§ Motion made, and Question proposed, That this House do now adjourn.—[Mr. Durant.]3.35 am
§ Sir Marcus Fox (Shipley)
My first thought on rising at 3.35 am is that I hope that I am not setting a precedent for Adjournment debates for the rest of this Session. If I am, this will be the last one that I apply for.
The subject of the debate has caused me considerable worry and I wish to draw attention to serious problems in our provision for the disabled. I am interested in about 100,000 of the most seriously disabled people in the United Kingdom. That number works out at an average of about 125 per constituency, though I believe that there are more such people in inner cities than in other areas.
Much has been done to help the disabled and I do not want to appear critical of the many good provisions in housing, mobility, transport, the provision of ramps to make it easier to get into public buildings, and so on. However, the debate is about the neglected issue of special clothing.
The people to whom I am referring cannot enjoy shopping as most of us do—if "enjoy" is the right word from a husband's point of view. They cannot go into multiple or chain stores in high streets and buy articles of clothing. Their garments have to be made specially. Businesses will not set up to provide such items, because most are one-off garments and there is no profit in them.
Our friends who are disadvantaged are no different from us in many ways. They have the same self-respect, and I think that dignity means more to them than to those of us who are fortunate. Many of them do not venture outside their homes because they do not have the right garments to wear. Their pride makes them housebound, and that is a reflection on our welfare state. I hope that the Minister will at least give me some hope that the importance of the matter has not escaped him.
Let me give one or two examples from my constituency. John has a dwarfing disease and is 54 in. round the waist, with an inside leg measurement of 12 in. He buys trousers and cuts the legs off above the knee. Suits are impossible to get and all other garments are much too long in the arm. His head is too big to go through T shirts, and polo, crew-neck or even round-neck jumpers.
Evelyn has an 86 in. bust and is 101 in. round the hips. She had only a nightdress when she was first met by the people who run this workshop in Shipley.
My third example is Samantha. She has spina bifida which has left her with a hump on her back just below the waist and a twisted spine. She is in a wheelchair and has to sit with her feet straight out in front of her. If she buys a jacket that fits her bust, it will not go over the bump and rides up. If it is big enough to go over the bump, it is too big everywhere else. Trousers were a dream for her. Her mother could not buy any that came anywhere near her waist at the back and masses of fabric collected in her lap. When the workshop made some trousers for Samantha, her mother burst into tears. One mother with curvature of the spine was not going to her daughter's wedding because she could not buy an outfit that hung correctly.
I shall now talk about warmth and give two examples. Andrew is 11 years old, has spina bifida and is mentally disabled. He lies flat all day and moves a hand to play with a rattle. He is blue with cold. An all-in-one suit was made 896 for him in a new thermal fabric and for the first time in his life he was pink like everyone else. Lastly, John's parents had to get up every two hours during the night to rub his arms and legs to keep the circulation going. A pair of pyjamas in a special fabric means that they can now sleep through the night.
Those examples convey just what a tragedy it can be for families who do not have access to the facilities that this workshop provides. In my constituency there is a dedicated lady called Nellie Thornton who decided to do something about this. She is a former dressmaking teacher and while on a community study course, she worked in a hospital with patients who had had strokes. She found that great emphasis was placed on making them independent and allowing them in the home to do whatever could be done. However, no one paid any attention to the special clothing that they needed. In 1981 she started this workshop, Fashion for the Disabled, in Shipley. With urban aid money and the help of the Manpower Services Commission, much progress has been made. We must not forget the sponsorship provided by the Bradford and Ilkley college.
I emphasise that two services are provided at the Fashion for the Disabled centre. One is training, where dressmaking courses are held for the disabled. Weekly courses are available for young spina bifida students, 16 to 19-year-olds from special schools, older disabled people and even young blind people. They learn how to measure, to fit and to make patterns, and to design and make garments. Within a week all of these people, whether or not they have sewn before, can make a garment to fit themselves. The joy that that brings to them because it is an achievement has to be seen to be believed.
Training is also provided for staff from other areas to set up their own centres. Regular courses are now held in Perth, Edinburgh, Kent and Surrey, and this year Belfast and, believe it or not, Athens, are to be added to the list. We were fortunate to have the Princess of Wales visit the centre in the early part of the year. She was deeply impressed by the work carried on there and by the devotion of the staff to the disabled. The Princess afterwards pointed that out in a very kind letter.
In the field of training there are no financial problems. Finance comes from the base budget of Bradford and Ilkley college and will continue to do so.
I come now to the second type of service, which is for the disabled who cannot help themselves. It is a workshop where individual garments are made to order for the sort of people that I described earlier. It is quite a task to fit such people and often means visits to them in their homes. If a fair charge reflecting the cost of the garment had to be made, these people would not be able to afford it. Hon. Members can imagine how time-consuming and expensive it is to make a garment to fit some of the people that I have described. Therefore, a subsidy of some sort is inevitable and the costs, according to figures that I have been given, vary from about three to eight times the price in a multiple store. That is easy to understand, given the wear and tear to which the garments are subjected and the extra work that is involved in making the garments.
