§ Motion made, and Question proposed, That this House do now adjourn.—[Mr. Stallard.]
§ 4.25 p.m.
§ Miss Jo Richardson (Barking)Let me say at the outset that in discussing the question of benefit for disabled married women, I want to put on record the fact that this Government have a record second to none in their concern and care for disabled people. No previous Government of either political party have introduced so many benefits designed to assist people of varying disability to achieve dignity, to live as decently and comfortably as possible and, in many cases, to make a working contribution to the standards of the rest of us.
Of course, this is never sufficient and there will always be people dreaming tip new ideas to help disabled people, but that is exactly as it should be. I know that the Government are not asking for gratitude; nor is the Labour Party, which thought of many of these benefits. We in the Labour Party feel strongly that for decades disabled people have been 2135 neglected by successive Governments and have been made to feel second-class citizens because they have been ignored. It is their right to receive benefits. This is in no way a charity. I want to make that clear.
It is precisely because the Labour Government, and particularly my hon. Friend the Minister responsible for the disabled, have given so much thought to the problems of the disabled that I was very saddened that in extending the most welcome non-contributory invalidity benefit from disabled men and single women to disabled married women the Government should have reduced the effect by attaching a discriminatory test. To qualify for the non-contributory invalidity benefit, men and single women who claim have only to show that they are incapable of paid employment. That is fair enough. No other test is attached, except age and residential qualification.
Many thousands of disabled people have benefited since the introduction of the original scheme in the autumn of 1975. At that time the Government said that they must look further into the question of applying the scheme to disabled married women. The House will recall that it was a Back Bench revolt which forced the Government to extend the benefit much earlier than was intended. That was hailed on all sides as a great step forward. It was hailed with much relief by disabled married women. However, when it became clear that the extension of the scheme would carry with it a new household duties test—in other words, that the married woman had to prove that she was incapable of normal household duties—that great step forward began to look like a yawning trap into which a married woman might fall. Indeed, many of them did.
Many organisations criticised the imposition of the test itself and forecast the enormous difficulties of applying it with justice and fairness. They recommended that the Act should be swiftly amended to permit married women to claim this benefit on equal terms with disabled men and disabled single women.
Let me first take the equality point. The application of the test of "normal household duties" reaffirms the age-old image of a married woman being the dependant of her husband and of house- 2136 hold duties being her normal and natural job. It perpetuates that image at a time when more and more people in this country, and more and more women, are questioning the inevitability of the role of the housewife which is traditionally allocated to her by society—the role that she is there always to be tied to the home. The fact that it is disabled married women who are thus being classified makes this discrimination even more humiliating.
We are talking about the woman who is trying hard to overcome her disability and to make a contribution in her family and to other people around her, who is by that very disability in a vulnerable and defensive position, having her role as a dependant confirmed in a law which should have been designed to help her to achieve greater dignity and independence and to receive a benefit in her own right as an individual person.
The household duties test is the very worst kind of test that could have been applied to women who already suffer not only considerable physical handicaps but severe strains as a result of their physical disabilities. It is hardly the best way of helping women to achieve a measure of independence which I believe the benefit was initially designed to give.
How is the test working? The Minister may have more up-to-date figures, but I understand that by May 1978 there were 35,000 women receiving the benefit. Up to that time, however, more than 9,000 claimants had been turned down because they could not prove that they could not do the household duties test. They might manage some duties. but not others and, therefore, they failed the test and were denied the benefit.
About 2,400 claimants managed to go through the trauma of appealing against the insurance officer's decision that they were incapable of performing these duties. More than half of those—about 52 per cent.—won their appeals, which in itself is a staggering figure of successes, and very significant. It points up the unfairness of the test and the patchy way in which appeals are allowed.
I want to say a word about the test itself. The woman has to complete a five-page form which is made up of 25 questions. Many of them are routine, obviously, requiring her name and 2137 address, her age, and so on. But most of the questions are crucial to the success or failure of her claim. She has to answer questions about the type of accommodation in which she lives. She has to give details of any special arrangements that she has to make to enable her to manage the housework—wider doors being provided and specially adjusted types of working surfaces, for example. She must say whether she has any special appliances, and whether she needs help with those appliances. But there that kind of question ends, and there is no finer or more defined definition of it. So how is the woman to answer? What is a "special" appliance? Is it a Hoover? Is it an automatic food mixer? Does it mean a specially designed gadget for disabled people? The form does not say.
Nor does the form expound on what is meant by "help" to use any of the appliances. Does it mean that the woman concerned has to ask someone in the house to plug in the Hoover, or to fill the washing machine? All these questions are drawn so widely that it is impossible to answer them accurately and fairly. So the woman has to guess, and her guess may disqualify her from benefit.
