INDEPENDENT LIVING FUND

HC Deb 03 April 1990 vol 170 cc1080-6

'In section 32 of the 1986 Act— (a) after subsection (2A) there shall be inserted the following subsection— (2B) A payment of £30 million shall be made out of hat fund to the Independent Living Fund in the year ending on 31st March 1991 for the purpose of helping people with severe disabilities to live independently in their own homes.". (b) after subsection (6) there shall be inserted the following subsection— (6A) The Secretary of State shall make a payment of £30 million into the Social Fund to enable the payment specified in subsection (2B) above to be made without reducing the amount of money available for the other purposes of the fund.".'—[Ms. Short.]

Brought up, and read the First time.

Mr. Alfred Morris

I beg to move, That the clause be read a Second time.

The new clause is an attempt to ease the serious financial crisis of the independent living fund—

Madam Deputy Speaker (Miss Betty Boothroyd)

Order. I beg the pardon of the House. The new clause must be moved by one of the hon. Members whose names appear on the amendment paper.

Ms. Clare Short (Birmingham, Ladywood)

I move formally.

Mr. Morris

As I said, the new clause attempts to ease the current serious financial crisis of the independent living fund. Again the time available to debate the new clause has been strictly rationed by the Government, but I must try both to explain its purpose and strongly to emphasise its importance to severely disabled people. As its name implies, the independent living fund works to help disabled people, even those with the most severe disabilities, to live their lives independently in their homes wherever that can be achieved. Many severely disabled people dread having to go into institutional care, which is fortunate for the taxpayer because the costs of such care are often much higher than for community care. The House needs no reminding that forcing people into institutions, against their will and against their best interests, can be self-defeating for the Government as well as inhumane.

The independent living fund was created as a safety net after shocking disclosures about the effects on severely disabled people of the social security changes in April 1988. But the safety net is now holed and the hole will grow wider and deeper if the Government do not act urgently to make more resources available to the independent living fund. The present level of funding clearly does not meet the demands that have been revealed. Unless much more substantial and secure funding is provided, the independent living fund will shortly be unable to make any further awards. The result will be that institutional care becomes the only option for disabled people who, with appropriate help, are perfectly capable of living at home.

At the launch of the independent living fund, the Minister said that additional money would be found for the fund if it became oversubscribed. As David Brindle of The Guardian first disclosed publicly, that manifestly is now the case, and I ask the Minister to accept the new clause and to do as he promised when the fund began its work. David Brindle wrote that, by the end of March: the fund will be paying 4,500 people—three times the maximum number originally anticipated—at an annual cost of £15.2 million. There are an additional 1,500 cases approved and pending, representing an additional annual cost of almost £5.1 million, and 600 approvals a month are being added to this at a further annual cost of £2 million. 6 pm

As the Minister knows, the Disablement Income Group, which has done so much to sustain the Fund's work since its inception, is calling for the ILF to be fully funded by the Government in 1990–91. It is doing so because, until the new arrangements for community care start in April 1991, there is nowhere else that disabled people can go for help in covering their expenditure on personal care.

I understand that applications for financial support are currently reaching the fund at a rate of 1,800 per month. Normally, one in three people meet the fund's strict criteria. Thus, a Government cash freeze will mean that, in every month of the next financial year, the fund will have to turn away 600 severely disabled people in need of vital assistance.

Peter Large of DIG states: We are dismayed by the threat to the Fund's existence because it has, until now, been such a success … The Fund's careful assessment of each applicant's individual requirements has revealed the true cost of community care for severely disabled people. And it is the extent of need that has [now] put the Fund's existence in jeopardy.

Payments from the fund have kept families together, enabled severely disabled people living alone to stay in their own homes, made it possible for others to leave institutional care and provided essential cover for hard-pressed relatives. The fund has made sound financial sense as well. For many severely disabled people, small amounts of cash have stood between them and an unwelcome move to institutional care, which is far more expensive to the taxpayer than the cost of maintaining the ILF.

Peter Large also states: When the Fund started we knew of severely disabled people existing on beans on toast in order to scrape together enough money to pay for the help they needed. We believed those days were over and that never again would it be necessary to put anyone in the position of having to choose between such basic necessities of life as food and personal support. Unfortunately, we were mistaken. What he is saying is that very soon the ILF will have to turn away some 650 to 700 "successful" applicants for help every month.

Yet to tighten the fund's eligibility criteria, as the Minister must know, would involve rewriting the trust deeds. He knows as well. from the letter sent to him by Elizabeth Hoodless of Community Service Volunteers on 29 March in what very high regard the fund is held by her organisation as by many others who know of its work. It would be helpful to the House if the Minister could respond to that important letter when he speaks in this debate.