It is not simply a question of covering these people's bodies. There is an immense social benefit for those people. It can take up to two hours for some of these disabled people to get dressed. Imagine the effort involved in that. If we consider the matter, we realise that people do not go out if they feel that what they are wearing is not 897 socially acceptable. They become housebound and their partners—when we consider married couples—get tired of going out alone and marriages have broken up as a result.
Imagine the change in our life styles if we had only clothing that was too big, which did not fit, with necklines that gaped, collars that poked or waistlines nowhere near the waist. Imagine all those clothes wearing out rapidly because we had to wear appliances and, because of our size, no ordinary clothes would fit.
I submit that we only realise what independence means when we lose it. Too many of those people have lost that independence. I hope that the Minister accepts that there is a need for this kind of service. The proof is that, following the experiment in Shipley, there are now 22 workshops around the country that are all in the same boat. In other words, they have no permanent funding. No one seems to want to pick up the funding of a scheme that is guaranteed to make a loss. This is a national problem. If we ask anyone in hospital, social workers or anyone involved in community work, I am sure that they will confirm the importance of the matter.
To give some idea of cost, the workshop in Shipley which employs six staff would need a subsidy of about £25,000–£35,000 to break even. I believe that that is a good investment for the improvement in morale of the disabled. I wonder how many fewer hours of medical attention are required because these people feel so much better with new clothes.
I hope that everyone now understands the importance of this subject. When I considered the provision of funds, I thought that I should first address my remarks to the Department of Health and Social Security. I understand that it is possible, through legislation, for local health authorities to provide some assistance in that direction. I have no doubt that local authorities could assist and the Social Services departments also have a responsibility. Perhaps the Minister can do something to bang a few heads together to ensure that this provision is not allowed to fade away. We need only think about the number of road accidents that occur and the ill-health that befalls people who do not believe that they will ever need this service to realise the extent of the problem. However, who knows what the future holds?
I submit that there is a basic human need to provide people with the dignity that comes with the right clothes and garments. I hope that the Minister will be able to give me some encouragement in this matter.
§ The Parliamentary Under-Secretary of State for Health and Social Security (Mr. Michael Portillo)
I thank my hon. Friend the Member for Shipley (Sir M. Fox) most warmly for raising this subject tonight and for giving us the opportunity of this short debate. I congratulate him on speaking so interestingly, movingly and penetratingly. I pay tribute to him for his clear concern about the future of an organisation in his constituency that is involved in such excellent and useful work. I re-emphasise one of the points that he made, for I understand that when Her Royal Highness the Princess of Wales visited Fashion Services for the Disabled in March she was most impressed with 898 what she saw. My hon. Friend's concern is typical of the assiduous way in which he cares for his constituency and all that goes on within it.
I am delighted to respond to the issues that my hon. Friend has raised, and, like him, I shall take my remarks a little wider than merely the subject of Fashion Services for the Disabled, although I shall deal with that first. I shall echo many of the things that my hon. Friend has said.
Dressing and undressing oneself is an important part of our everyday lives and something that most of us take very much for granted. Yet this operation, which is so simple to most of us, can be extremely difficult for some disabled people. It is essential that wherever possible disabled people should be able to dress and undress themselves to maintain their personal independence and dignity.
There are many reasons why disabled people might have difficulties and my hon. Friend has explained many of them. For example, arthritic hands and joints may not be able to cope with zips and buttons, mentaly handicapped people may find it difficult to cope with fasteners, there are those whose body shape does not fit conventional clothing and there are others whose clothing must accommodate body-worn supports or possibly incontinence pads.
It is important that all disabled people should be given the opportunity to lead lives that are as full and independent as possible, and this applies to their dressing and clothing needs as much as to other aspects of daily living. It means that there will be some who will need special clothing that is tailored to their individual disability. This helps disabled people to be and to feel more independent, and the act of dressing itself can have beneficial results. For example, it can help to mobilise joints and strengthen muscles as well as providing a boost to morale.
We recognise that it will not do to provide clothes that merely overcome the problems to which I have referred. Clothes are an integral part of the personality and individuality of the wearer and his or her acceptance socially. Good fashionable clothes increase the self-esteem of the wearer and the regard in which he or she is held by others. Disabled people now—I think that this is their absolute right—are very fasion conscious. They demand a choice of clothing which, while functional, does not obviously proclaim itself as being different from the sort of clothing that they might have been able to buy in a high street shop. This applies equally to those who might be unable to dress or undress themselves or who need help to do so.
It was against that background that Fashion Services for the Disabled proposed a three-year project, which was accepted for funding by the urban programme and the Manpower Services Commission. It was sponsored by the Bradford and Ilkley community college. The aim of the project was twofold. First, the aim was to provide a training centre offering courses to encourage self-help among disabled people and their carers. Courses were offered also to teachers to give them a deeper understanding of disability and practical experience of working with, designing for and fitting disabled persons. There are courses for disabled people and their carers to learn about fabrics, design, pattern making and garment construction. Professionals working with disabled people have the chance to discuss with Fashion Services for the Disabled the clothing problems that they meet and to work with the organisation to solve them.
