HC Deb 05 July 1995 vol 263 cc347-54 1.30 pm
Mr. Eric Clarke (Midlothian)

First, I should make it clear that my hon. Friend the Member for Monklands, West (Mr. Clarke) will be helping me in the debate. The Minister and I have agreed that he should share the time.

I am grateful for this Adjournment debate, which gives me the opportunity to draw to the attention of the Minister and of the House the injustice to the parents and carers of severely handicapped children under five years of age, and perhaps to do something to rectify the anomaly that the mobility component of the disability living allowance is denied to those parents and carers.

I wrote to the Ministry and received a reply from the chief executive of the Benefits Agency, Ian Magee, who kindly pointed out that, regardless of the compassionate case that I had presented to him, section 73 of the Social Security Contributions and Benefits Act 1992 states: Subject to the provisions of this Act, a person shall be entitled to the mobility component of a disability living allowance for any period in which he is over the age of 5". His letter also pointed out that appeals to tribunals and adjudication officers are to no avail as they must adhere to that clause. I ask the Minister to alter section 73 of the legislation.

I should like to quote as an example the case of my constituent, Rebecca Kennedy, of 17 Attlee crescent. Mayfield, Dalkeith. Today is the 50th anniversary of the election of the Attlee Government, so I hope it is a good omen for the case. Rebecca is 19 months old. Her mother has given me a list of what is wrong with her and I shall read it out. Rebecca has got brain damage and cerebral palsy—she has both ataxic cerebral palsy and spastic cerebral palsy. She has epilepsy—myoclonic seizures and petit mal seizures. She is microcephalic, which means her head will not grow to the normal size. She has abnormal swallow, which means she cannot eat and requires suction. She is blind. She has only 1 per cent. vision in her right eye and her left eye does not work properly. Rebecca cannot roll, sit, stand, let alone walk. She cannot use any part of her body. All she can do is lie on her back. I should add that she is a beautiful young child.

Transport is a problem. Her mother writes: To get a bus, I have to take a snug seat wheelchair, a tray for the suction machine, the suction machine itself, all her tubes, a bag carrying nappies, food plus her drugs. The seat of the wheelchair is very large and heavy. You cannot fold it down as it is hard backed for her spine. To fold the frame down you have to take the tray off and the frame is extremely heavy. There is no possible way I could use a bus, even with two adults helping. She then challenges anyone to come along for a demonstration. The most important part is as follows: Rebecca requires 24-hour care. You cannot leave her for a second as she could choke to death on her own saliva. She takes lots of muscle spasms due to her cerebral palsy. In the future, she will be getting an operation which will mean a tube shall be coming out of her belly to feed her through. That is heart rending and no one has challenged those facts or her condition.

The argument that children under five are not mobile and can be carried physically does not apply to Rebecca. There are many other children in similar predicaments.

Mr. Alfred Morris (Manchester, Wythenshawe)

The compelling case that my hon. Friend is making for a change in the rules can be of help to disabled people generally. It would be enormously helpful, as he says, to disabled children, but others too could benefit. My hon. Friend has long shared my concern and that of other right hon. and hon. Members that many people who have Alzheimer's disease are excluded from applying for the allowance because of the very restrictive criteria used. Is he aware that the Alzheimer's Disease Society now estimates that as many as 17,000 people with the disease who are under the age of 65 are being excluded because of those very restrictive criteria?

Mr. Clarke

I have had correspondence with the Alzheimer's Disease Society and there are practical examples in my constituency. As my right hon. Friend knows, we have been trying to form an organisation to look after people in that anomalous position.

I am sure that Rebecca's predicament is repeated throughout the country. Her case should be heard on its merits and should not be written off because she is under five. Rebecca will never be independently mobile and the whole Kennedy family have rallied round to offer her mother and father financial and physical help. The local community of Mayfield has contributed towards the very expensive walker that is needed for a child such as Rebecca. A normal walker that helps children start walking is nowhere near as expensive. Rebecca's grandparents, uncles and the rest of her family have rallied round, as has the local community, and I am proud to represent them. The family have an old car and its upkeep and running costs are a severe burden on the domestic budget.

