persuasive. It seems to me not all that difficult to check whether cash has been spent on buying a car. Lady Sharp argued that there would be problems in finding out whether the people concerned used the money for the legitimate purpose of buying a car. Surely, when one considers log books, receipts, and so forth, that would not be a very difficult problem.
Lady Sharp also argued in her report that it might be difficult to judge what the appropriate sum should be. I have no doubt that there would be a great deal of argument, but the fact that something causes a little argument should not be used as a reason for not doing it. If politicians were to take that view they 1280 would have a pretty miserable life and would get nowhere. Conservative Members have been much more sympathetic to the cash option than was Lady Sharp in her report.
This debate has been useful, since it has concentrated on major questions involving vehicles, but it has also produced one or two extremely good contributions on other aspects of mobility, in connection with the household, and so on. Two points have been put to me by Dr. Walsh, Director of the Spinal Injuries Unit at Stoke Mandeville, which is in my constituency. That unit has a right to speak on this subject in a way that can be claimed by no other institution in this country. Dr. Walsh is unhappy about the Department's decision—I do not blame the right hon. Lady the Secretary of State for Social Services, because this happened before her time in office—to stop supplying the Everest and Jennings wheelchairs, which are made by a subsidiary of an American company. Admittedly, they are more expensive than the alternative chair, the Esse.
Dr. Walsh says that the chair now favoured by the Department, although built to its specifications, is uncomfortable and unpopular with patients. He argues that the chair is quite useful as a cheap fall-back for intermittent use but that it is not acceptable for permanent full-time use. He also says that he does not accept that the supply situation for the Everest and Jennings wheelchairs justifies this switch. I understand that that is the argument which has been put forward.
I do not expect the Minister to answer these points immediately, but I hope that he will consider them to see whether the right decision has been made.
Perhaps the hon. Gentleman will also consider one other matter relating to the supply of wheelchairs to people who need them both at work and at home. I understand that in the past it was possible for people to have supplied to them two wheelchairs—one for use at each place. It was argued that there was some abuse of this. I do not know the details, but apparently it has become the practice to stop allowing people a second wheelchair at work. It does not take very much thought to realise that this can be a serious problem for people who obviously have this double requirement. I hope 1281 that the Minister will find time to see whether this policy is being administered as sensibly and in as enlightened a manner as possible.
This debate has proved well worth while. At the end of it we can say that a fairly clear consensus has emerged about the House's view on this extremely important subject. We look forward to the Minister's reply and even more to some rapid and effective action.
§ 9.47 p.m.
§ Mr. Alfred Morris
With the leave of the House I shall attempt to reply to the many matters raised by hon. Members in this brief debate.
I feel a little like the melancholy old man of 70 who was given a 20-year gaol sentence. He pointed out to the judge that at his age he could not possibly serve 20 years, only to have the judge tell him to try his best and to serve as many as he could. I shall do my very best to answer as many as possible of the questions which have been asked of me.
We have heard powerful speeches from hon. Members on both sides of the House. The hon. Member for Banbury (Mr. Marten), whose distinguished service to disabled people is recognised on both sides of the House, feared that I was in danger of being a poacher turned gamekeeper. I am sure that he will agree that I am a rather improbable gamekeeper. I share that improbability with the hon. Gentleman. I have to confess that I am still poaching, perhaps not quite so publicly, but still with as much energy as I can muster.
§ Mr. Morris
My hon. Friend the Member for Eccles (Mr. Carter-Jones) said that he hoped that he would not lose my friendship if he continued to press for more research and development in the service to disabled people. The contrary is true. My hon. Friend will increase and compound my regard for his efforts on behalf of disabled people if he continues to emphasise the importance of research and development.
The right hon. and learned Member for Surrey, East (Sir G. Howe) raised a number of matters in detail. I had hoped that it would be possible for me to reply to them all. There are some to which 1282 I can reply now. However, I shall have to write to him about others. I shall do so as quickly as possible, and I shall provide as much information as is available to me.
The right hon. and learned Gentleman asked me how many recipients there were of the vehicle service at the age of 16 years. We do not have immediately available the number of present recipients at that age. I think we can find out and write to the right hon. and learned Gentleman in the near future.
The right hon. and learned Gentleman asked me about the residual demand for three-wheelers. If cars were available, it is not possible to say how many would still wish to retain the three-wheeler. It might be that 80 per cent. could manage a car, which would leave 20 per cent. That is only a surmise.
I was asked about the faults found by MIRA. I take this opportunity to say that all model 70s will be withdrawn to have modifications made to their petrol tanks.
I was asked about possible cost. The right hon. and learned Gentleman will know that Lady Sharp mentioned the figure of an additional £12 million in paragraph 41 of her report. That is only a guess, and excludes persons over the age of 70. The cost is possibly higher, and Lady Sharp admits that it may well be higher. If 125,000 disabled passengers—that is one guess—were to be included, the cost would be between £20 million and £25 million.
