CHRONICALLY SICK AND DISABLED PERSONS BILL

HL Deb 30 April 1970 vol 309 cc1115-237

3.32 p.m.

THE EARL OF LONGFORD

My Lords, I beg to move that the House do now resolve itself into Committee on this Bill.

Moved, That the House do now resolve itself into Committee.—(The Earl of Longford.)

On Question, Motion agreed to.

House in Committee accordingly.

[THE EARL OF LISTOWEL in the Chair.]

Clause 1 [Information as to need for and existence of welfare services]:

LORD AMULREE moved Amendment No. 1: Page 1, line 8, leave out ("to take such steps as are reasonably practicable ").

The noble Lord said: I put down this Amendment because I do not see that the words in the clause which I wish to remove have any purpose at all. The intention of the clause would be far more binding on the local authorities if those words were to be erased from the Bill. There is always a danger in what one might call permissive legislation such as this, because it means that a local authority who are not particularly interested in the purpose of the Bill are not going to do a great deal more than they must. I should have thought it would be far better if it were here made the duty of the local authority to take steps to inform themselves as to the number of persons in their area to whom the clause applies.

A good way of encouraging the local authority to do their work and to com-pile their register would be for the Ministry involved (assuming the Bill becomes law) to issue a cogent circular to local authorities. That does far more good than can be done in an Act of Parliament. In my not very extensive experience I have found that if one can quote a circular to a local authority there is far more response than if one quotes something from an Act of Parliament. Therefore I beg to move the Amendment standing in my name, to remove from the Bill the words referred to in the Amendment.

BARONESS MASHAM OF ILTON

This Amendment eliminates the loop-hole and makes the clause stronger. Therefore I welcome it. I have discussed the clause with the clerk and the welfare officer of my local county council and they feel it will be helpful. We felt there was a great need for more publicity of the information available. It was suggested that this could be publicised at local authority association meetings. The Ministry could perhaps set up a mobile exhibition, which would tour all areas and be made available to the public in city and town squares and market places. Local authority members said that they knew that many people were unaware of much information. They felt there was much need to go out and search for such people. The Swedish Government advertise on hoardings what they are providing and what the people are entitled to, thus also giving the ratepayer information on how he is helping his fellow citizens. The clause is most useful and therefore I support the Amendment which makes it stronger.

THE EARL OF LONGFORD

I wonder whether the Lord Chairman could give us a little help here. Would it be possible to carry this Amendment, with the good will of everybody, without prejudice to the Amendment in the name of the noble Lord, Lord Wells-Pestell? I hope that the Government will accept this particular Amendment, but I do not want to shut out any discussion on Lord Wells-Pestell's Amendment.

THE CHAIRMAN OF COMMITTEES (THE EARL OF LISTOWEL)

I can advise the noble Earl that if this Amendment is agreed to it will not prejudice the later Amendments in the name of the noble Lord, Lord Wells-Pestell; but, of course, the first of his Amendments would have to be moved in a different form by reference to Amendment No. 1.

THE EARL OF LONGFORD

I wonder whether it would be possible for the Government to indicate their attitude to this first Amendment.

LORD SANDFORD

May I make a contribution to the debate before the Minister accedes to that suggestion, be-cause although 1 am entirely in sympathy with what the movers of the Amendment want to secure I am not quite so happy about the effect it would have? I should like to make some points before the Minister comments. I do not believe it is possible for the movers of this Amendment to know what they are asking local authorities to do. They cannot know because the definitions of those to whom the clause applies—we have already discussed this point—are not precise. In fact, until we come to Clause 24 we do not know for certain whether or not those persons include the mentally sick; and others are in a similar position.

Secondly, we do not know what we are asking local authorities to do because the full numbers involved are at present unknown. Thirdly, we do not know because the problems and difficulties of ascertaining precise facts are so far untested. Fourthly, we do not know because the effect required to make a full and accurate register, still less to keep it up to date, is also an imponderable. But it is quite certain that the keeping of full registers will take up a considerable amount of the time of the staff of the welfare department.

So it seems to me that the purpose of this Amendment and what it is seeking to achieve is to say to every local authority in England and Wales, "Never mind anything else you would like to do in the welfare field for anyone else in your care; never mind about all the other services that you are being asked to provide under this Bill. First of all, you have an absolute and prior obligation to get on with, and to keep at, your register. And however difficult you find it—and you do not know how difficult you are going to find it until you start—and however many staff you have to put on it, and however many other difficulties you encounter which you cannot at the moment foresee, this is the job that must be done." If the noble Lord, Lord Wells-Pestell, has his way, not only has this job got to be done but it must be finished in a year, and started again immediately afterwards for completion in a further year, and so on.

No one disputes the need for registers, and most authorities have registers of one kind or another, but surely there are better ways of advancing to full and accurate and comprehensive registers than by this sole device—this rather blunt and heavy instrument of comprehensive mandatory legislation. For instance, there is the power of inspection that the Secretary of State has in Section 35(3) of the National Assistance Act, and I myself should like to hear from the noble Baroness the Minister of State exactly how her Department proposes to use that in this case.

There is the information, still yet to be gleaned and disseminated, that will emerge from the social survey that Her Majesty's Government very properly set in hand some years ago. There is the scope for a fresh comprehensive circular from the Department of Health about Social Security on the lines of those issued in 1951 and 1958, which could give guidance to local authorities on how to set about this task. There is scope for more precise definitions under Clause 24 of this Bill which we have yet to come to, and there is every hope and expectation of a better service organised under the Local Authority Social Services Bill which is going through Parliament at the moment. It seems to me that in view of all those factors it would not be perhaps the best way to achieve the object which we all desire. However, I have an open mind on this matter and if the Minister thinks that the arguments put forward in support of these Amendments are weightier than mine I shall be happy to change my mind. I feel—

THE EARL OF LONGFORD

I should like to ask a question of the noble Lord, with whom I had some pleasant consultations, and I am bound to say that his speech comes as a most unpleasant surprise to me after those consultations. I say that straightaway in order to avoid misunderstanding. He speaks about "these Amendments"; in fact one Amendment is being moved which is a limited and general Amendment, and he is dealing with an Amendment which has not yet been moved. He is replying to the noble Lord, Lord Wells-Pestell, and I was trying to limit the discussion at this stage. Do I gather that he is against the first Amendment?

LORD SANDFORD

I think the Committee will agree that I said I have an open mind at the moment about the first Amendment, but I felt it was worth putting these factors before the Committee and in advance of what the noble Baroness the Minister had to say. I feel bound to say, in support of one of the arguments I used, that the Amendment tabled by the noble Lord, Lord Wells-Pestell (which we are not now discussing but which we have all seen) will impose an even more onerous and un-avoidable duty on the local authorities, and in view of all the other points I made I would suggest that there are advantages, more for the disabled than anybody else, in allowing a certain amount of flexibility.

LORD HASTINGS

Before the Minister replies I should like to support this Amendment very strongly indeed. In so doing I would draw the attention of the Committee to the fact that these words, or words very similar to them, appear in no fewer than seven other clauses of the Bill. Without wasting too much time I will just refer to Clauses 4, 5 and 6, where the words are in this form—and I quote: In so far as it is in the circumstances both practicable and reasonable". That refers to access to facilities open to the public, to the provision of public sanitary conveniences, and to the pro-vision of sanitary conveniences at certain premises open to the public. In those cases obviously there may be structural and engineering difficulties which cannot always be solved, and I do not think that anybody would ask that in every case these facilities must be provided, irrespective of cost and convenience.

Again, in Clause 14 the words are: "so far as is practicable", referring to the separation of younger from older patients. Here again one can see the difficulties, the limitations and restrictions on premises and the difficulties of staff. The same also refers, in greater or lesser degree, to those clauses which deal with educational treatment for the deaf-blind, autistic children and for those children suffering from chronic dyslexia. Again, one can see difficulties of staffing and possibly the desirability of more than one local authority co-operating to form a central place where this special treatment can be given.

In this clause we are dealing with an entirely different category. There is no physical obstruction or difficulty. There is no tangible difficulty. It is simply a question of collecting information, and we all know that the information is there to be collected. Any of us who have dealt with or worked in the Ministry of Health and Social Security or the Ministry of Housing and Local Government; any of us who have worked actively with voluntary societies dealing with the chronically sick and disabled, know that there are many authorities who always do their best and are only anxious to do more for the people we are discussing this afternoon. Equally we know that there are some local authorities who drag their feet and whose conduct, frankly, in some cases is quite disgraceful. If we pass this Amendment the good local authorities will welcome it, and it will not make any difference to them. If we do not pass it the lazy local authorities will do as little as they possibly can. I believe that if we pass this Amendment we shall be setting the whole tone of the Bill, and in that respect I disagree profoundly with the remarks made by my noble friend Lord Sandford, and I hope the Amendment will be passed.

THE EARL OF SWINTON

To clear my own mind, and perhaps the minds of some other noble Lords, I should like to ask a question. The words " such steps as are reasonably practicable" are very vague, but who will decide whether or not the steps are reasonably practicable? Will it be the Minister?

3.46 p.m.

BARONESS SEROTA

The noble Earl who is sponsoring this Bill asked if I would state the view of the Government on Amendment No. 1. I can quite see the difficulties in which certain noble Lords have found themselves in discussing this Amendment in isolation, but for the sake of clarity, and without prejudice to the Amendments that are tabled in the name of the noble Lord, Lord Wells-Pestell, I will try to confine my remarks to the first Amendment in the way requested by the noble Earl.

As I read this Amendment, its acceptance would mean that the clause would impose an equal obligation on all local authorities, although, as we all know, the facts of life are such that, for a number of different reasons, local authorities are not all equal. I was grateful to the noble Lord, Lord Hastings, when he reminded the Committee that the words we are now considering in this clause occur also in other parts of the Bill. The noble Lord made an important point there which the Committee would do well to bear in mind. However, I am confining my comments at the moment to the words as they stand in this particular clause.

When we discussed this Bill on Second Reading I reminded the House of a fact that perhaps some of us are inclined to forget; namely, that it is only since 1960 that local authorities have had their present statutory duties in this form, and it is quite natural that by 1970 the standards of provision should vary, and vary greatly; and for a variety of reasons. Sometimes—and I think others of your Lordships' House who are members of local authorities will know this only too well—one wonders whether the standards developed by local authorities are defined purely by the personality of the chair-man of a particular committee, or per-haps the chief officer. As I go round the country now I find that some local authorities have made great developments in certain services, as a result of particular local interests and enthusiasms, and that others have fallen behind.

I was glad that the noble Lord, Lord Sandford, reminded the House of the Government's social survey at this moment of time. It is the first occasion that such a major exercise has been undertaken, and we hope that at the end of it we shall be in a far better position to know what the situation really is. The noble Lord also asked what further steps we thought we should need to take following the results of this survey. Clearly, local authorities will need to inform themselves about the extent of the needs in their areas, and we hope the survey will give them some guidance that will enable them to carry out their own surveys. In addition to the techniques of survey and fact-finding, they will also, in my view, need to build up their communications and information services, a. subject about which I know all noble Lords involved in the discussion on this Bill are deeply concerned.

I do not want to go over the problems that have been already raised here; but, as I understood it, from the way in which the noble Lord, Lord Amulree, moved this Amendment, and from the comments of the noble Lord, Lord Hastings, those who put down this Amendment are anxious to see these words removed so that the clause may stand as a clear line of guidance to all local authorities, telling them that we want all of them to provide to the standards of the best. This is a principle with which I think all of us will agree. I have pointed out that there may be certain difficulties, and I ask the Committee not to adopt the same interpretation of these words in other parts of the Bill. With that proviso, I suggest to the Committee that it should accept this Amendment, in the spirit which the noble Lord, Lord Hastings, suggested, when he spoke at the outset.

THE EARL OF SWINTON

I am sorry to press the noble Baroness on this purely factual but rather important point. Who is going to decide what steps are "reason-ably practicable"? Will the decision rest with the court, or is it to be the decision of a Minister? That surely is a question which can be answered, a factual question.

BARONESS SEROTA

There will be a number of questions to be considered once this Bill becomes law, as I hope it will do shortly. Clearly, as I indicated on Second Reading, we in the Department shall have to consider what kind of guidance will be given to local authorities; and each local authority will have to decide, in the light of their circum-stances and resources, what this means in their own fields. I cannot at this moment give the noble Earl a more direct answer.

THE EARL OF LONGFORD

I hesitate to add to what was said with much more authority by the Minister, but as the noble Earl, who understands these legislative matters as well as anyone, will appreciate, the words which bother him, if this Amendment is carried, will disappear. May I, with respect, suggest to him and to the noble Lord, Lord Sandford, and to my noble friend in this matter, Lord Amulree, that they now make sure this Amendment is carried?

LORD AMULREE

Having heard what the Minister has said, I wish to press the Amendment standing in my name.

On Question, Amendment agreed to.

3.55 p.m.

LORD WELLS-PESTELL had given Notice of an Amendment (No. 2):

Page 1, line 8, leave out (" to take such steps as are reasonably practicable to inform them-selves of the number of") and insert— (" (a) to prepare a list, within twelve months of the passing of this Act, and on each anniversary of the preparation of such list, of those ").

The noble Lord said: I wish to move the Amendment No. 2 standing in my name, but I realise that in view of your Lordships' action in accepting the Amendment standing in the name of my noble friend Lord Amulree, my own Amendment will need some slight alteration. Notwithstanding that, I want to suggest that even now it is not strong enough. If I may refer your Lordships to Clause 1, it says: It shall be the duty of every local authority having functions under section 29 of the National Assistance Act 1948 … to inform themselves of the number of persons to whom that section applies within their area …

"To inform themselves "—again there is no time limit whatsoever; there is no degree of urgency about it. And I think we have to accept the fact that to-day in 1970, although a great deal has been done by the Ministry through local authorities and through voluntary organisations, we do not know the extent of the chronically sick and disabled in this country. I venture to suggest that we really have no reliable figures and no reliable information at all. On Second Reading your Lordships were told that local authorities reported that 1 per cent, of their population came within the category, while other local authorities reported a much higher figure. The short answer is that we do not know what this problem is.

I welcome very much what the noble Lord, Lord Hastings, said about local authorities. I do not want to appear to be critical. Like a good many of your Lordships, I have served on a number of local authorities in my time. We know that some of them are outstandingly good. We know that some of them will do as little as they possibly can, particularly when it comes to keeping down the rates. I am not quarrelling with that at the moment. What I am saying is that unless the seeking and getting of this information becomes obligatory upon the local authorities within a specified time, we may find a large number of them trailing their coats; and they can only trail their coats, if I may say so with very great respect, at the expense of the chronically sick and disabled in their areas. Therefore, in this Amendment I want to make it obligatory on the part of local authorities to prepare a list within twelve months of the passing of this Act and on each anniversary of the preparation of such lists. I should not have thought that that was unreasonable. Most local authorities, if not all of them, have a fairly substantial army of welfare workers. I should not have thought it difficult to secure this information, but I think there ought to be a mandatory obligation on their part to secure it.

If your Lordships will permit me to refer to Amendments Nos. 3, 4 and 5, which are also in relation to Clause 1, I should like to go further and say that it is desirable that the Secretary of State for the Department of Health and Social Security should have these lists in the Department so that the Ministry can from time to time see that in fact they are kept up to date. I am particularly concerned with Amendment No. 5, which says: (a) shall cause to be published annually for the chronically sick and disabled information as to the services, aids and appliances available to them and the procedures for obtaining such services, aids and appliances.

I think we must realise that there are pockets in every part of the country, in every local authority, of chronically sick and disabled who perhaps never see any-body at all from the local authority. They are visited occasionally by representatives of voluntary organisations. Many of them are cut off from everyday life and activity. I am not suggesting that my noble friend the Minister is going to say this, but I can well under-stand somebody saying," Let the Department of Health have a display; let them provide local authorities with displays of such aids and appliances as are available, and let the local authority publish a list of the services that are available." What I am concerned about is whether these lists of services, aids and appliances, and the procedure that one has to follow to obtain them, will in fact have reached the person concerned; and I have grave doubt as to whether such a list, if produced, either by the Ministry or by local displays or regional displays, will reach the people who are affected. What I want your Lordships to do is to accept the Amendment so that it is obligatory on local authorities to prepare a list of services, aids and appliances that are made available to the chronically sick and disabled. I feel that this is essential.

The noble Lord, Lord Sandford, was worried about the onerous responsibility that will be put on the local authority. With great respect, the local authority is there to serve the community; it is their job. I have no compunction in asking the local authority to discharge that responsibility right down to the point of the person who is involved. So I move Amendment No. 2 in the amended form.

Amendment moved—

Page 1, line 8, leave out ("to inform them-selves of the number of ") and insert— ("(a) to prepare a list, within twelve months of the passing of this Act, and on each anniversary of the preparation of such list, of those ").—{Lord Wells-Pestell.)

THE EARL OF LONGFORD

Are we going to hear from the Minister? I would hasten to say that many of us who are interested in the Bill are entirely in favour of the adoption of this course. I have not had a chance of discussing it with everyone, but I am very much in favour of it myself. Unless there is some insuperable objection in the mind of the Minister which we ought to try to counter, it seems, on the face of it, entirely unexceptionable.

LORD WELLS-PESTELL

I should welcome hearing what my noble friend the Minister is going to say. I do not want in any way to take up your Lord-ships' tune or to pursue the matter unnecessarily. It may well be that she can give some general assurance that something along these lines will be done. In that case, speaking for myself, I should be satisfied.

BARONESS SEROTA

I hesitated to intervene earlier because the noble Earl is really responsible for the Bill, although the Government are doing all they can to co-operate with him in its smooth passage through the House. May I confine myself to Lord Wells-Pestell's first Amendment? 1 am in some difficulty here because a number of the points made by the noble Lord in fact: ran over all his Amendments. The last of these points is also covered in a further Amendment on the Marshalled List. At this stage I confine myself to the question of registration. I am afraid I must advise the Committee that, for some of the reasons that the noble Lord, Lord Sandford, has already given so clearly to the Committee, we see the greatest difficulties in regard to what would amount to a 100 per cent. registration of the physically and mentally handicapped. There are clearly financial difficulties here, and I would remind the Committee that an exercise of this soope —I can give the Committee details, if they so wish—would in fact affect the Money Resolution and would therefore require consideration in another place. Equally, it would make heavy demands on the staff of the authorities concerned. Further, in some people's minds there are philosophical objections to such a proposal. There are those who might regard this duty placed upon the local authority as an intervention into their private lives.

These are points about which some Members of your Lordships' Committee might well be concerned. But primarily it is the practical problems that a mandatory provision of this kind in the Bill would raise which lead me to advise the Committee against taking it into the Bill. I am glad that the noble Lord referred once again to the Government's social survey. I would ask the Committee to await the findings of that survey. As he so rightly said, we simply do not know at the moment what is involved. The Government have taken steps—we believe proper steps—to find out the situation, and once we have the results of the survey and have been able to evaluate them, I think we shall be in a much better position to judge what the next step forward will be. I hope that the Committee will not accept the Amendments as put down by the noble Lord, Lord Wells-Pestell.

LORD WELLS-PESTELL

Before my noble friend sits down, may I ask her what the Ministry would be prepared to do, if anything, if a local authority did not inform itself of the position with regard to the chronic sick and disabled in its area?

LORD HASTINGS

May I revert to something which the noble Lord, Lord Amulree, said when moving the first Amendment; that is, the question of a Government circular? It seems to me that the wording of the Amendment that we are discussing now is rather too tight for local authorities. I speak from some knowledge of their operation and their difficulties. Would the Minister be able to give an undertaking that in due course a circular will be sent out, giving them what I would call a strong lead or guidance on points of this sort? After all, local authorities have a mandatory obligation placed upon them now as the result of the passing of the first Amendment. It seems to me that it is up to the Ministry concerned to see that they carry out their duties; but that could probably be done by means of a circular telling them perhaps how to do it, and when.

BARONESS SEROTA

It is the normal practice for the Government to issue circulars after legislation of this kind has been passed. There is one problem which will clearly affect our thinking on the circular that we issue after the passing of this Bill; namely, its relationship to the provisions of the Local Authority Social Services Bill which is now under discussion in another place and is not yet before this House. Clauses 1, 2 and 15 of the Bill that your Lordships are to-day considering affect services which will be-come the responsibility of the proposed new comprehensive social service departments; and one of the matters that we shall have to work out very carefully in-deed once this Bill becomes law, in what-ever form it takes, and when the Local Authority Social Services Bill receives the Royal Assent (as I certainly hope it will) is the kind of guidance we can best give to local authorities in relation to the new powers both under this Bill and under the one that will be coming forward almost at the same time.

LORD SANDFORD

I do not know whether the noble Earl, Lord Longford, would like to have my views, for what they are worth, before he advises the Committee on how to treat Amendment No. 2. It will not be any surprise to the Committee to know that I feel that the arguments I adduced by way of caution in speaking to Amendment No. 1 apply with far greater force against Amendment No. 2. The only thing that I should want to add applies to a remark by the noble Lord, Lord Wells-Pestell, about certain local authorities being reluctant to exercise their duties under various pieces of legislation towards the disabled and so on. Of course there are black sheep about, but I would suggest to your Lordships that those local authorities who are not doing their duty by the disabled are the same local authorities who are providing a deficient service over a wider range than that. The local authorities who are poor, weak or bad in respect of the disabled are poor, weak or bad over a much wider field. I do not think it is possible to bring evidence to support this contention, but it is my very strong impression that this is so. If I am right, the passing of this particular Amendment in this particular piece of legislation will not correct that situation. It is one that is far more amenable to inspection, to the reform of the local authority personal social services, to the reform of local government itself, and we are addressing ourselves to all those things.

I believe that in this narrow field it is a mistake to put too much weight on mandatory, comprehensive, obligatory legislation. It is not that local authorities generally are reluctant to do their duty in this area: the difficulty is that they are all short of staff and resources, and they very properly have to weigh in the balance the priority of making a register, on the one hand, and of actually dealing with the clients, on the other. It is the same member of staff who has to do one or the other, and to take away that discretion and that judgment, as this Amendment would do, is to my mind a mistake.

THE EARL OF LONGFORD

In view of the fact that the Government, and also the spokesman from the Opposition Front Bench, have expressed such strong reservations about this Amendment, I wonder whether it is likely to be carried this afternoon in its present form. It does not mean that I myself do not welcome it; I do favour it.

I see the difficulty which the noble Baroness, Lady Serota, mentioned, of the register. We are faced in the end with what she called a philosophical question: whether any official is entitled to come to any of us and say, "Are you or are you not disabled?", and to refuse to accept the answer, "I decline to say". If I understand it aright, the Amendment imposes that particular duty on the citizen to say that he is or is not disabled. I feel some difficulty about that. For that reason, therefore, apart from calculations of the voting, I would hesitate to want to see it carried in this form.

Assuming that we are now discussing all the Amendments put down in the name of the noble Lord, Lord Wells-Pestell, I would say that there is another aspect which I think is rather important, and that is the words in Amendment No. 5 which expand the phrase about the "services" in the Bill to include "ser vices, aids and appliances". In other words, there are aspects of these Amendments which I think ought not to be thrown over too lightly. So, for what it is worth—and I have no doubt that my advice will be rejected many times in the hours that follow—I would personally not favour pressing this Amendment this afternoon but would leave it open to the noble Lord. Lord Wells-Pestell, to see what can be rescued from this Amendment, and he may well decide to bring forward certain aspects of it at a later stage.

Amendment, by leave, withdrawn.

4.14 p.m.

LORD WELLS-PESTELL moved Amendment No. 5:

Page 1, line 13, leave out paragraph (a) and insert— (" (a) shall cause to be published annually for the chronically sick and disabled information as to the services, aids and appliances available to them and the procedures for obtaining such services, aids and appliances; ")

The noble Lord said: I beg to move Amendment No. 5 because, although I do not want to repeat the speech that I made a few moments ago, I think it is important that the chronically sick and disabled should themselves receive some direct information as to the "services, aids and appliances" which are available, and that they should be given a clear indication as to the procedures to be followed to obtain them. I do not know whether, on this particular Amendment —I am sorry to come back to my noble friend—the Minister can say if the Department will do something along the lines suggested by the noble Lord, Lord Hastings, in some form of a circular advising local authorities to do this. I beg to move.

THE EARL OF LONGFORD

I thought the question was put to the Minister, and I have never known her previously fail to answer a question. I am waiting for her to give an answer.

BARONESS SEROTA

I had in fact answered this point in answer to Lord Hastings, but once again I hesitated to intervene before the sponsor of the Bill has spoken.

