Mr. MICHAEL CARROLL (MOBILITY ALLOWANCE) (Hansard, 3 March 1980)

§ Mr. Arthur Davidson (Accrington)

I want to raise tonight the case of Mr. Michael Carroll, one of my constituents, who has many times been refused mobility allowance. He is a brave, honourable, uncomplaining and hard-working man, who lost both his arms and both his eyes in an explosion 20 years ago. He is unable to get out of his house on his own. Because of his particularly appalling disabilities, he cannot manage a guide dog, neither can he hold a white stick. Yet he has so managed to adjust to his disabilities as to be able to work as a telephone operator.

Most men suffering the injuries that Mr. Carroll has suffered would have given in under the strain. He has not done so. He is greatly helped by his wife, who takes him to and from work, but this means that she has to make eight separate journeys every day, and it is obviously a great strain to her, and it affects her own business as a hairdresser.

Mr. Carroll would be exactly the right sort of person to benefit from mobility allowance, because he could use it to employ someone to help him get to work and to get about. But he has been turned down no fewer than three times. He has been to a medical board on three occasions and has appealed to the medical appeal tribunal on three occasions, and each time, since early 1978, he has been refused. The last time was in January this year. The reason is that he is not considered virtually unable to walk, which is the definition in regulation 3 of the mobility allowance regulations 1975 as amended by the 1979 regulations.

206 The irony is that everyone has sympathy for Mr. Carroll. The appeal tribunal that turned him down on three successive occasions has sympathy for him, as have the past and present Ministers with responsibility for the disabled—my right hon Friend the Member for Manchester, Wythenshawe (Mr. Morris) in the last Government and the right hon. Member for Daventry (Mr. Prentice) in the present Government—yet both have been unable to intervene. I acquit both of lacking in compassion or of not wishing to help Mr. Carroll. Certainly, there is no one with more compassion than the Under-Secretary of State who is to reply to this debate. If he were in my position he would be making exactly the same speech and exactly the same plea as I am making.

My right hon Friend the Member for Wythenshawe when he was Minister wrote to me a letter dated 19 April 1978. Even before then Mr. Carroll had been battling. The letter says: You came to see me in the House on 6 April, further to your letter of 28 March, on behalf of Mr. Michael Carroll of 69 Plantation Street, Accrington. At our meeting you argued very strongly to me Mr. Carroll's case for the mobility allowance. As I explained, I recognise Mr. Carroll's very considerable difficulties and I would like nothing better than to he able to help. My difficulty, however, is that appeals are decided not by Ministers, but by independent adjudicating authorities appointed by Parliament. The disallowance of Mr. Carroll's claim for mobility allowance follows a decision of the national insurance commissioner. He is the highest of the independent adjudicating authorities who are responsible for deciding claims and, under the law, I have no power to set aside his decision. As I say, he is an independent person appointed by the Crown for the purpose of deciding claims. My right hon. Friend went on to suggest that Mr. Carroll should apply again. He did so and was again turned down. He applied again recently; and I shall read a letter which I received from the present Minister with responsibility for the disabled. It says: 207 Thank you for your letter of 4 June on behalf of Mr. Carroll…I am very sorry indeed to hear of his misfortunes. I am afraid, nevertheless, that the interpretation of the medical conditions for mobility allowance, and their application to individual cases, are entirely matters for the independent adjudicating authorities, specially appointed for this purpose. I cannot intervene to influence or set aside their decision…The tribunal will be considering the appeal in the light of the mobility allowance amendment regulations which came into operation on 21 March. These regulations improved the definition of 'virtually inability to walk' by explaining the kind of factors to be taken into account as limiting a claimant's ability to walk out of doors. These include the distance achieved, and the speed, length of time and manner in which progress can be made without severe discomfort. It will be for the medical appeal tribunal to decide whether Mr. Carroll is 'virtually unable to walk' within the meaning of these regulations. I am afraid that, once again, Mr. Carroll was turned down by the medical appeal tribunal. It said: There can be no doubt that he is not unable to walk. At the end of the report, members of the tribunal said: We have been invited to say"— by me— that the definition is too narrow and makes a mockery of the whole concept of mobility allowance. But, whether we approve or not, we hold ourselves bound by the wording of the regulations, and having given attention to each of the matters in regulation 3(1)(b) as amended, we regretfully must say that the claimant is not virtually unable to walk. If, as the claimant submits, the intention was that a person such as the claimant should receive the allowance, then the regulations should have been drafted differently. It is not for us, out of the sympathy which we undoubtedly have for the claimant, to treat the regulations as saying something which they do not say. Although Mr. Carroll is unable, on any layman's definition, to walk, or "virtually unable to walk", he is still unable to claim mobility allowance. Members of the public would certainly think that someone suffering Mr. Carroll's appalling disabilities, and who has sought to overcome them in such a praiseworthy fashion, should be entitled—if anyone is—to mobility allowance. Most people would say that he was just the sort of person for whom the allowance was introduced. I do not expect the Minister tonight to say that he can grant this allowance where others have failed. I know that it is not within his power. What I do ask is that he has another look at the regulations to 208 see whether they can be reviewed and overhauled so that a new definition can be brought in, enabling people like Mr. Carroll—who has done all that could reasonably be expected of him to make a decent life—to benefit. If he does that, Mr. Carroll himself will be able to benefit—he is only 49 years of age now—and many others who suffer similar disabilities and who are at present disqualified from receiving mobility allowance will be able to benefit.

