- '.—(1) Recipients of the highest rate of the care component oif the disability living allowance shall be entitled to a community care supplement payable out of the National Insurance Fund.
- (2) The weekly rate of the community care supplement shall depend on the individual circumstance of a severely disabled person. In particular it shall depend on the extent to which he is severely restricted in his ability to perform normal personal care and domestic tasks because of his disablement, on the extent of his need for help, attention or supervision from another person, on the cost of securing the required help, attention or supervision, and on such factors as the Secretary of State may prescribe.
- (3) For the purposes of subsection (1) above—
- (i) a community care supplement shall not be payable in addition to a payment from the Independent Living Fund;
- (ii) providing his circumstances qualify him for a payment from the Independent Living Fund, a community care supplement shall be payable to a severely disabled person in lieu of such a payment when the payment ceases on the expiry of the life of the Independent Living Fund Trust on or before 8th June 1993; and
- (iii) payment of the community care supplement shall be disregarded for the purposes of assessing housing benefit and community charge benefit.'.—[Mr. Hannam.]
§ Brought up, and read the First time.434 4.32 pm
§ Mr. John Hannam (Exeter)
I beg to move, That the clause be read a Second time.
I and other members of the all-party disablement group tabled the new clause to open up the debate on community care payments to enable severely disabled people to remain living in the community in their own homes. The new clause seeks to end the uncertainty about the future of the independent living fund, to fulfil the general desire to bring the payments more into line with social security disability benefits and to enable us to talk about meeting the crucial need for an alternative means of helping severely disabled people when independent living fund payments cease in 1993.
A theme running through several of the debates today will be the extra cost facing severely disabled people and the need to ensure that the costs are properly provided for in the benefit system. When the social security benefit reforms went through in 1986 and the system of additional cost payments was abolished, a worrying gap opened which threatened the community care programme as it affected severely disabled people. That is why the independent living fund was created and why it is vital that the uncertainty surrounding its future should be removed.
I congratulate my right hon. Friend on managing to secure £62 million this year for the independent living fund. The fund is highly successful in enabling severely disabled people to live independently in the community. It is an innovation, providing money directly to disabled people to enable them to buy in their own personal care and assistance services and to have maximum personal control over their living arrangements. Such a system, on a statutory basis, is central to any philosophy of independent living. Similar systems exist in Scandanavia. The basic philosophy of individual control over care arrangements is working well for many disabled people because of the money that they are receiving from the fund. Local authorities never have been, and never will be, able to provide that flexibility.
The fund helps more than 6,000 severely disabled people. The average payment is about £74 a week, and the highest payment is up to £400 a week. The trust deeds come to an end in April 1993, when the Government propose simply to transfer the fund to local authorities.
It is important to remind the House how the fund came into existence. During the passage of the Social Security Act 1986, much concern was expressed by disability organisations and by Members of all parties about the loss of additional requirements payments, in particular the domestic assistance allowance. At the 11th hour, the Government responded to our concern by setting up the independent living fund. I feel an awful sense of déjà vu, because April 1993 is approaching but no new arrangements are being made for severely disabled people. There will be an 11th hour panic as 6,000 severely disabled people, who currently receive payments from the fund, begin to make urgent representations to their Members of Parliament. I remind hon. Members that that figure represents about 10 for each constituency.
In Committee, the Minister said:It is inconceivable that on one day in April 1993 the whole of its case load will move over to the local authorities."—[Official Report, Standing Committee E, 11 December 1990; c. 63.]435 I strongly urge my right hon. Friend the Minister to assure the House that he will seriously consider setting up the ILF on a statutory basis. It would be stupid to have another panic such as we had in April 1988.
I draw the attention of my right hon. Friend the Minister to recommendations 11 and 12 in the ninth report of the Select Committee on Social Services, entitled "Social Security for Disabled People." It states:We continue to regard the ILF as an innovation that has enabled some disabled people to make community care work well … We further believe that the Government should consider the establishment of the Independent Living Fund as a statutory body.Those comments carry weight and I know that my hon. Friend the Member for Eastleigh (Sir D. Price), who is a member of that Select Committee, would like to add his comments.
In a sense, the fund has been a victim of its own success. The enforced restriction of the fund to disabled people in receipt of the higher rate attendance allowance and who are aged between 16 and 74 has meant that potential applicants have been losing out and there has been a drop in new applicants to the fund.
