HL Deb 10 April 1974 vol 350 cc1235-50

3.30 p.m.

BARONESS PHILLIPS rose to call attention to the Report on Mobility of Physically Disabled People; and to move for Papers. The noble Baroness said: My Lords, I beg to move the Motion standing in my name on the Order Paper. I should first like to express my appreciation to all noble Lords who are taking part in this debate, many of them at some inconvenience to themselves: my three noble friends (if I may so address them) who are sitting immediately behind Hansard; the noble Earl, Lord Snowdon, who is making his maiden speech; and the noble Baroness, Lady Sharp, who has come specially to the House on this occasion. I am deeply grateful to all noble Lords for the interest they have shown in this subject. Indeed, my Lords, we are victims of our own success. So many noble Lords have volunteered to speak that we are going to have to show how disciplined we are, and set a pattern for the House, by no one taking more than ten minutes to make their speech. Noble Lords will watch to make sure that I do not break my own rule.

My Lords, this is a debate about the Sharp Report, which refers to various details concerning about 359,000 disabled people. It seems to me, my Lords, that this debate falls into three divisions: the Report itself, the history of the Report and the action upon its recommendations. I should like to say immediately that I congratulate the Government on the appointment of a Minister for the Disabled. This is something long overdue; and we all know my right honourable friend who will fill that post to be compassionate, and one who is deeply interested in the subject. I should also like to congratulate the Government on publishing the Sharp Report so quickly after coming into office. In the debate on the Unstarred Question which I asked on February 5, the Minister then replying said that the Report was a very complex matter and had all sorts of financial implications as well as implications of eligibility; that the Government were studying it with great care, and that they would eventually publish the Report. He also told us that the motor industry's research association Reports, which are very relevant to this, were never published. Indeed, he said it would not be advisable for them to be published. Now, my Lords, in just under two months (with a General Election intervening, it is true, and a different Government) we have both these reports available, and so the question is much easier to debate in depth.

The terms of reference, according to the noble Baroness, Lady Sharp, herself, were wide-ranging. They covered not only medical problems but housing and mobility in and out of buildings. With such a splendid array of speakers, and with the time factor hanging over me, I have decided to confine myself to one subject. I will not say, my Lords, that I will deal with it "briefly", because I have found that that is quite fatal: anybody who says he will speak briefly is still on his feet two hours later. My Lords, the noble Baroness, Lady Sharp, makes the point very well when she says that it was indeed the difficulties into which the vehicle service had run which prompted her inquiry. Indeed, sonic people who wrote or talked to her seemed to think that this was the only matter with which she had to deal. She makes the point that, important as this matter is, it is not the most important. Now I think I should like to differ from her here. I feel that the situation of the disabled driver is one which is not only vitally important but urgent; and we must take the Sharp Report in conjunction with the details of the tests carried out by the motor industry's research establishment and the Report of the Research Institute for Consumer Affairs.

My Lords, I greatly welcome the main conclusions of the Sharp Report. The three-wheeler is condemned as dangerous, noisy, uncomfortable and liable to break down, and it cannot carry a passenger. Lady Sharp herself says—and I quote: I soon came to the conclusion that it should be replaced by a small car as and when it is practicable to do so.

A three-wheeler, my Lords—and this is a very telling point—costs more than a car. I would only say that I think it a pity that the Report did not go more deeply into the question of safety, as it would then have come out in a more determined fashion in favour of immediate action. If we look at the analysis of some of the 1,300 letters from disabled drivers which were sent in to the Research Institute for Consumer Affairs—and these were not based on structured questions, but were actual accounts of the drivers' experiences and how they saw the three-wheeled "trike"—we see that some 51 users had actually returned their vehicles to the Department, saying that they were unsafe and unreliable. When one considers that this meant that these folk were virtually housebound, I think it shows the force of their feeling.

The type of accidents that were there described range from tricycles being blown over to turning over when braking and swerving, doors bursting open, steering wheels collapsing and in severe cases the tricycle actually catching fire. All "trike" drivers, says the Report, were concerned with the fact that they considered the tricycles unreliable and unsafe, not only to themselves but to other road users. Various words were used to describe them. "Death traps", "Coffins on wheels", were some of the expressions used in the Report. Even if we do not place an emphasis on safety, Lady Sharp has accepted that the invalid tricycle should be replaced by a small car. As I have said, my Lords, she has made the very telling point that the "trike" costs more than a car. A car has an obvious advantage socially, and the majority of people would prefer it. The disadvantage of the "trike"—one of many—is that it cannot carry a passenger. Nor, indeed, can the driver receive instruction except from outside the vehicle.