Will the Minister also explain why Peter Large's letter for DIG to the Secretary of State for Health, although it was sent to the right hon. and learned Gentleman on 17 September last, has since been only acknowledged? When will the Secretary of State reply? As the right hon. Member for Chelsea (Mr. Scott) may know, the letter sent by DIG to his right hon. and learned Friend was of considerable importance in terms of trying to vouchsafe adequate community care for severely disabled people. Surely it deserves the courtesy of a considered reply.

I give just one case, among scores of which I have details, with regard to the importance of the ILF's work. It is that of Jenny, aged 47, who has been cared for by her sister since her mother died 11 years ago. Jenny suffered severe brain damage in a road accident when she was 15, resulting in a high degree of mental handicap, and she needs constant supervision as well as help in all personal care. Her actual communication is limited to the most basic needs but she talks and demands attention incessantly. The strain of caring for her contributed to the break-up of her sister's marriage and probably to the latter's deteriorating health. Her sister now suffers from angina.

Respite care for Jenny has not been an option since a disastrous experience two years ago which made her terrified of ever leaving home again and left her incontinent. Her sister would not countenance sending her away again, but she has been desperate for some sort of break from the responsibility. She would love to go back to her old part-time work and may well make use of some of the 25 hours a week care now paid for by the independent living fund to do so.

That is the kind of case for which no further help may be available if the Minister is not prepared to accept our proposal in new clause 15. I most strongly urge him to do so at a time when, as he is fully aware, the poll tax is making life even more difficult for severely disabled people and their carers. He will recall that I gave details in the House on 24 January of cases in which families which include a severely disabled person will have to find as much as £756 a year more in poll tax than their current rates. It would be very helpful to have some sort of response from the Government to the figures I was given by the Spinal Injuries Association. It and many other organisations of and for disabled people are deeply disquieted about the added problems that arise for disabled people from a tax which they regard as hideously unfair.

There will be Tory Members who share my deep concern about the people who face further hardship if the ILF is not given the financial support that it now most urgently needs. I hope that they will not only make their concern clear to the Minister, but will support the new clause which I now commend to the House.

Mr. Scott

The whole Government, of course, take the view that, where it is possible or appropriate, not just disabled people but the elderly and others who need help should have the opportunity to be supported within the community rather than have to go into institutional care. That is why my right hon. Friend the Secretary of State for Health is currently taking through proposals to enable that to happen increasingly from 1991 and for packages of care to be produced by local authorities to achieve that aim.

I am sure that the right hon. Member for Manchester, Wythenshawe (Mr. Morris) did not mean to imply, although he mentioned a letter to which my right hon. Friend the Secretary of State for Health might not have replied, that the Government have not maintained constant and regular contact with the trustees of the ILF and, in particular, the trustees appointed by DIG and DIG Scotland. On a number of occasions, both formal and informal, I have met Mr. Peter Large and Miss Pauline Thompson and discussed these matters with them, and I have, of course, kept in regular contact with the chairman of the trustees of the ILF.

Mr. Alfred Morris

I referred to the letter from Peter Large to the Secretary of State for Health in the debate today. He is very anxious to have a considered reply to a letter which, after all, was sent last September.

Mr. Scott

I cannot recall seeing a copy of that letter but, since it was sent in September, that may not be surprising. Certainly I have had a number of conversations with Peter Large, Pauline Thompson and, obviously, Mrs. Tumim in the interim to discuss not just the matters that we are discussing tonight but other matters affecting the ILF.

The new clause seeks a payment of £30 million for the ILF from the social fund. I recognise at the outset that this is a device—I do not use the word in a pejorative sense—to enable us to discuss an important matter. Obviously, this would not in practice be a sensible way of handling the flows of public money, and for that reason if for no other I would ask the House to reject the clause were it to be pressed to a Division. I appreciate the sentiment behind the proposal, and I hope that my remarks will go some way towards meeting the concern which the clause addresses.

But first I wish to remind the House of the origins of the independent living fund and to pay the warmest tribute to the trustees—those appointed by the Secretary of State and those appointed by the disablement income group and DIG Scotland—who have operated the fund successfully. They have worked much harder than any of them envisaged when they took on the responsibilities of trustees of the ILF, and I pay them the warmest possible tribute.

The House will recall that the fund was established in 1988 with a five-year life following the abolition of the additional payments for domestic assistance which had been available to disabled people under supplementary benefit. We recognised that that left a very small group of the most severely disabled people whose needs might not be fully addressed by the disability premiums available under the new income support scheme.

A separate fund, with cases examined individually by independent trustees, seemed to offer a way of directing help towards that group with a flexibility and sensitivity that would not be possible within the regulated social security system. As I said at the outset, many people—including perhaps Opposition Members—were sceptical when it was set up, but it has done a useful job in the intervening period.

Our original provision for the independent living fund in 1989–90 was £5 million. That was more than doubled, to over £10 million, last year and has been more than doubled again, to £24 million, for the year just starting. There is no doubt that the fund has met its original objective of providing a way of directing individual help to those most in need. But I am afraid that it is also providing money in a wide variety of cases that were never contemplated when it was established. That is rapidly making it impossible for it to function in the way that was originally envisaged.