In Committee, the Minister responded by stating that he envisaged that the local authorities would undertake the vast majority of cases after 1993. I point out to the House that the supposedly watertight statutory duties to assess and meet the needs of disabled people may come under section 2 of the Chronically Sick and Disabled Persons Act 1970 and section 4 of the Disabled Persons (Services, Consultation and Representation) Act 1986. The National Health Service and Community Care Act 1990 imposes no stronger statutory duties than are contained in section 2.
From our long experience of working with disabled people and their organisations, we know that local authorities fulfil only statutory duties. I cannot realistically envisage that one day in April 1993 all local authorities will suddenly, magically, assess and provide individually tailored packages of care for severely disabled people in the way that payments from the ILF do. Most fundamentally, the ILF gives disabled people control over their own care arrangements, arranging care at the limes when they need it, not at the times that the local authority is able to provide it. I must point out that usually they are unable to provide that care after the hours of darkness, when extra care and help often is needed.
I should be most reluctant to see the flexibility that is now in place disappear. Unless there is clear action and commitment from the Government to place the ILF on a statutory basis, one day in April 1993, 6,000 severely disabled people will begin to lose their payments from the fund.
In Committee, my right hon. Friend the Minister acknowledged the point made by my hon. Friend the Member for Mid-Kent (Mr. Rowe), which I reiterate. Local authorities often have differing and competing priorities. If money is simply transferred to focal authorities, what guarantee will there be that it will not disappear into child protection, into road mending or into other priorities? We recently heard of one authority that is sacking five occupational therapists so that it can afford to meet its responsibilities under the Children Act 1989. I should like to place it on record that I oppose the transfer of the fund to local authorities because there is no evidence that they will be able to provide the high level of support that the fund now provides so successfully and because it 436 will be perfectly legal for local authorities to divert the resources intended by central Government for disabled people into completely unrelated areas.
When we press for change to social security Bills, we are often told, "It is a matter of resources." All political parties recognise that disabled people and carers need more resources and that this cannot be achieved overnight. However, the argument is different with the independent living fund because the money has already been allowed for in the budget. Disabled people will lose out if the fund is stopped. I know some disabled people who are terrified about what could happen in 1993. They have tasted independent living and enjoyed a basic human right that we all take for granted. They are fearful at the prospect of being forced into institutional care and now face two years of uncertainty.
I will give an example. Before the introduction of the fund, James, who is paralysed from the neck down, received all his care from his mother aged 82. He now receives a large payment from the fund which enables him to live independently, but what will his future be? For other disabled people, the fund allows payment for much-needed respite. One parent received a payment from the fund which enabled her to buy in two hours of care a week which allowed her a break from caring for her severely mentally handicapped daughter. Uncertainty about the future payments from the fund is causing disruption because disabled people cannot make long-term care arrangements as they cannot rely on those payments continuing.
The Government rightly promote community care. The fund enables many disabled people to make a reality of that care. Does not my right hon. Friend the Minister agree that it is absurd to propose to wind up the fund that enables severely disabled people to live independently? I urge the Government to follow the recommendation of the former Select Committee on Social Services to place the fund on a statutory basis. This group of severely disabled people must be provided for. They cannot face institutional care. The Government recognised that and provided for it in 1988 and that provision must continue. There must be no question of existing beneficiaries losing out.
I look forward to a positive response from my right hon. Friend. At this stage, I hope for a reassurance at the very least that existing beneficiaries will continue to receive payments. The Minister is familiar with the work of the all-party disablement group and its continued representation on issues such as the mobility allowance and benefit for deaf students. In both cases, the Minister responded positively.
The issue of the ILF will not go away. I am sure that my right hon. Friend will receive representations from hon. Members of all parties when their constituents begin to face uncertainty. If some of that uncertainty can be lifted, we shall be happy to let members of our all-party group in another place pursue the nuts and bolts of a proper arrangement.
§ Mr. Graham Allen (Nottingham, North)
I am pleased to speak from the Dispatch Box for the first time on this important and serious matter, and especially to support the all-party disablement group, its many eminent members who are here today, and their new clause, which follows that moved by my right hon. Friend the Member 437 for Manchester, Wythenshawe (Mr. Morris). He has done more than hold my hand over the past few days while I have been working my way into this complex Bill.
I know of the interest of the hon. Member for Exeter (Mr. Hannam) in this issue and I concur with many of his remarks. He rightly said that the new clause would put the independent living fund on a statutory basis and, above all, safeguard the payments from that fund which are currently made to severely disabled people. Sadly, the new clause is necessary because the Government appear confused and uncertain about the future of the ILF.
