§ 3.11 p.m.
§ Baroness SHARP rose to call attention to the generally unsatisfactory character of the invalid car and to the uncertainties surrounding the future of the vehicle service for physically disabled people; and to move for Papers. The noble Baroness said: My Lords, I beg to move the Motion standing in my name. It seems that for years now we have been talking about the invalid car, which I will call the "trike"—the car which the Government provide for the severely disabled —but we do not seem to get any further. It is a long time ago since the Department first became very uneasy about the trike. They knew it was not satisfactory and they were getting more and more unhappy about it. What brought things to a head was when it became clear that the ordinary car, adapted to be driven by a disabled person was cheaper than the trike, and most of the drivers of the trikes were clamouring for it. But, there are difficult administrative and financial problems involved in substituting the car for the trike. So nearly three years ago the then Minister asked me if I would look into the whole problem of the mobility of the disabled. What this really meant was the trike.287
§ As your Lordships know, I concluded that the trike had to go, not suddenly overnight, but phased out gradually and replaced by small cars as and when it was practicable to do so. But if the cost of this was to be kept within bounds some very tough decisions had to be taken about who should have the car and on what terms, and these the Government have so far felt quite unable to make. What the Government have done is to decide to provide a mobility allowance of £4 a week for severely disabled people between the ages of 5 and 65. They estimate the number to be about 150,000. This allowance was something I had always hoped to see, but it was beyond my terms of reference. It will be of great value to many disabled people, and I am sure it is warmly welcomed by us all. But it does not solve the problem of the trike. The Government are still stuck with that; partly because they have said that the trike is to be retained for all who prefer it to the £4 allowance, but even more because there are many disabled people who simply must have a vehicle of sorts if they are to live independent lives— people who cannot afford to buy themselves a car, not even with the allowance. If the trike is all they can have, then the trike is what they will have to take, and the trike will be always with us.
§ This brings us to the question: how bad really is the trike? Is it tolerable that severely disabled people who really do need a vehicle of some kind and cannot afford a car should be provided with this machine? I do not think it is. First, there is the danger involved. We have heard a good deal in the House about this aspect, and there are noble Lords who are much better able to speak on it than I am. But I do not think there is any real doubt that the trike is dangerous. The Government initially took the line that there was not much wrong with the trike, apart perhaps from some minor design faults which could be remedied; but they have been steadily retreating. They have now reached the point where they admit that its safety is "not as good as we would wish"; a meiosis if ever there was one. I am no expert on this, but there really is no doubt about the danger of the trike. Whether, as some would claim, it is the most lethal car on the road, I do not know, but I think it is getting on that way. In a high wind it is 288 obviously a murderous machine; it is more liable to skid and overturn than a four-wheeled car, and it must be very vulnerable to impact. This is the vehicle that we provide for people who cannot walk. Imagine what it must be like to be imprisoned in an overturned car and absolutely helpless to do anything!
§ So much for the danger. There are other great disadvantages. The trike is uncomfortable; it is very liable to break down; and there is constant difficulty over repair. Perhaps these are faults in design which could be remedied, although presumably this would add to the cost. But nothing really can dispel the unsatisfactory nature of a vehicle which began life as a bath chair, is now propelled by a quite powerful engine and is loosed on roads carrying the traffic they now do.
§ I should like to say just one word about the repair problem. Trikes, of course, have to be repaired at special garages, approved garages which understand them and which carry spare parts. Necessarily there cannot be many such garages; and disabled drivers tell me, and told me all through my inquiry, that getting repairs done could be a nightmare. I heard often how much the disabled wished that when in trouble they could go to the nearest garage, or to the garage of their choice, as the able-bodied can. But while they are condemned to the trike that is not possible.
§ Last, but by no means least, there is the loneliness involved. As your Lordships will know, trikes cannot carry a passenger, so that the severely disabled must travel alone. For many I believe this to be the bitterest thing of all. It has the added disadvantage that the trike driver cannot be properly taught to drive and cannot properly be tested because no one can drive with him on the roads. I suspect that many trike drivers set off on their driving career very ill-equipped.
§ But what are the views of the drivers of the trikes? In spite of all the defects, I think the Government may say that many of the trike drivers like their trikes and beg the Government not to get rid of them. I am sure that some have done so. Some have written to me in these terms. In all the talk about danger, in my report which suggested that the conditions of eligibility for the trike had to be reconsidered, and with the promise of the mobility allowance, many of the 289 trike drivers must be in great doubt about what is to happen to them.
