§ 7.6 p.m.
§ Order of the Day for the Second Reading read.
§ BARONESS SWANBOROUGHMy Lords, I beg to move that this Bill foe read a second time. It comes to us from another place, where it was introduced as a Private Member's Bill by Mr. Geoffrey Johnson Smith and accepted with generous readiness on all sides. The purpose of this Bill is to authorise local authorities to provide a meals service and recreational facilities for elderly persons of pensionable age. It makes clear that in future local authorities dan incur capital expenditure in order to help voluntary bodies who wish to undertake the service either of "Meals on Wheels" or of recreational facilities fox old people, and this enablement of local authorities means that, in regard to the "Meals-on-Wheels" service, they could supply kitchens, transport, equipment, and, in a very heavy commitment, even help with staff. It also clarifies the point that assistance for recreational activities can be supplied on the same basis.
A change in the Government's attitude has now made it possible for expenditure under the Bill to rank for rate deficiency grant in England and Wales and for an Exchequer equalisation grant in Scotland, and as authorities which qualify for this grant are, in the main, those authorities which are less well off, it is in their areas that the elderly people need the help most acutely, and, therefore, where they will be looking for the assistance that this Bill will help to provide. I am convinced that local authorities will welcome this Bill because, although they have been able to give help in the way of grants to assist voluntary organisations undertaking the work of supplying 410 recreational facilities and meals services, they have had no clear instructions as to the lengths to which they could go in the provision of premises, equipment, transport and so forth.
It will be remembered that in the debate we had in your Lordships' House just over a year ago, when I declared my personal interest in a voluntary organisation, the plea put forward by most of the speakers was that the gap in local authority legislation should be closed. This Bill now makes the position quite clear and there can be no misunderstanding of any kind at all about the scope for assistance. The Bill does, in fact, close the gap, and in this I feel that Her Majesty's Government are not only giving real help to local authorities and voluntary organisations, and also to all those who wish to fulfil a task which they are anxious to undertake and achieve, but are also showing real vision in ensuring that in the long run one important aid to domiiailiary care is being established in a way in which it can make a pattern for the future.
Voluntary organisations, my Lords, can provide a real complement of voluntary workers, and by this I mean the number of people who are able to undertake the work; but it is impossible for these people to provide the cash with which to acquire the tools with which to do the job intended, and I personally do not think it would be right for them to have to do so. The Bill will make it possible for local authorities to supply to individual and accredited voluntary organisations the premises in which they can do the work, and, in the case of "Meal on Wheels", to help with equipment and transport.
It will also ensure that recreational help of the same sort is forthcoming. It will similarity make it possible to supply that equipment to undertake the type of service with which I am primarily responsible, which means that insulated equipment conforming to the hygiene requirements of to-day, and bringing the meal in the right shape to the person who needs it, will be 411 available; and, finally, it will help the burden when it becomes over-heavy when, in supplying 100 or more meals a day, three or five days a week, the local authority could, if necessary, assist the continuity fey supplying either a cook or assistant in the kitchen.
This Bill will make it possible, even more than heretofore, for local authorities and voluntary organisations to integrate their efforts, one with the other, in order to serve the community, and inasmuch as the undertaking is ultimately a direct responsibility of the local authority I am extremely happy that premises, equipment, transport and so on can be loaned as well as given. To my mind the loaning is, in fact, the better concept, for it retains in the hands of the local authority the control of as well as the responsibility for the scheme. Personally, I am delighted at the shape the Bill has taken. I feel that if voluntary organisations are working on a big scheme it is right, both for the voluntary organisation and also for the responsible body, that a form of control should be kept by the responsible body—in this case the responsible body is the local authority. And if the local authority is to loan or give temporarily equipment and other necessities to the voluntary organisation I think it is also necessary for the local authority to be thoroughly satisfied that the job is carried out in a way that is right from the point of view of the person served, and also that money is being used to the full advantage. I am not anxious to have great dollops of money allocated. I am much more anxious to have the tools with which to do the job, so that in fact the zest and the interest of the volunteer are preserved and not lost in the difficulty of acquiring the equipment with which to do the job.
To-day the social services of this country are carried through in very large measure by the local authorities, but local authorities do not wish to undertake such work by themselves without the contributory strength of their own citizens. If we are to achieve the future we look to, we must ensure that participation of this kind is of a shape acceptable to those it aims to serve and possible for the persons who wish to do the work. The local authority aims at decency of living and contentment of living for those 412 who are within its boundaries, and the volunteer who is a member of that community is anxious to play his part in that aim. But the responsibility is vested in the local authority, and therefore the standard of service is their concern.