THE EARL OF LONGFORD

I could not hear all that answer or interpret its full significance, and I do not know whether the noble Baroness still has a strong objection to the point raised by the noble Lord, Lord Wells-Pestell. Person-ally, I think he is right, but it could be argued that in the Bill itself a duty is laid on the authorities to make sure that the persons are given this information. Perhaps the noble Lord, Lord Wells-Pestell, will explain apart from the points I made earlier about the "aids and appliances" in addition to the "services", what his Amendment actually adds to what is already in the Bill.

LORD WELLS-PESTELL

If I may have the indulgence of your Lordships, may I say that I have read the Bill rather carefully and I do not feel that there is anywhere in the Bill an obligation on the part of anybody directly to in-form the chronically sick and disabled. If there is something in the Bill, then I missed it, but what I am sure is not in the Bill is a responsibility on either the Ministry or the local authority or any individual directly to inform the chronically sick and disabled of what is avail-able for their benefit. If there is I gladly withdraw.

THE EARL OF LONGFORD

Since the Minister is rather coy about providing the official answer, may I say that there is a clear statement in paragraph (b) that every local authority shall ensure that any person as aforesaid who uses any of those services is informed of any other of those services which in the opinion of the authority is relevant to his needs. There is an obligation there; whether it goes far enough is another matter. I am not quite sure what the noble Lord is asking for in addition, except that he would like to add a reference to "aids and appliances ". I think that is some-thing that should be brought up at the next stage.

LORD WELLS-PESTELL

With very great respect, the paragraph says, "who uses". The implication there is that they are using the services. I am concerned about the chronically sick and disabled who do not know of the existence of such services.

THE EARL OF LONGFORD

If I am allowed to offer any guidance, I would suggest that the noble Lord bears this discussion in mind and puts down an Amendment at the next stage.

LORD CHORLEY

I should have thought, as a lawyer, that the Amendment of the noble Lord, Lord Wells-Pestell, is obviously right. With great respect to the noble Earl who is carrying this Bill, what he has just read out does not put on the local authority the obligation which I think he himself wants, and which certainly the noble Lord, Lord Wells-Pestell, was asking for.

BARONESS SEROTA

As a non-lawyer, perhaps I may advise the Committee in the terms that I have been advised. As we interpret the noble Lord's Amendment, it would leave the scope of the in-formation unchanged, but it would be expressly elaborating the reference to "aids and appliances" as opposed to other aspects of information. I agree with the noble Lord who has put down this Amendment that we need to discover proper lines of communication and adequate ways of informing the disabled and chronically sick themselves about what is available in terms of "aids and appliances" and, indeed, of services generally. However, we see this Amendment as being somewhat inhibiting. Essenti ally, the object of this particular clause, as I understood from it from what I read of the debates in another place and of those who sponsored this Bill, was to require the local authority to find means of informing the community of which the chronically sick and disabled form a part, of the range of services which are actually available to them.

The real problem here is one of communication, and my Department will need to work with local authorities to find the most effective and practical answers. We are fully aware of this responsibility, and we accept it. Clearly, one will need to communicate in a number of different ways. There are within the group that we are discussing to-day different individuals who have different needs and different abilities. As the noble Earl knows only too well from discussions that we have had, I am firmly convinced—although I have not yet managed to convince him—that this Bill applies to the mentally handicapped; and informing the mentally handicapped members of the community of the services available to them might be different in certain respects from informing those who are suffering from the physical results of major road accidents.

There is a whole range of media here that will need to be considered, and we want not only individuals themselves to know of the services, but also members of the public, their relatives, their friends, and the volunteers who go into their homes and work with them, or visit them in residential homes of one kind or another. That is why, although we under-stand and sympathise with the noble Lord, Lord Wells-Pestell, we feel that this Amendment is not the way to achieve what he is seeking to achieve, and that is why I ask the Committee not to agree to it.

THE EARL OF LONGFORD

I should like to point out that the noble Baroness has not exactly answered one point made by the noble Lord, Lord Wells-Pestell. She picked out the point which I made, that the word "services" is expanded to cover aids and appliances. But I did not hear an answer given by her to the noble Lord's argument that at present the Bill refers only to people who are using the services, and does not cover those who are disabled but are not using the services at the present time.

BARONESS SEROTA

I am sorry, but my impression is that it does.

THE EARL OF LONGFORD

The Minister says that it covers anybody who is disabled, whether that person uses the services or not. That may be so according to a legal definition; but, on the face of it, it would not appear to be like that.

BARONESS SEROTA

I am prepared to take the guidance of the sponsor of the Bill and, if it is his definition that the subsection does not apply to users of the services, I can only accept it.

THE EARL OF LONGFORD

I am afraid that I am not going to swallow that argument so early in the day. The Minister is perfectly well aware that this is a Bill which, in another place and here, has been worked out in very close collaboration with the Government draftsmen. Though this clause must come before the House on my responsibility, it would be totally misleading— and we really must not be misled by this—to suggest that this has been worked out without reference to the Government draftsmen.

LORD HASTINGS

May I suggest that the words "who uses any of those services" are redundant, and that at a later stage we might amend paragraph (b) so that it merely states that the local authority shall ensure that any such person as afore-said which refers to the principal section?

LORD LEATHERLAND

This clause seems to give certain responsibilities to a local authority. I have served on local authorities for a very long time, and I know that they go out searching into the highways and byways to see which people are entitled to benefit from the services the authorities are prepared to provide, whether in the form of appliances, or special kinds of houses with ramps in-stead of steps, and so on. It seems to me that in concentrating the discussion upon paragraph (b) of subsection (2), which refers to persons who use any of these services, we are omitting to consider paragraph (a), which requires the local authority to publish from time to time such information as it considers generally applicable to all of these disabled people. So the larger of these responsibilities seems to be a blanket over the smaller of the responsibilities in paragraph (b). I think that paragraph (a) covers all the necessities which are required here, and I know from my own experience that the welfare officers try to find the people who could benefit in any way from the resources and facilities which the local authority is prepared to provide. I think that paragraph (a) covers the whole matter, and that paragraph (b) is a restricting paragraph which has to take a subordinate position to paragraph (d).

LORD PLATT

I am afraid that I can-not accept that interpretation, because I agree very strongly with the noble Lord, Lord Wells-Pestell, and the noble Earl, Lord Longford, that Amendment No. 5 extends the word "services" to services, aids and appliances, which is quite an essential part of this discussion. Exactly how this is to be done, and how it is going to link up with my Amendment on a similar subject which we shall be discussing shortly, I am not prepared to say. It may be that the best course is to leave the whole lot to another stage, having aired our views upon the subject. But I cannot accept that the present paragraphs (a) and (b) of subsection (2) do all that Amendment No. 5 is intended to do.

THE EARL OF LONGFORD

I feel that I have said all that I can usefully say on this subject. Inevitably, 1 think, the discussion has been a little confusing, and I should be happy to see a Division, if it came to that, at a later stage when the point had been clarified. But if the noble Lord, Lord Wells-Pestell, presses the Amendment this afternoon I shall support him.

LORD DRUMALBYN

May I make a suggestion here? Is it not the case that, as the Bill is now drafted, paragraph(a) relates to general information which could be put out in a general way to the people concerned, and that paragraph(b) enables certain information to be put out to those particularly affected? I should have thought this was the right way to do it, rather than to remove paragraph (a) altogether and substitute some-thing which would involve circulating an encyclopædia to everybody concerned at each stage. I wonder whether this matter ought not to be looked to again. It would be a pity to put this Amendment to a Division to-day in its present form, and it would be wiser to leave it over and decide at the next stage.

Before I sit down, may I make a more general observation, because I am some-what mystified over this matter? This subsection refers to services provided under arrangements made by the authority under Section 29 of the National Assistance Act. That section states: Without prejudice to the generality of the provisions of subsection (1) of this section, arrangements may be made there-under— (a) for informing persons to whom arrangements under that subsection relate of the services available for them there-under … It seems to me, with great respect, that all one wants to do is to change the word "may" to "shall", and then this provision will not be needed at all. But I think that this matter should be looked at again.

LORD WELLS-PESTELL

I am grateful to the noble Lord, Lord Platt, for his comments and observations, and I feel disposed to take the advice that has been given to me. All I would say is that, in the Amendment which stands in his name and in the name of my noble friend Lord Amulree, they are concerned with prescribers, as distinct from recipients, while I am concerned with the people who are at the receiving end. In answer to the noble Lord, Lord Drumalbyn, I would say that I am concerned not only with services but with aids and appliances, which I think are rather different. But in view of the fact that I shall get an opportunity of putting an Amendment down again on Report stage or Third Reading, if that is necessary, and because we want to make progress this afternoon, I beg leave to withdraw the Amendment.

Amendment, by leave, withdrawn.

4.30 p.m.

On Question, Whether Clause 1, as amended, shall stand part of the Bill?

LORD OAKSHOTT

It is with some diffidence that I intervene at this stage of the Bill, and I would most sincerely beg the noble Earl responsible for the Bill, the noble Lord, Lord Wells-Pestell, and others who are interested, to believe that I am not in any way unsympathetic to the underlying principles which animated the noble Earl in bringing this Bill before your Lordships' House; but I feel that at this stage, on the Question whether this clause shall stand part, it is not inappropriate for me to enter a cautionary word about the Parliamentary programme. Those of us who have served in another place know very well that at this time of the year, at this period of a Session, if a Bill comes up from the House of Commons to this House, is amended to a considerable degree and then goes back to the other place, there is a considerable risk that that Bill will be lost altogether. This is a very good Bill—a very good Bill indeed. Let us not strive top hard for perfection. I appeal to your Lord-ships' Committee to accept a modicum of imperfection, because I think that otherwise we run a grave risk of losing the Bill altogether.

THE EARL OF LONGFORD

I would respond to the kindly spirit of the noble Lord by saying, in two general words, that I read in the Daily Telegraph, the paper I read very faithfully on Mondays, that the Peers were in some danger of destroying this Bill. I repudiate that prospect utterly. This Committee must be allowed to do its duty. We cannot be told in relation to this Bill, which is of tremendous importance—perhaps the only Bill which will help the disabled directly for many years—that we must not spend a few hours on it, or a few extra hours, because it might be lost. I see no chance of that prospect whatever. We must do our duty properly. I should be very much surprised, and painfully surprised, if we found ourselves in collision with the House of Commons. I see no prospect of that. But I must say clearly at the beginning that even if we have to sit here all night, it is a very small price to pay for helping the disabled on the one occasion when we are able to be of service to them.

LORD OAKSHOTT

Before the noble Earl sits down, perhaps I may correct him. I was never suggesting that we should not do our duty or should not sit up all night, if that be necessary. All I was saying was that we should be very careful. As I have said, those of us who have been in another place know the difficulties of the time table at this time of the year and know that we are running a very great risk of losing what is an excellent Bill as it stands.

LORD LEATHERLAND

It grieves me very much to say that I disagree with my noble friend Lord Longford. This is a very good Bill, and I hope to see it passed through both Houses of Parliament during the present Session. My noble friend was responsible for bringing the Bill forward in its present form, and in its present form I am sure it would go through your Lordships' House very quickly and could also go through the other House very quickly. But we have 53 Amendments on the Order Paper. If we are to devote long periods of time to discussing those 53 Amendments, and if we carry perhaps 20 or 30 of them, and then the Bill goes to the other House, the other House will spend considerable time discussing those Amendments. We are now on the verge of the month of May, and then there will be June and July. We must pass this Bill, along with many other Bills, before this Session ends. I sincerely hope we shall concentrate on the main issue, and that is to get the Bill passed. If there are imperfections in it, if there are improvements that can be made at a later stage, let them be dealt with next year or the year after. But let us get this Bill through in this Session and not prejudice its passage by insisting on an innumerable number of Amendments.

Clause 1, as amended, agreed to.

LORD CRAWSHAW moved Amendment No. 6:

After Clause 1, insert the following new clause:

Access to public transport

".Where any public body constituted by or under any enactment undertake the pro-vision of public transport by road, rail, air or sea, the body shall make provision, in so far as it is in the circumstances both practicable and reasonable, for the needs of disabled travellers in connection with the use of such transport."

The noble Lord said: In moving this Amendment I wish to take your Lord-ships into the vast field of public trans-port. This is, as you can see, a wide Amendment. It has many escape routes; but I do not apologise for that at this stage, because we are here breaking fresh ground. I do not want to force the issue too fast, because up till now there have been precious few facili ties, or virtually no facilities at all, for the disabled in the field of public trans-port. So at the moment I am looking for assurances from the noble Lord who will respond that, either by the use of circulars or in other ways, in future, when public vehicles of any sort are being designed, facilities for and the needs of the disabled will be considered. It is most important. I know we are "stuck" with the vehicles we have already, but when it comes to new vehicles or new designs it is most important that efforts should be made to educate the designers about the needs of the disabled.

I want to mention the various forms of public transport which I should like approached. On Second Reading I went into (his subject, and I do not want to go over all that again. I commended what many of the airports and the major airlines are already doing in this field, and hoped that many other fields of public transport would follow their example. As to the railways, I went into that aspect fairly deeply, too, and at that stage I was prepared to develop my theme further about the furnishing and heating or otherwise of guards' vans on British Railways. But my noble friends on this Bench tell me I am not to press that matter, and I do not want to fall foul of them. All I would say, therefore, is: would it not be possible for carrying chairs which will go up the corridors of trains and into the various compartments to be available at main line stations, so that the disabled can in fact get into compartments? At the moment, as perhaps your Lordships know, I always travel in the guard's van. On a mild day, that is all right; and in a way I have an hereditary attachment to it because my father travelled there for preference during the war and I used to go with him. I am entirely fond, too, of the various people and objects one travels with. I travel with everything from motor bikes to mail bags and maggots, and I quite enjoy many of the journeys.

As to public transport on the roads, as I said before, the bus is normally an insuperable obstacle; and I know we are going to have a contribution from the noble Lord who is an expert in this field. I read the London Transport report the other day and it stated that there exists a state of antagonism between conductors and passengers. I know that the passengers who suffer most from this are the disabled passengers, who are perhaps treated with less patience than others. I want provision made in future, if possible, for certainly the ambulant disabled, and perhaps one day for those confined to chairs. On the question of road transport, I previously mentioned taxis. They are often impossible of access for chairbound travellers. I, combined with Red Coat and the police down here, have at last evolved a method of getting into a taxi which I shall be pleased to pass on to anybody who is interested. But it has taken me 16 years or more to do it; and I really feel that the designers of taxis, when any new model is being considered, ought to bear in mind the needs of disabled passengers.

I should mention the Underground, too, because I think the French Metro has evolved a scheme which is in advance of ours. I realise that new lines are being planned. The Piccadilly Line is being extended, I believe, to Heathrow; the Fleet Line is going from Stanmore to Lewisham; the Bakerloo Line is going to Peckham; and there is to be a new Holborn Line. I hope that in the planning of all these lines provision may be made to enable disabled passengers to get from the ground down to the plat-form, and that the platforms and trains will be at a uniform level, because various heights obviously present great difficulties.

As to sea travel, I mentioned the difficulties on liners, ferries and so on. There again, I want to stress the importance of being able to get from the car park of a car ferry to the passenger deck without much difficulty; and I, for one, find this usually impossible at the moment. As I say, the Amendment is wide. It per-haps breaks new ground. I realise that it is not perfect; but, on the other hand, I look for some assurances, and I know that other noble Lords will make some contributions from their own experiences. I therefore beg to move the Amendment.

LORD TEVIOT

I should like to sup-port my noble friend Lord Crawshaw on the principle of his Amendment. I feel that this Bill would not be complete with-out some provision being made for the needs—the word "needs" is in the Amendment—for disabled persons on public transport. My noble friend said that I was an expert. I should like to say that I was, purely and simply, an operative on buses or stage carriages. Stage carriages are buses; and it is on buses that one should concentrate when we are talking about making things easier for disabled people. In the case of long-distance coaches and so on, there may be a difficulty of access but there is plenty of time for the disabled to get on and off. But on a stage carriage or a bus which is running to a tight schedule, disabled people get the thin end of the stick. Blind people, I am happy to say, get all the attention in the world. People all go out of their way to be pleasant to them. But for the disabled generally one finds that the attitude of conductors—I hope they will forgive me for mentioning this—is simply to stand on the bus and say, "Hurry along please!" and "Get a move on! " which antagonises everybody.

One cannot write attitudes into this Amendment, but I should like to make a few comments. A smile to the disabled is a great boon. I used to find that so. If I came to a bus stop and there was a crowd of disabled old ladies, I found that the best way was to greet them, to let them all get on and when you had the last one on, you held her round the waist, you rang the bell, you put two thumbs under her stays, twirled her round and put her on her seat. One finds that one can get them on the bus quicker and with less trouble in that way.

Now I come to the business of the Amendment. Under Section 32 of the 1968 Transport Act operators were going to get a grant for certain approved types of vehicles. An extra four inches height was stipulated. Four inches may not seem very much, but to arthritic people it seems to represent a very retrograde step. I should like to suggest to the noble Lord who is to reply that standard types of approved vehicles should have a certificate from the Ministry of Health on behalf of disabled persons before they are approved. I am also told that operators in transport are supposed to be commercially minded. I should like to remind them that at off-peak hours and on Sundays on road and other services, disabled people contribute a great deal to the revenue. That point has been over-looked. In peak hours you get people on and off quickly; but the people who go shopping in the afternoons and on Sundays should have much more consideration than they get now. I should like to support my noble friend's Amendment.

LORD WYNNE-JONES

As an ex-near-cripple who is now the fortunate possessor of artificial hips, I have great sympathy with this Amendment. One of the enormous difficulties with which any person who is arthritic is faced is getting in and out of public service vehicles and in getting any type of help. Most of the doorways on our railway coaches, for instance, are singularly ill-designed for enabling people to get in and out easily. I find that practically always the door swings back on to one even when the train is stationary. It is really most important that on all public service vehicles there should be proper amenities and conveniences in order to enable one to move easily in and out.

I remember that about four years ago my late wife, who had had a very serious accident in London, was travelling back to Newcastle. She had insisted on doing so despite the advice of the hospital. I knew nothing about it, but the station at Newcastle had been informed. The station staff were extremely helpful. They produced what they termed an "invalid chair". This chair must have been de-signed about 1840. It was a sort of wooden padded throne on roughly square wooden wheels. It was impossible to get my wife on to this chair, and finally we had to get a stretcher. I think that there should be a clear instruction to all those who operate public transport that there should be available the proper amenities and accessories in order to enable people who are in any way handicapped—not only completely handicapped but partially handicapped—to be able to get in and out of vehicles.

VISCOUNT INGLEBY

I also should like to support this Amendment. There are a great many taxis on which the doors open only half-way, and somebody like myself who is a disabled person has difficulty in getting in. I would mention also priority seats on trains for disabled people. These seats could be labelled "Priority for Disabled People", and should be positioned near the lavatories. This is already done in some countries on the Continent.

THE EARL OF LONGFORD

I should like very strongly to support this Amendment. It is phrased in a very guarded way. There is the reference to the fact that the provision shall be practicable and reasonable in the circumstances, and I cannot imagine that anybody will be able to say that this is unworkable. I hope that we shall carry this Amend-ment.

4.58 p.m.

THE MINISTER OF STATE, SCOT-TISH OFFICE (LORD HUGHES)

This is an Amendment which I confess gives me a great deal of difficulty. Like everybody else, I sympathise with what is intended, yet none of the Departments of Government involved—the Ministry of Transport, the Board of Trade, and the Scottish Office—wishes to see the Amendment come into operation. I want to explain perhaps in some detail why we wish to take that line. It is not because we fail to recognise that many forms of public transport result in inconvenience, sometimes severe inconvenience, to disabled people—and, of course, no one is more aware of this inconvenience than the public transport bodies themselves. Naturally, both the Government and the transport officers are anxious to do what-ever can be done, within reason, to minimise this inconvenience. However, it is an unfortunate fact that the operation of transport undertakings is not the most profitable form of business to be found in this country to-day.

I would remind the Committee that this Amendment does not cover the whole of the passenger transport industry. It is directed only to the public sector—indeed, it is directed only to a section of the public sector, because it refers to that part of the publicly owned undertakings which operate under an enactment by Parliament. I am told—and I confess that it was quite a surprise to me, because my ignorance of many of the things that happen in England and Wales is pro-found—that many local authorities in England who operate public transport do so not under an Act of Parliament but under a charter; so they would not be covered. And, of course, the whole of the private sector of the transport industry would not be covered. So it becomes a bit difficult, when one is seeking to to do something to help disabled people generally in the field of public transport, to understand why we should make the legislation in a way which would in fact exclude large numbers of the disabled from any benefit whatsoever.

I appreciate the reference to the difficulty which confronts disabled people in getting into taxis, but taxis would not be covered; they are not operated by any publicly owned authority. So it is the difficulty of attempting to do by an Amendment such as this what people quite reasonably want that makes it un-reasonable for the Government to en-courage your Lordships to put this clause into the Bill. My difficulties were very much eased by the way in which the noble Lord, Lord Crawshaw, moved his Amendment. He practically invited me to give him assurances on what might be done, and suggested the issuing of a circular. I can certainly give an assurance that we should be very willing to do something on this line, particularly to manufacturers of public transport equipment, because, as the noble Lord said, the movers of the Amendment are thinking in terms of the future and about the types of buses and vehicles which are to come.

Obviously, it would not be impossible to convert existing buses for this purpose if one had unlimited funds; but it might be impossible for an impoverished transport undertaking to find the money necessary to convert many of its existing vehicles. It need not necessarily be more expensive in the future to design a bus in the way noble Lords have in mind. To this we would wish to give every possible encouragement—in fact, a certain amount is being done already. As against some, or at least one, of the things, to which the noble Lord, Lord Tevoit, referred, I am told that one manufacturer has lowered the floor level of his vehicles by four inches in order to make it easier.

LORD TEVIOT

I hesitate to interrupt the noble Lord, but I think he will find that the standard approved stipulates that the bus floors should be four inches above the axle, whatever height that may be. It may be that one manufacturer has lowered the floor, but he will not receive the full grant.

LORD HUGHES

I should be surprised at that, particularly when the Ministry of Transport are drawing attention to the advantages of doing this. The Ministry could hardly with one voice say, "This is an advantageous thing to do", and then say, "Because of your kind co-operation the people who buy your buses are going to be punished". I know that Government Departments do peculiar things, but that is not peculiar—that is just plain daft.

The noble Lord, Lord Crawshaw, spoke about breaking new ground. We are not entirely breaking new ground: some things are being done. And to emphasise this point may I say that one of the things which is specifically being explored with the manufacturers of buses, and with bus operators, is what more can be done to lower floor heights and the extent to which buses can use ramps instead of steps. These Section 32 grants under the Act are constantly being reviewed so that we may make additional provision for this kind of thing where it is desirable to do so.

I think that people are anxious to do the best they can. The Amendment, defective as it may be, is at least intended to be practicable in that it does not seek to impose a duty. It inserts words of qualification. But even the insertion of words about reasonableness and practicability does not help many of the undertakings because it is not they who are to be the judges of what is reasonable or practicable. They may be the judges in the first place; they may decide whether or not to act on what they think is reasonable or practicable. But that is not the end of the matter; somebody else— perhaps someone representing a potential disabled user of a bus—may not agree that it is reasonable to do nothing, or that it is practicable to take a particular step, and the remedy would then be in the courts. We can never be quite certain that people who resort to court action will themselves be either practicable in their thinking or reasonable in their attitude. So even the person in charge of an undertaking who is willing to do everything he can is at the mercy of the person who may wish to threaten court action. Operators may be willing to be helpful in these matters so far as their financial resources will permit. I know that it is a temptation to say to people, "You must do this", but remember that the people we are talking about are commercial operators, and they must operate within a commercial framework. There comes a point where the imposition of welfare duties could be unreasonable.

I think we should be well advised to take every possible step to encourage people to do everything which is reasonable and practicable. This may be done by the use of the consultative machinery, to which I have referred, to examine the manufacture of buses for the future, and by advice given by circular or letter to the operators of transport undertakings. I can assure noble Lords that the Ministry would be very willing to assist; and in the provision of grants the Ministry will seek to make the best possible use of them to encourage this sort of thing to be done in connection with the provision of new equipment. I hope that in these circumstances the noble Lord will feel that, at any rate at this stage, he is able to withdraw the Amendment.

THE EARL OF LONGFORD

May I ask the noble Lord one question? Does he think that, at any rate in broad terms, he will be able, before the next stage, to show noble Lords most concerned a draft of the proposed circular?

LORD HUGHES

I am not certain that this will be possible. What I am quite willing to undertake is to discuss with noble Lords concerned the sort of matter which they would like to see put into such a circular; and explore the extent to which we can agree. But as to the actual drafting of the circular itself, I doubt very much whether it would be in the best interests of everyone concerned to attempt to rush that against the need for speed in getting the Bill through.