§ Despite all its defects, of course, the trike has been immensely valuable to people who drive it. It is their only key to mobility, and they must be anxious to make certain that they do not lose it and get nothing in its place. The real question must be: what would be the reaction of the trike drivers if they were offered a small car adapted so that a disabled person could drive it? Is this the question that has been put to them? I do not doubt that if it were there would be a lew who would prefer the trike; a few who would be afraid that they could not drive a car or that a car would be more expensive to run; a few whose disability makes it difficult for them to drive a car or, perhaps, even to get into a car which could be driven by somebody else.
§ But I do not believe there would be one in ten of the present trike drivers who, if given the choice between trike and car, would choose the trike. Of over 7,000 war pensioners who had the choice, less than 3 per cent chose the trike. It is quite true that there are differences between war disabled and civilian disabled—there are differences of age, of sex and, to some degree, in the type of disability—and I think it is fair to say that these differences probably mean that a rather higher percentage of civilians would choose the trike. But I am still quite sure that only a very small minority of trike drivers prefer it to the car. They prefer it to nothing, but that is a different matter.
§ Then why do the Government cling to the trike and continue to produce it? I should like to ask the noble Lord how many trikes are to be produced every year. Of course, the reason why the Government stick to the trike is that if cars were provided and the rules about who gets a vehicle remained the same —except that it could no longer be insisted that the vehicle must be driven by the disabled person—then the demand for a vehicle would be enormously increased. The trikes are self-limiting; that is their charm. They must be driven by the disabled person, but a car need not be. On this, at least, I think we are all agreed; if cars are provided, they must be available as much to those who do not drive as to those who do. I should think that would be 290 likely to increase the demand three or four-fold. I hope the noble Lord will agree that this is the only stumbling block in the way of substituting a car for the trike. I hope he will not try to maintain that the trike is not really so very dangerous and that many of the disabled prefer it. As I have said, I do not doubt that there are a few who would prefer it, even given the choice.
§ My Lords, one of the problems, certainly, is whether it would be practicable to maintain the specialised vehicles for the few. I am doubtful about this, but I am not an expert. It may be part of the price that has to be paid for getting rid of the trike, but it is not a reason for forcing the trike on the great majority of disabled people who would prefer a car. After all, there will be those who do not want the car, or who simply cannot manage it, and there will be the allowance. Let us get it quite clear that the only reason for keeping the trike is the size of the demand for cars.
§ May I remind the House that when the right honourable gentleman the Prime Minister was Leader of the Opposition, he said that if this were the only reason for keeping the less satisifactory three-wheeler, it would be unacceptable. He said that it would mean rationing, not on the basis of need but on the basis of inferiority. This is exactly what is happening. It is unacceptable but, nevertheless, the problem of cost is a real one and we have to think about it even more now that the Government are committted to about £15 million a year for the mobility allowance. I do not think for a moment that the Government can be expected simply to provide the car in place of the trike, while accepting the disabled passenger as eligible along with the disabled driver.
§ What, then, should be done? First, I should like to ask the Government whether they really believe in providing a vehicle service at all now that they have the mobility allowance, or are they carrying on with it only because we have it? Do they perhaps hope that given the allowance, and if they can only stick to the unloved trike, it will in time fade out? Or do they accept that there is a good case for helping some severely disabled people to get a vehicle of their own? For my part, I am convinced there is such a good case. We all know that 291 there are some among the severely disabled who can live independent lives if they have their own vehicle, and who cannot if they do not. There will be others speaking in this debate who can give testimony to this. Would we not all agree that we ought to see that these people can have the vehicle they need, even if it means helping some to a greater degree than others.
§ My Lords, if the Government agree that it is right to provide vehicles for some, that we should envisage this as a permanent part of the provision for the disabled, then they must clearly accept the car sooner or later, and the sooner the better. This means that the Government must determine new priorities. They are committed to the present trike drivers; I think all of us would agree with that. It does not have to be a trike for ever and ever, provided that in one way or the other the existing drivers are kept mobile. But for future applicants there can be new rules limiting eligibility to those whose need is greatest. My suggestion was that those who need a vehicle of their own to do a job, to maintain their families, to maintain their households have the greatest need. I still believe this is the right criterion, given that, unhappily, one has to choose. But if anyone has a better way of making a distinction, I shall be delighted.