Then there is a self-assessment question. The form lists some household jobs, and the claimant has to tick one of three boxes alongside each job to show whether she is normally able to do it with much difficulty, without much difficulty, only with substantial difficulty—in other words, that it pains her to have to do it—or not at all. What is more, the jobs are, as it were, lumped together.
The claimant is asked to say whether she can plan, select at the shops, and collect her weekly shopping—not plan, "yes", select, "yes", and collect, "yes". All three are lumped together. There is no provision for her to indicate that she may be able only to plan or to select shopping, and that she cannot do the others.
The second household job question asks whether the claimant by herself can plan, prepare and cook a main meal for herself and the family. The whole thing is lumped together again—all the preparation, all the cooking, and all the planning.
2138 The third question asks whether the claimant can do the normal weekly washing and ironing for herself and her family—all this by herself. The last question asks whether she can keep her home clean and tidy from week to week.
In respect of these rather selective jobs, before it is considered that she has completed the form satisfactorily the claimant is asked to make some kind of judgment whether she can carry out those functions.
There are endless permutations and combinations of these jobs. A disabled married woman may be able to undertake part of one job and part of another. How, in honesty, does she answer the questions on the form? The fact is that in trying to be as honest as possible and in seeking to maintain some kind of dignity in what they are trying to achieve in their own homes, many people will reply that they can fulfil these jobs when they cannot in reality fulfil them completely. The form asks whether the person concerned can undertake a job completely. Many women have disqualified themselves from benefit by being overzealous and by trying too hard.
It seems to me, from my observations and correspondence and from discussions with people who have been put at a disadvantage that the more a disabled married woman tries the more she is likely to be penalised. It is a humiliating and degrading test, and it is understandable that many women feel bitter that their efforts to help themselves and their families—with great difficulty but with pride, so that they can make some kind of contribution to their families—result only in their being disqualified from the benefits to which they are entitled.
The form is not the end of the matter. There is then a medical check, which is designed to grade the person but which appears to degrade her in the process of judging which functions she can carry out.
With the aid of these forms, how can an insurance officer fairly and adequately come to a reasonable decision? The fact is that the decisions are inconsistent. Some decisions are very good ones, but there are comparable cases where an insurance officer has arrived at a totally different decision. That shows up the 2139 unfairness of the way in which the test has been designed.
Let us suppose that a woman's application is turned down. We all know that, as with all benefits in the social security system, applicants are told "If you are turned down, you have the safety net of an appeal." We appreciate that there must be a safety net, but any woman who has been through an appeal, even when she is 100 per cent. fit, will know that it is a somewhat difficult process. The process is daunting, in that it involves a good deal of form filling, and the applicant must gear herself up to face the prospect of appearing before an appeal tribunal. She must reveal before total strangers all the details of her life. If she is disabled, those difficulties will be far worse.
Experience has shown that appellants need to be represented. There are many well-documented cases involving two women with the same kind of disability who have been assessed by their doctors in roughly the same way. It has been proved that a woman who is represented on appeal succeeds, whereas one who is unrepresented often has her appeal turned down. I advise any married woman who finds herself in these difficulties to try to obtain some kind of representation.
Another trauma that faces a disabled woman is that she must find somebody to represent her. She must go to the citizen's advice bureau, a friend or a solicitor. All this adds up to a burden on disabled married women. I do not believe that such women should have to prove a much greater degree of handicap and a more precise one than disabled men or disabled single women have to establish. The effect at present is to hinder the rehabilitation of disabled women, because it discourages them from seeking to improve the functions which they undertake at home.
In my view, the answer is to abolish the test altogether. I know that the Minister will tell me that to abolish the test will mean the spending of more public money. It will mean that disabled married women will be able as of right to get the benefit without undergoing the test.
I am aware, too, of the competing claims of others who feel themselves to be disadvantaged. Some of them are married 2140 women with problems in the social security system. We must start now to give a commitment or undertaking—I hope that a future Labour Government will do so—to phase out the test. Perhaps that might be done by age group or by starting with those in receipt of the attendance allowance or the mobility allowance. There must be many ways of devising a system for phasing out the household duties test.
We are discussing a new benefit and a good benefit. All that we are doing by applying the test to disabled married women is perpetuating and institutionalising discrimination against them. They make up a most vulnerable group and they cannot fight back.