It is getting late and I will not burden your Lordships with the ramifications of the work that are adumbrated by this Bill. I think it is sufficient to say that if the Bill is used to advantage—as I am sure it will be—it will mean that in no time the additional number of meals to be served per week will be quite beyond what in envisaged to-day, and that by supplying such a meal regularly people will be saved going to hospital, as they so often have to do, because of malnutrition. Moreover, people will be able to come out of hospital that much sooner, confident that they will have a meal regularly supplied. I can see frail but ambulant old people served on a meals centre basis, and many useful projects for the benefit of the community developing from the Bill. With a visionary eye, one can see that, in the long run, fewer institutions will be necessary, because people will be able to remain in their own homes so much longer.
We all realise that the schemes themselves will in time change as to methods, and I am quite convinced that this Bill is the beginning of something very important in bringing happiness into the lives of old people, and that it has a great value financially to the country because of the savings it will effect in national expenditure. I earnestly hope that all concerned will recognise the opportunity which this Bill provides for local authorities and voluntary organisations to work as joint partners both in the production and the carrying through of really imaginative schemes and in making the outcome of the Bill one of happiness for those it aims to serve. I beg to move that the Bill be read a second time.
§ Moved, That the Bill be now read 2a.—(Baroness Swanborough.)
§ 7.15 p.m.
§ LORD AMULREEMy Lords, I should like to make one or two comments on this Bill before it is given a Second Reading. The Bill itself certainly has a great deal which one can welcome in it, but I do not think it goes 413 quite far enough. It certainly is of great advantage for old people, particularly those living by themselves, to be provided with a hot mid-day meal. I should therefore like to associate myself with what the noble Baroness has said about the very good work done by the voluntary organisations in making this provision and to express my pleasure that it will be possible now for the local authorities to assist them in the work which they are doing. From my point of view, however, I find the Bill a rather disappointing one, because for a long time I have been looking forward to the establishment of some sort of comprehensive domiciliary meals service. In fact about four years ago, when I was chairman of a voluntary body which gave an invalid meals service to people in London, together with one of my colleagues on that body I wrote an article which appeared in the medical Press dealing with this particular subject. And from the points of view we expressed there I certainly have seen nothing to change my opinion.
If your Lordships will forgive me, I will mention one or two points to show what I am referring to. Broadly speaking, there are two types of person who need a meal delivered to their home: those who need it for a short time, and those who need it for a long time, or may be even permanently. Those who need it for a short time may be young people or may be old people. They may be people convalescing from illness; they may be people who have been in hospital and have been discharged. It will apply to people of all ages. At the same time, if you are going to take the meal for a long time, or permanently, there will again be two types of person: those who require special diets to deal with some special form of disease from which they suffer, and those who require what one might call a normal diet—those elderly folk who are frail but not necessarily sick.
The noble Baroness mentioned the number of times the meal should be available, and I think that any service should be available on five days a week—not that everybody will want it, but a certain number will, and it should be available in that way. That is why I am rather disappointed in the Bill, because 414 it refers to elderly people or old people, and gives no indication what that means. I take it that it means when people reach pensionable age, 60 for women and 65 for men. It does not list all the younger people to whom I have referred who do require a meal delivered to them in their homes.
When the Bill was debated in another place it was stated that the Bill did not apply to disabled persons because they are covered by Section 29 of the National Assistance Act. Possibly that is so, but that means another complication, another series of meals to be given under different powers, which I should have thought again makes for overlapping and complication in administration.
Surely, it is possible for a local authority to provide a meal service of the kind of which I have spoken under Section 28 of the National Health Service Act, which deals with care, after-care and prevention of disease. Surely the supply of a midday meal is part of care and after-care and may well be taken as part of the prevention too. I rather think that one or two local authorities have done something under this section, but not a great many; and I think that again makes a third complication, a third power available to local authorities under this Bill.
At the same time, in regard to care and after-care and those under Section 29 of the National Assistance Act we have never found out the definition of the word "invalid". It is a matter which I have raised on more than one occasion in your Lordships' House and we have never got far. Though I have mentioned it now I do not expect to get far with it to-day. I am afraid that local authorities working and operating under several powers once again will mean that people will fall between Section 28 of the National Health Service Act, Section 29 of the National Assistance Act, and quite possibly Section 1 of this new Bill when it becomes an Act.
I should like to end on rather a more cheerful note. I trust that many local authorities will take advantage of the power they are given to contribute to forms of recreation for old people. I trust that they will take a broad view of what they may do. One example I can give which may be of great value to old 415 people is the provision of a day centre—Which could be contributed to, or provided, by the local authority—where old people could be taken, particularly those who were homebound. They could go to a club for the day, and thus give their families a respite. This would encourage them and be good for their morale. This would apply particularly to those who live by themselves who tend to be just as homebound as those who live with their families. I should call the Bill we are now discussing a definite step in the right direction. But there is a great deal more to do before we can say that we have a comprehensive meal service. I have great pleasure in supporting the Bill.
§ THE EARL OF LUCANMy Lords, my noble friend Lord Crook had hoped to speak on this Bill, but unfortunately he has had to leave the House for another engagement. He asks me to say on his behalf and that of my noble friends on these Benches that we wholeheartedly support this Bill.
