HC Deb 21 November 1978 vol 958 cc1205-16

Motion made, and Question proposed, That this House do now adjourn.—[Mr. John Evans.]

8.34 p.m.

Mr. Peter Fry (Wellingborough)

I could not help but think as I listened to the Minister winding up the previous debate that the first thing that we all can agree on is that the subject of benefits for the disabled is very complex. It is ironic that, after listening to speeches which perhaps quite rightly congratulated the Government on extending certain benefits, I have to rise tonight to complain about the way in which one of these benefits is operating, and is likely to operate in future.

Specificially, I rise to put the case for the claim for invalidity benefit by Mrs. Catherine Thompson, a constituent of mine. Everyone who has dealt with this case—at local level and right up to the commissioner who finally turned down the claim—is aware that Mrs. Thompson is a very brave young woman who has done a tremendous amount to overcome a severe disability. Indeed, the commissioner said that he turned down her claim with great regret.

In 1970 Mrs. Thompson had an illness which meant that one arm and much of one shoulder had to be amputated. The result of this very serious disability is that, unlike some people with one arm, she is unable to have any kind of artificial arm. The arm with which she has been provided is purely for cosmetic purposes. This means that this young woman has to go through life effectively coping with one arm.

To show her tremendous courage and determination not to sit back and let events overcome her, she has had two children whom she is struggling to bring up. It has been a struggle because she is very much dependent on her husband who has to have a full-time job. Looking after two small children, a husband and a house is a full-time job for most women with two arms, let alone one. Therefore, when this new benefit came into being Mrs. Thompson thought that at long last she would get some help and encouragement in her battle against adversity.

As she told me, the benefit would mean that she would be able to afford a home help for a few hours a week so that she would be able to relax a bit more and go out with her husband and family. Without any home help, even the most simple household duties tire her out. Very often she does not feel as if she can even talk to friends, let alone make any kind of social effort outside.

Mrs. Thompson was very shocked to discover that her original application for benefit had been turned down. I shall read to the House what she said. She puts the situation very clearly. She was turned down because it was considered at that time that she was capable of performing normal household duties. She says: To say that I am capable of performing normal household duties is nonsense. There are some things that I cannot do at all, such as hanging out washing, draining heavy saucepans, folding sheets and moving heavy objects which a housewife has to do every day in the course of normal housework. Other tasks like ironing take me so long—on average a whole day—and I can do no other work. She asks the appeals tribunal: Do you work an average of 15 hours a day as I have to to keep my house and children clean and tidy? I have no relatives living near me, I come from Scotland. My neighbours all work so I have no one at all to help me. There are some days when I cannot do anything at all. I regularly strain my wrist trying to do something beyond my abilities. I have to use a really sharp knife to work with, so I cut my fingers quite often. My artificial arm is only for cosmetic purposes and is quite useless. My two children are five and three years old and still need a lot of attention—attention which I cannot afford to give them. I point out that to take the children to and from school occupies her two hours a day. She ends her letter: I need help and you are the only one who can do that. How disabled does one have to be to get that help? The case of Mrs. Thompson has aroused very considerable interest not only in my constituency but throughout the region. Many people have found it incredible that someone with her degree of disability cannot avail herself of this benefit.

Having been turned down once, Mrs. Thompson did not give up, and with my encouragement she appealed again. Once again she was turned down, again on the ground that she was not incapable of performing normal household duties. It is interesting in this respect to refer to the report which her general practitioner completed. Perhaps the public are not aware that in these cases it is necessary for the local doctor to complete a form, in which he indicates whether the applicant can or cannot do certain duties. For example, he has to say whether there is any impairment, whether it is slight or substantial, for such things as lifting and carrying or bending or standing or kneeling.

I could not help but feel, having looked through the list of questions, how unsatisfactory the questionnaire was. The Minister told us earlier that the needs of the disabled are many and that their circumstances differ considerably from case to case. I believe that this questionnaire is totally unsatisfactory. It does not give the kind of information that is really needed for an objective assessment of a claim of this kind.

For example, despite Mrs. Thompson's considerable disability, on the form only two items were marked as showing slight impairment, and one item—manipulative ability—was shown to be substantial. Yet her doctor, of course, realised perfectly well that this gave a totally distorted picture of her problem. I give a clear example. He asked her "Can you make a bed?" Of course she can, but it takes her a tremendously long time and drains an enormous amount of her energy. That question is not even asked on the questionnaire, yet surely making a bed is one of the normal household duties that a housewife is expected to perform. There should be some recognition of that kind of difficulty in the questionnaire that the doctor has to complete.

It is great credit to Mrs. Thompson's general practitioner that he listed a whole series of things that Mrs. Thompson could not do. He said that she was unable to carry anything bulky or heavy. He pointed out that she had difficulty in keeping her balance because of the lack of one arm. He said that she had difficulty in lifting things from shelves. He added that, although she could stand, to stand for any length of time caused tremendous strain on her one arm. He pointed out that cleaning windows was a long and difficult job for her.