I hope that the Minister will say that he will very carefully consider the deficiencies of the regulations and the shortcomings of the definition and that soon we shall have the benefit of new regulations which will enable the mobility allowance to be given to many of those whom the House would certainly feel should receive it and enable someone like Mr. Carroll to benefit.

§ The Under-Secretary of State for Health and Social Security (Sir George Young)

The hon. and learned Member for Accrington (Mr. Davidson) has for some time now diligently and forcibly supported the claim to mobility allowance of his constituent Mr. Michael Carroll. Tonight he has restated the case with clarity and compassion. Everyone who has heard the details of the case will have the very greatest sympathy with Mr. Carroll's very considerable difficulties, and, if I may say so, he could not have a better advocate than the hon. and learned Gentleman.

Mobility allowance, as the House is aware, is a taxable non-contributory benefit for disabled people aged 5 to 64 inclusive who are unable, or virtually unable, to walk because of physical disablement. It was increased last November to a rate of £12 a week.

The regulations covering the qualifying conditions for the benefit were expanded and improved last year to spell out the kind of factors bearing upon an individual's inability to walk out of doors. These included the distance achieved, the time taken and the speed and manner of progress, together with any question of severe discomfort. It has always been the case that account has been taken of the effects of any exertion occasioned by walking which place the claimant's life or health in jeopardy.

It is a factor of the mobility allowance scheme that the interpretation of the 209 medical criteria for eligibility and their application to individual claims are entirely in the hands of independent adjudicating authorities statutorily appointed for this purpose. There are three levels of adjudication: the first is the insurance officer; then, on appeal, the medical board; and finally, and again on appeal, the medical appeal tribunal. On points of law arising from a medical appeal tribunal decision, a case can be taken to the national insurance commissioner.

We do, in fact, encourage every disabled person who thinks he may be able to satisfy the medical conditions to claim. This enables the independent adjudicating authorities to consider the question of eligibility. They can, and do, use their own medical expertise to come to a decision on the evidence before them. It is, of course, always open to them to call for additional medical evidence, for example from the claimant's own doctor or from a hospital consultant, if necessary.

In Mr. Carroll's own case there was on file evidence of the difficulties with which he has to contend and of the courageous way he has sought to minimise them. He has, in fact, successfully held down a job as a telephonist in circumstances which might cause many people to give up the struggle. He is a brave man and he has deservedly attracted great sympathy for his plight. I take this opportunity to express my admiration and sympathy for him. He is one example of the many disabled people who struggle daily against great odds to prove that what matters is not their handicap but what they can achieve. I must also pay tribute to Mrs. Carroll, who has devoted herself to helping her husband ever since his accident. The care and attention she has given are beyond praise.

I have listened carefully to all the points the hon. and learned Member has made and it seems to me that the issue really falls into two parts: have the two claims to mobility allowance made by Mr. Carroll been decided correctly within the present law; and, if so, is there anything that can be done about it?

Mr. Carroll's first claim was considered by all the independent medical authorities statutorily appointed to decide these claims and eventually was put to the national insurance commissioner, the highest authority on points of law in this 210 field. The commissioner considered that if the medical authorities found that a claimant was able to walk with assistance or support then, whether or not he was able to walk without such support, they could not find that he was, in law, unable or virtually unable to walk, unless the exertion required was found to constitute a danger to his life. Against that background he concluded that the earlier decision by the medical appeal tribunal was erroneous in law. As a result of the commissioner's decision the claim was referred back to a medical appeal tribunal. It decided that Mr. Carroll was not unable or virtually unable to walk. A second claim was subsequently made and this was considered by the insurance officer, then by a medical board and finally by a medical appeal tribunal. All of them decided that Mr. Carroll was not unable or virtually unable to walk.

