Disabled People (Northern Ireland) (Hansard, 4 December 1991)

§ Mr. Seamus Mallon (Newry and South Armagh)
Most people welcome the opportunity to have an Adjournment debate on matters of great importance. In this instance, I do not particularly welcome this debate, because I regret having to make these points tonight in this way.
I have made it clear to the Under-Secretary of State for Northern Ireland, the hon. Member for Wiltshire, North (Mr. Needham), that in general terms I have every sympathy with the people in the Housing Executive and the Department of Health's occupational therapy department whom, in effect, I shall be criticising. I must also criticise a system that puts them in a position in which problems occur.
My debate is about the way in which grants are paid from the Northern Ireland Housing Executive to disabled people to improve their environments in their own homes. They fall into two categories: people who own their own houses, the vast majority of whom have purchased their homes recently from the Housing Executive, and people who are Housing Executive tenants and require special adaptations.
The problem has been exacerbated by recent stringent cuts. The most recent cut of 16.5 per cent. in the Housing Executive's budget was announced on 28 November. That is estimated to cause a shortfall of £50 million over the next three years, which will eventually and inevitably make the problem worse.
I raise this matter also because my constituency has a high percentage of unfit housing. Although I am sure that these remarks will apply to all constituencies in the north of Ireland, I can judge only what is happening in the one that I know best, which is my own, where 3,344 houses have been deemed "unfit", as the Minister confirmed to me in a written answer in 1988. That is the background to this debate.
I shall raise four main issues, leaving aside the financial strictures and the policy itself, because such matters cannot be dealt with simply in an Adjournment debate. I refer to the problems in the system which I believe could be avoided. I repeat that I have sympathy with the staff of the Housing Executive and the Department of Health's occupational therapy department, but there are great problems that we must face.
The first is the average length of time between first receipt of an application and a visit. Most such applications come from people who, because of physical disabilities that are mostly associated with age, can no longer cope in their homes as currently structured. Most of the applicants require the provision of downstairs toilets and showers. A written reply last week confirmed that the average waiting time between the making of an application and the first visit or inspection is about nine weeks. If that is the average, we can take it that many will take longer than that. That is bad, but it could be dealt with. I cannot see any reason why that process cannot be speeded up within the system.
The second main problem relates to the delay in the occupational therapist's visit to assess the application. The applications cannot be processed by the Housing Executive unless they have been assessed by occupational 373 therapists from the Department of Health and unless recommendations are made by the occupational therapy department. Again a written reply last week stated that, in the Southern health board region, it took an average of four or five months before the occupational therapist gave an assessment, but in Belfast and in the Western board's region the delays were 11 months, with some being "very substantially longer".
We are talking about a system in which, on the admission of that written answer, a year can go by before that essential part of the process is undertaken. If one adds that delay to the average of about three months before the first visit is made, one is talking about a possible delay of one year and three months before the application starts to receive the attention that is required before it can proceed.
That in itself is bad enough. However, I tabled a written question some time ago about increasing the number of occupational therapists in Northern Ireland and was assured that that would happen. I know that it has happened in some regions, but that is certainly not evident in the areas of which I am most aware, where the problem seems great. Great difficulties arise if an aged person, who has probably just been released from hospital and who is very ill, cannot manage in what is usually a two-storey house where the facilities are upstairs, and has to wait 13 months before the application for downstairs facilities is even sanctioned. Those difficulties must be addressed.
Of course, there are exceptions and occasions when the process happens much more quickly—and others where it happens much more slowly—but I wish to outline the case of my constituent, Mrs. Patterson of 126 Dromalane Park, Newry, who received the Housing Executive's reply to her application on 2 October 1989, but was visited by an occupational therapist only last week. Almost two years elapsed before even the initial visit was made, making the applicant think that her application had been turned down. There can be no excuse for that. Something in the system must have gone very wrong. If that were the only such delay of which I knew, I would accept that there had simply been an oversight, but I am afraid that, in the circumstances, I cannot accept that.
Disabled people should be a priority in the system. They cannot be a priority if applications are so heavily burdened with bureaucratic requirements. There are not enough occupational therapists to do the job. Those who are doing it are grossly overworked. They have far too big an area to cover and far too many applications to deal with. The only way in which the position can be improved is to increase the number of occupational therapists.