§ Whatever is done the Government may say, even if they bring themselves to make the choice, that the cost is still too high. In my Report I calculated—and, admittedly, it had to be a guess—that, on the suggestions I made, there might be about 50,000 people eligible for the car that I was suggesting, as against something like 35,000 who now take the trike or the allowance in lieu; though there are far more than 35,000 who would be eligible for the trike if they chose to take it. So that, overall, there would be more claiming the car, although one must remember that the car is cheaper.
§ My Lords, I believe—and I have changed my mind since I wrote my Report—that the right course would be for the Government to provide only such help as a person needs in order to get a car. It might be by way of a loan—and I think there are some countries in Europe 292 who do it in that way—it might have to be a grant towards the cost of the car; or, in some cases, certainly, it would need to be the whole cost of the car, although the Government need not pay all. I suggested that it was the car itself that should be provided; I was anxious to be sure that the disabled were getting a sound car and at the lowest possible price. I have changed my mind on that. I think the help should be provided as the disabled people themselves have always wanted, by some form of cash grant towards what the person needs.
§ We must realise that there are many among the disabled who simply cannot afford to buy themselves a car, even with the aid of the new allowance, and even if they are earners. The disabled are not, as a rule, very high earners. They must have a sound car. As some of us may do, they must not rush off and buy a secondhand car and hope for the best; they cannot afford to take the risk. They must have a sound car. Many must be helped; otherwise they have to give up any idea of earning their living, of maintaining their independence.
§ My Lords, if the Government would do both of these things, would change the rules for new applicants and limit help to those whose need is greatest and to what each applicant needs, then I do not believe the future cost of the vehicle service would be very high once the claims of those existing trike drivers, who might not be eligible under the new rules, began to diminish. It is difficult to make an estimate but it would be no higher, I suggest, than the present vehicle service. In short, I do not think cost has to be a bugbear if the Government face the decisions involved.
§ I am aware that what I have proposed, with its discretionary administration and decision case by case, would raise very great administrative problems involving a case by case judgment. I would make a shrewd guess that my late colleagues in the Civil Service would say, "We cannot do this". But I can tell your Lordships from my experience that once the Government make up their mind about what they want to do, their servants will find a way to do it, and it is worth an enormous effort to get rid of the trike and to solve the problem of the vehicle service once for all. I beg to move for Papers.293
§ 3.28 p.m.
§ Lord ABERDARE
My Lords, I should like to thank the noble Baroness, Lady Sharp—I nearly said "noble Dame"—for having introduced this debate this afternoon on which she is such an expert. It is a matter which is very difficult to resolve. I should also like to start by expressing great sympathy with the noble Lord, Lord Wells-Pestell, who has been in action every day this week, hour after hour, with the Children Bill to start with, then yesterday the Social Security Bill; now he is involved with this very difficult question—I shall be "having at him "again later on when we are discussing the Elizabeth Garrett Anderson Hospital—all of us demanding in one way or another that the Government should spend more money on our pet causes.
To my mind, the whole question of providing cars in place of three-wheelers is a matter of money. There can, surely, be no doubt at all in anybody's mind that a four-wheeler is safer than a three-wheeler, for very obvious reasons, and that a car has the great additional advantage of allowing a passenger to be carried. That not only helps the disabled person, who can then do a good turn to somebody else by taking them as a passenger, but it also means that a disabled person who is unable to drive has some form of transport. But the trouble is that to make any such very desirable change would cost many millions of pounds, and the question that the noble Lord, Lord Wells-Pestell, has to face up to is whether this extra expense can be justified against the many other needs of the disabled and, indeed, the many other demands on the social services as a whole.
Personally, I do not agree with those who allege that the three-wheeler is so dangerous that it should be taken off the road. I do not believe that such allegations have been proved, and I believe that, if properly used, the three-wheeler gives good service. In fact, I should go further and say that those who are too loud in their condemnation of the three-wheeler do a disservice to many disabled people who have to use them.
I am sure that it is right that disabled drivers with three-wheeled cars should realise that this vehicle—like any other three-wheeler—is not as stable as a four- 294 wheeled car. It needs to be driven with greater care. But I think it wrong to cause panic by suggesting that this vehicle is too dangerous to use on the roads. Were the three-wheeler to be hurriedly withdrawn, considerable hardship would be caused to many disabled drivers who have come to rely on it, and to some who are, in fact, not able to drive cars. It would surely be quite impossible to replace three-wheelers by cars in a short space of time.