I know that my hon. Friend the Minister, with his great record of devotion to the needs of the disabled, will appreciate the problem. I only hope that he can persuade his colleagues in the Treasury of the justice of the claims of disabled married women. I hope he will persuade them that theirs is a deserving case that is worthy of more public expenditure so that we may go forward with a commitment to put an end to the present practice. If we do that, it will give renewed hope to many thousands of people.
§ 4.42 p.m.
§ The Under-Secretary of State for Health and Social Security (Mr. Alfred Morris)It is customary for the Minister replying to an Adjournment debate to thank the initiator. I do so with a special warmth today because my hon. Friend the Member for Barking (Miss Richardson) has shown by her work in the House an abidingly genuine and practical concern for the problems of the disabled. It is happily the sort of concern that in recent years has been shared by a growing number of right hon. and hon. Members on both sides of the House and by many outside organisations. Its effect helped us to introduce the non-contributory invalidity pension, NCIP, and to extend it last November to married women. As I know my hon. Friend appreciates, we extended NCIP to married women after an unprecedented degree of consultation with a host of interested people.
First and foremost we worked closely with representatives of the Disabled Income Group, DIG, sharing our views 2141 with them as we went along and getting their views about principle and detail in return. We held linked discussions with representatives of the all-party disablement group, again in an atmosphere of openness and trust. Leaving aside the help that we sought and obtained from other countries which had moved into this area before us, we consulted a number of experts and met representatives of the blind to look more closely at the particular problems of the blind housewife.
Finally, we arranged a pilot exercise, in conjunction with DIG and with particular help from the hon. Member for Wallasey (Mrs. Chalker), to try out with a small number of disabled housewives and doctors the sort of questions that we needed to incorporate in the final medical report and the claim form.
In short, a great deal of effort quite properly went into launching this important new benefit that is now called the housewives' non-contributory invalidity pension, HNCIP. It was quite different both in character and in extent from anything done before by this Government or any other. One reflection of the success of the work is that we told the House that we expected to provide a substantial net increase of income for about 40,000 disabled married women, and we have done precisely that. I understand and sympathise with the desire to do more, but the importance of what has been done must not be minimised.
We have now made over 43,000 awards of HNCIP and we are paying out £23 million in the current year to about 37,000 married women who would not have had a penny by way of disablement benefit before last November. They can also qualify for the attendance allowance and the mobility allowance, both of which have been considerably increased in value. There are severely disabled married women who not many years ago would have been entitled to no cash help who are now receiving £1,600 a year in HNCIP, attendance allowance and mobility allowance. Moreover, their income from my Department will rise to £1,900 a year in November. That may still not be enough, but it represents some progress for tens of thousands of disabled married women.
2142 Our plans for providing new benefits for disabled people were first presented to the House on 13th September 1974 in the document "Social Security Provision for Chronically Sick and Disabled People",—House of Commons paper 276.
NCIP was the first of our new benefits for disabled people. It was introduced in 1975 and now helps 130,000 people. They will all be receiving £11.70 a week from November.
NCIP was followed by the invalid care allowance—ICA—in July 1976, which gives an income as of right to nearly 6,000 people who have given up work to look after severely disabled relatives. "Social Security Provision for Chronically Sick and Disabled People" pledged that the Government would study how best to help disabled married women. At the same time, the document made it clear that NCIP could not cover women who were living with or maintained by their husbands. Nevertheless, it accepted that there were sound reasons for providing a non-contributory benefit for married women who, by reason of disablement, were unable to perform their household tasks as well as being unable to perform paid work.
The paper made it clear that it would be necessary to consider this group as a whole because
it would not be practicable or justifiable to seek to distinguish those who would have been working outside the home but for their disablement. The qualifying conditions to be satisfied by married women dependent on their husbands would be rather different from those relating to the benefit now proposed for other women and for men (in so far as incapacity to do housework would be the prime issue on which entitlement of dependent married women would turn)".There are not many countries which have an incapacity benefit for housewives. We looked very closely at those which have such a benefit before introducing our HNCIP. This and other consultations took time, and the commencement of the benefit had to be further delayed by the economy measures introduced in May 1976 by my right hon. Friend the Chancellor of the Exchequer. As I have shown, however, HNCIP is now in payment to 37,000 beneficiaries and awards have been approved for a total of 43,000 disabled married women so far.2143 My hon. Friend and others are critical of the household duties test for the new benefit. They feel strongly that inability to take paid employment outside the home should be the only test. But the household duties test was introduced in the knowledge that large numbers of married women leave employment outside the home for reasons unconnected with disablement.
Again, the extra costs of the disabled married woman who cannot do housework or shop for herself are likely to be much higher than those of the married woman who can. That was a further argument for spending the limited resources available to me on a benefit that would help a disabled married woman who could do neither housework nor paid employment outside the home. In particular, we had to face the fact that to dispense with the household duties test would cost far more than was available to us when we introduced the new benefit.