So I was a little disturbed to see my right honourable friend the Minister for Social Services repeating what the previous Minister had said in a debate; namely, that it would not be doing a service to the many contented users to take away something which gave them pleasure and mobility. Indeed, my Lords, one irate lady wrote to me saying that I was going to take away her "trike". Her letter was, of course, anonymous, as most unpleasant letters usually are. But there is no doubt that there is a certain area of confusion here. I should like to ask what kind of driver could handle this very tricky three-wheeled vehicle, but could not handle a car which had been specially adapted? And, if it is unsafe, should it continue to be used? I remember the debate on flammable nightwear, when it was said that children could literally be burnt if they were wearing these highly flammable nightdresses. The argument then put forward was that there are people who like this type of nightdress, which burns quickly. I would suggest that even if people like it, if a thing is unsafe it is surely not wise that they should continue to use it.

I agree with Lady Sharp that both disabled non-drivers and disabled drivers should be eligible to have a car. Last weekend I met a woman with a completely disabled husband. Equally, I have frequently met husbands with completely disabled wives. In this case, the disabled individual is almost totally housebound. It seems reasonable to suggest that the Government should supply these vehicles; and, indeed, that they should allow some extra grant-aid for petrol costs, and see that all servicing and spare parts are available over a wide area. My Lords, I plead with the Government to-day to take some immediate action on this recommendation of the Sharp Report. It is particularly important at this moment, when the Department is negotiating a contract to purchase more of these three-wheelers for yet another year. My Lords, I would seriously ask what further consultations are needed on this particular point. I appreciate they may need to talk again on the questions of housing, employment and eligibility, possibly, but Lady Sharp has made it clear that the three-wheelet should go—and this after hearing the comments of the people with whom the consultations would take place.

My Lords, let this not be a reason for any dragging of feet. There are estimates of costs given, and there are a number of possible users. But, my Lords—and I do plead here—this is a situation where cost must not be allowed to cloud the argument. The Government must accept the need to stop production of the tricycle. I welcome the statement of intention of the Government to have discussions with the disabled and I recognise the need for such discussions, but that need must not be used as a reason to delay the changeover to cars.

My Lords, I quote the Prime Minister who, in speaking as Leader of the Opposition in October, 1973, said: The problem of the invalid tricycle has been too long deferred. Every question, every representation has been shoved off with the excuse that we must wait for Sharp. Even when we get the Sharp Report the responsibility cannot be shoved off again, the reponsibility lies fairly and squarely with the Government. Exactly. My Lords, I know that the Minister to-day is not going to disappoint me and those brave and energetic people, the disabled drivers, who mounted their own campaign—a splendid exercise in self-help which I consider calls for the Government and all of us to take notice.

My Lords, I beg to move for Papers.

3.41 p.m.


My Lords, I congratulate the noble Baroness on returning once again to this most interesting and important question, and at a very topical moment when the Report has been published. We are delighted to have its author speaking in the debate to-day, and now to have an opportunity to go at the new Government with the same fervour and force as she used to go at us when we were on that side of the House. I wish the noble Lord, Lord Wells-Pestell, every success in replying to her. He has as one advantage on this occasion the fact that the "mobile Bench" are here at only three-quarter strength. I warn him that usually there are present four rather than three. It is also a very great pleasure to know that the noble Earl, Lord Snowdon, is to take part in this debate. We know what a tremendous interest he has taken in this subject, and we were aware that he was with us on the last occasion when we debated it.

It is not a habit of mine to re-read my speeches, but I did re-read the speech I made so very recently and from which the noble Baroness has in fact quoted when saying that I called this, "a very complex matter with a number of financial implications". I do not wish in any way to change my words. I think that in ignoring the financial implications the noble Baroness over-simplifies the position. It is indeed extremely complex. In the first instance, although it is true that a car is cheaper to provide than a three-wheeler, the very fact that it is so attractive would mean that a number of extra people who at present do not apply for a three-wheeler would apply for a car. In fact the estimate in the Report is that twice as many people would apply for a car as at present apply for the three-wheeler, and that means at once doubling the cost of provision.