LORD O'HAGAN

At the end of his remarks the noble Lord mentioned grants. Could he expand on that matter, either now or at some other time? He was talking about financial difficulties, and his answer to them in the form of the provision of grants, did not receive very much attention.

LORD HUGHES

There are provisions in the Transport Act for giving financial assistance towards capital expenditure. What I said in relation to grants was that they do come under consideration from time to time; and that if the provision of different facilities on buses, in order to make it easier for disabled people to make better use of these public transport facilities, resulted in extra expenditure, that sort of thing could be taken into account in determining the level of any grant to be given.

LORD CRAWSHAW

I thank the noble Lord for his reply. I am sorry that he cannot see his way to include this clause in the Bill, but I welcome his assurances about the circular and I shall be happy to confer with him about what is to go in it. I want to make just one or two points about it. The noble Lord talked about the commercial side of transport. I think we ought to bear in mind, as my noble friend said, that often it is good commercial practice to encourage disabled people to travel in various forms of transport. Many airlines already realise this. The other point is that the reason why in this Amendment we concentrate on the public sector is that British Rail and other nationalised industries are there primarily to give services to the community, rather than as a commercial exercise. Presumably they are there to serve all the community, and that of course includes disabled people. I shall certainly be conferring with others inside and outside the House between now and Report stage, and we may well come back with some further Amendment. But in the circumstances I am happy for the moment to withdraw my Amendment

Amendment, by leave, withdrawn.

5.2 p.m.

LORD AMULREE moved Amendment No. 7: After Clause 1, insert the following new clause:

Improved Information to Prescribers

".It shall be the duty of the Secretary of State to provide all authorities and officers now entitled to prescribe or issue appliances, aids or other items of equipment under the provisions of the National Health Service Act 1946 and the Health Services and Public Health Act 1968 and every local authority with information, at such intervals as shall be determined by the Secretary of State, of all appliances, aids or other items of equipment which may be so prescribed or issued to disabled persons."

The noble Lord said: In moving this Amendment I am really asking for more detailed information from the noble Baroness who has been replying, because it is very important that the catalogue of the various appliances available for disabled persons should be kept as up to date as possible. This information generally goes to the doctors in charge of disabled people or to the local authorities who may be providing these appliances. We have had some evidence that the catalogues which are supplied are not kept properly up to date. Two examples have been quoted to me, one of some items promised in the catalogue in October, 1967, but still not there in 1969; and only one out of the four promised was in the catalogue in 1970. There are a number of appliances avail-able at the present time under the National Health Service Act but which do not appear in the catalogue. The object of putting down this Amendment is to ensure that the catalogues are kept as up to date as is humanly possible and made freely available to disabled people and to local authorities involved in supplying the appliances. I beg to move.

LORD PLATT

I should like to sup-port very strongly the intention of this Amendment, which also stands in my name and in the names of other noble Lords. This is part of the whole subject of information which has already been partly opened and dealt with on Amendment No. 5, moved by the noble Lord, Lord Wells-Pestell. This information question divides itself into several sections: information to the disabled them-selves about services, information to the disabled about aids and appliances and, as in our Amendment, information to the people who actually prescribe the aids and appliances. The only uncertainty I have is whether it would not be better in some way to combine what we want in this Amendment with what the noble Lord, Lord Wells-Pestell, wanted in his Amendment, and I should like guidance upon that point. But I hope that we shall not lose sight of what appears in this paragraph, because I think it is very important.

LORD SANDFORD

May I add my support to this Amendment and in doing so make a suggestion for its possible improvement which I hope either the movers or the noble Baroness, the Minister of State, will consider? I believe that the local welfare authorities issue aids and equipment to handicapped people, under Section 29 of the National Assistance Act, in similar circumstances to those envisaged by this Amendment. I believe it is the intention of noble Lords that what is put down here should meet not only the medical needs of the chronically sick and disabled but also their general needs. If that is so, I would suggest that a specific reference to the National Assistance Act, under which those needs are being met at present by local authority welfare departments, would give the new clause more precision and clarity. I put this point forward only as a suggestion for further thought. I certainly support the Amendment as it stands.

BARONESS SUMMERSKILL

I do not wish to waste the time of the Commit-tee, but I should like to be associated with this Amendment. I believe that it is of profound importance that the fullest information should be given to the authorities and also to those who are in need of whatever equipment is available. Unless we are specific in ensuring that this information is not restricted, there is much waste of time and effort.

THE EARL OF LONGFORD

I should like to support this Amendment very strongly for the reasons given.

BARONESS SEROTA

I think that the whole Committee agree with the principle —I certainly do—that lies behind this Amendment. However, I find difficulties with the new clause itself. Perhaps I could detain the Committee for a few minutes to explain why. This Amendment is similar to one which was tabled in another place and not debated there. The Secretary of State already provides information to hospitals and consultants about items of central contract, and to general practitioners about what they may prescribe, through the drugs tariff that is issued regularly; but he does not provide such a service for local authority welfare authorities.

As I read this clause, it would require the Secretary of State to collect information about a large number of items which are either modifications of standard items or designed for individual cases. When this subject came up in another place, the authorities considered that the new supply of money that would be required to institute the service set out in the clause would not be within the Money Resolution which was passed by the Commons, and therefore this particular clause was not called. But I welcome the opportunity for us to consider the problems that are clearly in the minds of the supporters of this Amendment during the Commit-tee stage here to-day, to see how we can move towards achieving what we all want to achieve; namely, the best possible ser-vice to the chronically sick and the handicapped. As the noble Lord, Lord Platt, reminded us, this is one of the main features of this Bill and was very much underlined during our discussion on Second Reading—that is, information and knowledge—and many of the clauses are designed to provide better service in that field.

I certainly accept, as I think everyone with any knowledge in this field would, that there is an important job to be done in relation to aids and equipment for people handicapped by chronic sickness and disability. The real question is how one can best do this job. I am advised that this clause might actually inhibit us. It might make us do things that turn out in practice not to be useful or necessarily practical things. We do not know, for example, whether it is lack of knowledge or lack of will that is the trouble here. If it is the latter, the pumping of knowledge will not achieve the objective, and might indeed even clog the machine. If it is lack of knowledge, I am not sure that we know what knowledge is lacking, who lacks it, and what is the most effective way of collecting and communicating that knowledge to the right range of people concerned.

It was suggested in another place that some of these difficulties could be over-come if we had a national information centre, and many, I know, found that to be an attractive proposition. My honourable friend the Parliamentary Under-secretary of State has undertaken to consider the case for such a centre and the ways in which it should be organised. Again, as one travels to different parts of the country, seeing different aspects; of the Health and Welfare Services, one is conscious of the vast range of equipment that is available. One is anxious to see the spread of knowledge and experience here and, if I may put it in this way, the cross-fertilisation of ideas based on experience and use.

We are actively pursuing this matter, and will pursue it, with the range of bodies concerned, many of whom already have considerable experience in this field, including the voluntary bodies who have taken such a lead in this direction. We are also considering the possibility of having an exhibition this summer here in the Palace of Westminster, as a public building to which many people come and where we think an exhibition of this kind could perhaps be most successfully mounted. But what we want to do in having these discussions with those concerned is to take a fundamental look at the most fruitful forms of action, and we shall want to discuss it with all those bodies. One such body is the National Fund for Research into Crippling Diseases, which produced the great work that I have here, consisting of three volumes, which I thought I would show to your Lordships. This is their compendium of equipment for the disabled, and of itself, as they would be the first to agree, is not fully comprehensive.

We also want to talk to bodies such as the Central Council, with which the noble Lord, Lord Harding, is so closely associated; the Disabled Living Activities Group, in whose exhibition of clothing for the handicapped I have been greatly interested for a considerable time; the Spastics Society, the Red Cross and the whole range of bodies that have done so much in this field. Clearly, we want to draw on their experience and know-ledge. Also, we want to talk to people who are themselves disabled and handicapped, because, after all, they are the people who are concerned and involved, and we must find out what they want and how they want to get it.

I can assure the Committee that we are concerned with this problem, and that the work involved in developing better channels of communication of information will be put in hand. I hope that with the kind of undertaking that I have given to the noble Lords concerned, they will agree with me that it is better to proceed in the way that I have suggested rather than through the formal wording of this clause.

LORD AMULREE

I should like to thank the noble Baroness for what she has said. In view of what she has told us about the steps that are being taken to overcome the problems of ignorance and lack of communication, I beg leave to withdraw the Amendment.

LORD PLATT

I am not sure that I agree with my co-mover Lord Amulree there. It seems to me that what the noble Baroness has told us is that she agrees with everything in this clause, and she has told us how she may set about this; that is, by getting information from all kinds of societies. That is precisely what we want her to do. It seems to me that there is nothing that the noble Baroness has said which would make me want to withdraw the Amendment. I have already said that I should be willing for it to be reconsidered, along with Amendment No. 5, and that it should come back in a new form at a later stage; but without an assurance on that point, I do not feel that I am in favour of withdrawing the Amendment.

Amendment, by leave, withdrawn.

Clause 1, as amended, agreed to.

Clause 2 [Provision of welfare services]:

THE EARL OF LONGFORD moved Amendment No. 8A: Page 2, line 13, at end insert ("or assistance to that person in taking advantage of educational facilities available to him;").

The noble Earl said: I do not think that we need spend long on this Amendment. If noble Lords will look at Clause 2(1)(c), they will see the reference to the provision of lectures, games, outings or other recreational facilities outside his home".

Without dwelling on the matter, I think we are all aware—and the Government will probably agree—that it is wise and right, and indeed our duty, to extend that phrasing. Therefore, I move this Amendment which widens the phrase to include all educational facilities. I hope that the Government will accept this Amendment. I beg to move.

BARONESS SEROTA

We find this a very welcome Amendment which strikes just the note that the authors had in mind.

On Question, Amendment agreed to.

5.18 p.m.

LORD GRAY moved Amendment No. 9: Page 2, line 25, after (" greater") insert (" safety ").

The noble Lord said: My Amendment also is to Clause 2, and specifically to subsection (1)(e), which concerns works of adaptation to a person's home and provision of additional facilities where these are designed to secure his greater comfort or convenience ".

The Amendment seeks to add the criterion of safety to those of comfort and convenience, already in the Bill. I hope to persuade your Lordships that this addition is not merely within the spirit of the paragraph, but embodies the twin merits of strengthening its practical effect and clarifying its intention.

I readily accept that distinctions between comfort and convenience will, in practice, often be blurred, and similarly there will be areas of overlap between considerations of convenience and of safety. However, this is not a hairsplitting exercise, but an attempt to improve and strengthen an important provision. I am sure that in practice safety will often be a dominant or even the first consideration where provision of assistance is contemplated, and I submit that it should be —and that this Bill should say so. Inserting the word "safety" will mean: first, that positive decisions can be taken on grounds of safety alone; and secondly, it will clarify the intention of the sub-section both for those for whom we are legislating and also for local authorities. In mentioning clarification for local authorities, I have in mind references made both in another place and in our Second Reading debate, on the different standards between one local authority and another in what is done for the disabled. I have in mind also what my noble friend Lord Sandford said on Second Reading at col. 248—speculating admittedly on the merits of making such provisions mandatory—when he said: "It must be clear and precise beyond peradventure."

The mandatory nature of Clause 2, backed up, perhaps, in due course by provisions proposed in the Local Authority Social Services Bill, will do much to make for greater equality of performance between one local authority area and another. But none the less, the wording of the paragraph itself allows for the exercise of judgment and discretion as to the nature and extent of what may be done, and I feel most strongly that the importance of safety, as a specific criterion, should be spelt out.

It is also worth considering that according to individual circumstances—for instance, where the disabled person is living as one of a family—adaptations and facilities covered by this paragraph, which might be construed as convenient when someone else is in the house, can become matters of safety at such times as when the disabled person is alone. I have in mind such items as hand and guard rails, types of heating appliances, cooking stoves and even floor coverings. Apart from obvious items such as alarm systems, there is a further area in which I believe this Amendment could have worthwhile practical effect. It relates to what my noble friend Lord Stamp said in his forceful Second Reading speech about the development and provision—present and future—of speciality appliances for the use of the disabled and chronically sick, and referred to such as are and may be designed with safety and accident prevention as their purpose. Some such might well come within the scope of this provision if we add the word "safety".

Finally, in asking your Lordships to support this Amendment I suggest that it could just possibly in practical terms on some future occasion make the important difference between a person being able to remain in or return to his or her home rather than being kept in hospital or some other institution. I beg to move.

LADY SEMPILL

In supporting my noble friend on this Amendment I would add only one point. This provision as it now stands was welcomed in Standing Committee in another place, not only for its content, but because of what it could mean in particular for tenants as opposed to householders, be they tenants of public or private landlords. I feel that the addition of the word "safety" can only strengthen this aspect.

BARONESS SEROTA

May I say how glad I am to see this Amendment on the list of Amendments. I do not think the noble Lord who moved this Amendment need apologise in any way for having done so. We are all conscious of the danger—particularly in the home— to people with certain forms of disablement, and I feel that this is an improvement in the Bill.

THE EARL OF LONGFORD

I should like to join in supporting the Amendment.

On Question, Amendment agreed to.

THE EARL OF LONGFORD moved Amendment No. 10: Page 2, line 26, leave out ("in particular at holiday homes") and insert ("whether at holiday homes or otherwise and").

The noble Earl said: This is an Amendment to which I know the noble Baroness, Lady Elliot of Harwood, attaches a great deal of importance. Un-fortunately she cannot be with us to-day —much to her regret—owing to some quite inescapable engagement. I am moving it in her absence, leaving my noble friend, Lady Masham, who has given a great deal of thought to this problem, and had a lot of experience on it, to speak to the House in support of it.

BARONESS MASHAM OF ILTON

I had not been told that I should speak on this Amendment, but I agree that it raises a very important subject. I do not know whether your Lordships are aware of the fact that many disabled people are banned from holiday homes: these are the very people who need a holiday more than anyone else because they are incontinent. I am a member of the Red Cross Society, and although we run several holiday homes for the handicapped we are the very worst offenders in that we ban disabled people at these holiday homes. I have taken up this matter with the Red Cross. The parents or dependants of these people also need a holiday, and therefore holiday facilities should be made available so that they may take holidays wherever they want. I wholeheartedly support this Amendment.

LORD HASTINGS

I also support this Amendment. In doing so I will declare my interest, which may be unknown to some of the sponsors of this Bill. I am thinking in particular of those who suffer from epilepsy. I am President of the British Epilepsy Association. We run holidays every year for children who suffer from this complaint, and sometimes they are also accepted by other organisations for the handicapped. These holidays are organised entirely voluntarily, and we have the co-operation of a number of local authorities who contribute to-wards the holidays of some of the children. This work must be encouraged, and it would be very worth while to make it clear that to limit it to "holiday homes" alone is too restricted.

I should like to put it in the minds of the people interested in this Bill that in its implementation there is a very definite place for voluntary organisations. This came out very strongly in the Second Reading debate and was mentioned, I think, by the noble Baroness, the Minister. This would seem to be the only in-stance where it is specifically incorporated in the Bill in respect of these holidays. I do not want to complicate anything in the Bill but I wonder whether any mention should be made anywhere else in the Bill of voluntary societies who I feel should not be overlooked by the local authorities. I just mention that as an idea for those who are more especially interested. This Amendment is very important and I support it.

On Question, Amendment agreed to.

5.30 p.m.

BARONESS MASHAM OF ILTON moved Amendment No. 11: Page 2, line 32, leave out from ("obtaining") to end of line 34 and insert ("a telephone and any special equipment necessary to enable him to use a telephone,")

The noble Baroness said: I beg to move the Amendment which stands in my name. The Telephones for the Blind Fund has been running a scheme in this country, in Surrey, for three years. It has installed more than fifty telephones and is responsible for all rent and local call charges. Those who have received the telephones have been selected on a strict priority of need, and they include only blind people living alone, often additionally handicapped by sickness or age and, further, unable to afford the service from their own resources. This scheme has given an enormous gain of independence and security to the blind people. There are often badly disabled people who need this life-line to alleviate inflation and to help solve problems of daily living, such as shopping and calling for help when needed.

Last week I had a letter from a quadraplegic (that is, somebody who has a broken neck) who is living with his parents, both of whom are pensioners, so that the income is small. He is very worried about the increase in telephone charges. He says that the telephone to him is as important as a three-wheeler or a motor car is to somebody who can drive: it is his contact with friends and the outside world. As these people with very high lesions are being kept alive in the early stages of their injury, I think it is an ethical duty on society to give them some of the necessary aids to enable them to live their life with a bit of in-dependence and the feeling of being part of the community. Some local authorities are already helping with support in providing telephones in cases of proved need. I beg to move.

BARONESS BROOKE OF YSTRAD-FELLTE

I rise to support the noble Baroness, Lady Masham, in the Amendment she has moved on this point. To begin with, it seems to me that the essential thing is completely missing from the Bill. Clause 2(1)(h) refers to: the provision for that person of, or assistance to that person in obtaining, any special equipment necessary to enable that person to make use of a telephone in his home. Surely the first essential is to have the telephone, not to have equipment to help one to use it. For that reason, which I regard as a completely realistic one, and quite apart from the admirable case made by the noble Baroness, Lady Masham, I should like to support this Amendment.

BARONESS HYLTON-FOSTER

I too support the Amendment, because the telephone is indeed a lifeline to those people who are immobile. And I hope very much that when disabled people are pro-vided with telephones they are not fobbed off with the old, very heavy instruments, because it is impossible for people with some forms of disablement to support the weight of the old-fashioned telephones. For that, among other reasons, I support this Amendment.

LORD GRENFELL

I am a little worried about this Amendment, although I wholly support it. Suppose, for instance, that at the end of these Amendments we bring in the question of including in this Bill the mentally handicapped. Would they, under this Amendment, be entitled to a telephone and any special equipment? We seem to be going rather wide. I should like advice on whether it is practicable to provide telephones for everybody who may be concerned. I think it is desirable, but we must keep our feet on the ground and find out whether it is a possibility. Perhaps the noble Earl, Lord Longford, could advise us on this point, as he is in charge of the Bill.

BARONESS MASHAM OF ILTON

I suggested that telephones should be pro-vided to people of proved need. The mentally handicapped would not be considered in this connection if the Amendment did not apply to them.

LORD SANDFORD

I think the Committee should hear the view of the Minister of State and of the sponsor of the Bill before we come to a decision on this matter.

THE EARL OF LONGFORD

I am very much in favour of this Amendment, as is everyone with whom I happen to have spoken and who is joining in the promotion of the Bill.

BARONESS SEROTA

If it will help the Committee, I am advised that this Amendment simply declares a power which is already contained in Clause 1(2)(a), and the scope of it is very wide. I, too, welcome this Amendment and the spirit behind it, although of course one must accept the circumstances which exist. One cannot help feeling concerned about advising a widespread development of telephone installation, be-cause that is not going to help in every case. It is no good installing a telephone in the home of a friendless person, for example, because that person will never have any calls. And there are elderly and infirm people, and some with mental handicaps who could not really benefit by the telephone. As I understood it, the object of the Amendment here was to make it possible within this wider definition to provide a telephone where those who had handicaps, either physical or mental, could benefit by being in communication through this particular medium. It is in that setting that I hope the Committee will accept the Amendment.

LORD SANDFORD

Before we decide to accept this Amendment, I wonder whether I might ask the Minister of Slate a further question, about how this is going to be paid for. These are obligations which are to be laid on the local authority under the National Assistance Act. Can the noble Baroness say whether, in the case where it is decided by the local authority to meet the cost of providing a telephone under paragraph (h) the subsequent charges for the use of the telephone will be met by her Department? Because at present these charges are met, after due consideration, by the Supplementary Benefits Commission.

BARONESS SEROTA

I am grateful to the noble Lord for raising this practical and important point, and I am glad to have the opportunity of telling the Committee that my Department and the Supplementary Benefits Commission are at this very moment considering this very difficult question of responsibilities as between the Supplementary Benefits Com-mission and the local authorities in this particular field, and of giving other assistance, with a view to a discussion with the local authorities on it. After that, further guidance will be issued. This is an important point. One cannot afford to ignore what may be the very widespread implications of the development of ser-vices of this kind. This is why we have initiated the discussions to which I have just referred.

LORD SANDFORD

May I take it then that we shall at the next stage have further information from the noble Baroness, the Minister of State, on this point, in the light of these discussions? Otherwise, we are rather buying a pig in a poke.

BARONESS SEROTA

I will certainly undertake to do that, if it is possible. I am not yet quite clear how we are going to move through the various stages of this Bill; but certainly if it is possible by the next stage to give a more up-to-date report as to the way things are going on this, I shall be happy to do so.

THE EARL OF LONGFORD

I am not quite sure that I follow the noble Lord's point. Is he saying that he wants this matter postponed? There seems to be a general wish on the part of the Committee to carry the Amendment now.

LORD SANDFORD

I was not suggesting anything of the kind. But since the point has been raised, and since we have had, I think the noble Baroness will agree, an answer, though not a complete or final answer, I feel that it would be as well to hear more at the next stage. But I certainly agree with the Amendment.

THE EARL OF LONGFORD

I cannot understand the reference to the next stage. If this Amendment is carried, there will not be a next stage on it.

BARONESS SEROTA

As I understood the noble Lord opposite, he would like from me more information about the ways in which we see the provisions we are now discussing actually being carried out.

LORD SANDFORD

That is right. On Question, Amendment agreed to.

LORD DRUMALBYN had given Notice of an Amendment (No. 12):

Page 2, line 42, at end insert— ("() A local authority to whom this section applies shall have power to make arrangements for the provision of laundry facilities for any person for whom practical assistance in his home is provided or for his household.")

The noble Lord said: I tabled this Amendment because I observed that laundry services were not provided for under this clause, and as they are pro-vided for Scotland under the Social Work (Scotland) Act I thought it only fair that they should be provided for England as well. However, on further examination I discovered that laundry services are contained in Section 13 of the Health Services and Public Health Act 1968. When I read that section, I found that it applied to Scotland. However, it so happens that that Act was passed on July 26, 1968, and was repealed, for Scotland, on July 26, 1968—the same day. So although that Act does not apply to Scotland there is provision in the Social Work (Scotland) Act. For these reasons, it was not necessary for me to table this Amendment and I do not propose to move it.

BARONESS SEROTA

I can only ex-press my personal admiration for the way in which the noble Lord always does his homework.

5.42 p.m.

LORD DRUMALBYN moved Amendment No. 13:

Page 3, line 9, at end insert— () This section shall apply to Scotland without prejudice to the duty of local autho rities under sections 12 and 14 of the Social Work (Scotland) Act 1968.")

The noble Lord said: I beg to move Amendment No. 13. I have tabled it because people in Scotland felt concern that these two clauses did not apply to Scotland. I have already referred to the Social Work (Scotland) Act. Provision is made on a much wider basis in that Act for persons in need as a whole. Those provisions are contained in Sections 12 and 14, and a general power is given to local authorities to provide or secure the provision of such facilities … as they may consider suitable and adequate, and such assistance may be given to. or in respect of, the persons specified in the next following subsection.

The persons specified are children, and a person in need requiring assistance in kind. Then the application section, Section 94, defines "persons in need" very widely indeed to cover persons who are in need of care and attention arising out of infirmity, youth or age; or suffer from illness or mental disorder or are substantially handicapped by any deformity or disability; or have been rendered homeless and are in need of temporary accommodation; or being persons prescribed by the Secretary of State who have asked for assistance, and are, in the opinion of a local authority, persons to whom the authority may appropriately make available the services and facilities provided by them under this Act.

That of course covers much wider classes of persons than this Bill, but the question then arises whether every separate need which is specified in subsection (1) of this clause would be covered by the Social Works (Scotland) Act, and this is the point about which anxiety was felt in Scotland.

I do not think I need go into any detail, but there are positive advantages in placing on record in legislation the sort of services and facilities which Parliament considers local authorities should provide for the chronically sick and disabled, and I for my part would not mind if the chronically sick and disabled were specially singled out; indeed, in so far as the Amendments have been officially tabled to single out these categories, in those parts of this Bill which are to apply to Scotland they are already being singled out. But the argument against that is that the list may be, or may prove to be, not entirely comprehensive or complete. There may be services or facilities which, because they are not mentioned in the clause as it now stands, the local authorities would be debarred from providing.

So there is a balance of advantage and disadvantage here, and I am quite certain that the chronically sick and disabled in Scotland, and those who look after them, would be quite satisfied if they were to be informed by the noble Lord, Lord Hughes, that the Social Work (Scotland) Act in fact covers all the facilities that can be provided under this clause. If the noble Lord can give that assurance I shall be happy to withdraw the Amendment. I beg to move.