We cannot be certain how many more women would be brought into benefit if the test were abolished. As the House of Commons paper in 1974 stated, it is difficult to estimate how many people might qualify for new benefits when using survey data not specifically designed for the purpose.
Using the 1969 survey of the Office of Population Censuses and Surveys—OPCS—and our own departmental records of payments of invalidity benefit, we estimate that abolition of the test could bring an extra 240,000 married women into benefit. If the calculation is based upon the 1976 general household survey, a lower figure of 141,000 is suggested.
Although the OPCS survey is out of date and was not designed for the purpose of showing how many disabled married women are incapable of housework, it has proved a reliable guide in a number of forecasts. We believe, therefore, that the figure of 240,000 would be more reliable.
Using the OPCS data and the benefit rates to be introduced next November the gross benefit cost would be £146 million. After adjustments for benefits already in payment the cost would come down to £135 million, but extra administrative costs would come to £9 million, giving a total net cost of £144 million. On the same basis the figure of 141,000 2144 suggested by the GHS would give an extra net cost of £87 million.
At either figure, the increase in public expenditure would be considerable. I emphasise that expenditure on benefits for the disabled has increased in real terms by £387 million a year since we came to office. Furthermore, this figure will increase again in November on the basis of decisions that we have already announced to the House.
The provision of services for disabled people has also been substantially improved. My hon. Friend recognises the problem of resources. She suggests a phased abolition of the housework test. That is something at which we have looked. But even phasing out over five years would require a yearly increase in expenditure of considerably more than the present cost of the benefit. That is a measure of the increase in expenditure that we are discussing in this important debate.
If we increase the resources available for HNCIP there will be pressures not only to do what my hon. Friend is seeking to do but to increase the rate of the benefit and to have it disregarded for purposes of assessing entitlement to supplementary benefit. To raise the rate of HNCIP and NCIP to that of the contributory invalidity benefit would cost about £42 million gross per year. To disregard HNCEP and NCIP for supplementary benefit purposes would cost an additional large sum.
Several of my hon. Friends recently went to see the chairman of the Supplementary Benefit Commission to press the case for disregarding HNCIP. One matter that was put strongly to them was that this would conflict with the Commission's long-term aim of reducing dependence on means-tested benefits. Nevertheless, they feel strongly that HNCIP should be disregarded by the Commission. No doubt they will be taking advantage of the review of the supplementary benefit scheme to argue further the case that they made when they met Professor Donnison.
I mention the competing claims for further increasing resources, since there is no general agreement about what we should do first if more money becomes available to spend on benefits. If everyone who wants further improvement could present their priorities, it would be helpful 2145 to my Department in considering what it should do first if additional resources become available.
I am not saying that HNCIP cannot be improved. It certainly can be improved. But all the improvements that are called for will cost money, as my hon. Friend recognised. That is my main problem. The other problem is to encourage all the organisations that are seeking improvements to agree on priorities. There are pressures not only for improvement in HNCIP but for higher spending on our other benefits, not least on mobility allowance. We are already in the process of quintupling the level of public expenditure on outdoor mobility.
I turn to the important question of how claims for HNCIP are decided. Judging from some of the letters that I receive, and from press reports, I can see that there is still a good deal of misunderstanding. I emphasise that claims are decided not by Ministers or by my Department, but by the independent adjudicating authorities which have always decided national insurance claims.
The national officer is the first of these independent authorities. He decides cases on written evidence consisting of the claim form, any accompanying statement and a medical report, usually from the claimant's own general practitioner. The 2146 claimant who is dissatisfied with the insurance officer's decision can appeal to the local tribunal, as about 5,000 women have already done. Tribunals decide cases after hearings and, as the chief national insurance commissioner said in a recent case, it is very important that claimants should attend hearings to give evidence if that is possible.
Their expenses are paid. Where necessary, the expenses of a travelling companion can also be paid. I know, and am very grateful, that many claimants have been assisted in pursuing their appeals by seeking advice from such bodies as the tribunal representation units organised by the citizens advice bureaux in different parts of the country, from the advisory service of the Disablement Income Group, from branches of Disability Alliance and from other groups that exist to help appellants before tribunals.
Finally, there is the national insurance commissioner—
§ The Question having been proposed after Four o'clock and the debate having continued for half an hour, Mr. DEPUTY SPEAKER adjourned the House without Question put, pursuant to the Standing Order.
§ Adjourned at five minutes to Five o'clock.