In the second place—and this is also clearly brought out in the Sharp Report —once you have opted for a car and have agreed to provide a car you no longer have a reason for not providing a car for the disabled who cannot themselves drive. Again you are increasing the number of vehicles you have to provide and increasing the cost of their provision. The noble Baroness in writing her Report obviously saw the logic of this and endeavoured to meet it by producing a set of criteria which would have to be satisfied before a car was issued. These are the criteria in paragraph 48—for getting to work, or to a place of further education or training, or looking after a household. Certainly this proposition is attractive at first sight. Unfortunately its adoption would mean that a number of people who are at present eligible for vehicles would no longer receive them, and of those who at present have a vehicle some 13,500 would lose that vehicle when it was no longer usable. To me this is quite unacceptable. The net result is that the cost of these proposals is really formidable. The proposals suggested by the noble Baroness would cost another £3 million; but if it is unacceptable to leave out others who are at present eligible, then the cost soars to an extra £12 million or more, and we must surely ask ourselves what is the right priority.

The noble Baroness, Lady Sharp, clearly thinks that the provision of suitably adapted housing is a top priority that falls within the scope of her inquiry, and of course quite outside her inquiry there are a number of other problems in the general field of disablement income. Your Lordships will remember that when we were debating the Social Security Act of 1973 a number of these points were raised—an income for the disabled housewife was one; an income for a person who was devoting her life to looking after a disabled person was another. These are also very well deserving causes and all of them, I feel, must be judged together when we are talking about devoting large sums of money to the improvement of our services for the disabled.

Thanks to an Amendment passed in this House, the 1973 Act put a deadline of October this year for the Government to produce a statement of their plans for future provision for the disabled. The Government have made use of this particular provision to say that they will make their decisions on this Report as well as on other matters concerning the disabled at that time. We shall be very interested, if they still are the Government, to hear what those proposals are. Where we are critical in general of the Government's social policy to date is in their lack of discrimination and selectivity in benefits. The money that is available for social purposes is extremely limited. Even at the time when we were achieving a growth rate of 5 per cent. we never had enough money to do all we should have liked to do. Money is in very short supply, and it is surely unfair to those people who really need money and financial support if it is wasted on those who do not require assistance; and yet the Government are going ahead with some £500 million of food subsidies and with a rent freeze, all of which will help rich and poor alike.

The noble Baroness, Lady Sharp, suggests that at least the provision of cars, or cash allowances in lieu of cars, should be subject to a means test. I should like to know whether the Government have made up their mind on this point. I believe the suggestion is right in principle. The noble Baroness points out that there is some difficulty in applying it in the case of cars rather than cash allowances, but I should have thought that a scheme could be devised which would be fair and would mean that people who already have a car and are quite well off would not be subsidised, while those who really needed one would get the benefit.

My Lords, the other question that I would like to ask is whether the Government have given any consideration to the practical implementation of the provision of cars. Would it really be possible to provide 40,000 cars within any reasonable time scale? How quickly could they be provided, and what would happen in the event of switching to cars, to the supply of three-wheelers? Surely it would no longer be economic for producers to continue to manufacture three-wheelers, and we might well find that three-wheelers would go out of use. Although the noble Baroness might like that, because she alleges it is not a safe vehicle, I know of a great many people who depend on the three-wheeler and who very much appreciate it and could not use cars. There are those among the war pensioners who opt for the three-wheeler rather than the car. This proves my point.

My Lords, I have to watch the clock, and as I have one minute to go I will mention briefly the other problems of mobility on which the noble Baroness touches in Part III of her Report. First of all, in the medical field, may I say how very glad I was to see that the initiatives of my right honourable friend Sir Keith Joseph in the realm of rehabilitation have been recognised. As part of them, he set in train negotiations on the future of the rehabilitation professions, the physiotherapists, the occupational therapists and the remedial gymnasts. I do not know whether the noble Lord can say anything about the progress which has been made on those discussions. I should be most grateful if he could do so.