So what is the answer? The noble Baroness, Lady Sharp, gave one answer in her Report—although she has somewhat modified her approach today— which was to issue cars in future to priority users, broadly defined as those who need them for work or to continue education. But the drawback of that proposal is that there are many categories of people who are at present qualified for an invalid car but who would no longer qualify. Certainly I would find that very hard to accept. I do not think that the Government would accept it. I do not think the disabled have accepted it, and I do not really think it to be practical politics. I also have very considerable doubt about the practicality of the suggestion that she put forward today of each case being considered on its merits. I have grave doubts as to whether this really is a practical way of proceeding, and whether there would not be so many anomalies as to make it unworkable.
The Government have given another answer, and that is to continue to issue the three-wheeler and to give a mobility allowance to all those with restricted walking ability. In many ways this has great attraction, in that it makes the mobility allowance available to those who need help regardless of whether or not they can drive a car. But at £4 a week, this is not likely to enable many people to buy and run their own car. I wondered, as the noble Baroness has also suggested, whether the Government had given any thought to the possibility of providing interest-free loans to those who qualify for this mobility allowance to help them to buy a car over a period. May I ask the noble Lord to confirm that the mobility allowance will be introduced in 1975–76, and, if so. when we may expect the relevant legislation to be ready?
295 Our position—as expressed in the Election Manifesto—was that we thought it a minimum aim to ensure that all those who were qualified for three-wheelers should be able to exchange them for cars if they wished to do so. That was taking the same criterion as exists at present for the issue of a three-wheeler, but allowing a car to be an alternative choice. That was the policy we had in mind. Of course, the situation has now changed and it is likely that a mobility allowance will be introduced. I should think that, once that is done, it would be unthinkable to return to the present system.
In my view, future progress would be more likely to lie in the direction of improvements in the rate and conditions of the new allowance rather than in the direct issue of cars. But, of course, any such improvement would cause a further large demand on national resources, once again raising questions of priorities with regard to other needs. I began by sympathising with the noble Lord who is carrying such a heavy burden of Government work, but I have no sympathy with the Government themselves in facing up to the problem of the provision of cars instead of three-wheelers. They were loud in their protestations at our delay in so doing, and they were the first, when in Opposition to condemn the three-wheeler and demand its replacement. They now sing a different song of £4 a week and keep the three-wheeler. It is one thing to call for increased benefits in Opposition, it is quite another to put them into practice when in Government.
Nor have the Government been very generous with the petrol allowance for those who drive an invalid vehicle. It has been increased to £10 a year from the 1st January last, but how far does that go at the present price of petrol? Can the noble Lord tell us what a three-wheeler does in miles per gallon and therefore how many miles the £10 represents? I wonder whether they have in mind any increase to keep this figure more in line with the tremendous increase in petrol prices. My Lords, there is a great head of steam behind the campaign to replace the three-wheeler by a car, and the Party opposite, in Opposition, added to that pressure. They have only themselves to blame if they are now in danger of causing an explosion.
§ 3.39 p.m.
Lord WALLACE of COSLANY
My Lords, in addressing this House for the first time may I crave your Lordships' indulgence, the traditional indulgence given to innocent victims like myself making the traditional first speech. However, in some sense, for me it is a reincarnation, because in point of fact on the 16th February 1946, I made my maiden speech in another place, in fact in this Chamber, when your Lordships so generously gave haven to a bombed-out Commons. It was in fact on the occasion of the Second Reading of the National Insurance Bill. The theme of the debate in 1946 was the need to assist the less fortunate members of society and to give protection and help to them and their families, and this, I feel, is in fact the underlying theme of the debate this afternoon. May I respectfully congratulate the noble Baroness, Lady Sharp, and thank her for giving us the opportunity to debate such a vital social issue.
For all the limitations and faults of the invalid car, there is no doubt whatever that their issue under the present scheme has provided the great blessing of mobility and access to employment. Mobility by such means in turn gives independence and, indeed a most important factor, a feeling of usefulness to society. While I have admitted the value of the present vehicle, let us face the fact that it tends by its very appearance to classify the disabled person. Many of us have shared the frustration of those who long for a vehicle but marginally are not qualified. Those of us who have represented our people in another place and met them at weekends have known many such cases. Of course there must be rules under which provision is made, but I have often felt, and still feel, that those rules have been too tightly drawn.