899 The second aim was to set up a workshop to produce fashionable clothing that meets individual need and gives maximum independence in dressing and care. For this purpose people from the workshops visit homes, centres, hospitals, schools and individuals on request to discuss with individuals the problems and to take measurements as necessary. Garments are made in the fabric of the client's choice and fitted before completion. The prices to the customer are normally then comparable with similar commercial products.
As my hon. Friend said, the project began in 1983 and continued until April 1987, which was when the funding problem reared its head. Fashion Services for the Disabled contacted the Department of Health and Social Security on several occasions, most recently in June, requesting funding for a continuation of the project at a cost of about £32,000 per annum.
Unfortunately, we were unable to agree to the request as the project did not meet the criteria under section 64 of the Health Services Public Health Act 1968; nor did it meet the criteria as a research project.
My hon. Friend will appreciate that funding schemes must necessarily have rules or criteria governing the purpose for which a grant may be made, and to whom it may be made. The section 64 funds are provided mainly to assist with the central administration costs of national voluntary organisations in the health and personal social services spheres. Funds are, however, also provided to support innovatory projects of potential national significance, or to develop a particular pattern of service. Such project funding is essentially pump priming, and is intended to be time-limited, normally to a maximum of three years.
The organisation that put in the request is not now an innovatory one, and I very much regret that we have been unable to help that very worthwhile organisation.
Fashion Services also raised the question of joint funding, and was advised to seek support from local statutory authorities or voluntary bodies that use their services. My understanding of the pesent position is that Fashion Services' workshop has been taken under the wing of Bradford and Ilkley community college, which has agreed to cover the costs until March 1988. Beyond that, I understand that Bradford education department is currently reviewing the position from April 1988 onwards, and recently met representatives of Dr Barnardo's with a view to the latter having some involvement with Fashion Services. Dr. Barnardo's is discussing with Fashion Services the possibility of some involvement in the management and development of the project as a youth training scheme, together with the city of Bradford. Such involvement will obviously depend on a number of factors, including the satisfactory resolution of financial arrangements and sufficient grant aid from the local authority to match any input from Dr. Barnardo's. I earnestly hope that the arrangements will be concluded satisfactorily, and I am very sorry that, as far as I can judge, the project does not fit the section 64 criteria, for the reasons that I have explained.
None the less, we recognise that my Department has a primary responsibility for disabled people, and must play a part in helping. For the majority of disabled people, their needs for clothing and to exercise personal choice of style can be met by certain types of clothing produced for the general market, or by adaptations to standard garments. That view is supported by the Disabled Living foundation, 900 perhaps the major voluntary organisation for the disabled. My hon. Friend the Minister for the Disabled will be visiting that organisation in a few hours' time. We provide a substantial grant to the Disabled Living Foundation, whose clothing advisory service is the main source of information on the subject, collecting, storing and disseminating information on all aspects of clothing for disabled people.
I mentioned earlier the special needs of people who are mentally handicapped, and who may lack the necessary intellectual ability or dexterity to dress themselves in conventional clothing. In 1985, my Department agreed to provide the DLF with an additional grant of some £20,000 to fund a project to produce a book on clothing and dressing intended for all concerned with the care and teaching of mentally handicapped people, to enable them to help such people achieve greater independence. A final draft of the book has just been received.
My Department also funds the organisation Equipment for the Disabled, which provides and updates a series of reference books on a wide range of disability equipment and self-help devices currently available. One of their publications, "Clothing and Dressing for Adults," provides information on a number of factors which need to be taken into account in selecting clothing, and which help the individual to choose suitable styles. Work on updating the book is shortly to begin.
Through its disability equipment assessment programme, the Department sponsored the Southampton general hospital's assessment of the use of lower limb dressing aids. The programme assesses disability equipment while it is in use by disabled people under clinical supervision and records the advantages and disadvantages of the equipment. It offers guidelines on the most important aspects to be considered when such equipment is prescribed.
The programme is aimed primarily at helping disabled people, their carers and the professionals working with them to choose the most suitable equipment to meet their needs. It is also of value to manufacturers and suppliers. The feedback that they obtain helps them to see whether their products need to be modified to improve performance or convenience. A number of reports have been published, including that from Southampton, and they are available from the Department on request. The Southampton unit is currently engaged on the assessment of upper limb dressing equipment and garment fastenings.
I hope that my hon. Friend now accepts that the Department is aware of the problems that are associated with special clothing needs and that it is doing something about them. I hope that my hon. Friend will also accept the assurance that I have given him, even though I am unable at this stage to give him firm news about Fashion Services for the Disabled. I very much hope that the plans that are now being considered in order to continue the financing of that project will be successful. It is a most worthwhile project that has done very valuable work. I join my hon. Friend in commending Mrs. Thornton on the very valuable work that she has done. Not least for that reason, again I thank my hon. Friend most warmly for raising the subject and for giving us the opportunity to have this short debate.
§ Question put and agreed to.
§ Adjourned accordingly at one minute past Four o'clock am.