We all know that the deeds that created the charity—the ILF—expire on 8 June 1993. If the new clause does nothing else, I hope that it will smoke out the Government and give them the opportunity to make clear the future of the ILF and, above all, the future of those people who desperately need it or whatever takes its place. We hope that the Government will take this opportunity today.
There is great strength of feeling behind the new clause which is shown both by the fact that it is tabled by the all-party disablement group and by the presence of the hon. Member for Eastleigh (Sir D. Price) and other members of the former Select Committee on Social Services who propose that the ILF should be placed on a statutory basis. I hope that the Government will listen to the bodies that speak for disabled people, to parties of all complexions and to Parliament itself which found its voice through the former Social Services Select Committee.
The fund was set up to rectify the mistakes caused by the recklessness of the Social Security Act 1986, which left many severely disabled people as losers under what was then the new income support scheme. The ILF was not a spontaneous act of generosity by the Government. It was an attempt to make good some of the damage that they wrought in their social security expenditure changes in 1986 which were implemented in 1988. Having removed an essential provision, the Government rightly sought to put that right, at least in part.
The philosophical problem facing the Government is that they appear to regard severely disabled people as a public expenditure problem. The issue will not go away. Severely disabled people will not be reshuffled and will not disappear because of the 1986 Act, the ILF, a fancy agency or whatever takes the place of the ILF. A new answer must be devised which commands all-party support, which will stick and which will be for the benefit of severely disabled people.
The latest Government wheeze is to shuffle this "problem" over to local authorities under the community care policy and to hive off responsibility ever further until they can say, "This is somebody else's baby. It is not our responsibility." Whatever institutional rearrangement the Government come up with, the demand of severely disabled people for basic assistance to meet their obvious fundamental right to live independently as far as possible will reassert itself. The Government must understand that that fundamental need will not be organised away.
The ILF started with £5 million a year. As the hon. Member for Exeter said, next year it will have £62 million. Even that figure entails rejecting nearly three quarters of the applications received and restricing the original criteria 438 to those who are over 16 or under 74 years old. Anyone who is not on the higher-rate attendance allowance is also disqualified.
As the hon. Member for Exeter said, the ILF is threatened by its very success. That underlines the need for the fund or a successor body. Who knows what is the unmet demand from among the 6,000 disabled people in the United Kingdom? The answer to that frightens the Government and motivates their search for someone—anyone but the Government—to administer a scheme such as this. In Committee, the Minister said:After 1993, the generality of cases should go to local authorities. There will obviously be a need for some interim arrangement to deal with the existing load of the ILF . . There will have to be some transitional provision and there may be some provision for new cases. I am not able to go much further than that today".—[Official Report, Standing Committee E, 11 December 1990; c. 63.]In the two months that have elapsed since the Minister said that, perhaps he has had a chance to think about what will happen next for those with severe disability. I invite him to tell the House those thoughts.
§ Sir David Price (Eastleigh)
I shall be brief, being aware of the desire of hon. Members to make progress due to circumstances outside the House.
I congratulate the hon. Member for Nottingham, North (Mr. Allen) on his first appearance at the Dispatch Box. This is a good subject on which to make one's first appearance there because the issue rightly produces harmony across the Floor of the House. I am pleased that he and my hon. Friend the Member for Exeter (Mr. Hannam) referred to the report of the Social Services Committee, and, as it is clear that hon. Members present today have read it, I need say little about it.
Attention was drawn to our second recommendation in the part of the report dealing with the independent living fund, which was to put it on a permanent basis. I need not rehearse the arguments, but I draw attention to our other recommendation, which was based on this quotation from the chairman of the trustees of the fund, the admirable Mrs. Winifred Tumim:We would agree that there is an enormous amount, a huge amount, of unmet need and a vast amount of misery which is not being attended to. As trustees, obviously, we cannot do more than administer the resources in the most equitable way we can.All who have been involved over the years with the severely disabled know that what Mrs. Tumim said is true, so it was not surprising that our first recommendation under that part of the report stated:We recommend that the Independent Living Fund be provided with additional resources specifically to collect more detailed information about the characteristics of applications to and awards from the Fund, and that the Government should use this information to help plan the development of social security benefits for disabled people.That is a reasonable recommendation. We are concerned with an evolving scene. Other reports have produced more information, and it is clear that we do not know it all. Anyone who thinks that it is a static situation and who suggests that we need only upgrade for inflation does not understand the scale of the issue with which we are trying to deal. I hope that the Minister will respond to both recommendations, which appear to command the support of the majority of the House.