On Friday last—and this, my Lords, was the reason for my intervening today in a maiden speech—I was privileged to give a little film show at a club for the handicapped. As your Lordships will have noticed, by far the biggest problem was the collection and dispersal of members; and indeed, but for the invaluable help of the British Red Cross Society, such a gathering would not have been possible. May I say in passing that it was a most exceptionally cheerful afternoon.
297 With the Motion of the noble Baroness in mind, I sounded the opinions of some of the club members on the standard vehicle, and the reaction can be summed up in the words of one lady: "Don't think I'm ungrateful, dear, but a converted Mini would be lovely and comfortable. "I must say that the able-bodied volunteers helping at the club were very forthright in their condemnation of the present vehicle. What many disabled people long for is the means of having their wives or husbands with them, together with their children, and not to have their mobility partially negatived by single isolation. Perhaps there should indeed be a choice, as the noble Baroness has said. One reason why I make this comment is that I have been to a number of football matches, particularly at Carrow Road in Norwich, and have there seen many of the disabled single vehicles around the football pitch; but, of course, if the other vehicle was made a standard issue it would not be possible for those keen followers of football to attend the matches in their present vehicles. Another point which I think is vitally important is that handicapped mothers with children long for the opportunity to take their children to school and to collect them, rather than depending on a neighbour.
My Lords, underlying all this is that longing for independence, which handicapped people want and can have if we give them the means. This is a notable desire and one that we should bear in mind. I am a pedestrian. My family tells me that I do not have an 10 high enough to learn to drive a car, but that is not quite true. However, as a pedestrian and not a motorist, I do not feel qualified to comment on the technical advantages or disadvantages of the present standard vehicle. But many times I have experienced the feelings and frustrations of the handicapped with families, and for them a converted four-wheel car is a dream that does not often come true.
Of course, as the last speaker from the Opposition Front Bench has said, the question of cost arises. Every time one asks for reforms the question of cost arises. I agree, that this is a difficult time to think about incurring additional costs, but I put this to your Lordships' House: is it a case of "cannot afford it or 298 go without"? To me the question is one of human priorities. Some time ago at an international conference in Delhi I said that I would rather solve the problem of world poverty than fly to the moon. This rather disturbed the civil servant in charge of us, representing the Foreign Office, because he thought I would upset the Americans and the Russians. But in this world of ours we have responsibilities one to another, and that sense of priorities, of human values, I submit with respect, applies to our debate today.
§ 3.46 p.m.
§ Baroness MASHAM of ILTON
My Lords, it lies with me to congratulate the noble Lord, Lord Wallace of Coslany, on his excellent maiden speech. He has illustrated to us his great understanding of the need for mobility and the united family, which I feel is so very important, and I personally was highy delighted to hear him mention the Red Cross, as I am myself a member. I hope we may look forward to his further support in this matter on many other occasions, and hear him speak regularly.
My Lords, I seem to have been speaking in your Lordships' House on several occasions lately and I hope your Lordships will bear with me once more. Like the noble Lord, Lord Aberdare, I should like to congratulate the noble Lord, Lord Wells-Pestell, on the enormous amount of work he has been able to cope with in the last few weeks. When the noble Baroness, Lady Sharp, asked the Starred Question on this subject a short time ago, there was; great interest from all parts of the House; therefore I thank the noble Baroness for her persistence in giving your Lordships yet another chance of discussing this serious matter, and I hope that some of the uncertainties will be made clear today by the noble Lord, Lord Wells-Pestell.
Many disabled people have been greatly worried at the increase in the VAT on petrol and the ever increasing price of petrol, but the Government announced on 21st November last year that £10 a year would be paid to all drivers of petrol-driven three-wheelers and cars supplied by the Health Department. Also, the Government are introducing the £4 a week mobility allowance for those who do not have Ministry vehicles. May I ask the Minister to make absolutely 299 clear who will qualify for this new mobility allowance?