LORD HUGHES

The noble Earl, Lord Longford, has encouraged Ministers to state the view of the Government before he intervenes, so I do not think he will object if I step in at this stage. I could not help thinking, when the noble Lord, Lord Drumalbyn, was speaking to this Amendment, that he was animated by certain feelings of patriotism which encouraged him to remind your Lordships how far ahead Scotland is in this matter over the rest of the country. My recollection is that, when we were discussing the Social Work (Scotland) Bill, we had to work very hard in order to keep the provision in the wide terms in which it was stated, and we resisted attempts to define it more closely on the basis that, as soon as one started to make definitions, one almost certainly would be liable to narrow the general field which we Were seeking to establish.

I think the terms in which the Bill is drawn are such that it is almost impossible to envisage any category of person in need who cannot be covered by the powers now conferred on local authorities in Scotland. It certainly was our intention that everybody known to be in need, or anybody who might possibly in the future become in need, should be covered without the need for any amendment to the legislation. For that reason, the Bill excludes Scotland from the operation of these clauses.

It would perhaps be helpful to your Lordships if I were to quote from the Social Work (Scotland) Act 1968. Section 12 of that Act places a general duty on Scottish local authorities "to promote social welfare", which enables them to do any of the things listed in Clauses 1 and 2. Also, there is the requirement on local authorities in Section 5 of the Social Work (Scotland) Act that they shall per-form their functions under the general guidance of the Secretary of State and this section complements this requirement by empowering the Secretary of State to make regulations in relation to the performance of the functions assigned to local authorities by this Act". If we were to apply Clauses 1 and 2 to Scotland it would, as the noble Lord, Lord Drumalbyn, has indicated, have the undesirable effect of making special statutory provision for a particular category of people who need help from local authorities, separating them off from all the other people who may need that help. We do not think it is desirable to do this, having regard to the needs of other sections who have (to put it no higher) an equally strong claim on the help of the authorities, such as the elderly and the young.

In addition, as the noble Lord has indicated, it is not so easy to amend a Statute. Once one starts to specify various categories, ore discovers something which ought to have been put in, and one has to await the opportunity for an amend-ing Bill. But we do not need to do that; we can do it by the guidance which can be issued by the Secretary of State, and we think this is much more helpful.

During the Report stage of the Bill in another place the Joint Parliamentary Under-Secretary of State for Scotland, in giving an assurance that the powers which are to be taken in Clauses 1 and 2 of the Bill were already covered by Sections 5 and 12 of the Social Work (Scotland) Act, stated: We shall see in the meantime that social work in Scotland in no way falls behind any measures which are taken elsewhere"— meaning, of course, in this Bill— for the benefit of the chronically sick and disabled."—[OFFICIAL REPORT, Commons, 20/3/1970, col. 895.] I am glad to repeat to your Lordships this assurance on behalf of the Government. I wish to say also that consultations in Scotland with bodies concerned with the disabled there about the precise contents of this guidance will, of course, be desirable. But the Government assurance is that the ensuing guidance will give the disabled in Scotland no less support than Clause 2 will give to the disabled in England and Wales. I am quite confident that with this assurance the noble Lord will be able to pursue what I think is his real wish, not to push this Amendment.

LORD DRUMALBYN

The noble Lord has given a very satisfactory answer to my probing Amendment, and therefore I have pleasure in asking leave to with-draw it.

Amendment, by leave, withdrawn.

On Question, Whether Clause 2, as amended, shall be agreed to?

LORD SANDFORD

AS we have just heard, Scotland is an admirable place, and England is an admirable place. But they are different places, and different in the way in which they have chosen to modify the style of their social work services. Scotland has already done this; England has yet to do it. But one of the effects, when the Bill that changes the whole style of social work in England is enacted, is that Section 35(2) of the National Assistance Act will be repealed. That being so, I should like to ask, first of all the noble Earl, Lord Longford, and then the noble Baroness the Minister of State (or perhaps the noble Baroness, Lady Phillips, is going to deal with this) what will happen to the Bill that we are now considering when all references to Section 35(2), as it were, disappear from Clause 2 of our Bill. This is the clause under which the powers of the local authorities are exercised under the guidance of the Secretary of State. It seems to be an important part of this clause, but it will not be there when the Local Authority Social Service Bill is enacted, because it will thereby be repealed.

BARONESS PHILLIPS

I think the safest thing would be to tell the noble Lord that he will have an answer during the passage of the Bill. As he probably appreciates, we are dividing it into Departments, and this caught us both at odds. But we will see that he gets a reply.

Clause 2, as amended, agreed to.

Clause 3 [Duties of housing authorities]:

5.54 p.m.

LORD MAIS moved Amendment No. 14:

Page 3, line 24, at end insert— ("() It shall be the duty of every local authority already providing accommodation to chronically sick or disabled persons who, by reason of their chronic sickness or disability, are in need of care and attention which is not otherwise available to them to provide for such persons not wishing to live in such accommodation an allowance in money which shall be in addition to Social Security Benefit and Supplementary Benefit to meet any needs resulting from such chronic sickness or disability.")

The noble Lord said: I beg to move the Amendment which stands in my name. Before doing so I should like, since I was unable to be present at the Second Reading, to say that I whole-heartedly support this Bill. May I also express the hope already expressed by other noble Lords this afternoon, that we send this Bill back to the Commons without undue delay, in order to ensure that it reaches the Statute Book during this Session of Parliament? We must bear in mind that there are thousands of disabled people who would feel that the relief which is offered to them has been snatched away if for some reason or other the enactment of this Bill were deferred until another Parliament.

This Bill is almost entirely directed towards helping disabled people—children, young, middle-aged and elderly— either directly or indirectly, to live outside institutions, that is to say, in their own homes or in the homes of friends, and to partake in all kinds of normal activities, whether they be social or educational, recreational or work. In fact, with the exception of Clauses 14 and 15, which provide for the more severely handicapped younger patients, the Bill is attempting to facilitate the integration of all types of disabled people into our everyday life in so far as that is possible.

There is a growing awareness that disabled people are, first and foremost, people; that their disability is merely an attribute. Some of us are tall and some short; some are blind, some deaf and some cannot walk; but these are secondary attributes, if I may say so. The disabled are, first and foremost, people, with a desire to be accepted and, most important of all, to be on the one hand independent and on the other hand of use to their fellow citizens. We all wish to be needed, and this lack of a feeling of being needed is particularly applicable to the younger people. A disabled friend of mine told me recently of something which gave her the very greatest pleasure, and that was that she was able (she being very critically disabled) to take an able-bodied friend in her car, together with the friend's luggage, to the station. This gave my friend pleasure out of all pro-portion to the pleasure that an able-bodied person would have felt.

With young people, in particular, this desire to be part of society, to be accepted, is a very strong one. The very existence of this Bill, and the publicity that it has attracted, has raised hopes and ambitions among a very consider-able number of young disabled people; it has raised the hope that they will be helped into the position of becoming useful citizens and able to contribute to society rather than simply taking from society. If I may say so, to-day there is a little too much of taking and a little too little giving, and therefore every encouragement should be given to these young people. There are a number of them, some living in residential homes for the disabled, and others in hospitals, who wish to live in outside accommodation. Some of these young people wish to marry; some of them wish to share a flat or house with friends, and some of them wish to go to university or an-other form of college.

The position is at present covered by the National Assistance Act 1948, Part III, "Local Authority Services, Provision of Accommodation". Section 21 says: It shall be the duty of every local authority, subject to and in accordance with the provisions of this Part of this Act, to pro-vide residential accommodation for persons who by reasons of age, infirmity or any other circumstances are in need of care and attention which is not otherwise available to them.

This accommodation can cost anything up to £1,000 a year, maybe even more. But if the young person wishes to leave this accommodation and live in the community, the local authority is not empowered to make any contribution to the extra expense of living as a result of the person's disability. All such per-sons will receive is the normal grant from the Ministry of Social Security; and this may be only one-half, or even less, of what it costs to keep them in care.

If they are determined to leave, then they are reduced to appealing far and wide to as many voluntary organisations as they may be able to find, frequently with little result. This not only applies to those who wish to study or to learn a trade, but also to young people wishing to marry or to live with their friends. The extra expense of their disability makes this move well-nigh impossible unless they receive extra financial sup-port. This financial support would in many cases relieve the community of some part of the financial burden of keeping these young people in institutions and, so far as we can ascertain, in no circumstances would it cost the community any more than is already being expended. I beg to move the Amendment which stands in my name.

LORD AMULREE

I should like most strongly to support this Amendment. I have always felt it a great gap in our social service that it was not possible to provide somebody with some kind of income so that they may take care of their relatives at home should they so desire. I have tried to put this across in various places in regard to the care of elderly people—that their daughter might be given a sum whereby she may be enabled to stay at home and take care of her mother if she be so willing, rather than that the mother should be removed to an institution or hospital or to some kind of communal living because the daughter has to go out to work in order to earn money. In a number of cases I do not think it would cost a great deal more than keeping a person in a communal home, whether that be a hospital, an institution or a welfare home. Supposing it were not to be a great deal cheaper, certainly it would be a far kinder and more humane way of doing things, because a great number of people would rather be in their homes, being taken care of by their relatives, than to be sent some distance away to be taken care of by strangers. Therefore, I hope that the noble Lord, Lord Mais, will get a kindly reply to his Amendment. I am sure that this is something that we would welcome. I am sure that if it does not come now it will come in time, because it appears to me to have a good basis for encouragement.

BARONESS MASHAM OF ILTON

To many people this would be a welcome clause. A survey taken at spinal units throughout the country showed that badly disabled people, living in their own poor and inadequate homes, lived longer and were happier than those similarly afflicted and living in institutional care, there-by proving that "an Englishman's home is his castle". Where a badly disabled person no longer can live at home because of the financial strain on the family and they are put into care, it breaks up the family. In my work in borstal institutions I have seen a very high percentage of young men who have come from families with badly disabled members. This has put great strain on the family and family relations have broken down. For many people with a progressive disability or aging dependants the possibility of going into an institution looms over them. This would be a heaven sent clause. Therefore I support it.

THE EARL OF LONGFORD

I, too, strongly support this Amendment. When the noble Lord, Lord Mais, explained his Amendment to me, I told him that I felt that the Government would have considerable difficulty in accepting anything which increased expenditure outside Clause 2. But with a great deal of financial knowledge behind him, he pointed out that this clause, in spite of a reference to an allowance in money, must not be taken to increase expenditure. So I hope that that part of the argument will be accepted by the Government. It does not involve an increased expenditure, and therefore I would hope that it would be acceptable.

BARONESS PHILLIPS

It falls to me to give the point of view of Her Majesty's Government in connection with this Amendment. We at once agree that there is great force in the argument that provision by means of residential care should be restricted to those who must have it because they have no other provision. I think we have to remind ourselves that there is a wide range of non-hospital residential care ranging from the old institutional accommodation to new self-contained flatlets with a warden service, many of which I have myself seen.

The nearer the provision for those in need of care can be brought to domestic need, the better, and if a disabled person's own home is right then, naturally, it gives them a greater feeling of independence. But convictions about the best type of residential care, or the importance of services in the home, should not, however, lead to the conclusion (this is the important point of this Amendment) that the local authority is the right body to make cash payments to people in their own homes. Integration is essential, as is a measure of flexibility, and even of over-lap. We are now dealing, as noble Lords will know, with the Seebohm proposals and the Health Service Green Papers, which recognise the fact that we must have integration. But that is a different matter from giving one body an import-ant, extensive and costly responsibility, completely duplicating the responsibility of another body which is better equipped to do the job. The National Insurance Scheme provides the basic benefits—in this instance sickness benefit or retirement pension for people with a contribution record.

The National Superannuation and Social Insurance Bill now being considered in another place—and we must bear this in mind right throughout the course of our discussions—will provide an attendance allowance for the most severely handicapped among the chronically sick and disabled. It is an important new provision, as many noble Lords will know. The Supplementary Benefits Scheme supplements the basic National Insurance provisions. In the case of the chronically sick or disabled help can be given, for example, for the cost of a home help or for extra heating. The cost of special diets or abnormal wear and tear of clothing can also be met. Thus arrangements exist for providing additional cash benefits to people who need them.

I would remind your Lordships that the Amendment would make local authorities responsible for cash payments, and would specifically make these payments additional to the payments being made under the National Insurance and Supplementary Benefits Schemes. The effect in the case of those with special needs would be that, while basic supplementary benefit might be payable, any special expenses covered by a local authority payment could not be met again by way of an exceptional circumstances addition under the Ministry of Social Security Act. I hope that noble Lords will appreciate this point. So the Amendment would be unproductive, and would conflict with the statutory provision already made, if duplicate provision was made for the same need. Apart from this fundamental objection, it must not be overlooked that any increase in cash payments does not necessarily ensure that the services required would become available. The need for people as well as money is something that must not be lost sight of.

The Government's policy is to improve the range and level of cash benefits, if we take, for instance, the introduction of the Supplementary Benefits Scheme, the improved real value of benefits, and the proposals for higher and new benefits, such as the attendance allowance, which will be introduced in the National Superannuation and Social Insurance Scheme. It is the Government's intention to improve the quality and the extent of services in residential care, for instance, the plans that we have debated on other occasions. Finally, it is the Government's intention to ensure proper integration—for example, there is the creation of the Department of Health and Social Security and the Secretary of State for Social Services. Common sense and proper deployment of resources, however, dictate that there should be a rational allocation of responsibilities. The Amendment seems to breach this principle, and it is on this ground unacceptable, although it reflects a concern, which the Government share, that there should be as much choice, and as few gaps as possible in our provision for the chronically sick and disabled.

LORD MAIS

I thank the noble Baroness for her very detailed reply, but the list of various sources to which these unfortunate disabled people have to go in order to obtain these benefits fills me with a little more alarm than I had when I made the proposal. The reason for my Amendment was that these disabled people are not in a position to go round and find the various sources from which they can collect the various other grants. If the Amendment put before this Committee could be accepted, they would have no difficulty. Knowing that they can have a reasonable allowance immediately, which would allow them to plan, they would be saving the local authority the cost of in-care. But in order to obtain all these other facilities, surely they would have to discharge themselves first from the institution or hospital; and what do they do in the intervening period? I am loath to with-draw this Amendment. Could the noble Baroness give me a little more assurance than I have had so far that this matter will not be swept aside, underneath all the other various sources that may or may not be available in the future? Would she assure us that this matter will be considered between now and the Report stage?

LORD DRUMALBYN

May I invite the noble Lord to withdraw the Amendment, because I should find difficulty in supporting it for the reasons that the noble Baroness has given, and in particular because of the fact that when we were discussing the Social Work (Scotland) Act we were very conscious that Government policy was to draw this firm distinction between the local authority services in kind and the services in cash. I have before me the words of the Social Work (Scotland) Act, where it says: a person in need requiring assistance in kind or, in exceptional circumstances constituting an emergency, in cash ". This is very tightly drawn indeed, and I am bound to say that I think it would be difficult for us in this House to send back to another place an Amendment in terms which departed widely from that and from the financial Resolution that they had in another place on this Bill.

Moreover, I would suggest to the noble Lord that if he wanted to carry an Amendment in this form he would have to define in some way or other what the allowance should be, how much it should be, and in what circumstances it should be given. At the present time, so far as I can see, the Amendment does not specify in any way how that allowance is to be calculated. I cannot conceive of the other place accepting an Amendment in that form. For these reasons, I suggest to the noble Lord that it might be better to reconsider it.

BARONESS PHILLIPS

I would only say to the noble Lord that I can give him no such assurance as he seeks. I think he is a little out of date, if I may say so, because these benefits are collected from a single source, the Department of Health and Social Security. Even pensioners now collect on one book, whether they get supplementary benefit or not, whereas in this case, if this Amendment were carried, as I understand it "local authority" would mean many sources.

LORD MAIS

I thank the noble Baroness for her further comments, and I also thank the noble Lord for his advice. In the circumstances I will reserve my right to raise the matter again at the Report stage. Therefore I beg leave to withdraw the Amendment.

Amendment, by leave, withdrawn.

THE EARL OF LONGFORD

Before we reach the next Amendment, may I ask whether I am right in thinking that those who govern our affairs in this House are ready for a break after Clause 6? The word reached me, and, if that is so, I think members of the Committee should be aware of it.

BARONESS PHILLIPS

I think that we are all anxious to make as much progress to-night as is consistent with our natural human wants. I would suggest that we should continue, and if we find that dinner is served by the time we get to Clause 6, perhaps we could break at that point.

BARONESS MASHAM OF ILTON moved Amendment No. 15:

After Clause 3, insert the following new clause:

Notification of certain disabling injuries

".—(1) It shall be the duty of a registered medical practitioner as soon as he is of opinion that a person under his care in hospital is suffering from disabling neck or back injuries, to certify that fact in writing to the hospital. (2) 'Disabling neck or back injuries' means such neck or back injuries as have caused or are likely to cause paralysis resulting in disability. (3) The hospital shall, within forty-eight hours of the receipt by them of a certificate under subsection (1) above, send a copy of the certificate to the Chief Medical Officer of the Ministry of Health or (in Scotland) the Scottish Home and Health Department.

The noble Baroness said: I beg to move the Amendment standing in my name on the Order Paper. I feel that this Amendment can do nothing but help the Ministry, help the patient, and save money in the long run. Looking at the four of us sitting in a row, your Lord-ships may think that we are all similarly afflicted, but that is not so: one of us is the odd man out, the noble Viscount, Lord Ingleby. The reason is that he is a "polio" and the three of us are paraplegics; we all have spinal injuries, and we do not feel our paralysed parts. We are paralysed from the chest downwards, and it could be that we could sit on an upturned knife and we should not feel it.

I was fortunate to be transferred from an accident unit to a spinal unit within 24 hours of my injury. When the hospital realised that I was paralysed, with bladder retention, the need of catheterisation, three-hourly turns, and all the other tasks that go towards specialised treatment of a spinal case, they were only too pleased to transfer me. Perhaps if I had not been so lucky as to have landed, by chance, in a well-informed hospital, I should not be here to-day. I have seen people who have not been transferred but have lain for months in general hospitals. They have become crippled from contractures due to lack of physiotherapy, poisoned by infection of the urinary tract, and depressed because of lack of rehabilitation facilities. In spinal units the patient avoids complications of the skin as the ward routine is geared to three-hourly turns, bladder training is carried out and the correct positioning of the patient avoids thrombosis in the legs, which is a complication in paraplegia.

In someone without feeling, any incur-rent illness is difficult to diagnose, and the doctors in spinal units have special experience of this situation. Spinal units are staffed and equipped to do a particular, difficult job, and therefore rehabilitation can start immediately. I feel that to make neck and back injuries resulting in paralysis notifiable will encourage doctors to transfer these cases to the appropriate unit, and will also make available to the Ministry over the years information about the areas in the country where most spinal injuries occur. The time factor mentioned in this Amendment is important, because a great deal of damage can be sustained in the first few days of injury. I beg to move.

LORD AMULREE

I should like to support the noble Baroness very strongly on the plea she has made that people with injuries of the spine should be transferred to spinal injury units, where they can get proper attention as quickly as is humanly possible. She knows, from one point of view—the point of view of the patient—one of the big hospitals in the country for treating spinal injuries. I know the same one, which I visited frequently because the Registrar became a great friend of mine and I saw him a good deal. I know a great deal about the work which he did, and what he thought about the treatment of people with fractured spines and other spinal injuries. He said —and I think the noble Baroness will agree—that if he got a person there within 24 hours, there was a fair chance that that person might be back at work again in seven or eight months. But if that person went to another hospital where he was not so well treated, it might be a couple of years or more before he could be discharged. Indeed, he would probably die before he was discharged.

What I am saying does not imply any criticism at all of the medical staff of the other hospitals. But one must have a lot of experience to treat these injuries properly, and in a spinal unit there are people who have had experience of treating tens of hundreds of patients like that, so they can do it a great deal better than people who have not had that experience. Furthermore, one gets a large supporting staff, and one of the important items is the nursing staff, with orderlies, so that the patient can be turned every two hours during the 24 hours. That puts an enormous strain on the nursing staff and a very big staff is required. In addition there are all the other people involved in the rehabilitation of the patient.

That is one point which I should like to mention in passing. If there are these departments which are taking care of spinal injuries, it must be seen that they are kept as fully staffed as possible. The place to which I have been referring is now running rather short of staff. They have quite enough to treat the acute patients, but people have to go back from time to time for a check up and the skilled staff is not becoming available for that. So not only do I support the noble Baroness in her suggestion that people should be transferred as quickly as possible to a spinal unit, but I think that the central Department should do the best it can to see that these places are kept fully staffed, bearing in mind that they are extremely extravagant in staff.

LORD WELLS-PESTELL

I urge your Lordships to accept this Amendment if you are asked to do so. I do not want to dwell on my own personal experiences, but having suffered total paralysis I do not think that the noble Baroness has put too great a stress upon the importance of this clause. Those of us who have had the good fortune to be in the right hospital or the right sector when something of this kind has happened, know how very important it is to one's future activity. But for every patient who has been taken within the right period to a hospital specialising in injuries to neck and spine, a good many are left in hospitals for long periods to end up finally in hospitals for the incurable.

I do not suggest that this is the most important clause before your Lordships to-day, because other clauses are governing and assisting a much wider range of chronically sick and disabled, but this is of supreme importance to a large number of people who find themselves suffering from quite serious neck and spinal injuries. If the suggestion in the Amendment is put into operation, I am quite sure that it will result in many people being able to return to a fairly normal and active life within a comparatively short time. If this is an Amendment which the Government can accept, I urge them to do so.

THE EARL OF LONGFORD

I should like to add my pleas to those which have just been offered.

BARONESS DARCY (DE KNAYTH)

I should like to add my fullest support to this Amendment and to back up all that my noble friend Lady Masham said about the importance of the correct treatment in the early days of tetraplegia or paraplegia. I do not think that 48 hours is an unreasonable time limit for notification, for without proper attention pressure sores and contractures can develop extremely quickly. After 48 hours a large number of patients will have an early pressure sore if they are not nursed correctly from the start. These will not only delay the patient's rehabilitation by months or even years but, as the noble Lord, Lord Wells-Pestell, has said, may well prevent his ever becoming as independent, active and capable of keeping a steady job as he could have been, had he been correctly cared for in those vital early weeks.

I should also like to say a word about long-term care, especially of tetraplegics whose families cannot always look after them at home. A survey done in South-port proved, as my noble friend Lady Masham mentioned, that there was a higher mortality rate among those suffering from paralysis who went to local authority homes, than among those living in their own homes. The Star and Garter Home and Chaseley—both for ex-Servicemen—and one or two of the Cheshire homes provide excellent facilities; but I should like to see more hostels like the Ludwig Guttman hostel at Stoke Mandeville, built near to, and supervised by, the existing spinal units. These woud also provide somewhere for tetraplegics, normally living at home, to go to while their families had a holiday; and bad pressure sores can develop in a fortnight if the tetraplegic is not properly cared for.

Paraplegics can now have a normal life expectancy—many insurance companies will give them life insurance—and I feel that this Amendment, requiring the notification within 48 hours of disabling neck or back injuries, will help to ensure that, by receiving correct treatment, they will indeed live as long as their able-bodied countrymen. I fully support this Amendment.

LORD PLATT

I should like to add a word or two in support of this Amendment. I think that this is one of the most important aspects that there are to consider. I was not included at the stage when the Amendment was drafted, so I do not know why it comes to us exactly in this form. I wonder whether it is urgent enough, and whether there is sufficient provision of centres in which special injuries can be treated extremely promptly, because it is in the first few days—although it is important after that, as well—that an enormous amount of damage can be done. But if this new clause as it stands is a beginning, and leads on later to an even better system of getting people into expert spinal units as quickly as possible, then I support it very strongly.

BARONESS SEROTA

The Government are in complete sympathy with the objectives which lie behind the thinking of the sponsors in putting down this new clause; namely, that all possible steps should be taken to secure the early ad-mission of patients suffering from spinal injuries which are likely to result in paralysis, to centres which specialise in their treatment and rehabilitation. I personally welcome the opportunity which this Committee stage gives noble Lords to express their views from their own personal experience on how these services should be developed.

Apart, however, from certain technical drafting defects which we see in this clause, I am not going to advise the Committee to accept it, because we do not think it is feasible in legislation to lay down the kind of clinical care which should be given to certain patients. The noble Lord, Lord Amulree, quite rightly reminded us that there are questions of the individual clinical judgment of doctors here, and it is the doctor who is responsible who should be aware of all the considerations in each particular case. Moreover, I see difficulty about the Department's medical staff intervening in certain cases which are being cared for by doctors. If the object of the Amendment is simply to collect information about the number of cases—as the noble Baroness, Lady Masham, indicated—then I can assure her that we can do this by other means, and not necessarily by legislation.