§ Mr. Jack Ashley (Stoke-on-Trent, South)
I was sorry to miss the opening speech of the hon. Member for Exeter (Mr. Hannam), who has done much work on behalf of the 439 independent living fund. The new clause is about a small group of special people who are particularly and severely disabled. Their struggle is unbelievable—in many ways, beyond the imagination of many of us.
Hon. Members will recall the contribution of Mary Greaves, the director of the Disablement Income Group. She told me that it took hours for her to prepare simply to go out to a meeting—to get dressed, bathed, leave home and get into the car—activities that we perform easily when we come to the House. As I say, the effort required by them is extraordinary and is unimaginable by able-bodied people. We should keep people such as Mary Greaves in mind as we decide whether to accept this new clause.
The Minister should remember that, by agreeing to the new clause, he would help not only the disabled but himself, because he knows, being a statistician, that he will, as a Minister, have to find much more to keep them in institutions rather than it would cost to allow them their independence.
Local authorities are not the appropriate organisations to provide the type of provision that is given by the independent living fund. Indeed, they are the last bodies to wish to undertake the task, because local authorities always provide funds for popular causes. The severely disabled are not a popular cause in that sense. Therefore, I hope that the Minister will accept the common sense embodied in the new clause, which would then clearly be approved by the House.
§ Mr. Dafydd Wigley (Caernarfon)
I too support the new clause, and I apologise to the hon. Member for Exeter (Mr. Hannam) for missing his speech. I was caught by the starting gun in dashing through the snow to get here. I also welcome the comments of the hon. Member for Nottingham, North (Mr. Allen) and congratulate him on his initial performance at the Dispatch Box. I hope that it was the first of many, and I am sure that we shall co-operate on cross-party lines on other issues such as that being discussed today.
The Minister heard many of the arguments in Committee and I shall not rehearse them again. I believe that in his heart he has sympathy with the direction in which we wish to go. I hope on a day such as this, when we are reminded of the importance of making provision for disabled people, that the Minister will meet the points embodied in the new clause.
§ Dame Elaine Kellett-Bowman (Lancaster)
I too hope that the Minister will find a way to accept the new clause. I do not agree with the right hon. Member for Stoke-on-Trent, South (Mr. Ashley) that the people we are referring to are not a popular group. Although small in number, they comprise an important group who elicit public support well beyond their numbers.
§ The Minister for Social Security and Disabled People (Mr. Nicholas Scott)
I welcome the hon. Member for Nottingham, North (Mr. Allen) to the Dispatch Box—in taking part in a debate rather than asking questions—and wish him well. No man who could remove Gary Sobers twice in a fortnight from the wicket can be bereft of a certain quality. I congratulate him on that and on his succession to the Opposition Front Bench. Although in the summer we played in the same team together, whereas now 440 we are condemned to be on opposing sides, I hope that the spirit that was engendered on those earlier occasions will pervade our discussions.
I assure the hon. Gentleman that in no sense do I regard the troubles of, or individuals who suffer from, severe disability as a problem. Our job, as the Government and as a legislature, is to see this as an opportunity to enable disabled people to enjoy a quality of life that has been denied their predecessors and many of them.
Much has happened. I will not go over the ground that I have covered on other occasions in saying why I believe that the next 10 years will be important in terms of improving the quality of life and accessibility of disabled people to opportunities in employment, leisure and independent living that the rest of us can take for granted.
I am anxious to play my part to the greatest possible extent in bringing that about, and I know, because of the all-party Select Committee, on which the right hon. Member for Stoke-on-Trent, South (Mr. Ashley) and my hon. Friend the Member for Exeter (Mr. Hannam) play an important part, that, when hon. Members discuss these issues, they do not discuss them on a partisan basis. We want genuinely to help people with disabilities. Perhaps I run some gentle danger elsewhere in Government if I say that I welcome the pressure that I am frequently put under by hon. Members in urging me to do still better.
We are discussing, in particular, the independent living fund. I take a personal interest, and some satisfaction, in the way in which the ILF has developed and expanded. I recall approaching the present Prime Minister when he was Chief Secretary to the Treasury to persuade him to produce £5 million for the fund, whereas the budget this year is £62 million. It has been a great success, not least because it has identified a real need in the community and gives disabled people the chance to exercise control over the provision made for them. It ensures that they are not simply told that somebody can come at a particular time of day that suits the timetable of the social services department. Instead, choice can be exercised about the nature and extent of the care that they are given.