The Government are to be thanked for those allowances, however small they may be. As your Lordships will know, there is great concern on the part of the general public over the continued use of the three-wheel tricycle. The greatest concern among many seems to be the fact that several disabled people drive alone and often cannot get help when the vehicle breaks down, which is a very common occurrence. But abolishing the invalid tricycle overnight and replacing it by a small car would not solve all the problems, though it would help with some of them, as has been so ably stated by the noble Baroness, Lady Sharp. I should like to ask the Minister why, for those people who qualify for the Government car, the Government have chosen the Mini? I ask this question because I find the Mini a very difficult car to get out of and into a wheelchair. It is too low. When I was a patient in Stoke Mandeville, I observed that many serious road accidents involving neck and back injuries occurred in Minis. My noble friend Lady Darcy de Knayth is one such victim. There is little in the front of a Mini for protection, and they can be driven fast round corners.
I must declare a personal interest in this debate as I am Chairman of the Spinal Injuries Association and nearly all our members are greatly concerned over the uncertainties surrounding the future of the vehicle service for physically disabled people, and the rapid deterioration of this service during the past year. My main concern is of the attitude of civil servants at the Department of Health and Social Security at Blackpool to consultants specialising in rehabilitation and to their patients. No Department could have displayed more clearly their bureaucratic stubborness towards the real needs of severely disabled people.
In 1970, the Amelia Harris Report on disabled people stated that the majority were elderely, many suffering from rheumatic and arthritic conditions. The elderly people in our community have generally had many active, full years of youth and they no longer wish to lead strenuous, hard lives, but there is a small and vital group of young disabled people cut off suddenly in the prime of life, 300 or even before they have reached it. I speak now of the severe spastic, the young boy with muscular dystrophy, the severe spinal injury, and others, all so badly paralysed that they have to use a wheelchair 24 hours a day. To rehabilitate these severely disabled people and get them to accept their condition is not an easy job, especially those young people who have lived and loved and have had a traumatic sudden injury. Just what does a young man of 19 feel like when he realises what he has done when he breaks his back? Can you honestly compare him with a grannie of 75 with arthritis? That is exactly what the Department of Health and Social Security is doing.
I quote from a letter received by a consultant from a senior medical officer in Blackpool writing over the supply of wheelchairs to patients:It is not the question of one doctor's understandable desire to do the very best for an individual patient but of Department policy in the light of our overall obligations. Such a policy necessarily has to take account of many factors, including the money that can be allocated to a given class of patient, the need to demonstrate equal treatment to all our clients, and the very compelling claims for improving in other directions.Whatever direction you look in to these severely disabled people a wheelchair is an essential, and if they are working they need two. If the noble Lord, Lord Wells-Pestell, could do anything to speed up the very inadequate repair service for chairs, many people would be saved incredible inconvenience. Unless an experienced consultant can select the wheelchair most suitable for his patient, there will continue to be dissatisfied patients and frustrated doctors. How can patients prepare for living full lives at home if they cannot look forward to having such vehicles and the adaptations needed to make them independent?
While listening to the Second Reading debate of the Social Security Benefits Bill yesterday and hearing of the millions of pounds that the Government are going to spend, I thought of the debate today. How much more satisfactory it would be to make as many disabled people as possible mobile so that they can get out to work and earn a good wage and pay their taxes. To integrate disabled people into the community they must learn to jump a wheelchair up a kerb and up a step. This is common practice in re- 301 habilitation all over the world, but to do this a well-balanced, strong wheelchair must be used. Some physiotherapists from Newcastle-upon-Tyne told me that they had written to Blackpool trying to secure the correct chair for a boy patient, because the 8L Ministry specification which is so inferior and difficult to manipulate was the one supplied. The answer received from Blackpool was that the practice of mounting a kerb was not approved of by them. The physiotherapists' indignation was unfortunately just another example of wasted energy. How can they win when they are dealing with people with closed minds to the needs of individual patients?
Before ending, I should like to mention one more disturbing practice, and I would ask the noble Lord, Lord Wells-Pestell, whether there is anything he can do to help. In some areas such as South London and South Yorkshire, the ambulance men have refused to carry a wheel-chair belonging to a severely disabled patient. To be divided from your own chair is the same as having your artificial legs removed or, if you are a very shortsighted person, much worse that having your glasses taken away. This practice seems totally inhuman, and I should be very grateful if the noble Lord could advise me on this.
§ 3.56 p.m.
§ Lord AIREDALE
My Lords, the noble Baroness speaks from practical experience, and I believe that we shall hear of more practical experience in this matter as soon as I sit down. These are the speeches which are so valuable in a debate of this kind. I join with the noble Lord, Lord Wallace of Coslany, whose attractive maiden speech we listened to just now, in not feeling able to comment on the technical shortcomings of what the noble Baroness, Lady Sharp, refers to as the "trike", but I have always thought that Mr. Graham Hill seemed to make good sense when he said. "Give me a wheel at each corner every time."