I understand that lifting the five-year policy will cost the Government money, but if children such as Rebecca were cared for not by their families but by the state, the cost to the country would escalate. I am in no way threatening the Minister. The Kennedys would never contemplate that option as their love and dedication are far too great, but keeping children such as Rebecca in an institution would be more costly than the sums of money that would accumulate if they received an allowance. The figure has been roughly estimated as £30 million. That is not a large amount when one takes into account the budget of the DSS.

I hope that the Minister will override the Treasury. I am aware that the dead hand of the Treasury locks on to every detail of Government spending and that, for some reason, it claws money back, usually not from the fat cats but from the people who most need it.

I ask the Minister to give carer families justice, and to make that justice effective. The Kennedys and others like them need help now. If we wait until Rebecca is five years old—she will not qualify for another three years—her family, who deserve better, will have to carry a heavy burden of increased costs. Of course communities are sympathetic to such cases—no one who knows about the disabilities of this little girl and the burden on her family could be otherwise—but sympathy is not enough. The Kennedys of this world who have dedicated their whole lives to the care of disabled children need help, guidance and financial backing.

My trade union background has taught me to be short, concise and to the point, and I intend to be so. I only wish that many other people in this place were the same. I urge the Minister to drop the five-year qualifying rule in section 73 and to allow those cases to be examined and then to qualify for the mobility component of the disability living allowance. That would give the people caring for such children a morale boost. Even more importantly, it would be a way of showing that the community and the country believe that justice should be delivered to the people who dedicate their lives to the children like Rebecca whom they love so dearly.

1.40 pm
Mr. Tom Clarke (Monklands, West)

I thank my hon. Friend the Member for Midlothian (Mr. Clarke) for initiating this debate. I think that the House was impressed by the lucid and sincere way in which he invited us to discuss this case and other relevant matters.

The case raised by my hon. Friend is, as he knows, not unique. I have a number of similar problems in my constituency, as, I am sure, do other right hon. and hon. Members. Like my hon. Friend, I want to pay tribute to the dedication of parents such as those whom he has described—there are many of them—and to their commitment, which is simply colossal. To care for a child with multiple disabilities is hard enough for any parent. For those—I have met some of them—who are themselves disabled, it is doubly difficult. For those who cannot take employment because of the demands of their parental responsibilities, the willingness of the wider community to provide the necessary support is vital to their day-to-day lives.

I know that solutions do not come easily, but our minds are set on seeking to achieve genuine community care. That is why I was delighted to hear my hon. Friend pay tribute to his community. When a child of three or four cannot walk because of a disability, that causes quite enough stress for his or her parents. When moving the child requires more physical effort than a single adult can muster, the stress is clearly redoubled. Such parents know that mobility problems will be with their children for life—for the whole of their lives. So their inability to obtain mobility support is a further source of stress and strain in an already difficult situation.

The Prime Minister has signalled his recognition of the fact that children under the age of five can and should benefit from nursery education. Of course we welcome that. This is therefore surely a good opportunity to review the cut-off at five years of age for access to mobility support—that was the kernel of my hon. Friend's case.

I should be interested to hear from the Minister what new thinking the Government have done on this matter. I imagine that he will not dispute that it can become clear long before the age of five—as in the case mentioned by my hon. Friend—that a child will never be capable of independent mobility. Hence the needs of the family and others must be taken into account in any forthcoming review. I certainly hope that a review is under way.

I am sure that the Minister will not dispute, either, that the purpose of the mobility element of the disability living allowance is to promote independent mobility for those facing long-term disability, or that there can be clear benefits from providing such support at an early age. We have heard of the constant care required in some of these cases, and of the difficulties experienced when moving children with severe disabilities. The issue is the independence of carers as well as of their children. We should try to alleviate, wherever we can, the burdens carried by those who choose to do the caring.

Many voluntary organisations and professional bodies are involved too—Mencap and the Royal Association for Disability and Rehabilitation to name but two. My right hon. Friend the Member for Manchester, Wythenshawe (Mr. Morris) will confirm that the organisations dealing with the 19-plus groups also have a stake in this matter. I visited some of them only last week in Rochdale and Oldham, and I expect to visit more of them before the end of this week. I know that I shall witness there more problems similar to those that we have been discussing today.

Not for a second do I want to make a party point, but the Minister knows that Lord Brian Rix of Mencap and many others draw to our attention time after time in the all-party group on disability—my right hon. Friend the Member for Wythenshawe has played a noble role in it, as have Conservative Members and Members from the smaller parties—problems of the sort identified by my hon. Friend the Member for Midlothian. There are no doubts about their views of those problems.