In recent years, as these services have developed from the pioneering efforts of men like Sir Ludwig Guttmann at Stoke Mandeville and others, we have had a continuing debate, if I may put it in that way, with the professions involved on how these services should be developed; and only last year my Department held a conference with all doctors involved in the treatment of paraplegia to consider the future of the hospital services for these patients. We have also brought the conclusions of this most valuable conference to the sub-committee of the Standing Medical Advisory Committee on Rehabilitation, which is now sitting under the chairmanship of Sir Ronald Tunbridge, so that they can consider the rehabilitation aspects of services for paraplegics, which noble Lords have touched on in their remarks supporting this Amendment.

One of the problems that one must face is that the six spinal units which are in existence in England—and I believe there is also one in Wales—which make specialist provision for the treatment of patients with paraplegia, and provide a total of some 400 beds, are unfortunately not necessarily in the best and most suitable parts of the country. One accepts that the early admission of the patient, if possible within 24 hours of injury, and then the use of all the skills and knowledge that we have in these special centres, with the emphasis on restoring the patient whenever possible to his own home, are all things which our centres are seeking to do. One of the problems—and the noble Lord, Lord Amulree, touched on this—arises from the need to recruit highly skilled staff, including nursing staff, into these units. Moreover, quite apart from the fact that the regional spread is not as perfect as one would want, it is sometimes difficult to get patients readmitted after their initial treatment for the very essential follow-up work, or indeed if any kind of complications have set in.

I believe that, with Sir Ronald's Committee looking at the National Health Service rehabilitation services as a whole, including the rehabilitation of particular categories of patient of the kind we are now considering in this Amendment, we can feel well assured that the problems of providing services to paraplegics, as well as to other kinds of handicapped persons who need very specialised hospital care and treatment, are in very good hands; and, of course, they will have before them the results of the specialist conference that I referred to earlier. I believe quite genuinely that this is the way forward in the development of ser-vices, rather than in selecting a particular category of patients who need very special care and providing for them in legislation.

So I would suggest to the Committee, having listened to what I regard as a most valuable debate on a very important sector of the National Health Service which provides for very special needs, that we should not put this new clause into the Bill. However, I give your Lord ships the undertaking that the Tunbridge Committee are looking at these services, including services for paraplegics, and certainly my Department will continue to do all it can to facilitate communication among the health professions involved in this field, and to develop the services to the limits of our knowledge.

LORD PLATT

May I ask the noble Baroness whether it would be possible to emphasise to Sir Ronald Tunbridge's Committee the necessity for urgent notification of these cases in some way, not necessarily to the Department? Because I think this is where things go wrong. One may set up another six spinal centres in the country with a great deal of expert care and advice; and they may be in the right places rather than in the wrong places in the country. Yet people in the more remote hospitals, or particularly conservative types of doctors, may still not realise the urgency of the need to get their patient to the right place. I wonder whether that message could be passed on in some way to Sir Ronald's Committee.

BARONESS SEROTA

I will certainly undertake to convey to Sir Ronald the points which have been made in our Committee stage to-day, in the hope that it will assist him and his Committee in considering the needs of this group of patients within the wider framework of his terms of reference.

BARONESS MASHAM OF ILTON

I thank the Minister for her remarks, but I feel that they are not very satisfactory, because several cases have come to my notice, especially in the North of England, where patients have been kept in general hospitals only 10 miles from a spinal unit in which there were free beds. I checked up on the two spinal units, one in Wake-field and one in Sheffield, and there were free beds throughout the whole of the summer. One patient was kept for eight months in a general hospital, and there was no excuse for this. Therefore perhaps we can re-draft the Amendment and bring it up again on the Report stage.

BARONESS SEROTA

Perhaps I may say just one more word on this. First, if the noble Baroness will give me the details of the cases she has just mentioned, I will certainly go into them. Secondly, I am not quite sure that her Amendment would have prevented the situation which she has just described to us.

BARONESS MASHAM OF ILTON

Perhaps I may tell the noble Baroness that I did have a public health inquiry into that case, and the then Minister of Health, Mr. Kenneth Robinson, wrote a letter of apology to the wife of the patient concerned. I have all the information, which I will gladly pass on to her. I should like to thank those noble Lords who have supported this Amendment, because it is so important to those people whose future life depends on this. I beg leave to withdraw my Amendment until Report stage.

Amendment, by leave, withdrawn.

Clause 4 [Access to, and facilities at, premises open to the public]:

THE PARLIAMENTARY SECRE-TARY, MINISTRY OF HOUSING AND LOCAL GOVERNMENT (LORD KENNET)

This is a drafting Amendment to secure uniformity of wording through-out the clause. I beg to move Amendment No. 17.

Amendment moved— Page 3, line 29, after ("building") insert ("or premises ").—(Lord Kennet.)

On Question, Amendment agreed to.

6.36 p.m.

LORD CRAWSHAW moved Amendment No. 17A: Page 3, line 33, at end insert (" and to ensure that the provision so made is adequately signposted and publicised.")

The noble Lord said: This is the first of a series of Amendments about sign-posting, and I shall deal with it very briefly. Obviously, the principle to be borne in mind when considering sign-posting is that there is no point in having facilities if nobody knows they are there, so a great deal of research has been carried out into this question. I have with me—and it might save time if I hold it aloft—the symbol which has been recognised as suitable and which will convey to all disabled people places where proper facilities are available. This is the symbol which I think is generally acceptable, and the one that I should like the Minister to adhere to, if he will. I beg to move.

VISCOUNT INGLEBY

I should like to support this Amendment.

LORD KENNET

I think that what the proposers of this Amendment want done is a very good idea, and the Government would wish to do everything to further its being done; but I am in a slight difficulty about it because the Amendment became available only this morning. This is a complicated Bill, and I should not like simply to advise the Committee to accept this Amendment here and now in the form in which it stands. We are dealing here with existing buildings, and we are talking about the advertising and publicising of special access to those buildings, of parking facilities by those buildings and of lavatories within those buildings. If we lay a duty on the owners of those buildings to use these advertisement forms, which the Government quite agree are the best advertisement forms, we possibly run the risk of suggesting that those facilities, particularly lavatories and parking facilities, were being provided by the owner of the building for the use of members of the public whether or not they were going into the building. This is the complication; and in order to clarify this matter, to see that we impose duties on the owners of buildings only to advertise the special facilities which they offer to people who are going to use the buildings as opposed to any-body who may be in the street, I hope that the proposers of the Amendment and the sponsor of the Bill will agree that it might be a good plan, in view of the very short notice—we, the Government, saw this Amendment at 12 o'clock this morning—to hold it over to a later stage, and between now and then to have some proper, thorough discussions about what effect it would have, what effect is desired and how that effect can best be achieved.

LORD DRUMALBYN

Before the noble Lord sits down, may I ask him this question? When he said that we are dealing here with existing buildings, did he mean that this clause would apply to existing buildings rather than to buildings to be provided in the future?

LORD KENNET

If I have it wrong, I beg the Committee's pardon. This is because I saw the Amendment at noon to-day for the first time. It is difficult to keep one's head at such short notice; but this seems to be a good reason for taking it at the next stage.

THE EARL OF LONGFORD

I agree that it seems reasonable to take it at the next stage in view of the friendly response of the Minister. But I do not quite understand this repeated reference to "noon". I saw the Amendment at breakfast time. I do not know when the Government start work. The noble Lord said it once and said it again. It is some time since I was in the Government. Perhaps they start work later nowadays.

LORD KENNET

The Government also start work at breakfast time. But this particular Member of it was not free to cancel his engagements this morning to take account of this late Amendment.

THE EARL OF LONGFORD

In my time Ministers had officials; but they may have died out, too!

LORD KENNET

We still have officials but I still have the problem of myself seeing this Amendment for the first time at twelve o'clock.

LORD CRAWSHAW

I do not want to tease my noble kinsman any further. I think an Amendment dealing with signposting has been on the Marshalled List for some time—but perhaps not this particular one. However, like the noble Earl, Lord Longford, I am glad that the noble Lord has welcomed at any rate the principle of this Amendment, and I am therefore prepared to go into it again at the next stage. I beg leave to with-draw my Amendment.

Amendment, by leave, withdrawn.

VISCOUNT INGLEBY moved Amendment No. 17B:

Page 3, line 33, at end insert— ("This section shall apply to places of education including schools, colleges and universities, to employment exchanges, and to places of employment including offices and factories.")

The noble Viscount said: Clause 4 deals with the making of special pro-vision for the needs of disabled people in future buildings or in any conversions of existing premises. The purpose of this Amendment is to make sure that places of education and places of employment are covered by it, since it is obviously important that disabled people should be able to pursue their education and their employment and not be prevented from doing so by unnecessary physical hazards. I beg to move.

LORD CRAWSHAW

I wish to sup-port this Amendment. I think the principle adopted in designing new public buildings is that what helps disabled people will help all. I am sure that lifts, nose-taps and flat entrances, help not only the chairborne but also the old, the blind and many other people. One's first thoughts turn to the architect involved with new buildings; and in their favour I must say that after what I said during the Second Reading debate, I was sent a copy of Selwyn Goldsmith's Design for the Disabled, and I realise that they are more mindful of this problem than I thought at the time. I am also anxious that all architects should have a copy of CP.96 which is the code setting out requirements. Like my noble friend Lord Ingleby, I am anxious to include places of work in this Amendment, because it is one of the main themes of the Bill that the disabled should where possible be employed. I feel that all factories and offices subject to the 3 per cent. quota — that is, factories employing 20 or more —should make provision.

There is also the question of places of education. The noble Viscount, Lord Ingleby, and I spent part of our careers at Oxford in a chair, so that we know at first hand the difficulties of being educated in that way. Although one can understand it happening at Oxford, I think it a pity when it happens, as it did the other day at Redbridge Technical College, that a disabled student was un-able to study in the way he ought. The excuse was lack of funds; but I feel that it was probably more likely lack of thought and foresight. I hope also that new community centres and other places that are being built will include proper provisions.

On the Second Reading I spoke about places of entertainment and I mentioned the problems relating to racecourses. I am sorry that the noble Lord, Lord Wigg, is not here. I would address a few remarks to him, so that when the Levy Board are designing new stands in future they may think of what might be done. The example of the racecourses could then be followed in the football stands— particularly as racing itself produces a few casualties, and many people have been injured in racing or elsewhere but are still very interested in the sport. I think that for hotels and restaurants also, it would make commercial sense for them to make proper facilities.

BARONESS DARCY (DE KNAYTH)

I too should like to support this Amendment, for the reasons given.

LORD DRUMALBYN

Before the noble Lord replies, I wonder if the noble Earl who is in charge of the Bill could tell us whether this Amendment would do what, plainly, its movers and seconders would like it to do and what I think we should all like it to do. Purely on a matter of drafting I am not sure that it will do so, because the clause as it stands seems to be limited to premises to which the public are to be admitted. I am not sure that "employees" are "the public." I am not sure that, technically, matriculated students are "the public". I think they are people who have some right to enter, as opposed to the public as a whole. I am asking merely for information. Can the noble Earl say whether this Amendment would do what the movers want it to do?

THE EARL OF LONGFORD

I am entirely in sympathy with this Amendment, which was drawn up with my strong collaboration, and therefore I should like it to do the things which have been mentioned and which I believe the noble Lord himself supports. The noble Lord will appreciate that I have no legal advice open to me, except that the Government have been kind enough to say that if we want the help of Government draftsmen, we can obtain it. I have no other legal advice and therefore I have no particular way of saying whether it does, or does not, cover the categories mentioned. How-ever, the Government will no doubt be able to give us their opinion on that, and if there is any doubt the promoters can obtain legal advice before the next stage.

There is one point which I do not think it would be unfair to mention in advance, as it may save time for the noble Lord. It can be argued that in various parts of the Bill the purpose to be achieved would be fulfilled just as well by some kind of Government circular which might be rather more flexible than actually putting something into the Statute. But here I am bound to say that a circular would not be adequate. I think that the noble Lord, Lord Drumalbyn, who is himself a lawyer, will agree that the Government could not take all these steps without statutory authority and simply by means of a circular. The Government could not give orders to employers, for example, or to the universities just by circular; and therefore one must have statutory authority if these purposes are to be achieved. I do not think that we can avoid the fact that this takes us pretty wide, but I think those who support the Bill feel that it is high time we did take the necessary steps.

LORD DRUMALBYN

May I refute the imputation that I am a lawyer?

THE EARL OF LONGFORD

I thought I was paying the noble Lord a compliment. I thought, from his general legal expertise, that the noble Lord was a lawyer. I apologise if it was not a compliment.

LORD HUGHES

I can well under-stand the noble Lord, Lord Drumalbyn, being mistaken for a lawyer, and I can equally well understand him not regarding it as a compliment. The noble Earl, Lord Longford, said the Government had given a certain amount of legal advice. There are some cases where the advice has already been given and others where the advice may be yet to come. I suspect that this case falls into the second category. From the bits of paper that have been handed to me about it I am quite certain that none of the Government draftsmen wishes to accept responsibility for this as it stands. The purpose of the Amendment as spoken to by the noble Lord, Lord Crawshaw, is clear. It is certain that it is not intended to apply just to members of the public: it is intended to apply to the people who work inside these places and to people who may study there. The advice that I have received is that the Amendment, as drafted, would not cover the case, be-cause this is in the context of a clause which refers to members of the public

There is a second disadvantage about the Amendment, which is that it applies, inter alia, to educational establishments, employment exchanges and places of work. One of the effects of the way that it is worded would be to limit the application of the clause only to the type of premises listed.

THE EARL OF LONGFORD

May I break in on one point? Would the noble Lord tell us why that is so? It says: This section shall apply to places of education including— such-and-such. Is the point that it would refer only to places of education, employment exchanges and places of employ-ment—those three groups?

LORD HUGHES

The noble Earl knows as well as I do why that is so, because I am certain that during the period when he adorned this Bench he gave the same advice: that as soon as one specifies, one limits. I am certain that I have heard him advising the House in the same way as I am doing at present; that this is not the best way to achieve the purpose. We do not wish to be difficult in this matter. My noble friend, Lord Kennet, has already undertaken to speak with the promoters of the previous Amendment before the next stage. He would be equally willing to talk about this matter.

There is one other thing that I should say on this subject. The First Secretary of State and Secretary of State for Employment and Productivity announced during the Second Reading of the Employed Persons (Health and Safety) Bill her intention to set up an Inquiry into the whole field of safety, health and welfare legislation. The inclusion in legislation of requirements to make pro-vision for chronically sick and disabled employees might well be a matter for consideration, by that Inquiry. In any case, the Minister does not feel that it would be appropriate to include requirements in relation to employees in the present Bill because of the considerable implications that this would have.

About half of all the new places of employment built are for ten employees or less, and the statistical probability of many of these small places employing a disabled person is very small. More important, however, is the fact that if Amendment 18A were accepted, for the wording of Clause 4 to include places of employment would have far-reaching and unacceptable implications. There is also the question of employment ex changes, as Crown property, falling out-side the provisions of the Bill. However, I should wish to close on the note that my noble friend Lord Kennet would be quite happy to discuss this matter, at least with a view to putting your Lord-ships in the position that if you are considering an Amendment along these lines it would be one to which he could not offer any drafting objections.

VISCOUNT INGLEBY

In view of what has been said I shall be very happy to ask leave to withdraw my Amendment at this point, with a view to bringing it up again later. I beg to ask leave to withdraw the Amendment.

Amendment, by leave, withdrawn.

6.56 p.m.

VISCOUNT INGLEBY moved Amendment No. 18A:

Page 3, line 33, at end insert— ("() Where there are steps in any existing building to which the public are admitted, whether on payment or otherwise, one means of access shall be provided with handrails and, so far as it is in the circumstances both practicable and reasonable, a level entrance or ramp.")

The noble Viscount said: The Amendment which we have just been discussing deals with future buildings, but nothing in the Bill makes any provision for the needs of disabled people with regard to existing buildings. The purpose of this Amendment is to provide what I should have thought was the minimum that ought to be provided, namely, that where there are steps leading up to the main floor of a building to which the public is admitted a hand-rail should be in-stalled and, if it is practicable, a level entrance or ramp. I well remember turning up at the County Hall, Northallerton, for my first meeting and feeling very despondent when I saw two large flights of white marble steps without any sort of rail at all. It took me about seven or eight minutes of hard work to negotiate those steps. I beg to move.

THE EARL OF LONGFORD

Harking back to the question put by the noble Lord, Lord Drumalbyn, during the previous discussion, I take it that this Amendment is defective from our point of view because this again would not allow students to enter the building. Are we to understand that from the Government?

LORD HUGHES

No, there would be no question of stopping students from entering the building. Presumably, until they enter the building they are members of the public.

THE EARL OF LONGFORD

I was trying to hark back to the point of special difficulty raised by the noble Lord, Lord Drumalbyn, on the previous Amendment. I assumed that it would arise again; in other words, that there would be a need to redraft this Amendment to meet that particular point.

LORD HUGHES

At this stage I do not want to anticipate what I shall say, but that was not going to be one of the arguments I would produce against the Amendment.

VISCOUNT INGLEBY

If I may say so, it seems to take rather more than these difficulties to stop students from coming into buildings.

LORD HUGHES

This Amendment extends the clause, as far as it applies to handrails and ramps, to cover existing buildings. No precise figures are available, but we believe that the number of buildings affected which would fall within the scope of this Amendment cannot be much short of a million. I am told that at an extremely conservative estimate the average cost of handrails and ramps for external access could not be less than £ 30. To provide for internal rails and ramps would increase the cost proportionately. Granted that many premises, such as retail shops, already have level premises, the bill for carrying out the Amendment could hardly be less than £ 25 million and might well be consider-ably more. Much of this would fall on private owners. If by expenditure of this order we could ensure the full use by disabled people of all existing buildings, it might be right to accept the Amendment, notwithstanding the cost; but all we should be ensuring would be that disabled people could get into them. The scope of the provision for new buildings under Clause 4 is itself evidence that considerably more than obtaining access to buildings is necessary. In these circumstances, the obligation we are imposing would be, and would be seen to be, unreasonable, the more so as the duty to provide handrails, unlike any other of the requirements of the Bill, would be made absolute.

I am certain that the vast majority of the general public wish to see this Bill become law, and most of what goes into it will command general support. But I am equally certain that if we accept this Amendment we shall alienate the support of many people when they find that they are compelled to undertake expenditure which would not serve the purpose intended.

In the view of my advisers, the Amendment is further defective in that it does not state on whom the obligation falls. Had we been disposed to appear helpful, without taking any odium from opposing any Amendment, we could have let this go through and then nothing would happen, because no obligation could be firmly placed on anybody. This would be particularly the case in regard to buildings in multiple occupation. If we are to have an Amendment capable of working it requires fundamental re-thinking; and in view of the extent of the obligation which we should be seeking to impose, it is doubtful whether it would be right for me to offer any encouragement about attempting to draft an alternative Amendment.

LORD HASTINGS

I apologise for intervening, but I am not happy about the Minister's categorically turning down this Amendment. I am also not clear about the real intention of its sponsors. The noble Viscount who moved it referred to difficulties at a town hall, and the Minister in his reply referred to a great many other types of building, including shops and commercial premises. I should not think it is the intention of the movers to oblige private owners to go to this sort of expense. On the other hand, I do not think it beyond the bounds of reasonableness and practicability for public buildings—buildings owned by the public and supported by the taxpayers' money—to have these facilities. Internally, many of these buildings have the necessary lifts and other amenities which make their use possible by disabled persons. I should think that if this Amendment were limited to public buildings, it might have some real use and that it would be possible to carry it out.

LORD HUGHES

I think the noble Lord is right. The Amendment would have a different complexion altogether if it were confined to public buildings, but it talks about buildings "to which the public are admitted." The number of offices, shops and so on which come under the appropriate section of the 1963 Act is 730,000 and the vast majority of these would fall into the category of buildings to which the public are admitted, apart from the people who work in them. Factories which employ more than 11 people number 55,000, and factories which employ fewer number 50,000. It is doubtful whether these would be included, because many of them are premises to which the public does not resort, only the folk who work in them. But the number which would be affected would be certainly large.

If another Amendment were drafted along the lines suggested by the noble Lord, Lord Hastings, obviously the number would be much less, the use made of the buildings would be much greater and the cost would be less, but we would still not take things very much further. If we are only providing the means of entering into buildings that otherwise cannot reasonably be made suitable for disabled people, we are not really helping.

I think we have to do two things: first, narrow the Amendment to the type of building suggested by the noble Lord —though the promoters will speak for themselves—and secondly, narrow it down to those places where the provision of facilities would not be a waste of money because the next step, facilities in-side the building, is not capable of being carried out. A good deal of consideration must be applied to any attempt at redrafting this Amendment.

VISCOUNT INGLEBY

I think the difficulties have been overstated. A great many public buildings have these handrails. If we multiply the sum involved, which I do not think is very great—£ 10 or £ 20—by something fantastic, we arrive at an even more fantastic answer. But the real question is how much would be spent on this facility in any particular building? We thought that we ought to stop at the ground floor. The noble Lord, Lord Hughes, thought that there might be something to be said for lifts up to the third and fourth floors, but we thought it reasonable and practical to stop at getting into the buildings. I accept the fact that the Amendment is defective and beg leave to withdraw it, with a view to improving it and perhaps putting it down at a later stage.

Amendment, by leave, withdrawn.

Clause 4, as amended, agreed to.

[The Sitting was suspended at ten minutes past seven and resumed at eight o'clock.]

Clause 5 [Provision of public sanitary conveniences]:

LORD HUGHES moved Amendment No. 19: Page 3, line 34, leave out from ("Where") to ("authority") in line 42 and insert ("any local").

This Amendment is in three parts. The first part widens the scope of the existing clause which is limited to local authorities exercising certain statutory powers. The three powers listed in the clause are the main powers under which a local authority may provide convenience? for the public, but they are not the only ones. Moreover, it sometimes happens that an authority provides a convenience as an ancillary facility in the exercise of the powers which they do not themselves specifically refer to in such provision— for example, in laying out a park or recreation ground. The Amendment therefore seeks to apply the requirements of the clause whenever a local authority provides a convenienec irrespective of the powers upon which they rely.

The second part of the Amendment puts a duty on local authorities who have already erected public conveniences with special facilities for disabled persons, or who may do so in the future, to put up such directional signs or other notices as may be reasonable to indicate where these facilities are. The Amendment meets the spirit of an Amendment tabled by the noble Lord, Lord Crawshaw, and others which is not drafted in an acceptable form; that is to say, Amendment No. 20.

The British Standards Institution are understood to have evolved a special symbol which might be used for signposting purposes and which would be easily recognised—and I think that would be the sign which the noble Lord displayed. Appropriate steps will be taken in due course to encourage local authorities to adopt this symbol when its form has been finally settled.

The final part of the Amendment is simply a definition. This has become necessary in consequence of the omission of any reference to specific statutory powers. It is in conventional terms, and is wide enough to include a local authority acting in the capacity of a local planning authority who provide conveniences in national parks.

I referred, when I was speaking to a previous Amendment, to the fact that in some cases the Government had given drafting help in advance and in others it was still to come. This is a case where the alternative Amendments in an acceptable form have been tabled at the same time as the original Amendment. I hope noble Lords will find that the Government's Amendments accomplish their purpose, and that it will not be necessary for Amendment No. 20 to be moved. I beg to move.

On Question, Amendment agreed to.

LORD HUGHES

I beg to move Amendment No. 22.

Amendment moved—

Page 3, line 45, at end insert— ("() Any local authority which in any public sanitary convenience provided by them make or have made provision for the needs of disabled persons shall take such steps as may be reasonable, by sign-posts or similar notices, to indicate the whereabouts of the convenience.")—(Lord Hughes.)

On Question, Amendment agreed to.

LORD HUGHES

I beg to move Amendment No. 23.

Amendment moved—

Page 3, line 45, at end insert— ("() In this section "local authority" means a local authority within the meaning of the Local Government Act 1933 or the Local Government (Scotland) Act 1947 and any joint board or joint committee of which all the constituent authorities are local authorities within the meaning of either of those Acts.")—(Lord Hughes.)

On Question, Amendment agreed to.

Clause 5, as amended, agreed to.

Clause 6 [Provision of sanitary conveniences at certain premises open to the public]:

8.6 p.m.

LORD CRAWSHAW moved Amendment No. 23A: Page 4, line 10, at end insert ("and to ensure that the provision so made is adequately sign-posted and publicised.")