I should like to underline the compliment paid by my hon. Friend the Member for Eastleigh (Sir D. Price) to Mrs. Tumim and the other trustees of the independent living fund. I doubt whether any of them realised the extent of the work that they were undertaking when they took on the responsibility. They have carried out that work with sympathy, flexibility and imagination. I congratulate the chairman and, although it is invidious to pick out a single trustee, make a special mention of Pauline Thompson of the Disablement Income Group, who has played a most constructive role in the affairs of the independent living fund since its introduction.
I recognise that the new clause is a device to obtain assurances about the long-term future of the independent living fund, but I am bound to say a word or two about the merits of the new clause. The most satisfactory way forward is not to put it on a statutory, regulated basis. By 1993–94, we expect that the adjudication officers in our Department will be making about 20,000 decisions a week on disability living allowance. They will thus have to be very much concerned with the regulations for that benefit.
One of the most important parts of the magic of the ILF is that trained social workers make individual visits, go in some depth into the needs of disabled people and come up 441 with a package to meet those needs. However worthy our staff are in the Department of Social Security, because of the pressure under which they are working, 1 doubt whether they could provide such attention and sympathy to the needs of individual disabled people in the same way as the ILF provides at present.
I understand the concern of the right hon. Member for Stoke-on-Trent, South and of other hon. Members who have spoken in the debate about the ability of local authorities to pick up those cases. I reiterate that, as the ILF has been running in recent years, I have been worried about the number of local authorities that have, in essence, been passing on cases to the ILF that should properly have been the responsibility of local authority social services departments. It has been an easy option for them to take when there are other priorities competing for their budgets.
I stand by what I said in Committee, that I believe that the vast majority of cases that, at present, are the responsibility—
§ Mr. Ashley
If the Minister feels unable to accept the new clause, will he give strong guidance on the fund to local authorities?
§ Mr. Scott
We still have two years before it is contemplated that the Griffths proposals on community care will be introduced. The vast majority of cases presently being handled by the independent living fund should then be able to be handled by local authorities. I shall draw the attention of my ministerial colleagues to the right hon. Gentleman's point about the need for guidance when that change is made, so that local authorities are conscious of their responsibilities.
The words that I used in Committee were carefully chosen. Although I take seriously the points that have been made today about the future position of people currently being helped by the ILF and understand anxieties—many people have communicated them directly to me—now I can say only that we wish to look most closely at the proposed arrangements that will come into effect in 1993, the timetable for the transfer of cases and any transitional arrangements necessary. Without wishing to sound arrogant, I hope that, given my track record of launching the ILF and seeing its successful expansion, hon. Members will accept my assurance that I wish to be satisfied about the practical effects of the arrangements.
§ Mr. Allen
Although I accept that the Minister cannot give a firm date or set of organisational arrangements today, will he offer some encouragement by saying when he will make announcements so that hon. Members and people who work for disabled groups can make representations to him and work towards that proposed date?
§ Mr. Scott
That is difficult, because of the natural decision-making processes in Government. There must be discussion and, apart from the purse strings aspect, the arrangements will involve local government, which is a matter for my right hon. Friend the Secretary of State for the Environment. I want to announce, as soon as possible, the arrangements that will come into effect after 1993, not least because I know of the anxieties that many people on the ILF are feeling, and I do not wish unduly to delay that process.
§ Mr. Hannam
I wish to deal more with the present than the future. My right hon. Friend is aware of the problems caused by the restricted criteria presently applied to the ILF, especially the upper age limit. I understand that the trustees were looking at the restrictive criteria. Does my right hon. Friend know whether changes could be made to make matters easier?
§ Mr. Scott
I met a number of the trustees of the ILF yesterday to discuss a variety of matters. During the meeting, they said that they were going to lift the restriction on the upper age eligibility for the ILF from 1 March this year. I hope that that will be seen as a positive step.
I have listened carefully to the points made by several hon. Members. I understand the anxieties and am keen to put them at rest as soon as possible. For the moment, I rest on the words that I used in Committee.
§ Mr. Hannam
I am grateful to my right hon. Friend the Minister for summing up the debate as he has, and I hope that we shall be able to pursue the subject in another place. I beg leave to withdraw the new clause.
Motion and clause, by leave, withdrawn.