It is proving not to be possible to provide detailed and individual consideration in a centralised scheme handling as many cases as the fund now handles. As a result, there is a growing danger that the fund will no longer be able to provide the necessary attention to the needs of the original target group. Indeed, handling the current volume of applications is already placing a burden on the trustees which it is unreasonable to ask them to carry.

Because of the developing situation, I have been discussing the matter with the trustees, as I mentioned earlier, in an endeavour to find ways of reorganising the work of the fund so that those for whom the fund was established can receive the help they need.

It is obviously necessary for those discussions to be placed in the context of the new arrangements for community care to be introduced from April 1991. Under those arrangements, local authorities will be devising care packages on an individual basis and in a way that clearly overlaps with the present role of the independent living fund.

6.15 pm

Once the new arrangements are in place, people seeking help should generally be able to look to local authorities, but we recognise that authorities will need time to develop the detailed assessments and complex care packages that will be required. We therefore could not expect them to take on the entire case load of the ILF in April 1991. There will have to be some phasing, with local authorities gradually taking on such cases. There will also need to be some limited short-term arrangements for new cases that arise during the evolutionary stage.

The details will have to be discussed with the local authorities, but we shall obviously have to build in safeguards to prevent irresponsible authorities from placing an unwanted burden on the ILF. So we envisage some form of joint approach to these cases, with a revamped ILF, so to speak, providing only supplemental help from a clearly specified budget during the transitional phase. The way ahead now for me is to discuss with the trustees how the resources available to the fund can most effectively be used in the current year in a way which enables the fund to meet its original objectives and which provides a smooth transition to the appropriate arrangement after April 1991.

Unfortunately—the right hon. Member for Wythenshawe alluded to this—the rapid growth in claims to which I referred means that provision in the fund for 1990–91 is already heavily committed to current beneficiaries and to those to whom offers of help have already been made. That leaves little scope for the implementation of the suggested changes to which I referred.

I hope that we can reach agreement with the trustees on a sensible limiting of the scope of the fund, and in that case we shall be prepared to find the resources within our existing public expenditure programme to make a further £8 million available for the current year. That is an increase of a third in the current year allocation and a more than sixfold increase in the resources originally envisaged for the fund. I hope that the House will welcome that as an appropriate response to the concerns that have been voiced and, were the clause to be pressed to a Division, which I hope it will not, to reject it.

Sir David Price (Eastleigh)

I thank my right hon. Friend for his reply, although a few problems remain outstanding. There is concern about the increase in the burden of cases placed on the fund. My right hon. Friend said that some of those cases were of a nature not envisaged when the fund was established. It would be helpful if he would explain how he thinks they should be handled. If they should not be handled by the fund, who should handle them, certainly in the interim?

Who will handle the cases in the early days of the build-up of responsibility of the local authorities? It is not unfair to local authorities to say that some of them will be able to handle such cases more quickly and better than others. The professionalism needed to handle cases of this nature—many of which are extremely complicated and need much sensitivity and experience to handle—is not universal. It would be strange if it were. It is inevitable that there will be uneven provision in the early days. It is important that something like the fund should remain available in the carry-over period as a longstop. The fund was established in the first instance so that somewhere in the scheme of things there would be a longstop arrangement for really severe cases.

I agree with my right hon. Friend that that should not be an excuse for reluctant local authorities putting an increased burden on the fund. It would be reassuring for all concerned if the fund remained in place for as long as is needed, and I beg my right hon. Friend in his discussions with the Treasury not to agree a terminal date yet, but to see how matters progress.

Mr. Scott

I am grateful to my hon. Friend the Member for Eastleigh (Sir D. Price) for raising those two points. The answer to the first—about the type of cases that the fund has accepted and for which it has been paying—is that I am not betraying any confidences when I say that the fund has become aware that, as it has become more widely known, a number of local authorities which already have responsibility in this area to cope with the needs of disabled people, instead of meeting those responsibilities, have sent people to the ILF, suggesting that they apply to that area simply to protect their own budgets. That has been a significant factor in the growth that has occurred in the case load of the ILF.

My hon. Friend's second point was that, as we moved into the period after April 1991, with the new community care arrangements in place, inevitably some local authorities would do better than others and there would be, as he put it, an uneven implementation of the new arrangements. That is why I could not envisage the fund coming to an end in April 1991. I assure my hon. Friend that no terminal date has been agreed and that we shall have to see how implementation goes after April 1991.

Mr. Alfred Morris

I hope that the Minister for Social Security will meet the trustees very soon. Meanwhile, I note his announcement of a further £8 million for the independent living fund, and I will not be pressing the new clause to a Division.

Ms. Short

I beg leave to withdraw the motion.

Motion and clause, by leave, withdrawn.