The third problem is the Housing Executive's requirement under its warranted contractor scheme, which was introduced in 1987, that people who receive grants for this type of improvement employ a warranted contractor. Yet there is the anomaly that the Housing Executive employs contractors who are not warranted on major jobs. People naturally assume that a contractor employed by the Housing Executive is the firm to get, but then find that the contractor is not warranted. That is causing enormous delays. I know of several cases in which the proposals were sent in, the occupational therapist's assessment was given and everything was in order except that an unwarranted contractor had been chosen.
374 The people who make applications are not in a position to know who is warranted and who is not. The Housing Executive has the list in its offices. I should have thought that as a matter of course, when it sent out its communications to the applicant, it would include the list. The net result is that the lack of that information results in the application being delayed for many months. The application of Mr. and Mrs. Collins was delayed for 12 months on this score without the Housing Executive giving any idea of the reason for the delay. The application of another lady, a Mrs. Nan Lavell, who was very ill indeed, was delayed a matter of months for that same reason, without the Housing Executive giving any reason for the delay. That procedure should be streamlined as a matter of urgency.
People in such situations are reaching the age when they cannot cope physically or with the bureaucracy. Is not there a means of creating a one-stop application in such circumstances? The work does not involve major adaptations or renovation. By any standards the jobs are small, yet people have to make available three sets of plans for the planning department, three for the building control department, three for the Housing Executive and three for the occupational therapists department. If things are not just right, they have to go through that process all over again.
I have a case of a constituent in Newry, Mrs. Freda Williams, who has had two strokes and is bedridden. She very much needs the facilities that she has requested. After 12 months the relevant authorities are still asking for more copies of the plans that were submitted about nine months ago. There is something wrong there. That process could be speeded up substantially. I strongly request that the Minister consider a way in which a one-stop application could be made in such cases.
The fourth problem is delays in the payments for adaptations carried out. Perchance I was speaking by telephone this afternoon to a building contractor who specialises in this type of work. He mentioned to me several cases that were outstanding and told me that he and other contractors are stopping doing work involving a Housing Executive grant because they have to wait anything up to three months to wait for payment after the work has been done. Either the applicant must take out a bridging loan for that period—most are not in a position to do so—or the contractor goes without payment. That is the difficulty. Contractors will reluctantly say, "No, we simply cannot do your work because we cannot afford to be out of the money for that period."
In the cases that I have mentioned everything is in order —all the forms have been filled in and returned by the contractor, the work has been completed satisfactorily—but it is a long time before the cheque is processed and the contractor paid. In the present economic climate, he cannot cope with that situation.
There are a substantial number of cases before the Housing Executive concerning homes where major adaptations are required. I refer especially to the case of a constituent, a boy who cannot walk, talk, feed himself or do anything for himself, and will never be any different, as a result of meningitis at the age of three. He has to be carried everywhere by his mother and there are another five children in the house. That family has applied for a renovation grant on an old building. They were turned down because it did not fit the criteria.
375 As a result of advice from me and from others, the family has applied for a new replacement grant on the same building. However, as the criteria have still not been given by the Department to the Housing Executive, that case, among others, is waiting. Those criteria should be sent to the Housing Executive immediately so that it can begin to process such cases.
Will the Minister ensure that his Department study the criteria carefully? I know of no set of criteria that could be drawn up to include such a tragic case. It is impossible to write such criteria. Yet if there is no leeway within the system a tragic family like that will suffer most.
I should have preferred not to have to raise this matter in an Adjournment debate. I recognise that substantial staffing problems exist within the grants department of the Housing Executive, and I recognise the problems that that creates. I also recognise the fact that there are simply not enough occupational therapists. However, while I accept all those things and I have sympathy with those staff in the workload that they have to deal with, there are many ways that we could start to speed up the system. I have taken this opportunity to point them out to the Minister and I hope that something good will come of it.

§ The Parliamentary Under-Secretary of State for Northern Ireland (Mr. Richard Needham)
I welcome the opportunity to reply to the debate. The hon. Member for Newry and Armagh (Mr. Mallon) has raised issues of considerable importance to disabled people in his constituency and to all those affected by disability in Northern Ireland, who look to the grant scheme to work efficiently and speedily for them.
The hon. Gentleman said that he did not wish to criticise the personnel involved in the administration of the schemes. However, in some of the cases that he mentioned it appears that there must have been some error, or they would have been dealt with more promptly.