The noble Lord said: This is another signposting Amendment which I explained earlier on, and I hope that the Government will be able to accept it. I beg to move.

LORD HUGHES

When my noble friend Lord Kennet was talking to the other Amendment in relation to sign-posting and publicity, he certainly had it in mind that this Amendment should receive the same treatment. I hope, therefore, that the noble Lord will feel able to withdraw it at this stage and include it in the discussions which my noble friend is willing to undertake, without prejudice, of course, to the right of the noble Lord to come back to the matter if he is not satisfied as a result of those discussions.

LORD CRAWSHAW

I was very satisfied with the assurance given by the noble Lord, Lord Kennet, and I am happy to withdraw this Amendment.

Amendment, by leave, withdrawn.

LORD HUGHES moved Amendment No. 24:

Page 4, line 10, at end insert— ("() The owner of a building, who has been ordered under section 11(4) of the Building (Scotland) Act 1959 to make the building conform to a provision of building standards regulations made under section 3 of that Act requiring the provision of suitable and sufficient sanitary conveniences therein, shall in complying with that order make provision, in so far as it is in the circumstances both practicable and reasonable, for the needs of persons frequenting that building who are disabled.")

The noble Lord said: This Amendment adds a new subsection to Clause 6 to pro-vide a Scottish equivalent to what is pro-vided for England and Wales by the pre-sent clause. Put quite briefly, Section 11 of the 1959 Building Act empowers Scottish local authorities to order owners of existing buildings to bring them up to the standards which would apply in the case of newly constructed buildings. That is done by ordering compliance with the specific Building Standards regulation in question. Here, where we are concerned with sanitary conveniences in places of public resort, the regulation in question is currently 162 of the Building Standards (Scotland) Regulations 1963, as set out in Regulation 48 of the Building Standards (Scotland) Amendment Regulations 1967. To cater for changes in the numbering of the regulations, for example on consolidation, the draftsman has in the Amendment expressed the reference to these standards in general terms. The Amendment thus secures that when an owner in Scotland is called upon to provide conveniences in existing premises to which the public have access he will have to consider, in making provision, the reeds of the disabled frequenting the premises, as will those concerned in England and Wales under the existing provision of Clause 6. I beg to move.

On Question, Amendment agreed to.

Clause 6, as amended, agreed to.

Clause 7 [Central advisory committee on war pensions]:

LORD HARDING OF PETHERTON moved Amendment No. 25: Page 4, line 16, after ("Act") insert ("and includes at least one war disabled pensioner")

The noble Lord said: I beg to move the Amendment standing in my name. The reasons for it are very simple. I believe it is incontestable that in dealing with human problems nothing can equal first-hand experience. The inclusion of a war-disabled pensioner as a member of the Central Advisory Committee will, I am certain, greatly strengthen that body by providing it with first-hand experience of the problems and difficulties of the war-disabled pensioner. But what is of equal or perhaps greater importance is that it will, I firmly believe, greatly increase the confidence of all war-disabled pensioners in the decisions of that body. Through consultation with the various ex-Service organisations there should be no practical difficulty, I submit, in finding a suitable war-disabled pensioner with the necessary sense of responsibility and experience who would be ready to serve on the central advisory committee. In my view there should be no practical difficulty about implementing this Amendment. I beg to move.

BARONESS PHILLIPS

Perhaps I may state the views of Her Majesty's Government. The requirement is that at present at least one member of the central advisory committee, whether or not a chairman of a war pensions committee, should be a war-disabled pensioner. This is in line with the package of Amendments to Clauses 8 to 12, and with the proposed new clause after Clause 13, except that these require only that "regard shall be had to the desirability" of appointing persons who are themselves chronically sick and disabled. In other words, Her Majesty's Government accept this Amendment.

On Question, Amendment agreed to.

Clause 7, as amended, agreed to.

Clause 8 [Central Housing Advisory Committee]:

BARONESS DARCY (DE KNAYTH) moved Amendment No. 26A: Page 4, line 25, at end insert ("and to the person or persons with that knowledge being or including a chronically sick or disabled person or persons.").

The noble Baroness said: I wish to move this Amendment which stands in my name, and if the House is agreeable I should like to take with it the following three Amendments. The words "where possible" ensure that only a suitable chronically sick or disabled person would be chosen to be included on a Committee. As I understand the Amendment, the wording does not ask for a chronically sick or disabled person to take the place of someone with experience of work among or the needs of the chronically sick and disabled. I appreciate the arguments that I have heard that a disabled person will view a specific problem from the standpoint of his own disability: for example, the amputee cannot fully appreciate the blind person's difficulties. But only another chronically sick or disabled person can help to shed light on the general problems facing the chronically sick and disabled and improve communications between them and the authorities. Someone who has personally experienced some of the problems facing the disabled has a better understanding than somebody who has worked among the disabled, however hard that person may try to put himself in their place. If a disabled person were seen to be holding a responsible position, and doing the job well, it would improve the public's attitude to the disabled and might well have vast repercussions, encouraging them to improve access for and offer better jobs to the disabled. I am all in favour of this Amendment. I beg to move.

BARONESS PHILLIPS

With permission, I will reply on behalf of Her Majesty's Government to the four Amendments spoken to by the noble Lady. Though the precise terminology varies from one Amendment to another to suit the preceding reference in each clause to "knowledgeable persons", the intention of all of them is the same; namely, to secure that a person appointed to a body for his knowledge of relevant problems should, if it is thought desirable, be a person whose knowledge is sharpened by his actual and personal experience of chronic sickness and/or disablement. It would have been less appropriate to provide that a member should have as his sole credential for advising or assisting in running services that he should himself be handicapped.

None of the clauses as amended positively requires that a "knowledgeable person" must be appointed, or that such a person, if appointed, must be disabled, But in accepting the clauses and the pre-sent Amendments to them, the Departments concerned accept a requirement to use their best endeavours to this end. It will be noted that the knowledgeability and the disablement precisely concerned will vary as between the clauses which are concerned with housing, social security, employment and various consumer groups.

It will also be noted that the procedure and composition of the various bodies varies. While most are relatively static, one kind at least—namely; the Transport Users'—is peripatetic, and a disabled per-son appointed to it must be able and willing to travel from place to place. An-other, the National Insurance Advisory Committee, has a statutory limitation on the number of its members. A further appointment to that Committee must await a suitable vacancy. There must accordingly be difficulties in coping with the moral obligation of the Amendments. It may not always be achievable; but the effort will be made. Finally, it may be noted that the Amendment to Clause 11 affects subsection (2) but not subsection (1) which would be inappropriate to this body.

I am glad to tell your Lordships that the Minister of State for the Department of Health and Social Security said in a Standing Committee on the National Superannuation and Social Insurance Bill (which was considered in another place this morning) that the Government regarded the present wording of Clause 96, as amended, of the National Superannuation and Social Insurance Bill (which follows the wording used in the Bill be-fore us) as sufficient to cover the appointment of someone who is himself chronically sick or disabled.

BARONESS DARCY (DE KNAYTH)

I should like to thank the Minister very much.

On Question, Amendment agreed to.

Clause 8, as amended, agreed to.

Clause 9 [National Insurance Advisory Committee]:

BARONESS DARCY (DE KNAYTH)

I beg to move Amendment No. 27A.

Amendment moved— Page 4, line 28, at end insert ("and in selecting any such person regard shall be had to the desirability of having a chronically sick or disabled person.").—(Baroness Darcy (de Knayth).)

On Question, Amendment agreed to.

Clause 9, as amended, agreed to.

Clause 10 [Industrial Injuries Advisory Council]:

BARONESS DARCY (DE KNAYTH)

I beg to move Amendment No. 28A.

Amendment moved— Page 4, line 31, at end insert (" and in selecting any such person regard shall be had to the desirability of having a chronically sick or disabled person.").—(Baroness Darcy (de Knayth).)

On Question, Amendment agreed to.

Clause 10, as amended, agreed to.

Clause 11 [Youth Employment service]:

BARONESS DARCY (DE KNAYTH)

I beg to move Amendment No. 29A.

Amendment moved— Page 5, line 2, at end insert ("and to the person or persons with that experience being or including a disabled person or persons."). —(Baroness Darcy (de Knayth).)

On Question, Amendment agreed to.

Clause 11, as amended, agreed to.

Clause 12 [Miscellaneous advisory committees]:

BARONESS PHILLIPS moved Amendment No. 29B: Page 5, line 7, leave out first ("Council") and insert (" Councils ").

The noble Baroness said: Amendments 29B and 29C are drafting Amendments to correct the reference to the Domestic Coal Users' (properly Consumers') Councils and the Post Office Users' (properly Users' National) Council. The opportunity is taken in the new subsection (2) to complete the coverage by referring to Section 14 of the Post Office Act 1969. This creates not only a National Council but Country Councils for Scotland, for Northern Ireland and for Wales and Monmouthshire. I beg to move Amendment 29B.

On Question, Amendment agreed to.

BARONESS PHILLIPS

I beg to move Amendment No. 29C.

Amendment moved— Page 5, line 7, leave out second ("Users'") and insert (" Consumers' ").—(Baroness Phillips.)

On Question, Amendment agreed to.

BARONESS DARCY (DE KNAYTH)

I beg to move Amendment No. 30A.

Amendment moved— Page 5, line 10, at end insert ("and to the person or persons with that experience being or including a disabled person or persons.").—(Baroness Darcy (de Knayth).)

On Question, Amendment agreed to.

BARONESS PHILLIPS

Amendment No. 30B is consequential. I beg to move.

Amendment moved—

Page 5, line 10, at end insert— ("(2) In this section the reference to the Post Office Users" Councils is a reference to the Councils established under section 14 of the Post Office Act 1969, and in relation to those Councils this section shall extend to Northern Ireland ").—(Baroness Phillips.)

On Question, Amendment agreed to.

THE EARL OF LONGFORD

Before the next item is taken, may I apologise for my absence? I was involved in discussions and I was not aware how far things had gone. But I should like to make my apologies to the Committee for not being here when Amendments in my name were called. I need hardly say that they have my very strong support.

Clause 12, as amended, agreed to.

8.22 p.m.

THE EARL OF LONGFORD

moved Amendment No. 31A:

After Clause 12, insert the following new clause:

Co-option of chronically sick or disabled persons to local authority Committees

". Where a local authority within the meaning of the Local Government Act 1933 or the Local Government (Scotland) Act 1947 appoint a committee of the authority under any enactment, and the members of the committee include or may include persons who are not members of the authority, then in considering the appointment to the committee of such persons regard shall be had, if the committee is concerned with matters in which the chronically sick or disabled have special needs, to the desirability of appointing to the committee persons with experience of work among and of the needs of the chronically sick and disabled, and to the person or persons with that experience being or including a chronically sick or disabled person or persons."

The noble Earl said: There is no doubt that this Amendment concerns a very important principle. The more we think about these matters, the more we in a sense realise that we desire to extend the range of the principle that, wherever possible, one should place on the authorities or committees or councils people referred to in this Amendment, who know the problems at first hand. I am not going to elaborate this point because we may find a good deal of sympathy from the Government. I should like the chance to be given to my noble friend Lady Masham to say a few words, but I hope and believe that we shall find a great deal of sympathy from the Government.

BARONESS MASHAM OF ILTON

This Bill was found to be necessary because some local authorities were not doing nearly enough to help the disabled with housing, welfare services, health and education, while others were well ahead. It is likely that the leading local authorities will already have had the services of people with "experience of work among and of the needs of the chronically sick and disabled" and also of persons who are themselves chronically sick and disabled. Who can know better the problems than the disabled them-selves—those who have experienced the problems?

I feel that people should serve on committees only if they can give loyal and valuable service. I should not like to see people put on committees solely because they are disabled. I have served for nine years on two Government-appointed Committees, and I have never considered myself disabled while doing committee work. It would be wrong if a person were barred from being on a committee because he or she was disabled.

Last week I came across a most disturbing case of discrimination against disabled people. And I should like to quote: The following letter has been received by the editor of the Wakefield Express from Mr. Sid Hollinworth of 13, Ledger Place, Outwood. Last Friday night I attended a meeting for paraplegics at Pinderfields Hospital which ended at 9 o'clock. Two friends and I decided to go for a drink in the city. We parked our invalid cars and went in the main entrance to the hotel in our chairs. We sat near a table at least five yards from the bar and ten yards from where dancing was taking place—out of everyone's way, so we thought. A young man came over and told us the landlady had said to him: 'Go and tell those men in the wheelchairs to go and sit against the door'. The young man said that he thought it was unfair, so we sat where we were. Everyone near us agreed with us. When the pub closed the landlord came over and told us, in no uncertain terms, that we couldn't come in that room again, as he didn't allow dogs in as they got in the way and the same applied to us in our wheelchairs. I am 43 years old but any two friends, one who was nearly in this, are only in their twenties. I find it rather unjust as we have been all over the country in hotels and cafes and have never been insulted like this. We don't want sympathy but to be insulted like this is beyond me. That was from a man who had served his country loyally by serving in the mines and who sustained a back injury while pursuing his occupation. I know these people, who are honourable men, and I think this treatment is most unjust.

This clause includes provision for local authority committees to co-opt either people with experience or people who are themselves disabled. This will help to widen the outlook of the authorities which are lagging behind, and will help to bring special needs to their notice.

LORD SANDFORD

I do not want in any way to oppose this Amendment, which I certainly think does no harm and may do some good. But a few moments ago, in moving the first of a batch of Amendments (I think it was Amendment No. 26A), the noble Baroness, Lady Darcy, was making the point, or admitting the force of the argument, that a disabled person, say a person who is blind, is not necessarily particularly well qualified to press the cause of somebody who is confined to a wheelchair. I think there is a certain amount of force in that argument. However, the countervailing argument which the noble Baroness deployed prevailed in the case of that batch of Amendments.

In this particular case, where we are considering that committee within the local authority which is concerned with matters in which all the chronically sick and disabled have special needs, I think the other side of the argument is the one that carries weight. I question whether this particular pattern, which is not laid upon local authorities in this clause as an obligation but is simply commended, is the best pattern. Is it not perhaps the case that the central welfare committee (as it is at the moment; it will be the unified social work department of a local authority) will be best served with advice if at some point in its structure it has a committee or sub-committee in which all the needs of the different classes of disabled are represented; that is to say, something rather similar in structure to the Central Council for the Disabled? It would be helpful for your Lordships to hear what other noble Lords, and in particular the Minister, have to say in answer to that point. But I certainly do not want to oppose the Amendment.

THE EARL OF LONGFORD

I am under the impression that this formulation will be acceptable to the Government. I may of course be quite wrong. I see the force of what the noble Lord says. None of us really can be quite sure to-day how our local government services are going to look in a few years time. It is all rather hypothetical, and it is difficult to be dogmatic as to the precise way in which this matter ought to be formulated. We have tried to find out among the promoters what would be the most sensible course to take, in view of what is thought likely to happen, whoever happens to be in power at the time. As the noble Lord says, I think the best course now is to hear what the Minister has to say about it.

BARONESS PHILLIPS

The Government do not intend to offer any objection to this new clause; indeed, we propose to accept it. But (and I hope that this will meet the noble Lord's point) they are not thereby to be seen to be departing from their general view, particularly with local government reform in prospect, that no unnecessary controls should be imposed, and, by extension, no injunctions offered that appear to conflict with that principle. With that on the Record, I hope the point has been cleared up for the noble Lord.

On Question, Amendment agreed to.

Clause 13 [Duties of national advisory council under Disabled Persons (Employment) Act 1944]:

8.30 p.m.

THE EARL OF LONGFORD moved Amendment No. 31B: Page 5, line 16, leave out ("or").

The noble Earl said: I think the noble Lord, Lord Crawshaw, who has done yeoman work already, would like me to say a few words, if only to atone for my earlier absence. I hope the Government will regard this Amendment favourably. The words may not be the most appropriate but I hope that the Government will feel that this is thoroughly worth while. We have tabled this Amendment because some of us have been much influenced by the experience of those who are possessed of considerable gifts and yet who have found great difficulty in obtaining work in view of their disablement. I must not rely too much on one case perhaps, but my informant points out that she was considered to be too disabled—and indeed was too disabled—to be suitable for manual work. When she inquired whether there was a suitable sedentary occupation, if possible of a literary nature, she was given no helpful advice at all. Finally, to cut a long story short, she hit on a course arranged by the London School of Journalism and this enabled her to obtain a job which she has held for the last three and a half years.

I want to emphasise to the Minister that it was only when this woman re-ported that she had secured employment that she was told that in fact there was a course in journalism available through the Department. The Minister may have some defence to that. I have not given him any other examples, and I have not given him notice of this particular case, but it seems to me essential, particularly with people of high intellectual calibre, who are disabled, that there should be some assurance that there will be advice from an occupational psychologist So far as I understand the position, all too often these people are told that there is really "nothing doing"; they are incapable of manual work, and my friend was in fact told that the best thing she could do was to go and obtain the "dole". That is true; that actually happened, and we do not know how often it happens. So I hope the Minister will see no harm, and a little good—indeed it could be a lot of good—in accepting this Amendment. I beg to move.

LORD HUGHES

After such a string of acceptances from the Government, I am rather disappointed that it should fall to me to be the first to say "No" to an Amendment. However, I am consoled by the fact that the last time I spoke it was to propose on behalf of the Government an Amendment that was wholly acceptable to the promoters of the Bill. In this case, although I would advise the Committee not to accept this Amendment, it is not because of any hostility to what is contained in it but because we believe that the Bill as it stands better accomplishes the purposes intended than does the Amendment.

This is a difficult Bill to draft in any event, but these particular Amendments are not well drafted. Amendment No. 31C, for instance, does not even read sensibly when joined on to the Bill. Of course that is not the reason why I am objecting to the Amendment; if it were purely a drafting objection this could be put right. The Bill, however, if amended in this way, would read: The duties of the national advisory council established under Section 17(l)(a) of the Disabled Persons (Employment) Act 1944 shall include in particular the duty of giving to the Secretary of State such advice as appears to the council to be necessary on the training of persons concerned with … (c) consulting the advice of occupational psychologists where cases prove difficult to assess … It does not make sense in that form, although the intention is quite clear. Really, the only effect of the Amendment would be to purport to give advice as to the way in which things should be done.

However, I should like to deal first with paragraph (b), of Amendment No. 31C, that is: training disabled persons for suitable employment in manual, vocational or professional occupations ". This proposed new paragraph, in trying to be specific, achieves in fact a less comprehensive result than the Bill as it stands, because the present paragraph (b) covers the whole range of training provided by the Secretary of State for Employment and Productivity. As the paragraph is drafted in this Amendment, for instance, it would not cover training in an office. Most office work could not, under any ordinary description, be regarded as being manual work. The use of the word "vocational" is rather difficult. It can be regarded in one interpretation as being "occupational"; but if one regarded it in the way in which the word "vocation" is generally used it describes particular professions—say, nurses or clergymen. But the shopworker or office worker would not come under the category of vocational, and they certainly cannot be regarded as coming under the professional category. This again shows the difficulty of trying to cover everybody by naming categories. It is much better to cover everybody in the way in which the Bill did as it came to us from another place by means of a generality.

The training of disabled people for employment is provided by the Secretary of State either directly in Government training centres or by agents on her behalf. Such agents include residential training centres run especially for disabled persons by voluntary associations, technical and commercial colleges, employers' establishments and training institutions approved by the governing bodies of the professions. The list of occupations for which training is currently being given to disabled persons is really far too long to give in detail, but I think it would be worth while to give some examples to show the range that is already being undertaken.

THE EARL OF LONGFORD

If I may interrupt the noble Lord, of course we are all most anxious to hear what he has to say, but I accept straight away the force of what he has just said, that taking three categories can actually narrow the clause. So let me concede that this is what I think is called a "veritable hit". In other words, the noble Lord does not need to "rub that in". May I say that that particular aspect of it is perfectly clear to me now.

LORD HUGHES

I am very grateful for that intervention, but my experience so far has been that the noble Earl has been very difficult to persuade. I thought it would be of interest for the Committee to know just how wide the range was, and that we were not attempting to blind the noble Earl with science. We believe that what is contained in the Bill will do every-thing the promoters want and will do it more effectively. If the noble Earl is encouraging me to sit down because he is now prepared to withdraw the Amendment, then of course I shall be delighted to concur.

THE EARL OF LONGFORD

I was saying that I thought that the first part of it was otiose, but earlier some noble Lord gave us a great exhortation about not taking up a great deal of time. I do not really accept that argument, and if the noble Lord wishes to tell us the wonderful story of what is being done now I should like to say that I swallow it in advance—I am ready to accept it. If he wants to know whether we withdraw the first part, the answer is "Yes", but as regards the second part concerning the psychologists, I should like to hear more from him.

LORD HUGHES

If the noble Earl had allowed me to finish the paragraph I was dealing with I should have been half way through the third paragraph by this time. However, I will proceed straight to the other point. I have already pointed out how badly the first part fits into the clause, because the wording is incorrect. That is a minor point, be cause I concede that the Amendment could be redrafted, but it is not necessary. The Department of Employment and Productivity are already well aware of the value of consulting occupational psychologists in these difficult cases. They are so impressed by the value of this work that they have on their own staff a number of occupational psychologists specifically for this purpose. So we have already accepted what is asked for; it is already applied.

If the noble Earl were to ask me— and I think he would be quite entitled to do so—why, if all this is in existence, does the case he quoted, come about; why it should have happened that with all these arrangements already in existence this lady could not have been given an opportunity already, the only answer I can give is that I do not know why it should have happened. But we are all well aware of the fact that it does not matter how extensively one may make arrangements for catering for a situation in an organisation as widespread as the Department of Employment and Productivity. We are dependent on the human beings who make up the machine, and sooner or later somebody does not know his job as well as he ought to, or there may be a temporary lapse of memory, and some poor individual does not get the advice he ought to get. But it is not because the machinery was defective, not because the opportunities were not there; it is because for some reason or other somebody did not apply it.

From the enormous range of activities going on, including the use of psychologists and making special arrangements for people, I am quite convinced that the case which the noble Earl quoted will be very exceptional, and the number of people who are getting satisfactory service from the facilities are the general rule. I would certainly hope that, as a result of what the noble Earl has said, the Department will investigate what took place in this particular case, because sometimes the best way of ensuring that a thing does not go wrong again is to find out why it went wrong the last time and to take steps to eliminate the cause. I am grateful to the noble Earl for quoting the case, because, if there is one thing worse than not having the machinery capable of accomplishing the purpose, it is having the machinery and having it messed up by somebody.

THE EARL OF LONGFORD

It is a great pleasure to me to think that there was a time when the noble Lord was part of my team; I think he is a tremendous credit to whoever is responsible for him now. I beg leave to withdraw the Amendment.

Amendment, by leave, withdrawn.

Clause 13 agreed to.

Clause 14 [Separation of younger from older patients]:

LORD AMULREE moved Amendment No. 34A: Page 5, lins 25, leave out ("under the age of 50 ").

The noble Lord said: I want to move this Amendment to Clause 14 because I think it would work a great deal better if we were not to include any particular age limit. The purpose of the clause is to make sure that young people—and by "young" it is extremely difficult to define what one means—with long-term chronic sickness which means that they must be cared for in some kind of communal way, either in a hospital ward or in local authority accommodation, shall not be taken care of with people a good deal older than themselves, people living in the long-stay geriatric wards, where one finds people who are mentally degenerate, senile and incontinent, entirely improper people for younger people to be nursed with. I would far rather see no age specified there, because what is the difference between persons of 50, 51, 52 or 55? I am encouraged in my view by a circular from the Ministry of Health, Circular 6841, which deals at great length with the care of the younger chronic sick.

LORD RAGLAN

If I may interrupt the noble Lord, there seems to be some confusion about which Amendment we are considering.

THE DEPUTY CHAIRMAN OF COMMITTEES (LORD ROYLE)

Amendment No. 32 was not moved and therefore the two Amendments to the Amendment could not be called. The noble Lord is now moving Amendment No. 34A, which is in substitution for No. 32.

LORD AMULREE

The circular which I quoted from the Ministry of Health explains this point extremely well. If we could take out from the clause the words which I wish to take out, it would make it far more flexible and would give a statutory backing to this circular which has already gone out from the Ministry and which outlines the conditions we want to be sure of: that young people with long-term chronic illness do not get taken care of in wards full of people mentally senile and incontinent. I beg to move.