I must re-emphasise the independence of the adjudicating authorities dealing with claims to mobility allowance. Their function, which is inquisitorial rather than adversarial, is to reach a proper decision within the law—not simply to justify the decision given originally. I am advised that the decisions of the statutory authorities in the case of Mr. Carroll undoubtedly appear to be correct within the law as it stands.

It has never been argued that Mr. Carroll is unable to walk. He can and does walk. What has been in question is whether he might be considered to be "virtually" unable to walk because, when walking out of doors, he needs assistance. The term "virtually unable to walk" was recently redefined in the Mobility Allowance Regulations 1979.

The medical appeal tribunal which considered Mr. Carroll's second claim stated: we have considered carefully whether the physical condition of the claimant as a whole is such that he is virtually unable to walk within the terms of Regulation 3 of the Mobility Allowance Regulation 1975 as amended by Mobility Allowance Regulation 1979. It concluded that Mr. Carroll's claim did succeed and it emphasised that the assistance he required out of doors was not for support but by way of guidance. The Secretary of State in his submission to the tribunal had emphasised that, if Mr. Carroll required support, in the view of the Secretary of State the claim 211 should succeed. However, the tribunal has concluded that the help he requires from his companions is for guidance and not for support.

I have stressed the independence of the statutory adjudication authorities which decide claims for mobility allowance. It has always been the case in the national insurane scheme, since 1948, that Ministers should not have the power to decide whether any individual is to be allowed benefit. I am sure the House will appreciate the reasons for this. But it means that neither the Secretary of State nor any of his colleagues can overturn the decisions made by these authorities. This has always been so. The case of Mr. Carroll was presented with vigour by the hon. and learned Gentleman to the previous Minister with responsibility for the disabled, the right hon. Member for Manchester, Wythenshawe (Mr. Morris). He, too, was sympathetic to Mr. Carroll, but equally he was bound by the rules and could not interfere in a decision properly arrived at.

The hon. and learned Gentleman has suggested that the rules have been construed too rigidly. Whatever its name might imply, mobility allowance has been statutorily defined as catering for those who are unable or virtually unable to walk. If it had been intended to cater for people who suffered from mobility problems of one sort or another, the legislation would undoubtedly have been framed differently.

Indeed, we all know that many groups have pressed since the allowance was introduced for an extension of its scope to cater for people with these very problems—people who are blind, those suffering from epilepsy, the mentally ill, and hyperactive children, for example. However, the allowance was clearly designed from the outset for people who were unable or virtually unable to walk.

It has been argued that the term "virtually unable" was originally meant to cover people such as Mr. Carroll. But that could be so only if the original intention was to include everyone who was unable to walk unattended or who needed an escort to do so. That was not the case, and as early as 1976 the national insurance commissioner made that very clear. The commissioner said that 212 what 'virtualy unable to walk' means is a question of law, and in my view it means unable to walk to any appreciable extent or practically unable to walk". In Mr. Carroll's case there is no evidence to suggest that he cannot walk; the question which has been raised is whether the assistance he needs in walking is for guidance. The tribunal considering his case thought that it was and went on to say: It is not for us, out of the sympathy which we undoubtedly have for the claimant, to treat the Regulations as saying something which they do not say. I am afraid, therefore, that Mr. Carroll, like a number of other severely disabled people, does not satisfy the statutory conditions for the receipt of mobility allowance. His need for attendance is, however, recognised by the award of an attendance allowance at the highest rate—which is now £18.60 a week.

There is a great deal of pressure on the Government to extend the scope of mobility allowance in a number of ways. We accept that at present it gives help only to those who are unable or virtually unable to walk. But we recognise that there are people who can walk but still have mobility problems. Mr. Carroll is an example of this situation.

We could, however, provide the help needed to such groups only if we were to extend the scope of the allowance, and in the present economic climate we can make no commitment to such improvements in the foreseeable future. I assure the House that my right hon. Friend the Minister with special responsibility for disabled people is very much aware of the difficulties faced by many groups of disabled people, and he will take account of these when cash becomes available.

In their manifesto, the Government said that they would seek a more rational approach to the benefits for disabled people. Mr. Carroll's case demonstrates how the piecemeal approach to cash help can result in hard cases. A more comprehensive approach is what is needed if we are to avoid such problems. Improvements can come only when the economy is strong enough to bear the cost of new help.

But I hope that I can respond positively to the plea which the hon. and learned Gentleman made at the end of his speech. 213 I assure the hon. and learned Gentleman that I shall draw my right hon. Friend's attention to this case and ask him to bear Mr. Carroll's problems in mind when he is evaluating all the views about how we should proceed and how the existing 214 arrangements might be amended and improved.