Parents, especially young parents, are greatly shocked to find, sometimes overnight, that the child whom they were expecting to provide the greatest joy of their lives has severe disabilities that mean that a great deal of caring and understanding on the part of everyone concerned will be needed.

We are not charging towards the Government demanding a reply today, but we do seriously invite them to hold a review—and to involve others in it. We can learn a great deal, not just from the national organisations that I have mentioned, but from local groups. I thought it wonderful that my hon. Friend paid tribute to such groups. He was talking about a 19-month-old child; that suggests to me that people quickly rallied round to meet the family's needs.

I hope that the Minister will respond to my hon. Friend's excellent speech in the spirit in which the debate has been held. I hope that he will consider the case sympathetically, because it was a sensibly made and compassionate one. That is only what I would expect from my hon. Friend the Member for Midlothian.

1.48 pm
The Parliamentary Under-Secretary of State for Social Security (Mr. Roger Evans)

I begin by congratulating the hon. Member for Midlothian (Mr. Clarke) not only on selecting an important general issue but on directing our attention to a particularly sad and tragic case in his constituency. He promised to be short, concise and to the point, and he most admirably was.

We cannot listen to an account of the predicament of Rebecca Kennedy without being moved by it. Her position is obviously a most difficult one. Her family are coping admirably in very difficult circumstances, and any appeal for more help for them is bound to stir our hearts. The hon. Gentleman is absolutely right to say that discretion cannot be exercised in this case because of the terms of the statute—that is the basic point. He has therefore come to the House to invite the Government to consider altering the law. I entirely accept that that is a proper way of putting the argument.

We are talking about—I shall briefly put the matter in context—the entitlement to the mobility component of disability living allowance. The allowance was introduced in 1992 for people disabled before the age of 65 and, for them, it replaces the help formerly available through attendance allowance and mobility allowance. People who need frequent help in connection with bodily functions, and who would previously have received attendance allowance, now receive the care component of DLA at either the middle or higher rate. People who are physically disabled and, as a result, are unable to walk, or virtually unable to walk, who would previously have been entitled to mobility allowance, now receive the mobility component of DLA at the higher rate. New lower rates of both components were introduced to extend help to people who, though disabled, could not previously qualify for the old benefits. Disability living allowance is tax free, non-contributory and non-income related, and is intended to provide help with the extra costs associated with disability.

It is important to understand the principles that at least traditionally have been understood to lie behind these matters. Disability living allowance is not a form of compensation for disability but a personal benefit based on the effect of a disability rather than on the fact that someone has a particular disability or condition. What matters is whether the condition gives rise to care and mobility needs and, if so, how those needs affect the day-to-day life of the disabled person. An award of DLA can trigger eligibility to other benefits—for example, someone who is caring for a disabled person receiving DLA may be entitled to invalid care allowance, as I understand that Mrs. Kennedy is. An award of DLA can also provide access to one of the premiums payable with the income-related benefits such as income support or housing benefit.

As the hon. Member for Midlothian said, the purpose of the mobility component, because it is directed to the effects and dealing with what has to be done to ameliorate those effects, rather than with the condition itself, is to help people to be independently mobile. That point was taken up by the hon. Member for Monklands, West (Mr. Clarke). That, of course, assumes that it would not be right to pay benefit to anyone whose mobility could not be improved. To take an extreme case as an example, someone who is in a coma will never be independently mobile.

Two statutory tests may be relevant. One of them, which we have heard about in detail, is section 73(1) of the Social Security (Contributions and Benefits) Act 1992. That is the age restriction. The second test is section 73(8), which states: A person shall not be entitled to the mobility component for a period unless during most of that period his condition will be such as permits him from time to time to benefit from enhanced facilities for locomotion. The classic example of someone who would not be so entitled is my example of someone whose condition is so severe that he is in a coma. I understand that very few cases are refused on that particular head.

The second matter, and the most important one, is the position of children under five years of age. I have no doubt that the hon. Member for Midlothian appreciates—I saw the right hon. Member for Manchester, Wythenshawe (Mr. Morris) in his place earlier; he has now left the Chamber but he stood in my place in 1975 to advance the argument that I am about to put to the House, but I understand that he has changed his views since—that we are talking about a restriction that goes back all the way to 1975–76.