In 1989–90 the total amount of grant was £33.8 million, in 1990–91 it was £31.2 million and for 1991–92 it is £29.7 million. In the region which covers the Newry and Armagh constituency, the grant was £4.85 million in 1989–90, £4.43 million in 1990–91 and £4.3 million this year. I accept that the figures are slightly down, but not enormously so. I hope that the hon. Member for Newry and Armagh, and other hon. Members who represent Northern Ireland, will agree that one of the absolute keys is to ensure that the money we spend gets to the people who most deserve and need it as quickly as possible. We had hoped to announce the new scheme for consultation today, but that has been delayed until tomorrow or perhaps the end of the week.
The present scheme must operate a priority list. I believe that the Housing Executive ensures that those who most need the grants are put at the top of the list. The hon. Member for Newry and Armagh will be aware from his constituency that there have been problems with the preliminary investigations. Those problems were one cause of the delay that the hon. Gentleman described, but I have been told that the wait for that preliminary investigation is now down from six months to three months—the average in Northern Ireland. That time scale compares well with the rest of the country.
The length of the time that the occupational therapists take to complete their investigations is also down to about three months. In 1987, there were 28 occupational 376 therapists in the hon. Gentleman's constituency; now, there are 47. That is a significant increase. The total number of occupational therapists in Northern Ireland has increased from 206 to 277.
The hon. Gentleman might be interested to know that, in his constituency, 12.5 per cent. of the grants given to the disabled are dealt with by the Craigavon and Newry offices. Two years ago, the maximum limit on the grants went from £10,200 to £12,600. Furthermore, my hon. Friend the Member for Richmond and Barnes (Mr. Hanley) has added £2.6 million to this year's budget for occupational therapy, and about £500,000 has been made available to the Newry and Craigavon area.
Some of the delay is inevitably due to the way in which the applicant, having been through the preliminary investigation and the visit from the occupational therapist, considers the scheme proposed for him before proceeding to the formal application stage. I am sure that the hon. Gentleman appreciates that that takes some time.
I agree with the hon. Gentleman that every conceivable thing that can be done should be done to ensure that the applicant—the hon. Gentleman was right to say that he may be old and slightly confused—is assisted in filling out the forms. The hon. Gentleman spoke about approved contractors—that application form clearly states the need for such an approved contractor.

§ Mr. Mallon
It does not say who they are.

§ Mr. Needham
No, because there are about 900 of them. Many more are coming on to the list.
The applicant can contact the Housing Executive or the grant officer to discover who is on the list. I am sure that the hon. Gentleman will agree that an approved contractor is important, because the grant is paid to the applicant. Nothing would be more serious than to have unapproved contractors receiving the grant. However, I shall study the issue that the hon. Gentleman has raised about the length of time it takes for the grant to get to the applicant and then back to the contractor. The last thing we want is approved contractors having to wait too long for their money. I am sure that the hon. Gentleman agrees that is crucial that approved contractors are used to ensure that the work is done to the highest possible standard.
The new scheme is important. We will go out for consultation on the draft order in the next few days. The new scheme will allow specific grants up to the full cost of the work. At present, the maximum amount is 90 per cent. and it can be and often is 75 per cent., depending on someone's resources. There will be a grant of up to 100 per cent. of the total of what is required, following a test of resources. That is an important step forward. Naturally, I appreciate that it will mean that there will be gainers and losers, but the gainers will be the poorest and the losers will be those most able to afford a contribution toward what is required.
Nevertheless, I fully accept the points that the hon. Gentleman made about the need to be as quick as possible. The grant officer's job is specialised and needs someone who will look, particularly on major adaptations, at what is required. In addition, the occupational therapist needs to go into the appropriate scheme for the disabled person to ensure that the work is right for his or her requirements. I accept that, if there are unnecessary bureaucratic rules or 377 regulations or ways to get forms filled out singly rather than in triplicate, we shall do everything we can to speed up the process.
In the hon. Gentleman's constituency, the time taken is being reduced, although it has not been reduced as fast as we should like. There are more occupational therapists, and the time that they are taking is also being reduced. Some delays are inevitable, and it is often difficult to get round them, but that is no one's fault.
378 The Government take the matter extremely seriously and want to ensure that grants go to those who most need them. I assure the hon. Gentleman that my hon. Friend and I give the matter a high priority. I shall take up the individual cases that the hon. Gentleman has brought to my attention and give as detailed an answer on them as possible.