Finally, I was very pleased to read the tribute which was paid to ALAcs—the artificial limb and appliance centres. They have come in for a great deal of criticism one way or another in the past, but this Report pays them a tribute which, as I say, I was very pleased to read. Now, my Lords, my time is up. I have a great deal more to say, but I am afraid I ought to stop now.

3.53 p.m.


My Lords, since this is the first time I have had the privilege of addressing your Lordships' House, I ask for your usual indulgence. I am, needless to say, extremely honoured to be given the chance to speak here to day on a subject whose problems have concerned me over recent years. The most commendable Report of the noble Baroness, Lady Sharp, has reminded us that there are almost 1¼ million adults in this country whose disabilities severely handicap them. That means that one in every dozen or so households is intimately concerned in their problems, sharing the frustrations of a world not built, and a society not adjusted, to let them be wholly a part of it.

Of course, progress has been made and attitudes are more generous than in the days of Charles Dickens. The recent appointment of a Minister for the Disabled—the first, I believe, in the world with sole responsibility for that part of our community—was a most heartening and enlightened step forward. I hope that this office will endure and that other countries will follow this lead, for obviously the problems are international as much as national. But there is far to go before the humane ideals which inspired the Chronically Sick and Disabled Persons Act of 1970 are adequately met. They demand, and we must still demand, no less than the dignified integration of disabled people into our lives, and us into theirs, whenever and wherever that can be achieved. This means far more than just providing ramps for wheelchairs in our public buildings, more than providing extra accommodation in places of entertainment or quotas of stairless, stepless houses in new housing schemes, or specific proportions of disabled people in every work force. All that and other necessary points dealing with schools, recreation and other services were, of course, covered by the Act; but real needs go much deeper.

How can we assure the acceptance of disabled people, and their needs and rights, by the rest of the community—not merely as a charitable burden but as an unpatronising, unself-conscious, automatic act? When I say "by the rest of the community" I mean by all the rest of us: not the young, whose record in this field these days is better than ever before, but by the adult population; by the sort of unsympathetic managements who, despite the Act, still discriminate against handicapped people and ban wheelchairs from their cinemas, theatres, exhibition halls and stores, using their own unsolved fire precautions as their excuse; by such administrators of our social services as treat the disadvantaged as a nuisance; by those who put disabled people all in a coach together and then well-meaningly label them as though they were a circus act; by anyone who isolates the handicapped in any way or lets them feel that they are less than full members of society or robs them of the right to be anonymous. These, my Lords, are the people who must be taught.

Disabled people have enough problems. They do not wish to complain, or be made exceptions of, or to be granted favours. They need the same facilities to go where they want when they want, and not only in groups on certain days. That is why they have to be met more than halfway, not only by the Government and the Department of Health, but by all of us. We have still, in 1974, in spite of Section 1 of the Act, urgently to identify the needs of the disabled. We still have not done nearly enough research in consultation with them, as opposed to laying down the law for them. It seems that what is needed for the disabled—as indeed for the aged, too—is an all-out communal effort to discover, again in consultation, what they do not have, so that they may be given it.

This debate is about their mobility. The Department of Health does not even know with any exactness how many people need specialised, as distinct from adapted, cars. We do not know, and neither do all disabled people, what their rights are, what technical aids are available and what financial aid they may claim. Is there not something wrong when disabled people form themselves not just into social clubs or advisory bodies—that is fair enough—but also into pressure groups? I should like to see every regional authority in the country running central local showrooms equipped with all the latest appliances, devices, designs, prototypes and information which make a disabled life easier, whether for the home or for mobility out of doors. These showrooms should ensure a two-way exchange of ideas designed equally for the encouragement of the disabled as for the enlightenment of everyone else.

My Lords, nowhere, to my mind, have the attitudes which must be altered shown themselves to worse advantage than in the matter of invalid motorised tricycles. Their social shortcomings are recognised in Lady Sharp's Report, though, loneliness apart, more might have been made of the medical risks to a disabled person forced to travel solo. Her conclusion that four-wheelers should be substituted for the tricycles seems incontestable. The outstanding question is: when will the phasing-out start? It is also essential that nobody now mobile is made immobile.