The Minister has a case to answer about the questionnaire as it is now, and he should consider whether it should not be improved so as to get a more satisfactory picture of the degree of disability.

After being turned down again, Mrs. Thompson was, by this time, very disappointed. I took up her case with the commissioner and wrote supporting her. In her own letter and comments to the commissioner, Mrs. Thompson said: I cannot agree that I can do normal household duties as the word 'normal' applies. There is not one single job that I can do normally. Everything I do is a labour not only in time but in effort … I feel"— and this is very significant— that having coped with my disability and getting on with my life as normally as possible, especially having my two children, has prejudiced the tribunal against my case, though I do not see why this should be so. I am not the type of person who sits around crying when something goes wrong. I fight back and will keep on fighting. It has taken seven years to learn to come to terms with my disability and I am still learning how to do things, but the strain on my remaining arm is tremendous. After I have been doing something strenuous … I am unable to do anything for several hours afterwards. My children suffer, as I have very little time left over to play with them or take them out. About the only time I see my friends is when I take my eldest boy to school". She ends by saying: I hope and pray that you give your decision in my favour as then I would be able to pay someone to help me in the house. Then could say that at last I could live my life more normally. It is interesting that when the commissioner regretfully turned down Mrs. Thompson's application he did so on slightly different grounds. He turned down the appeal against the refusal of benefit on the ground that Mrs. Thompson was not unavailable for work but could do some kind of job.

I admit—I am sure that Mrs. Thompson and many other disabled people would admit—that perhaps many people with only one arm can do a very useful job, and are indeed doing so throughout the country. But is a woman with two small children, a woman with only one arm, and with a home and husband to look after, seriously expected to do a full-time job and then to go home and try to cope with the housework in the evening and at the weekend? That offends against most of our concepts of social justice or common justice in this area. Therefore, we should look very closely at that definition.

What is perhaps more surprising is that the commissioner overrode Mrs. Thompson's own doctor's view. When her doctor filled in the appropriate form, he made it clear that in his view Mrs. Thompson was incapable of work, and he recommended that she could not do any. Therefore, there is a contradiction. Mrs. Thompson's medical advisers say that she was not capable of work. The commissioner has decided that, because he thinks she was capable of work, her appeal should not be upheld.

What perturbed me even more when I went into the details of the commissioner's reply was that, even if he had been disposed to interpret the regulations in Mrs. Thompson's favour, the Government had laid before the House fresh regulations that would make it virtually impossible for Mrs. Thompson and anyone in her category to obtain that kind of benefit. As I understand it, the grounds are that there is a danger of too many people applying and that it might well cost a little more of the taxpayer's money.

My hon. Friends and I are fully aware of the problems of public expenditure. The Minister will know that full well. May I make it clear to him that I am in no way accusing him of being hardhearted, because I know what he has done for the disabled in his many years of service to the House and to the community. But if the Government are to alter the regulations merely because they are frightened that too many people in a certain category may apply, it is a very sad day and against the principles for which I know the Minister stands and has stood for many years.

One further aspect of the case causes me some concern. Some time ago there was an Adjournment debate on the general subject of the benefit. It was initiated by the hon. Member for Barking (Miss Richardson). At that time she made a very interesting point. She said that, of the large number of people who had appealed against the refusal of this benefit, those who had been legally represented seemed to have a much higher success rate.

I have had several such cases in my constituency in the last year. One woman who appealed against the refusal of benefit came to me afterwards and asked if I would tell anyone else who appealed to employ a solicitor. She said that she was sure that if she had not been legally represented at the tribunal her case would have been turned down and she would have lost. It is all very well for the Minister to talk about appointing people with legal expertise to chair the various appeal tribunals.

I am seeking a greater degree of justice for people like Mrs. Thompson who have battled against the tribunals without the aid of legal advice. We are in an age of a multiplicity of judicial or quasi-judicial tribunals. We have an elaborate system of legal aid. But if we are to ensure that people have their cases considered on all fours with other similar cases, that should not depend on whether they can afford solicitors to put forward their cases.

The Government should conduct a thorough-going examination of the advice and help that is given to people who appeal against decisions such as the one I have mentioned tonight to see whether they can help.

I come to the three specific points that I wish to make. I want the Minister to have a close look at the questionnaire and at the kind of questions that have to be put to local general practitioners. I want him to consider whether there can be an improvement so that a fuller picture is obtained of an individual's disability so as to take account of what the Minister said tonight about the many individual cases that exist. Secondly, I hope that he will think again about the regulations that are being laid before the House that, in effect, will turn the screw on too many women who had hoped that they would get this benefit. Thirdly, I hope that the Minister will look at the problem of legal representation. At the moment it seems that some appeals are allowed when other apparently stronger appeals are not.