§ Mr. Morris
That would be additional, as my right hon. Friend reminds me. However, I must emphasise that all these figures can only be guesswork. How are we to know, for example, what the number of nominated drivers would be if we said to those who are too severely disabled to drive that they could nominate others to drive for them?
The hon. Member for Hazel Grove (Dr. Winstanley) referred to the rumour about handing over the vehicle service to the social security network. I am pleased to allay this rumour. I have heard it previously. This debate provides a good opportunity to allay what 1283 could be a disturbing rumour to many disabled people.
My hon. Friend the Member for Eccles referred to Mr. Paul Bates, a severely disabled man also referred to in earlier debates. He is widely respected by right hon. and hon. Members on both sides of the House. Paul Bates said in a recent article in the weekly journal Social Services that it would take the wisdom of Solomon to solve a problem as complex as the one we are discussing. Solomon was an individual and we are a fellowship of people seeking to solve a difficult problem. The collective wisdom that emerges from the debate will take us much further towards the solution of a problem which all of us know is formidable, daunting and intimidating.
The hon. Member for Oxford (Mr. Woodhouse) said that the director of MIRA was prepared for the commercial vehicles, tested for comparison with the model 70, to be referred to by the letters A, B and C to hide their identity. I will pass copies of the exchange of letters between my right hon. Friend and Mr. Macmillan, the director of MIRA, on this point. Mr. Macmillan is not satisfied that one could hide the identity of the other vehicles tested.
I referred earlier in the debate to the problem of commercial confidence. The hon. Member for Hazel Grove, who is respected for his deep interest in this problem, will accept that we did our best to publish the MIRA reports in their entirety. I honour my right hon. Friend for the immediate action she took in writing to the director of MIRA about her desire to publish the MIRA reports as a whole.
The hon. Member for Aylesbury (Mr. Raison) asked whether, when we said that we could not disentitle present beneficiaries of the scheme, we were talking also about their successors. My right hon. Friend has said that we could not disentitle the categories of people whom Lady Sharp would disentitle. Of course we could not, nor could any Government, commit successor administrations. I have given my right hon. Friend's view, which, as the House knows, she holds strongly.
I was deeply impressed by the speeches made by my hon. Friends the Members for Chorley (Mr. Rodgers) and Watford 1284 (Mr. Tuck). They brought to the debate experience of the realities of life for severely disabled people. We have not looked very much at the problems of housing for the disabled or at the details of indoor mobility for those who are very severely disabled. The speeches by the hon. Members for Lancaster and for Wallasey dealt with these important matters more thoroughly than other speeches made in the debate. These matters were reviewed by Lady Sharp in her report. There will be other occasions to consider the housing problems of disabled people and access problems of those who find it difficult to negotiate steps and narrow corridors.
§ Mrs. Kellett-Bowman
As far as I can follow, the hon. Member referred to a statement by his right hon. Friend as reported in column 31 of the OFFICIAL REPORT for 25th March. I do not read it in the sense that the hon. Gentleman gave it. I understand that the Secretary of State for Social Services was saying there that only those who had an existing entitlement to a vehicle would retain it and others would do so while stocks lasted. Is the hon. Member going further than that now?
§ Mr. Morris
The point is a little difficult. My right hon. Friend is saying that she does not intend to disentitle existing categories of people whom Lady Sharp would disentitle. I am not certain that we are dealing with much more than semantics at this stage. I realise that an important point was raised by the hon. Member for Aylesbury when he said that we must think of the successors as well as the current beneficiaries, but I hope that the assurance I have given will be taken as a firm and important one from my right hon. Friend.
§ Mr. Raison
I wonder whether the hon. Gentleman would say whether the Government definitely reject the Sharp criteria for eligibility.
§ Mr. Morris
That is partly what my right hon. Friend was saying. She accepts that the question is very complex, but she was saying that she rejects the criteria accepted by Lady Sharp in so far as they would disentitle categories of people who are now entitled to the service. I think the short answer to the hon. Gentleman and to his hon. Friend is, "Yes".
1285 I have very little time left now. I proposed to refer as far as I could to the other question raised by the hon. Gentleman about those who require wheelchairs at work and at home. Like many other questions that have been raised in the debate, this is a matter that I shall have to try to deal with by correspondence.
I say again, in conclusion, that I think that this has been an extremely important debate that shows how devoted the House of Commons is in its concern to alleviate the problems of severely disabled people.
§ Mr. Joseph Harper (Comptroller of Her Majesty's Household)
I beg to ask leave to withdraw the motion.
§ Motion, by leave, withdrawn.