THE EARL OF LONGFORD

I should certainly like to support very strongly the Amendment moved by the noble Lord, Lord Amulree, and supported by other colleagues. There is possibly a danger, because we have probably reached agreement here, after discussions with our friends the Government, if one may refer to them every now and then in that way, that this matter might be passed over almost too quickly. It is something of tremendous poignancy, as we all know, either from our background or from the discussions on Second Reading. There is no doubt that there is no clause in the Bill as it comes to us in the Lords which arouses more concern than this one. Therefore I should like to put it on record, because I know the Committee agrees, that no one would be happy with this Bill at all if we did not reach substantial agreement about this clause. Before adding a few more words, may I just say that my noble friend Lord Wells-Pestell has asked me to apologise for his having to leave the House earlier for another engagement. As pointed out by the noble Lord, Lord Amulree, his Amendments fall to the ground, but I should like the Committee to be aware that he cannot be with us this evening but no doubt will be here on Report.

The subject is not at all an easy one and perhaps one cannot produce the perfect clause. We are all agreed, I think, that in the clause as it now comes forward the age of 50 should be removed, because many of us are aware of cases of people who are either already 50 or soon to be 50, who are disabled and who might still find themselves in geriatric institutions unless there were a fundamental revision of the clause. At the same time, none of the words which what one thinks ought to be done, spring to one's lips, if one begins to say appear to be satisfactory. The word "young" is very misleading; it may mean young persons in the ordinary sense, or anybody not actually in a home for old people, or under 65. A layman like myself may come along and say that no one who is not geriatric should be in a geriatric institution. That sounds fine, and it is in a sense what we mean; but when it comes to the point it cannot be said that way, as the noble Lord, Lord Amulree, himself a distinguished geriatrician, will agree. I hope and believe that everyone in the House will feel that this is just about the best that can be managed and that no one who is not geriatric should in fact find himself in a geriatric home under this clause. Although we cannot put those words in the Bill, that is the general desire, and I hope it is achieved by the clause. May I say that we have had great help from the Government here, as elsewhere, but here particularly, and I should like to feel that those who are outside this House watching this Bill will be much reassured by the clause as it now comes before your Lordships.

BARONESS SEROTA

The noble Earl, the sponsor of the Bill, has reminded us that the objective of the Amendments that the noble Lord, Lord Amulree, has moved—and here, if the Committee would agree, I should like to speak to Amendments 34A to 34E, because they really hang together—is one which has given us great cause for concern and to which many of us have given close attention. When the Bill was being debated in another place my honourable friend gave an undertaking that the Government would put their mind to ways and means of meeting the different points that were made, with a view to assisting in providing a clause that would meet a number of objections that were raised to it, both in debate and also by resolutions passed by various organisations concerned with services for the handicapped.

For the reasons that both noble Lords have given, I believe that the Amendments overcome some of the very real difficulties which we were anxious to avoid. Therefore, on behalf of the Government I welcome Amendments Nos. 34A to 34E. I believe that they substantially improve this clause by removing the unsatisfactory division at the age of 50 which appears in the clause as it has come before your Lordships. To my mind, the underlying objective behind all our efforts here has been to avoid placing people with active intellects which they are able to use despite their physical disabilities in an environment which will be inimical to this. That is the point to which I think all of us attach the greatest importance, and it is one which I can assure the Committee that my right honourable friend and I intend to stress strongly in the guidance that we give to hospital authorities once the Bill receives the Royal Assent.

On Question, Amendment agreed to.

LORD AMULREE

I beg to move Amendment No. 34B.

Amendment moved— Page 5, leave out line 38 and insert ("elderly persons, unless he is himself an elderly person.").—{Lord Amulree.)

On Question, Amendment agreed to.

LORD AMULREE

I beg to move Amendment No. 34C.

Amendment moved— Page 5, line 42, leave out ("under the age of 50 ").—(Lord Amulree.)

On Question, Amendment agreed to.

LORD AMULREE

I beg to move Amendment No. 34D.

Amendment moved— Page 6, line 1, after ("who") insert (", not being elderly persons,").—(Lord Amulree.)

On Question, Amendment agreed to.

LORD AMULREE

I beg to move Amendment No. 34E.

Amendment moved—

Page 6, line 6. at end insert— ("(3) In this section "elderly person" means a person who is aged sixty-five or more or is suffering from the effects of premature ageing.").—(Lord Amulree.)

On Question, Amendment agreed to.

Clause 14, as amended, agree to.

Clause 15 agreed to.

Clause 16 [Provision of information relating to chiropody services]:

LORD AMULREE moved Amendment No. 35: Page 6, line 33, leave out ("providing") and insert (" empowered to provide ").

The noble Lord said: This is a more or less formal Amendment. I think it expresses the meaning rather better than the words contained in the Bill as drafted. I beg to move.

On Question, Amendment agreed to.

LORD AMULREE moved Amendment No. 36: Page 6, line 38, after ("are") insert ("available and").

The noble Lord said: This is really the same kind of Amendment. I think it makes the meaning a little clearer than in the Bill as drafted. Therefore, I beg to move.

On Question, Amendment agreed to.

On Question, Whether Clause 16 shall stand part of the Bill?

LORD SANDFORD

I should like to raise a small query on this clause, not on the substance of it but on a technical point. If I am right in what I think, the power to provide the chiropody ser-vice in Scotland under Section 27 of the National Health Service (Scotland) Bill 1947 has been transferred by Clause l(4)(c) of the Social Works (Scotland) Act 1968 to local authority social work departments; so in respect of Scotland the references to the "local health authority" is wrong. The power to pro-vide these services in England and Wales, which is contained in Section 12 of the Health Service and Public Health Act 1968, is shortly to be transferred from the local authority health department to the local authority social work departments under Schedule 1 of the Local Authority Social Services Bill which has just passed through the Commit tee stage in another place. So in respect of England and Wales the reference to the "local health authorities", though correct at the moment, will soon be wrong, too. These are small matters, but I think they require attention at some stage before the Bill becomes law.

BARONESS SEROTA

I am grateful to the noble Lord for making those points. We are aware that we shall have to do a great deal of work after the Bill becomes law. We are in a somewhat difficult position here, as the Local Authority Social Services Bill is not yet before the House; therefore we cannot really discuss it because we do not know its final form. Yet this Bill has reached its Committee stage. However, I take the noble Lord's point.

LORD HUGHES

If it should be the case that the noble Lord is right in his reference to the Scottish Act, them it may be necessary to table an Amendment at the next stage of the Bill. I will look into the matter. I have a feeling that the noble Lord is probably right, if only from the fact that he has recently been sitting next to the noble Lord, Lord Drumalbyn, who is an expert at picking up points like this which brush off on to other noble Lords.

LORD SANDFORD

I would recommend the noble Lord not to take any short cuts here, because it does not come from Lord Drumalbyn and may therefore be wrong.

Clause 16, as amended, agreed to.

8.58 p.m.

LORD AMULREE moved Amendment No. 37: After Clause 16, insert the following new clause:

Information on availability of domiciliary physiotherapy services

".It shall be the duty of every local authority to facilitate the provision of physiotherapy services in the home of a disabled person by providing information on the availability of any domiciliary physiotherapy services whether provided under the National Health Service, or by private organisations or individuals under arrangements made by the authority or otherwise."

The noble Lord said: This is an Amendment which I hope will appeal to your Lordships. We all know that in the treatment of many disabled persons physiotherapy can be of enormous value; in fact it is recommended for young people who are disabled as well as for the old. Some young people, as well as old, find it difficult to come for their treatment to the physiotherapy departments of hospitals. The point of my Amendment is to make it possible for physiotherapy to be given in their homes when the appropriate organisation is available to give that physiotherapy. There are one or two domiciliary physiotherapy services in the country, particularly one in London with which I have myself been involved for quite a long time.

The number of people who require treatment in their homes is comparatively small. Wherever possible, one would like to bring the patient to the physiotherapy department of a hospital, largely because at present physiotherapists are in short supply and in the past it has been considered a waste of their time that they should travel about treating people in their homes. How-over, if you are going to transport people by ambulance to hospital, when they could be treated in their homes rather better, it is going to be a rather extravagant and wasteful service, and one wonders whether it would not be better to treat them in their homes. The organisation with which I am connected, which is called the London Area Mobile Physiotherapy Service, at one time had a contract with the Norlh-East Metropolitan Regional Hospital Board for the treatment of patients in their homes, but for some reason which I cannot explain that contract was cancelled in 1950 or 1951, and it has not been possible to do that any more.

When one looks across the field one comes to chiropody, and it is possible for people who cannot come up to the chiropody centres to be given chiropody in their own home, with the local authority paying for it. The number who receive that treatment is extremely small —I believe it is about 5 per cent. of the total number of patients treated in chiropody clinics run by the local authority. One would like to see whether that privilege which is given to patients requiring chiropody could be extended to patients requiring physiotherapy. The numbers would be small, so the expense would not be very great. The Amendment has the approval of the Chartered Society of Physiotherapists, and I can see no real reason why the Government should not allow this to happen for the small number of patients for whom it would be more suitable. I beg to move.

BARONESS SEROTA

As ever, the noble Lord, Lord Amulree, argues his case with great cogency and compassion. I know that this is a subject which is very close to his heart, and we have discussed it on a number of occasions. As I indicated in my reply during the Second Reading debate on this Bill, the present policy of the Government is to base the physiotherapy services on the hospitals: that is for medical reasons, and indeed for staffing reasons, too. At this late hour, I am only too conscious that I shall not be able to persuade the noble Lord to change his view of the developments he thinks should come in this field. But even if the Government were so minded, and were convinced by his arguments, I think we should in any event have to await the outcome of the two Committees now sitting, one of which I have already referred to earlier in the debate, the Committee under the chairmanship of Sir Ronald Tunbridge, which is examining the services of rehabilitation. There is also a further Committee, under the same distinguished chairman, which is considering the function and inter-relationship of the professions supplementary to medicine, if I may use that expression for those who comprise that particular group. I feel that it would be wrong to legislate for a development of this kind before we have had the considered views of these two expert Committees.

I am aware that in some local authority areas there is longstanding provision for domiciliary physiotherapy, but in the light of our current policy in this field, and because of the existence of the two Committees to which I have already referred, I believe that it would be wrong to encourage new schemes of this kind at the present time. I would therefore ask the noble Lord to withdraw his Amendment now, and I can assure him that when the Reports of these Committees come to be considered their recommendations will be widely discussed, and every opportunity will be given for bodies concerned with these matters to comment. I have no doubt that the noble Lord, Lord Amulree, will give the benefit of his advice, too. I would ask the noble Lord to withdraw this Amendment, for the reasons I have just given and in the knowledge that he will continue his campaign in the future as actively as he has done in the past.

LORD AMULREE

I thank the noble Baroness for her kind remarks. In view of the fact that this matter is being considered by two Committees rather than one, I beg leave to withdraw my Amendment.

Amendment, by leave, withdrawn.

Clause 17 [Use of invalid carriages on highways]:

On Question, Whether Clause 17 shall stand part of the Bill?

LORD ABERDARE

Clause 17 makes provision for the use of an invalid carriage on a footway, and this is indeed a most welcome provision. In fact, it is so welcome that it is about the only clause on which no Amendment has been put down, and it may seem churlish of me to say anything about it. However, there is just one point that I want to make briefly, and I make it only because it has been put to me by someone whose opinion I value very highly. The point is that although it is quite right to make provision for those in wheelchairs to make use of the footway, there is often one insuperable obstacle, and that is the kerb. I wonder whether it could be considered in future planning that where there is a pedestrian crossing there should be no kerb but a sloping approach from the footway. This seems to me a sensible idea: it would not only help those in wheelchairs, but would also be of considerable help to many mothers with prams. I know that it does not come within the ambit of the Bill, but I thought it would be worth making the point and perhaps pursuing it in another way.

VISCOUNT INGLEBY

I should very much like to support the noble Lord, Lord Aberdare, on that point.

LORD HUGHES

As the noble Lord, Lord Aberdare, has said, this point does not come within the ambit of the Bill, but I think it is well worth making, and I will make certian that it is drawn to the attention of my right honourable friend.

LORD ABERDARE

I am most grateful.

Clause 17 agreed to.

9.8 p.m.

BARONESS MASHAM OF ILTON moved Amendment No. 38:

After Clause 17, insert the following new clause:

Parking regulations for disabled persons

".—(1) After consultation with the Secretary of State, the Minister of Transport and the Secretary of State for Scotland shall in exercise of their powers under the Road Traffic Regulation Act 1967 make such regulations for the benefit of disabled persons as they think fit, and in particular regulations exempting the vehicles of disabled persons:

1. (a) from parking restrictions, and
2. (b) from payment of charges for parking in places designated under section 35 of that Act.

(2) The power to make regulations under the Road Traffic Regulation Act 1967 shall include power to make regulations providing for the issue to disabled persons of such means of identification for their vehicles (whether or not owned by them) as shall be specified in the regulations.

(3) "Vehicles of disabled persons" means—

1. (a) any vehicle constructed or adapted for use by a disabled driver, and
2. (b) any vehicle constructed or adapted for the carriage of a person too disabled to drive himself.

(4) The regulations may provide that it shall be an offence to affix any such means of identification as is mentioned in subsection (2) above to a vehicle when it is being used other than for the carriage of the disabled person to whom the means of identification was issued."

The noble Baroness said: I ask your Lordships' permission to discuss with this Amendment No. 39, as they deal with similar matters; and perhaps if the Government are in agreement there can be a redraft afterwards. With the increasing traffic in towns, it is becoming more and more difficult for disabled people to find parking places. The yellow parking badges help, but both police and parking attendants are very often badly informed. On one occasion a young policeman pounced on me after I had driven around Harrogate about six times. I was collecting a parcel from a shop. To encourage him to be helpful I explained that I had a yellow badge. But he looked at the badge and said, "That was issued in the North Riding. Harrogate is in the West Riding." I have heard of many similar cases. Some towns are very much more generous than others towards allowing disabled people to park at meters free of charge. Parking can impose great extra cost on the disabled, who cannot manage to park in free car parks because of the distance and rough passage for walking with crutches or wheeling.

I should like to bring your Lordships' attention to the great difficulties which a badly disabled passenger experiences at the moment in regard to parking. He has no concessions or badges. A very badly disabled woman was taken shop-ping in Middlesbrough by her husband. He parked the car six inches outside the parking line, to enable him to get the wheelchair out of the boot. When they returned they found a ticket from the police telling them to report to the police station. The husband, who is a very conscientious man, was most upset. After difficulty they located the police station, and had to wait until the officer involved finished his cup of tea. The husband then explained about the wheelchair and the policeman said, "How was I to know? You had no sign to show me that you had a disabled passenger." Would it not be possible to have a badge which could be used only when the disabled passenger was using the car? I hope that the Minister will find it possible to be considerate in these matters. I beg to move.

LORD NAPIER AND ETTRICK

In supporting my noble friend Lady Masham in all that she has said, I would add that it seems to me incredible that there is still no uniformity throughout the country as regards recognition of these yellow badges for the disabled driver. Surely it is now high time that a badge issued in Glasgow was immediately recognised in, say, Leeds or London. I understand that Scotland is now moving in this direction, and I hops that England will do likewise.

LORD HUGHES

The effect of the first clause would be to require the Minister or the Secretary of State to make regulations which would exempt the vehicles of disabled persons, whether drivers or passengers, from parking restrictions. These regulations would make it obligatory on local authorities—and Ministers in respect of trunk roads—to include such exemptions in parking regulation orders. The effect of the second clause would be to make it compulsory for local authorities to operate a car badge scheme, so as to identify vehicles either driven by disabled drivers or specially adapted for disabled passengers. It also provides for the Secretary of State to make regulations defining the circumstances in which the scheme would operate.

There is a certain amount of overlapping in the two clauses. The intention of subsection (2) of the second clause appears to reflect the intent of the whole of the first clause. The whole of the first clause and the second half of the second clause (from "The Secretary of State" to the end) can be provided for under the same existing legislation; that is to say, Section 84C(3) and (4) of the Road Traffic Regulation Act 1967, as amended by the Transport Act 1968. The general effect of both clauses is thus to make more systematic, and give the greater authority of law to, the existing arrangements for parking relaxations for disabled drivers, at present provided for partly by administration and partly by exemptions written into local authority traffic orders at their discretion, and also to add to that similar exemptions for vehicles adapted for the use of disabled passengers.

The present arrangements consist of the car badge scheme (or "yellow badge" scheme, at it is often called) promoted in Ministry of Transport circular No. 32/67, which urges local authorities to waive the limit to which disabled drivers' vehicles can be parked in parking places on the street. It does nothing to relax restrictions or prohibitions on waiting in streets. That is to say, while the scheme urges that a disabled driver should be allowed to park for as long as he likes at a designated parking place—for example, at a parking meter—it does not urge relaxations at places where waiting is restricted or prohibited—for example, on yellow lines.

The present arrangements are flexible, and their exercise is a matter for the discretion of the police, except where exemptions are specially written into traffic regulation orders. This method has always seemed the best to the Government, who fear 'that to give the scheme the force of law would require a great many careful definitions, with which the constable on the beat would have to cope, so introducing a risk of inflexibility which would cut against the interest of the disabled. On the other hand, there are some advantages in giving the scheme the force of law. First, it would give greater emphasis and status to the needs of the disabled. Secondly, it woud make it easier to secure that badges issued by one authority were recognised as applying in the area of another authority. As the noble Baroness, Lady Masham, has said, this is definitely not the case at the present time. Then, thirdly, it would give greater standardisation of conditions and more equal treatment of the disabled in different authority areas.

The Government are not opposed to the principles and objectives of the two clauses, but we wish to secure that they are expressed in the best possible way to act fairly in the interests of both the disabled and the police—who, after all, have the duty to enforce the traffic law, for the sake of good traffic movement and of safety. The Government are therefore prepared to give an undertaking to table at the next stage such provisions as are necessary to fulfil the principles behind the clauses, so far as is practicable for the order-making authorities, with the interests of the disabled in mind, and so far as existing legislation does not already provide for them.

In effect, our proposals are likely to take the form of a provision to express more precisely the theme of the first sentence of the second clause; that is, making it a duty for local authorities to maintain a yellow badge scheme, with the categories of the disabled left to the powers of guidance and regulation which the Secretary of State for Health and Social Services and the Secretary of State for Scotland already have. The extent to which Section 84C of the Road Traffic Regulation Act 1967 ought to be used to carry out this proposal ought to be the subject of discussion between the Government and those representing the interests of local authorities, the police and the disabled. It would be out of the question, for example—and I am quite certain that the sponsors of the new clauses recognise this—that the vehicles used by disabled drivers and passengers should be exempt in all circumstances from waiting restrictions. Indeed, that might expose the vehicles and the drivers and passengers themselves, if they were either getting out of them or getting into them, to very considerable danger.

Whether there are some circumstances in which relaxations in regard to yellow lines can formally be catered for in respect of disabled drivers and/or passengers ought to be a matter for the negotiations which we propose. What-ever arrangements emerge from these negotiations, it is likely that they will be able to apply only to new orders. In respect of the thousands of existing orders, the Government propose, if the present clauses are not pressed, to invite local authorities to meet the spirit of the arrangements to be arrived at in relation to existing orders and to amend them accordingly at the earliest opportunity open to them. I hope that these arrangements will be acceptable to the noble Baroness who has moved the two new clauses, and that when the appropriate Amendments are tabled at the Report stage the House will find that they are in a form acceptable to accomplish the objects which these two new clauses seek to obtain.

BARONESS MASHAM OF ILTON

I thank the Minister for his most helpful suggestions. Perhaps our committee can meet his Department before the Report stage to hear more about the proposals that he is going to put forward. 1 have already met some of the officials of his Department, and they felt they were in favour but that the new clauses needed some redrafting. I therefore beg leave to withdraw the Amendment.

Amendment, by leave, withdrawn.

9.20 p.m.

LORD O'HAGAN moved Amendment No. 40:

After Clause 17, insert the following new clause:

Provision of vehicles for haemophiliacs

" . Section 33(1) of the Health Services and Public Health Act 1968 shall be amended by adding to the end thereof the following pro viso: Provided that any person who has been diagnosed or registered at a designated haemophilia centre as suffering from severe haemophilia or other severe congenital coagulation disorder shall on the recommendation of the director of the haemophilia centre be eligible to be provided with a suitably adapted small car".

The noble Lord said: I am speaking on behalf of the overworked experts. This Amendment refers to a unique group of people to whom the most minor injury to any part of the body can have the most serious consequences. Of no other disabled group can this be said. I should be most interested to hear from the noble Baroness whether the Government dispute the medical evidence, particularly from people of the calibre of Dr. Rosemary Biggs, which shows that this group is in a unique medical category. Even meet their needs. What they must have the latest automatic tricycle does not is the suspension, stability and safety of a small car, which would also have room for a passenger in case of a sudden haemorrhage, say, on the way to a distant haemophilic treatment centre. The help provided by the present vehicles is pro-vided only at an unjustifiable risk.

As the noble Lord, Lord Hughes, is with us still, I feel that I am on strong grounds when talking on economic lines. There are only 100 tricycles on issue to very severe haemophiliacs, and it has been estimated by a Minister in another place that the cost of a car for these people would amount to only £28 10s. Od. per head a year extra. I submit that £3,000 or so is a very cheap price for the enhancement of life, perhaps even the preservation of life, that would result. I need hardly add that haemorrhages are not fun and are very expensive to deal with. It would be much cheaper, let alone more humane, to stop haemorrhages caused by unsuitable vehicles, as emergency treatment of this nature can cost between £12 and £15 a session. These vehicles, which were never designed to meet the specific needs of this small unique group, can be easily and inexpensively replaced along the lines suggested by this Amendment. I beg to move.

BARONESS MASHAM OF ILTON

Before I was married I used to drive a Ministry three-wheeler. I lived 11 miles from the nearest town in the North of Scotland. This vehicle proved so un-reliable that every time I went out I took a long rope so that when I broke down I could be towed to the nearest garage. Most garages did not know how to mend it and they wasted hours of time trying to find out. I dread to think what it cost the Ministry. I also found that in a high wind a three-wheeler was very unstable and when descending a steep hill it was an art not to be run away with. I do not think that this is a suitable vehicle for the sufferers from severe haemophilia or the consequent coagulation disorders. Because of the instability of the three-wheeler, they might well land in the ditch and bleed to death. It would be useful for people issued with a Ministry three-wheeler also to be issued with a "Help" sign that they could stick out of the window to summon help when they have broken down.

BARONESS SEROTA

The noble Lord, Lord O'Hagan, moved and spoke to Amendment No. 40; but Amendments Nos. 40 to 43 all turn on this question of eligibility for invalid vehicles. Per-haps it might help the Committee if at this stage I indicated the Government's attitude to the principles that lie behind these new clauses.

LORD O'HAGAN

I am sorry if I have "mucked things up". Would the noble Baroness agree that if there are noble Lords who wish to speak to Amendments Nos. 41 and 42, they should have the chance to do so before she speaks. I was asked to deputise on one Amendment only and I have done so. I am sorry to have confused people.

BARONESS SEROTA

The last thing I intended to convey was that the noble Lord had "mucked things up". On the contrary, I thought that he moved his Amendment extremely well. I simply wanted to make it clear that as well as trying to answer the particular point that he put about the eligibility of haemophiliacs for vehicles, I could help the Committee by making the attitude of the Government clear on the general question of the vehicle service, because it is quite clear that each of these four Amendments attempts to legislate to include specific groups who are not already provided for in the vehicle service.

THE EARL OF LONGFORD

May I break in for just one moment? I think that if noble Lords who are particularly interested in these Amendments had thought that the noble Baroness was replying to all of them together, they would probably have wanted to make out the case in advance for the various Amendments.

BARONESS SEROTA

That was not my intention at all. It is quite clear that I was not able to make my position clear on this. May I therefore deal with the matter in two parts? I will first speak generally on the Government's view to-wards developments in the vehicle service, and then I will answer the noble Lord, Lord O'Hagan, on the specific point of his Amendment relating to haemophiliacs.

On Second Reading I indicated my sympathy with those who are anxious to take steps to improve the provision of vehicles for disabled persons. We are all anxious that improvements should take place as fast as possible, although I am not sure that we would necessarily all agree about the priorities of the different categories of need. To my mind, the difficulties lie not so much in deciding whether or not more should be done, but in settling the order in which improvements which cannot be introduced simultaneously should be made, and how we can secure the necessary resources to achieve our objectives.

It is for those reasons that we have undertaken (and my honourable friend has paid close and personal attention to this matter since he became the Parliamentary Under-Secretary of State) a full review of the vehicle service, as my honourable friend recently announced in another place. We are now considering the results of this review, including all the suggestions made to us by disabled people and their representatives and those mentioned in the discussions which have taken place in the context of this Bill. As part of our review, we are also drawing on the Department's knowledge, built up over a considerable period of years, regarding the mobility problems of disabled persons, some of whom are not able to press their own case but whose needs are as great as those of others who are able to find articulate supporters.