Let me quote again the words of my constituent because she can put her problem much more graphically than I can. It is she who has suffered and who knows what it means. She says: It seems however that I am not considered sufficiently handicapped to receive the above allowance. I have worked hard to keep a degree of normality about my life but the fact remains I do have a handicap. It seems to me that if I had let everyone run after me and done nothing I would get a little more help from the social services. Who was the Act supposed to help? People like me, or to keep a couple of hundred of social security people in work? I hate to think how much time and money has been wasted already on my case and, I don't doubt, on a considerable number of other cases … It is time that this whole affair was looked into before other women waste their time and their doctors' time in applying for it. As you are my Member of Parliament I would like you to do just that not only for my sake but also for all those other handicapped women who think they are having a raw deal. There is no doubt in Mrs. Thompson's mind, in my mind or in the minds of thousands of people in my constituency and in the Anglian area that Mrs. Thompson has had a raw deal. Perhaps the Minister will be unable to give us the kind of assurances and answers that he, being the kind of person he is, would like to give. But it is most important that the Government should not legislate and raise hopes and then dash them in the way that Mrs. Thompson and others have had their hopes dashed over this benefit. It is very important that these people should be given hope and encouragement and that there should be some recognition of the enormous courage needed to overcome a disability such as this.

8.55 p.m.

The Under-Secretary of State for Health and Social Security (Mr. Alfred Morris)

I am most grateful to the hon. Member for Wellingborough (Mr. Fry) for raising the unfortunate case of his disabled constituent, Mrs. Thompson. We have been in correspondence about the matter, and I well know of his concern. He has argued his constituent's case very strongly tonight.

As the hon. Member will recall, it was this House which decided that the housewives' non-contributory invalidity pension would be payable only to married women who satisfied two main conditions. The first was that she should be incapable of paid work outside the home. The second was that she should also be incapable of performing her normal household duties. Thus there is a double test.

It was also decided by this House that decisions on claims for this benefit would not be given by Ministers or by their officials. Instead, they are given by completely independent adjudicating authorities. A number of press comments on Mrs. Thompson's case show that this is still very widely misunderstood.

Let me quote just two examples. The first comes from a national paper which said that Mrs. Thompson had been turned down by "hard-hearted Ministry men". The other comes from a local paper which circulates in the hon. Member's constituency. This said that Mrs. Thompson's claim had been refused by Social Security officials". Neither of these statements is true. The law does not allow my officials to do what they are accused of doing. It is no part of my argument, however, that these misunderstandings are the fault of any newspaper. I take my own share of responsibility with all other right hon. and hon. Members for the fact that too many people still think that individual cases are decided by Ministers and their officials. Yet I know that the hon. Member will agree that I take every possible opportunity to make the position clear to as many people as I can.

Mrs. Thompson claimed HNCIP from November 1977. After her claim had been disallowed by the first of the independent adjudicating authorities and then on appeal by the local tribunal, she appealed to the national insurance commissioner. The hon. Member referred to the courage and fortitude of Mrs. Thompson, and rightly so. I know that her spirit was admired by the commissioners who said that she in no way exaggerated her difficulties. Indeed, on her original claim form Mrs. Thompson stated that she was able to do general office work or work as a telephonist, if it was local. She told the commissioner that she had worked as a telephonist before she lost her arm and that one of the other telephonists with whom she worked was a man with only one arm. She said that she could still do that work but that it would not be reasonable to expect her to do it because there was no such work in or near her home village and because she could not combine the work with the running of her home.

The national insurance commissioner found that Mrs. Thompson was not incapable of work within the meaning of the Act and he rejected her appeal, as he put it, "with great regret". He explained that incapacity for work must he the result of a specific disease or bodily or mental disablement, and not the non-availability of work or the impossibility of combining it with household duties. That statement was based on long-standing case law.

I must clear up two misconceptions. First, the denial of HNCIP in this case was made not by my Department but by the national insurance commissioner as the highest adjudicating authority. Secondly, the household duties test is not at issue. The commissioner decided the case on the ground that Mrs. Thompson was not incapable of paid work.

Mr. Fry

Does the Minister agree that in the early stage of the previous appeals her case was turned down on the ground that she was able to do normal housework? It was not until the commissioner dealt with the matter that the question of being able to do paid work arose.

Mr. Morris

I am dealing with the crucial decision in this case. The national insurance commissioner made his decision on the basis that Mrs. Thompson was not incapable of paid work. Had the national insurance commissioner found in her favour, it would have been a different matter. The decision made it unnecessary for the commissioner to decide whether Mrs. Thompson was incapable of normal household duties.