When this Motion was put down in our Minutes I knew that somewhere I had read of the Government's intentions about a mobility allowance, and I went to our highly efficient Printed Paper Office to ask them whether they could trace the document, but they could not. I managed to establish from the Depart- 302 ment that it had been issued on 13th September, and I felt sure that the relevant back number of The Times would print the reference number to the document, because they nearly always do, but in this case they did not. The Library of another place managed to find me a copy of it; furthermore, they kindly gave me a Xeroxed copy of it, and I am very grateful to them.
Here is a document which is referred to in The Times as a House of Commons Paper, but I should call it virtually a Government White Paper, because it sets out the Government's intentions to be implemented shortly by legislation. It has no reference number printed on it, so far as I know it appears in no index, and so no wonder the Printed Paper Office could not find it. I am not, of course, attacking the noble Lord, Lord Wells-Pestell, but I would say that any Government must make documents of this kind more readily available, and they must not hide their light under a bushel. How can a Parliamentary debate be of full value if the latest document announcing the Government's intentions is so difficult to find?
Coming now to the merits of the document, I am filled with enthusiasm for it. I welcome for instance that the document says that the Government recognise the limitations of the present invalid vehicle in comparison with a car. That is not quite as strong as the noble Baroness, Lady Sharp, puts it, but the recognition is there. I welcome also the Government's recognition that this new mobility cash grant must be applicable to non-drivers as well as to disabled people who happen to be able to drive. It seems to me that the one great merit of the cash grant is that it introduces elasticity into the means available to the person in receipt of the grant and gets rid. of the conception that Whitehall knows best how to provide in kind for each and every disabled person with his own peculiar personal difficulties.
I would hope that it would be positively fun for disabled people coming into this scheme in the future to plan how to get the best advantage out of their cash mobility grant. There are all sorts of possibilities which are opened up and which are referred to in the Government statement. Coach trips are one 303 of the best valued methods of transportation. These will be available to people out of their cash grant. Others may prefer more occasionally to travel by taxi. There are, of course, powered wheelchairs, and some may prefer to spend their grants in the provision for themselves of one of these. Then there is the possibility of sharing motoring costs with a friend and not feeling dependent on him, but having a grant out of which the disabled person can remunerate his friend and share the cost of his car.
In this connection there is one matter that I suggest the Government should consider rather carefully. I believe the law is that if you carry a passenger for reward—and I would imagine that a disabled person handing over part of his grant would come within this category—you are infringing one of the conditions of your insurance policy. I would hope that before this cash grant arrangement becomes sanctified the Government would take the opportunity of discussing this matter with the insurance companies to try to provide that the carrying of disabled people and receiving part of their grant would not constitute carrying a passenger for reward and breaching the conditions of the insurance policy. I believe that when we had a severe fuel crisis last winter there was a relaxation in this regard, and what could be wrung from the insurance companies over the fuel crisis I would hope could be wrung from them in regard to disabled people sharing other people's cars.
We are told that the intention is that there is to be a flat rate mobility grant of £200. May I briefly examine both those propositions. First of all, why a flat rate? I can see that a flat rate is easy to administer, but does it produce justice? So far as leisure travel is concerned I should be quite happy with a flat rate grant; but if there is to be an element to cover travelling to and from work, surely the flat rate conception fails utterly. I should have thought that a disabled person travelling to and from work ought to receive a grant representing the difference between what it costs him in his present state and what it would cost to travel to and from work if he were an able-bodied person. If he lives in the country and there is no bus service 304 and he has to drive to work, and an able-bodied person would likewise have to drive to work, then the grant would be nil. On the other hand, supposing there is a bus service but the disabled person cannot use it. Surely he is entitled to a grant to represent the difference between the bus fare and what it costs to use whatever form of transport he has to use. I would hope that in respect of travelling to work the flat rate conception would be abandoned.
We are told it is to be £200. If you have a flat rate, why £200? I am not quarrelling with that figure; all I am saying is that, so far as I have been able to discover, the Government have not explained how they have done their sums in order to arrive at £200. I do not know whether the noble Lord will be able to answer this point this evening, but I hope that if a flat rate grant is to be provided and before the scheme gets statutory approval we shall be told and be able to judge whether £200 is a suitable figure.