This is not a simple matter. It will require more resources and it is therefore absolutely imperative to ensure that what-ever changes we make are such as will stretch the resources to the greatest possible extent in order to benefit as many disabled people as we can; bearing in mind the claims of those who already have vehicles, but would like different ones, and those who, as yet, have no vehicles at all. What I am anxious to avoid—and this is why I wished to speak at the outset of the Committee's consideration of these four different Amend-ments—is by legislation becoming committed to a particular change before we have had an opportunity fully to examine the implications of a scheme for general advance, which we have not yet (I want to be quite frank about this) been able to formulate in all the necessary detail.

We have been looking closely at our present arrangements and are now seeking further information about possible ways of squeezing the utmost value out of the resources we have already and those which we aim to have for this purpose. Clearly, there are interactions to appraise if we are to be sure that we are being fair to everyone and not benefiting some at the expense of others. That is why I am afraid that I am unable to accept any of the Amendments. We are making progress, and I can assure the Committee that my right honourable friend and I will see that the momentum is maintained. Meanwhile, I ask the Committee not to prevent us, by tying our hands too closely, from pursuing our general purpose of improving the vehicle service in as progressive a manner as is possible at present.

I turn now to the Amendment. This would make cars, instead of three-wheeler vehicles, available to people who qualify by their leg disability for a vehicle and who are also haemophiliac. I am not sure that I can agree with the noble Lord that medical opinion is unanimous in this matter; my advice is to the contrary.

LORD O'HAGAN

I did not say "unanimous"; I said "overwhelming".

BARONESS SEROTA

That depends upon which side one is listening to. I can assure my noble friend that medical opinion may be overwhelming in one direction but it may be equally over-whelming in another. But the noble Lord's proposal means that the selection of candidates for a car by reference to a disease additional to a leg disability and irrespective of the merits of the case, introduces a completely new principle into the service. It would require careful investigation in order to determine which diseases should claim priority. I do not think I need say any more at this stage about the general principle, but it makes me feel that this would be the wrong moment to write this proposal into our legislation. I would only stress to noble Lords, who I know have strong views on this subject, some of which I share, that this is not a matter with which we should deal piecemeal in this way, if we are to be just and fair in using our resources to their greatest possible extent.

THE EARL OF LONGFORD

Probably I ought to blame myself for acquiescing in the development of the discussion along these lines, which' have been rather unusual. The Minister is perfectly in order to reply to the Amendment, but before even hearing the case for the other proposals in relation to vehicles she has told us that they are just not "in"; they are "out". That is very unusual in this House. I daresay that I ought to have stepped in earlier, but that is what has happened. We have not heard the case but we are told in advance that vehicles are "out" at this period of time. It is unfortunate that the debate should have taken this course. I cannot remember any Minister coming into this House fairly recently who has won such golden opinions as the noble Baroness, but it is extraordinary, in my recollection, to say, before hearing the case, that there is nothing in it and it cannot be considered at this time.

BARONESS SEROTA

I am in some difficulty here. Earlier on in our consideration of different Amendments the noble Earl asked me on Amendment after Amendment to state the Government's view. Before I came to the Des-patch Box to answer the noble Lord, Lord O'Hagan, I turned to the noble Earl and hoped that, as sponsor of the Bill, he would take the opportunity to speak, but in fact he chose not to do so. 1 felt it only right and fair to be frank with the Committee at the outset, and I do not think it is fair to infer from what I said that I will not listen or that all your Lordships will not listen to the cogent case which I believe may be made on these Amendments. I am somewhat surprised that the noble Earl, who has known me so many years, has even begun to think from the statement I have just made that I would not listen fairly and fully to the case that was going to come later.

THE EARL OF LONGFORD

The noble Baroness would never be lacking in courtesy and she will certainly listen in a delightful way, but she has said that there is "nothing doing". That has been made abundantly plain. However good the arguments, the Government consider that these matters are not in a state where any suggestions can be fruitful. I am afraid I must make that plain. It is not a question of the noble Baroness being surprised or of my being surprised. I blame myself. But this is an unusual situation, because she has replied in advance to a number of Amendments that have not even been moved. But now, having had that little exchange, I am only saying that I think the Committee will want to hear the Amendments. I think it would be a great pity if the Committee could not listen to these arguments and then decide on them.

LORD ABERDARE

Surely it is up to the Committee to decide what view they take on the Amendments. I would say that we all appreciate very much hearing at an early stage the general opinion of the Government because it helps us to know where they stand.

THE EARL OF LONGFORD

It is a free country, and a free House, but it is unusual, not having heard the arguments, to reply to them in advance and to say that they are out.

LORD ABERDARE

They are not out.

LORD O'HAGAN

I feel that I ought to crack a joke at this point, but perhaps I can restrict my amiable remarks to one specific thing. I will not attempt to penetrate the blanket of general considerations which the noble Baroness brought to bear against the Amendment that I moved. Nor shall I attempt to undermine the argument which she produced against the technical difficulties that arise when you start trying to differentiate between various groups. But I should welcome from her, for the benefit of those people who are interested in taking this Amendment further at a later stage, an assurance about the medical evidence to which she referred. Those who are interested in this problem but are simply members of the public and not privy to the Government's views are intrigued to know who are these phantom experts (if I may so call them) who take the views which cause the noble Baroness to be so strongly against the proposal that I was putting forward. Before I withdraw the Amendment I should welcome an assurance that she will either let those interested parties know what this medical evidence is or have it published so that everybody can see it.

BARONESS SEROTA

Perhaps I may briefly explain that the advice on which I based my reply followed a medical discussion which was held about a year ago at the Department at which eminent haematologists, including some who had previously criticised the non-issue of cars for haemophiliacs, met the Department to discuss the subject and to examine the cars and the three-wheelers issued in the context of their agreement on the special needs of haemophiliacs. Their conclusion was that neither vehicle was ideal for a haemophiliac, but that the three-wheelers possessed intrinsic advantages for people with leg disabilities which qualified them for vehicles. They thought that the balance of advantage was in favour of the three-wheeler when the new one, with its absolutely jerk-free automatic transmission and optional steering wheel, which the Department is shortly to produce becomes available soon. It is this kind of consideration that I think we need to examine before incorporating in our legislation a clause of the kind suggested by the noble Lord.

LORD O'HAGAN

I am eager to get on. I was aware of most of what the noble Baroness has said. But I think she will sympathise with those interested in this problem, because while we are aware of what the people who support our view think, we are not aware in detail of the medical evidence to which the Government attach such importance. Therefore we are, as it were, punching a punch bag that is not there and we do not know what it is. I should be grateful if she could reassure the Committee that those people who are interested in this problem will know what is the medical turning point in this issue.

BARONESS SEROTA

The noble Lord is aware that I am always ready to talk with any Member of this House, or with any groups of people, who care to come to the Department. If he can suggest any ways in which this information can be put across, or any discussions that he would like to hold, I shall be pleased to do anything I can at any time.

LORD O'HAGAN

I beg leave to withdraw the Amendment.

Amendment, by leave, withdrawn.

9.41 p.m.

BARONESS DARCY (DE KNAYTH)

moved Amendment No. 41:

After Clause 17, insert the following new clause:

Provision of vehicles for disabled persons unable to drive

".The Secretary of State shall provide a suitably adapted small car or van to a person who is so severely disabled that he is unable to drive it himself but who can designate a person to drive it for him.

This shall apply only to those who, under regulations made by the Secretary of State, are sufficiently disabled to be eligible for an invalid tricycle."

The noble Baroness said: I spoke at length during the Second Reading debate on my reasons for hoping that this new clause would be included in the Bill. I shall not take up much of your Lord-ship's time now. Let me remind you briefly of the problems facing the disabled passenger. The main point is that he is being penalised simply because he is more disabled than the other categories of people sufficiently disabled to qualify for an invalid tricycle. We must remember that we are talking of people who are actually too severely physically disabled to drive themselves, and not of people who choose to be driven by someone else. Since the disabled passenger is so severely disabled as to be dependent on other people for help with washing, dressing and so on, it is particularly important that he obtains outdoor mobility and a measure of independence, in that he can go out and earn his living. Yet he is at present being treated in every way as an able-bodied private motorist, subject to the same taxes and receiving none of the concessions allowed to disabled drivers.

If I may I will read part of a letter from one of these disabled passengers. He said: I have been polio disabled since the age of 18—I am now 31. I am confined to a wheelchair and have movement only in my left forearm, wrist and hand. Although I qualify for an invalid carriage, my disability is severe enough to prevent my being able to drive one. I am a writer and find it necessary for my work to go out and meet people and experience the outside world, as it were. Eighteen months ago I got married and, as we cannot afford a car, I relied on my wife pushing me for outdoor excursions. We were limited by the distance that my wife could walk, but at least we got out. Six months ago we had a baby. Obviously my wife cannot push both myself and the baby; equally obviously, we cannot leave the baby alone in the house or even—given the weak-ness of my arms—solely in my care.

As the letter says, experience of the out-side world is the breath of life to a writer, and by denying him the means of leaving his house I would suggest that we are virtually suffocating him.

There is another aspect of the disabled passenger problem which disturbs me greatly: the thalidomide children will soon outgrow their Emma trolleys and start clamouring for outdoor mobility as adults. Some of these children have neither arms nor legs. Even they can drive the Emma with powered arms, but will they be allowed to drive cars. Has everybody realised that, as things stand now, the thalidomide children without arms or legs will grow up to be disabled passengers receiving no help at all towards outdoor mobility? If a disabled passenger can go out to work he can make a concrete contribution towards society by earning his living, and in terms of human happiness his gain would be inestimable. I beg to move.

BARONESS MASHAM OF ILTON

I should like to support my noble friend Lady Darcy. We who are disabled, inasmuch as we are unable to walk and use public transport, feel very strongly that some sort of help should be given to make our more disabled members of society, who are unable to drive themselves as we are with hand controls, more mobile. To give everyone who is a disabled passenger a car would be impossible, as the numbers are so vast. For the disabled person who is earning his living and has managed to buy his own car, surely it is only fair to give that person free tax and insurance for his motor car.

LORD CRAWSHAW

I also want to say a few words in support of my noble friend's Amendment. I believe that here there is gross injustice—and I call it no less—to a most unfortunate section of the community. Those of us who are disabled have spent long periods of time in hospitals dealing with severe injuries and so on. One of the most salutary experiences we have all had is to see the position of those with neck injuries or with bad poliomyelitis which can disrupt the use of their arms and so on. And although one may curse one's luck at times, one realises how fortunate one is compared with that group of people. I do not think I need say any more. I am sure everybody realises the need. I feel most strongly that here there is a great injustice, and it is the kind of area where the power or panoply (as one might call it) of the Welfare State ought to act with massive force.

Also, I want to support the plea that, at the very least, tax exemption should be awarded for disabled passengers' cars. I should like to ask the Minister this question. If we can find a four-wheeled vehicle—and I shall say a little more about this particular point on my own Amendment in a minute—which is no more expensive than a three-wheeler, to which these people are entitled but can-not drive, may I take it that that vehicle will be issued to these people? I wish to support the Amendment.

THE EARL OF LONGFORD

I, too, should like to support the Amendment very strongly. I am not quite sure whether the noble Lord will wish to develop at this stage his point about the nature of the vehicles. If he has a number of points to make about the vehicles he has in mind, would it not be convenient, with the leave of the Committee, to mention them now? It is rather hard to discuss this Amendment until we know what he has in mind. I know he has given a tremendous amount of thought to the matter.

LORD CRAWSHAW

Would it be convenient to the Committee if I took my own Amendment now?

THE EARL OF LONGFORD

It is important to have a discussion about the vehicles; that is really the point. Whether or not the noble Lord takes his own Amendment, I think the Committee ought to know what he has in mind when he is talking about vehicles.

LORD CRAWSHAW

May I explain this? It happened only this afternoon, but perhaps some of your Lordships saw Mr. Graham Hill in the House before lunch. He is keenly concerned and in-deed experienced in this particular matter. Not only is he probably the most experienced driver in the country—a former world champion, as your Lordships know, and a person who has driven many forms of production car—but he has recently been disabled and has been in the position of using one of these three-wheeled vehicles. So he was particularly strong on many of the points he made.

He was worried, as we all are, about the safety aspects of these three-wheelers. He said (and I more or less quote him) that a three-wheeler with a wheel in front is the most dangerous form of three-wheeler, because a car when moving at any speed in going round a corner will tend to roll, as he called it, and throw all the weight on a part of the vehicle where there is no wheel. One knows that there have been many accidents with three-wheelers of this kind. We feel that that design is a relic of the old basket chair in which people used to sit years and years ago, and the matter has not progressed from that stage. Mr. Hill also said that he often drove in the Brighton Rally and he found that motor cars of 1904 were a great deal safer than these three-wheelers. Disabled people, after all, start with a disadvantage, but then they are made to drive a vehicle which is more difficult to drive than an ordinary car. That is the point I wish to make.

Mr. Hill then said, "Surely to goodness we can approach some of the large motor companies"—I do not know; per-haps the Government have. He said, "What is wanted is a four-wheeled vehicle with at least two seats, mass produced by a company such as B.M.C. or the Ford Motor Company, which by being mass produced will be a great deal cheaper that the specialist vehicle which is being issued." He later to-day told me that he had contacted Lord Stokes, Chair-man of B.M.C, and Lord Stokes told him that he was most anxious to co-operate. He is also going to approach the chairman of the Ford Motor Company. We are full of hope that, after all this, we may find there is a four-wheeled vehicle, mass produced, which can be issued to disabled people and costing little more than the present three-wheeled vehicle. That is the argument that I wish to develop again on my own Amendment in a minute; but after what the noble Earl, Lord Long-ford, has said it might help to have it now. I shall be grateful if the Government can first say whether they have been in touch with any of the mass produced motor car companies and, if so, what the results were.

THE EARL OF LONGFORD

May I add a word as to my opinion on the relevance and significance of what the noble Lord has just said? When I came down to the House to-day I expected to be met with the argument that Amendments of this kind would cost a vast sum of money. If the noble Lord, Lord Crawshaw, is right, and Mr. Graham Hill is right, the financial aspect begins to look very different, and I think one must go into that. Even between now and the Report stage I think we might look at that again and submit a case to the Government which would argue in effect that this proposal would not cost any substantial sum of money. This is clearly relevant, in view of the fact that the financial clause covers only the early part of the Bill.

I apologise if I said anything to the noble Baroness that jarred on her. That was not my intention at all. But if I understood her argument correctly she was saying that all these matters are under consideration and therefore it was impossible to accept anything. Up to now, at any rate, she was not deploying the financial argument; she was saying that these matters are in such a stage of thought in Government circles that Amendments, however attractive, could not be considered. That is what I thought she was saying. I hope that is not so, because if that argument were used it would only defeat all social reform. All matters of social reform are always under consideration in all Government Departments, and we happen to have reached a moment in the case of vehicles where no doubt a lot of thought is being given. But I hope the noble Baroness will not press the argument that we cannot even think about the merit of these things because of all the thought that is going on, and I hope she will, at any rate, express an interest in what the noble Lord, Lord Crawshaw, said about the possibility of a much cheaper vehicle than has been considered so far.

LORD RAGLAN

May I reinforce what the noble Lord, Lord Crawshaw, has said about the instability of a vehicle with three wheels, the third single wheel being at the front? It is a most dangerous vehicle. I say that with some consider-able experience of motoring matters over the years. There was a most famous three-wheeler, the Morgan three-wheeler, which many people drove over years. It was a sports car but it had two wheels at the front and one at the rear. It was a stable little vehicle, the only disadvantage being that if you went over one of those cattle grids which consisted of two troughs the third wheel got jammed in the well in between. I know of one car which was broken in half in that way because the man forgot that the car had only three wheels. But the vehicles with the one wheel in front are dangerous, and I hope that the Government, in considering the design of invalid vehicles in future, will bear that point very much in mind.

LORD SANDFORD

May I make one suggestion before the noble Baroness replies to this Amendment? It is that unless she is able to answer it now fully, if this topic is discussed at all at the next stage we might hear a little more about the possibilities of concessions upon the taxation of vehicles and the licensing of vehicles. The proposition that is being put forward by the noble Lord, Lord Crawshaw, about the cheaper vehicle will go a long way to meet that problem if it materialises, but the question of road tax and licences will still remain to be dealt with by the Government.

9.54 p.m.

BARONESS SEROTA

I wonder whether I might deal first with the question of taxation. The noble Lord, Lord Sandford, suggested that we might discuss this at a later stage, but I think this would not be appropriate on this particular Bill. This is surely a matter for the Finance Bill, which is discussed in another place, and it would be for the promoters of this Bill to deal with it in the ways that they find most suitable, when the Finance Bill is dealt with in another place. I do not think that one can discuss these matters on this Bill.

The noble Earl, Lord Longford, seemed a little disappointed that I did not plead shortage of money as a reason for not being able to accept some of these most interesting Amendments. I did of course talk about resources, which is the polite way of talking about money these days— at least I meant money as part of these resources. I accept his point that one achieves social change through great measures of social legislation only after a great deal of social pressure. But one has to know, as a Government, what such change is going to cost. I think our real difficulty at the moment with this particular Amendment is that no-one can estimate with any kind of precision what it is likely to cost, except that it would be many millions of pounds. That is the true position, and it would be less than fair of me if I did not explain that position to the House.

The new clause the noble Lord moved would make mandatory on the Secretary of State his present permissive power, under Section 33 of the Health Services and Public Health Act, to provide vehicles to people who cannot walk and are unable or unfit to drive. That would be the simple effect of this Amendment, although none of us could possibly begin to know what it would cost. Whereas the present Government have doubled expenditure on vehicles in the last five years, I do not think successive Governments over the years have been able because of the cost implications I have just mentioned, to move at all in the direction of providing vehicles for people who can-not drive themselves.

BARONESS DARCY (DE KNAYTH)

In view of the Minister's reply, I beg leave to withdraw this clause, but I hope that Ministers participating in the debate here will convey very strongly to the Chancellor of the Exchequer our hope that he will accede to the Amend-ment—designed to help disabled passengers with the running costs of the motor vehicle—which is to be tabled to the Finance Bill mentioned by the noble Baroness, and published on Tues-day. I want to find out a little more about exactly what is going to be done to help these people, and especially in view of what my noble friend Lord Crawshaw has said, I may consider bringing back the Amendment at Report stage.

Amendment, by leave, withdrawn.

BARONESS DARCY (DE KNAYTH) moved Amendment No. 42:

After Clause 17, insert the following new clause:

Provision of vehicles for disabled mothers of children below school-leaving age

". The Secretary of State shall provide a suitably adapted small car to a disabled driver who is a mother with a child below school-leaving age."

The noble Baroness said: This new clause is again something which I dwelt on in the Second Reading debate, so I shall just recapitulate the predicament of the disabled mother with children below school-leaving age. She is faced with two main problems: she cannot accompany her children to and from school because she cannot carry passengers in her invalid tricycle; and secondly, if she wants to go shopping, she either has to leave her children alone at home or forget about the shopping. It may sometimes be possible for other mothers to help her out, but the disabled mother should not be forced to depend on others in this way. The situation is aggravated by the fact that, if the couple cannot afford a car, the family can never go out together as a unit, and the marriage is placed under additional strain. The following letter sums up the situation very well; it is brief and unemotional: My wife is disabled as a result of polio some 12 years ago. She has a Ministry invalid tricycle which is of great assistance to her, but it has one very serious drawback in that she is unable to carry passengers with her. We have two young boys, aged 5 and 7 years who have to be taken to, and collected from, school each day. I am a police officer performing shift duties, and, consequently, more often than not I am not available to take or collect the boys. My wife has to rely very much on assistance from other mothers, which, although very willingly given, is a constant worry to her. As I am on duty most week-ends, further difficulties arise if she wishes to take the children out.

I should like to remind your Lordships also of the case I mentioned in the Second Reading debate of the mother with the mentally handicapped son. Not only was her life made difficult because she could not leave him alone in the house while she went shopping, but his development was being further retarded by the fact that she could not take him out to experience what was going on in the world outside.

Another aspect of the problem is illustrated by the case of a family with five children. The mother had to have both legs amputated due to thromboses which occurred soon after the birth of her youngest child. She has artificial limbs, but due to heart involvement she has to spend most of her time in a wheelchair. The four eldest children, aged from 3 to 13, live at home. But because this disabled mother cannot look after her one-year old baby, her husband insists on its being looked after by relatives living three or four miles away. The child comes home at weekends, but neither he nor the family like the arrangement. There have been tearful scenes, and the mother has had a nervous breakdown. If this mother had a car she could at least take the child daily to and from the relatives, saving the baby, herself and the rest of the family a lot of unhappiness.

This case emphasises the fact that in this clause we are dealing not with individuals but with whole families. Because the disabled mother cannot properly care for her children the whole family suffers, and sometimes the marriage breaks up. The policeman's wife worries about getting her children to school, and cannot take them out at weekends. The mother of the mentally handicapped son, in addition to having the usual transport problems, feels that his development is being restricted. The mother who can see her baby only at weekends has had a nervous breakdown, and the whole family is under great strain. These are but three examples. There are endless permutations of the problem. I suggest that the position of these mothers is intolerable in a civilised society. I beg to move.

BARONESS MASHAM OF ILTON

I hope your Lordships appreciate that we in wheel chairs have a great deal of pressure put on us by people outside who expect us to speak for them. There-fore, it is for us to put forward their points. I am the mother of an adopted daughter aged 5. She is very pretty, with blonde hair and blue eyes. I live three-quarters of a mile from the nearest primary school. I know that it would be impossible for me to allow her to walk to school. With so many sex maniacs around no mother could rest until she knew that her daughter was safely home. Think what terrible frustration the mother who cannot take her daughter to school must suffer. If I had a three-wheeler in which I was not allowed to take my two children, I do not think that the children would find this acceptable. In fact, to isolate the children from the mother when going out I am sure could damage the children psychologically. I know there are a few mothers in this country who are in this difficult situation. Perhaps the Minister could consider looking into individual cases of proved need and helping to solve this problem by providing them with a small car.

BARONESS SEROTA

I well recall the speech of the noble Baroness, Lady Darcy, on this subject on Second Reading. I think all noble Lords who were present in the Chamber will agree with me that she made a very powerful case for this particular group. It would, of course, involve more expenditure. Noble Lords are no doubt aware that since February, 1967, cars have in fact been provided to parents entitled to vehicles when they are in sole charge of a child —that is, if they are widowed or divorced. Young children are provided for, and in this context we take as a "young child" the age of 14.

The argument for granting a further extension of this category to apply to a mother even though her husband lives at home, is presumably on the grounds that he is normally out at work while the children have to be taken to school and shopping has to be done. The claim for this particular group would clearly involve additional money. But it would not, as noble Lords have indicated, be a very large group, and I can assure the Committee that this is one of the groups which was very much in the forefront of our minds during the current vehicle re-view to which I have just referred.

I think certain Members of your Lordships' House are aware how difficult it is for me personally to resist this kind of claim, and I hope that what I have said to-day is evidence to the noble Earl that when I spoke at the outset I did not in any way mean that our minds were made up about any changes that could be effected in the categories. I was merely trying to indicate to the Committee that I felt this was the wrong moment to legislate for a new category.

THE EARL OF LONGFORD

Perhaps I might just ask the noble Baroness one question—and let me say that nobody, least of all myself, doubts her concern for these people. But, supposing, for the sake of argument, that after the Government review it was decided that these people were going to be helped, it would be far too late to include them in this Bill, and it is unlikely they would be brought into some other Bill brought especially for their own purpose. How would they in fact be assisted?

BARONESS SEROTA

There is no need whatever to have a Bill to undertake extensions to the provision of vehicles. This is one of the things which has puzzled me about this particular discussion here to-night. If the Government were to decide to-morrow to give a car free, to every single person in the country, disabled or not, they would be perfectly entitled to do it if they could find the money. They would not need to legislate in order to increase the categories of people eligible for invalid vehicles.

BARONESS DARCY (DE KNAYTH)

I thank the Minister for her remarks, and I beg leave to withdraw this Amendment, at the same time reminding the Minister that we are penalising whole families and not individuals. I hope that the question of helping these people will be looked into most carefully, and I may consider bringing this Amendment back at the Report stage.

Amendment, by leave, withdrawn.

LORD BESWICK

Certain Members of the House have had an extremely arduous time, and we have come to a point at which my noble friend Lord Longford might feel is a time when we should adjourn. If he agrees, either he or I might move that the House be now resumed.

THE EARL OF LONGFORD

I am very grateful for the suggestion. I know that my colleagues here are indefatigable, but all of us have done our best for about seven hours, and I think it is a good suggestion that we should now adjourn.

House resumed.