Last month the Secretary of State for Health repeated once more that, and I quote: … there are no reasons on grounds of safety alone why the three-wheeler should be withdrawn". The basis for this judgment was the short and entirely inadequate series of MIRA tests last year. In a front impact test the present model burst its petrol tank (mounted over the driver's knees) and buckled at the sides. In the wind gust tests, it slewed from a true course by twice the recommended amount. Are these grounds for declaring the present production model safe—let alone for giving a clean bill to all 20,000-odd tricycles of all models now on the road, any one of which would have its chassis over-ridden if in collision with virtually any other type of vehicle, with possibly disastrous consequences?

The tricycle is still being produced, and it is made largely of foreign parts—unstable, easily upsettable, unreliable, flimsy, inflammable; still without a jack or spare wheel; without bumpers, without an anti-roll bar; with the petrol tank still just in front of the driver, the interior bristling with sharp levers, its steering column non-collapsible, the internal noise insupportable, and with its perfectly appalling accident record.

My Lords, this is the vehicle for the disabled. They are not given the choice of a safer car. It may be driven by a paraplegic or someone suffering from the progressive deterioration of muscular dystrophy, so of course it matters if it reacts to a cross-wind by an average of 100 per cent. more than it ought to. The direct steering of these trikes is, as your Lordships may know, so sensitive that the tendency is to over-correct any sudden swerve at the best of times. That is bad enough, but the end will be calamitous if, as has often happened, the seat comes adrift without warning and slides violently sideways.

Who can blame the driver if, when that sort of thing happens on a bend, he panics and, voluntarily or involuntarily, brakes hard? This one does by pushing the handlebars downwards. The chances are that the tricycle will turn right over, and with the wind to help such a thing is even easier. The swerving tests at Cranfield last summer were abandoned for fear of an accident. The model 70 can travel as fast as 60 m.p.h. But, my Lords, I have myself turned over in one travelling at less than 20 m.p.h. In my case the petrol tank did not burst, but petrol poured on the ground and I was unable to get out unaided.

Nothing will convince me that this lethal machine is intrinsically suitable for a disabled person, or that its production should be allowed to continue for a moment longer; and, least of all, the argument which I have heard deployed by the Department of Health, that its instability induces greater caution in the driver and therefore promotes greater safety in its use. A Departmental public relations officer I spoke to had never had time to drive a tricycle; a Departmental engineer claimed to have found it absolutely safe when overtaking lorries in the fast lane of our motorways, and an administrator at the Department advised me to "lay off this safety lark". Another official told me that as I was not disabled I was not qualified to pass judgment on a car designed for the disabled.

It has been stated that the organisations for the disabled are to be consulted before changes are made and that we must hear in mind the report on social security provisions for the disabled next autumn. My Lords, I can already see delay mounting up before the trike is replaced by a real car—before replacement even starts. We know that thousands of small cars are going to be needed, irrespective of how the new criteria for their ownership may be defined, especially if we are changing over to an all-British vehicle. Could not the decision to order them be taken at once, so that by the time we have finished arguing about who is to have them some, at least, will be ready? I thank your Lordships for listening to me so patiently.

4.3 p.m.


My Lords, it is a very great pleasure and privilege to follow the noble Earl who has just made an admirable and humane maiden speech; I hope it will be one of many in your Lordships' House. The noble Earl, Lord Snowdon, might have been siting on the "mobile Bench" with us in a wheelchair, for the noble Earl has had polio. He gives great encouragement to thousands of disabled people and their helpers, and encourages others to help. I thank the noble Earl, Lord Snowdon, for this interest.

I also thank the noble Baroness, Lady Phillips, for instigating this debate. It is such a pity that some noble Lords who would have liked to speak have not been able to do so because of shortage of time. I also thank the noble Baroness, Lady Sharp, for having undertaken her mammoth task. The noble Baroness states housing to be the first necessity for the disabled, but for a young person who becomes a prisoner within a house this might be worse than death. With Chairs of Rehabilitation at Edinburgh and Southampton there is at least hope that rehabilitation in the British Isles may at long last reach a higher status in medicine than it has in the past. Housing and mobility are part of a fully comprehensive rehabilitation programme. This should be the right of all disabled people so that they may have the opportunity to develop to their full potential.