§ 7.24 p.m.
§ BARONESS ELLIOT OF HARWOODMy Lords, I rise as a member of a local authority to say how much I welcome this Bill. The noble Baroness, Lady Swanborough, has pointed out the tremendous value of co-operation between voluntary organisations and statutory authorities in work of this kind. I suppose we have all had experience of this, both from being associated with voluntary organisations and also from being on local authorities. I know of at least two or three places where this work is going on and where I am sure it could be more successfully and more effectively carried out if there were a little more money available from the local authorities, a little more assistance with equipment, and so on. It would then be an even more effective service than it is already.
I, too should like to say, as Lord Amulree has said, how valuable, in addition to the "Meals on Wheels" food aspect, is the aspect of recreation and the possibility of providing for old people a certain amount of community life which they otherwise might not have, either because of loneliness, because of not being able to get about, or because of having no place to which to go. I 416 think one of the sadder facts which has recently emerged—I saw it in the paper not long ago—is the great number of old people who commit suicide. This is a really tragic fact. I am sure that one reason for it is loneliness, having nobody to talk to and nobody to take an interest in them.
With the assistance of the voluntary organisations, and with the co-operation of the local authorities, not only will "Meals on Wheels" and other forms of service of that kind be encouraged and I hope enlarged, but also this aspect of clubs for old people, or a day centre such as Lord Amulree has suggested, will come within the ambit of this Bill. I think this is most important. It is very valuable indeed, and we are much indebted to Mr. Geoffrey Johnson Smith in another place and to the noble Baroness for bringing forward this Bill. I hope that it will be supported strongly, not only in your Lordships' House but in the country; that the whole of the local authority areas will realise the opportunity that is given to them, and that it will really be a most effective piece of legislation.
§ 7.27 p.m.
§ LORD DENHAMMy Lords, the noble Baroness who moved the Second Reading of this Bill has dealt so fully with the details of it that it only remains for me to welcome it warmly on behalf of Her Majesty's Government. The purpose of the Bill is to enable local authorities and voluntary organisations, working in partnership, to give more help and comfort to the elderly, especially in their own homes. My right honourable friend the Minister of Health sets great store on this sort of partnership between the statutory and voluntary services. The "Meals on Wheels" service is particularly well suited to the voluntary organisations. As my noble friend Lady Elliot of Harwood has emphasised, one of the greatest burdens of old age is loneliness. The voluntary worker who delivers the meals can make friends with the elderly, listen to their problems and generally make a break in the monotony of living alone, to such an extent that his or her visit is often of as great benefit as the meal itself. My right honourable friend is confident that, with the additional powers given to them in this Bill, local authorities will do what they 417 can to help voluntary organisations make their maximum contribution in this field. Where there is need of services that cannot be met by voluntary organisations, local authorities will now have the power to provide them direct.
The aim of statutory and voluntary services is to provide conditions in which elderly people can live for as long as possible in their own homes. However welcoming institutions for the care of the elderly may be, however great the comfort, companionship and security they may provide, there can be no substitute for a person's own home. There must sometimes come a point when old people can no longer safely look after themselves at home, but this Bill will ensure that that point is delayed as long as possible. I am personally pleased that it falls to my lot to welcome this Bill on behalf of Her Majesty's Government, to congratulate the noble Baroness and her honourable friend in another place for bringing it before the House, and to express the hope that your Lordships will give it a Second Reading.
§ 7.29 p.m.
§ BARONESS SWANBOROUGHMy Lords, there are two things that I should like to say before I ask your Lordships to give this Bill a Second Reading. The first is that I perhaps did not say sufficient about how much help has been given in the past by local authorities. They have been more than generous in the subsidy per capita that they have given for meals. But the gap in the legislation was so broad that, quite often, they were frightened to make capital grants for which they had no authority. This is what this Bill seeks to remedy.
Inasmuch as it is now under the "Expenses" heading for rate deficiency grants in England and Wales, and Exchequer equalisation grants in Scotland, I think that my noble friend Lord Amulree need not be too apprehensive that people coming out of hospital will be in difficulty about getting meals. The fact that the meals required fall into two categories has always been recognised and dealt with. The short term and the long or permanent term fall into two easy categories. The difficult category is that of the young person who needs a meal for only a short time. But everybody 418 occupied in this job is anxious to see that all who should have a meal get it and get it regularly. Many of us are exploring and experimenting in the field of luncheon clubs and day centres on a neighbourhood basis, so that small clubs can not only provide day-to-day luncheons within the club but also send out a meal to the person who is home-bound or bedridden. Voluntary organisations throughout the country will welcome this Bill tremendously, because they will feel that they have the opportunity to serve and get the full benefit of their energies. I am quite convinced that local authorities will be happy to have a clarification of the difficulty that has presented itself to them. I do hope that your Lordships will support the Bill, and now give it a Second Reading.
§ On Question, Bill read 2a, and committed to a Committee of the Whole House.