Nevertheless, the hon. Member has mentioned the household duties test, so perhaps I may make some comments on it. The test is contained in the Social Security Act and in regulation 13A of the non-contributory invalidity pension regulations. This regulation was made as an easement of the conditions in section 36(2) of the 1975 Act, which requires a woman to show that she is incapable of performing normal household duties. The regulation was designed to ensure that a woman did not have to be helpless or nearly so before she could get benefit. All she had to do was show that she was incapable of performing her household duties to any substantial extent. The regulation was approved by the National Insurance Advisory Committee.

We intended that the test in the regulation would require the adjudicating authorities to take into account both what a woman could not do and what she could do in her household. That was the way in which the authorities interpreted it until on 8th September 1978 a tribunal of commissioners decided that regulation 13A was concerned not with what a woman could do, but only with what she could not do. If that was substantial, she was entitled to benefit, even if she was also able to do a substantial amount of her household duties.

That was a much easier test than had been intended and a much easier test than had already been applied in the determination of more than 60,000 claims for HNCIP. So we amended the regulation from 13th September to restore the original intention.

I must stress that what the Government did has not made it any more difficult to get HNCIP than the old regulation did up to the time that the tribunal of commissioners held that it had been wrongly interpreted. I must also repeat that neither the old nor the new regulation has anything to do with the deciding factor in Mrs. Thompson's case. The new regulation is intended to apply the same test which has already been applied to over 60,000 cases. In other words, the amendment regulation restores the position to what it has always been thought to be.

The hon. Member suggests that even if a person with a disablement like Mrs. Thompson's is found to be capable of paid work, it is unreasonable to expect her to combine it with the performance of her household duties. But I must point out that HNCIP is an "incapacity" benefit, by which I mean that it is a benefit designed for those who are incapable of work. The incapacity must result from some specific disease or bodily or mental disablement". It is not enough for a person to show that she cannot do paid work as well as her housework, or that the kind of job she could do is not available where she lives. This has always been the position with benefits such as sickness, injury and invalidity benefit. The benefit does not depend on disablement itself, but only on its incapacitating effects.

The hon. Member suggests that the standard medical report form which provides the adjudicating authorities with evidence about claimants' incapacity does not do justice to those who can do some household tasks but only very slowly and with great difficulty. Of course, we recognise that no standard form can meet precisely the circumstances of each individual case. That would be too much to expect of any form. But I should point out that on the claim form claimants are asked to show the things they can only do with much pain or very slowly and a copy is provided for the doctor.

The House will wish to know that, not long after the benefit was introduced, we started a review of the claim form, the explanatory leaflet and the medical report form. I am pleased to inform the hon. Gentleman that we have consulted widely with representatives of the Disablement Income Group, the Disability Alliance, the Child Poverty Action Group, citizens advice bureaux, doctors and a host of others, and revised leaflets and claim forms will be available in the new year. A similar exercise is under way with the medical report and a revised version of that will be brought into use as soon as possible.

Whatever benefit conditions are laid down—and, after all, they only reflect Parliament's decisions on eligibility, and the Government can do no more than this House permits us to do—it is inevitable that some claimants will fail to satisfy them. Naturally, they will be disappointed—just as many people were disappointed that my Department did not have the resources to accept the consequences of the broader interpretation of the legislation laid down by the tribunal of commissioners last September.

I do not want to debate this matter in detail tonight, but I wish to make a few brief points. There was nothing unconstitutional about making the regulations during a parliamentary recess. Regulations are often made during recesses. Indeed, more than 200 sets of regulations were made this summer. It has even been suggested that the Government were being furtive. I put out a press notice publicising the change. That was hardly furtive. Secondly, the 40 days in which the regulations can be prayed against did not start ticking away when the change was announced in September. The 40 days started to run from 1st November, so that critics had longer in which to prepare their case.

Again, it has been said that it was wrong to reverse the decision of the tribunal of commissioners which had found in favour of claimants. But that would have led to a huge increase in expenditure on HNCIP—perhaps doubling or trebling the current cost of £23 million a year. My Department cannot spend money which it does not have.

The introduction of HNCIP followed an unprecedented degree of consultation with representatives of the disabled and, as I have shown, the process has by no means stopped. In amending the regulation, we have merely sought to preserve the benefit conditions upon which we then resolved. There are many pressures from organisations of and for disabled people that we are still unable to meet. But we are entitled to claim that, during a period of immense pressure on resources, we have made marked progress. Since we came to office in 1974, expenditure on cash benefits for the disabled has risen by £387 million a year in real terms. We have shown our resolve to do more as soon as priorities and resources allow.

I wish to renew my thanks to the hon. Gentleman for raising the case of Mrs. Thompson, to whose courage and the courage of all like her I pay sincere tribute. I shall bear in mind everything the hon. Gentleman has said. He has provided the House with the kind of opportunity which we occasionally need to examine the practical effects of what we enact.