I hope mobility for the disabled will remain under the Department of Health and Social Security, and that the Government will take counsel from all the medical staff in charge of the physically disabled before considering transferring responsibilities. Paragraph 143 of the Report worries me. It reads: This could best be provided by empowering officials to decide applications for cars, after review of the personal circumstances. Disabled people are very often frightened by officials and officialdom. They have often suffered many indignities due to their disabilities. Is this humiliation going to continue for the rest of their lives? If the Government can find a way to supply mobility other than by way of the means test I think it would be much more acceptable. If in regard to the supplying of cars to the disabled, the means test is used, might not the Government be penalising the industrious, decent workers who are worried if they do not have something in the bank to fall back on, yet be rewarding the dodgers?

The noble Baroness, Lady Sharp, has said that there have not been many complaints about wheelchairs. I would query that statement. May I ask the Government thoroughly to examine this aspect and to consult the disabled users and the medical experts as to which chairs they find most acceptable? As the noble Baroness, Lady Sharp, has said, it is essential that children's needs are reviewed as they grow. I had the pleasure of opening a lovely special school in Barnsley a few months ago. Some of the children there were acutely disabled. The school had the most excellent facilities. Two physiotherapists were needed to give the children the necessary treatment. It has been impossible to get even one part-time physiotherapist. The physiotherapists are the people who are most able to make disabled people, children or adult, mobile. Can the Government do something to encourage more of these vitally needed skilled therapists?

For disabled people who cannot drive a car or a tricycle an outside chair is often their last hope of independence. I am delighted to hear the Departments are working on the design of one. When a desperate lady wrote to me from Cardiff saying that she longed for an outside chair I was lucky to find two voluntary societies who raised the money and bought her one. She wrote afterwards to me saying, "I feel like a bird let out of a cage." And at Christmas she wrote again, saying what a wonderful summer she had had of freedom from being housebound. She was ecstatic about all the things she had done.

There does not seem to be an emergency breakdown service at week-ends for people living alone and depending on indoor powered chairs. A community worker told me he found the disabled lady he took out once a week from her high-rise flat dragging along the floor on her hands and knees. The powered chair had broken down; he could find no agency able to repair it. I have also heard from several people that there is a long delay in repairing electric chairs. On Sunday I heard of two in Halifax which had been waiting for six months.

In paragraph 115 of the Report the noble Baroness mentions dropped kerbs—a very important point. I wish the noble Baroness had mentioned the way a door to public conveniences is hinged. I have found very few which I have been able to shut behind me. I should like to take this opportunity of paying a tribute to the many porters who help disabled people in and out of trains. With the new swinging doors inside the corridors this is not easy. We could not do without this sort of manpower. If turnstiles and turning doors could be discouraged this would help mobility not only for chairs, but for ambulant people walking with crutches who often find them dangerous. I agree with what the noble Baroness says about war pensioners, but I should like their preferential treatment extended to the police.

My Lords, I am pleased the noble Baroness has been in favour of the four-wheeled car as a more satisfactory vehicle for the disabled. I think public opinion was the basis for this Report. The public feel uncomfortable when they see the familiar little blue three-wheelers broken down, pushed into the side of the road, with a stranded, lonely figure inside. Before I had a car, I drove a tricycle, which constantly broke down. I knew only too well all the disadvantages of those vehicles. But all the same, I would rather have a three-wheeler than nothing. What frightens me in what Lady Sharp has said about those who would or would not be eligible for a car is that some people who now have a tricycle would have nothing. The public would not know. The disabled people would be shut away out of sight in their houses. This would be cruelty personified. I hope no Government will ever let that happen. It is a pleasure to allocate something useful, but to tell someone they can no longer have their one bit of freedom, which has almost become a part of them, would be almost as bad as carrying out the death sentence. There still seems to be a place for the tricycle—for those who cannot manage a car, or for those between sixteen and seventeen who are permitted to drive them. Your Lordships will know this to be a most sensitive age, when young people need independence from their parents. They may have to reach work or further education.

My Lords, the disabled passenger also needs assistance. So often he needs more help and seems to get less. This matter is so much more complicated. A mobility grant scheme for them seems to be the most suitable. No disabled person is similar to another, nor are their circumstances the same. But all chairbound people have one thing in common, be they a disabled driver or passenger: they are all hit hard by rising prices, especially of petrol. Their mobility is no luxury; it is an essential of life. When dealing with this vital necessity I hope that the people with mobility problems will not be lumped together as "the disabled", but will be grouped according to their disabilities and their individual needs.