Children under five were never eligible for mobility allowance which, as I have explained, was the predecessor benefit. That goes back to the introduction of mobility allowance in 1976. It has been argued throughout—that argument has been advanced in the House on several occasions—that the rule should be changed. However, the general view of Governments of all descriptions since that period, nearly 20 years ago, has been that it is best to retain the exclusion.

Research conducted in the mid-1980s by the Office of Population Censuses and Surveys into the incidence and prevalence of disability concluded that mobility allowance was well targeted on people who were severely disabled. That is why, when we introduced DLA, we decided to base eligibility on the higher rate mobility component, largely on the old mobility allowance conditions of entitlement. The OPCS findings also informed the creation of a new lower rate of the mobility component to help people who were able to walk but needed supervision to make use of the facility out of doors, extending help with mobility needs for the first time to people with a mental impairment rather than a physical disability.

The principle that underpins DLA is that awards are intended, in general terms, to be based on the effect that disability has on the care and mobility needs of an individual and not on the disability itself. There is a distinction in the case of children. I appreciate that we can argue about how great the distinction is. I appreciate also that we can argue whether it should apply to three, four or five-year-olds. How much is there an amount of additional care and supervision that the disabled child needs beyond what a child of normal health would require?

We recognise that some young babies need substantially more care than able-bodied children. That is why there is no age limit comparable to the one that we are discussing when it comes to the care component of DLA. We do not accept as a general proposition, however, that the position is quite the same for the mobility component. It is the Government's view that it is not so convincing to talk of a three or four-year-old as being independently mobile. I appreciate the problems, of course, when I hear about the difficulties of getting poor Rebecca Kennedy on to a bus and lifting a particularly heavy snug seat, or whatever it is called, which is part of the wheelchair. I understand that there is a real problem. As a general proposition, however, we say that the mobility component is all about making people independently mobile. That is the great success of it for the older person.

We say that the position of children is different. I recognise that there are cases where it may be—

Mr. Eric Clarke

I understand what the Minister is saying. I am a father of three children and I understand that there is involved a normal upbringing, including going shopping with them. They are mobile, or partially mobile. Shopping outings are part of learning, of meeting other people and being in the community. The same can be said of meeting relations and making journeys to visit them. Why should a person who is disabled stay at home? That is really what the Minister is suggesting should happen.

Mr. Evans

The hon. Gentleman is right. There is an element of degree of mobility. We are saying that, classically, the mobility component is directed towards independent mobility. As the hon. Gentleman said, perhaps with remembrance of his own children, young children of three or four years of age learn to walk about, and the amount of supervision that is required diminishes as they become older. As I have said, it is a matter of degree. At the end, the difficulty for the Government is that we have competing priorities. However heart-rending is the case which the hon. Gentleman moved us with, we say that when taking the principle of independent mobility, disabled children under five, given the traditional way of looking at these matters, must be at the lower rather than the higher end of the priority list.

I cannot put it any more firmly than that. There will always be difficult decisions in social security matters when it comes to drawing a line. Undoubtedly, the drawing of lines creates hard cases. It is our view, however—this has been a conventional view of Governments, as I have said, for 20 years—that the proper dividing line, if we have to draw one, is the age of five years in this instance for the mobility component of DLA. That is comparable with school age, when normally children become less dependent on their parents. Before the age of five, it is normal for children to be unable to go about without their parents' help.

Much careful consideration was given to this issue. It was the subject of much debate during the passage of the Disability Living Allowance and Disability Working Allowance Bill, which went through Parliament not that long ago. We do not believe that extending the mobility component to the under-fives can be the principal or leading-head claim on the list of priorities for benefit expenditure when there is so much pressure on resources and so many competing priorities. The hon. Gentleman is absolutely right to say that that would be expensive. He correctly quoted a figure of £30 million a year, which would indeed be the cost of extending the limit from the age of five to two. Although I appreciate that, as he said, it is perhaps not that big a sum when cast in the wider budget of the Department, it is nevertheless a considerable sum.

I apologise to the hon. Gentleman; he has moved our hearts on the issue, but I am afraid that the Government have to take the view that, on competing priorities for social security expenditure, we are not presently minded to alter the law, and it would require statute to do what the hon. Gentleman wants.

Madam Deputy Speaker (Dame Janet Fookes)

Order. We must move to the next topic.