My Lords, I welcome the statement that the changes proposed will not interfere with the arrangement which disabled people already have. I would also welcome that even a person with a trike who is happy with his trike and wants to continue with it, and does not want to have to start again working out all his arrangements under a new scheme, should be enabled to continue with something with which he is happy even though other people would not be happy with it.
Finally, there is one matter which is not referred to in the statement. I understand that disabled people running cars are at present excused the vehicle excise duty. I would hope that this concession would continue, and that under the new scheme the vehicle excise licence would not be required of disabled people running cars. With these few observations I welcome the statement of the Government's intention which I found so hard to come by.
§ 4.7 p.m.
§ Baroness DARCY de KNAYTH
My Lords, much has been said with increasing fervour lately against the invalid tricycle—that it is dangerous, that it singles out disabled people because of its specific design, that it is anti-social because it 305 can carry no passengers, and is useless for a disabled passenger who is too disabled to drive himself. Certainly for me the most welcome aspect of the Report of the noble Baroness was the conclusion that disabled drivers and passengers should be treated alike; that it was absurd that the most severely disabled were excluded from the invalid vehicle service because eligibility depended on the physical ability to drive. I am further delighted to learn today that the noble Baroness, Lady Sharp, has changed her mind in favour of a cash grant rather than supplying cars. I should also like to add my thanks to her for giving us the opportunity to debate this matter.
I think I should say here that I am a member of the Joint Committee for Mobility for the Disabled on which most organisations concerned with disabled people are represented. The Committee's views embrace the opinions of all its members and are ones which I heartily support. Before we press too hard for the immediate abolition of the three-wheeler, can we for a moment consider the situation of those who stand to lose by its disappearance. The noble Baroness, Lady Sharp, and the noble Lord, Lord Aberdare, have already mentioned these people. First of all, there are 16-year-olds who, although they will admittedly be phased into the new proposed mobility allowance, are at an age when independence and the need to get out and about and away from their families is very important. I do not think that the £4 a week allowance would give them as much independent mileage as they now enjoy. Some people suggest that a car for 16-year-old disabled drivers would be a possibility, but since the minimum age limit for able-bodied drivers is, in any case, likely to be raised I do not see this as a realistic proposition. Secondly, there are some people who may not be able to pass their driving test in currently available adapted cars, and they value their present independent mobility. Thirdly, there are some who think they are incapable of driving conventional cars, and some do not want to try. These are mainly elderly people without previous motoring experience.
I must rapidly underline that I am not advocating retention of the three-wheeler in its present form. I think it has many faults and drawbacks and the Joint Com- 306 mittee regard research and development into the production of a specialised vehicle as of prime importance, because they believe there will be a continuing need for some form of specialised vehicle for some physically disabled people. It is interesting to note that Sweden, which is a particularly go-ahead country in giving help to the disabled, offers a special vehicle as an alternative to a mobility grant. Many people in the categories I have mentioned would have been denied any form of outdoor mobility if the recommendations in the noble Baroness's Report had been followed. While they will now receive the new mobility allowance—and, incidentally, I hope that the over-65s will be included in this mobility allowance, although it seems at present that they will not be—those who cannot for one reason or another drive currently available adapted cars will be denied the choice between independent mobility and hired transport if there is no specialised vehicle available.
In common with the noble Lord, Lord Airedale, I see this feature of choice in the proposed mobility allowance as being so very important. The second part of the noble Baroness's Motion calls "attention to the uncertainties surrounding … the vehicle service for physically disabled people ". I do not see "uncertainties"; I see rather the start of a move towards a mature and realistic solution of the out door mobility problems of disabled people. I must stress that it is only a start; the proposed £208 per annum taxable allowance will be worth little more than the value of the £100 per annum private car allowance when it was introduced in 1972.
But there are two enormously important principles contained in the Government's proposals: first, following the lead of the noble Baroness's Report, there is the fact that disabled passengers and drivers should be treated alike; and, secondly, there is the fact that those receiving the grant will be able to spend it on whatever form of mobility they choose. Is that not a breakthrough? We have moved from a vehicle service available only to those who can drive, to a mobility scheme which offers freedom of choice to both disabled drivers and passengers. While mobility allowance as proposed at present will, as the noble Baroness, Lady Sharp, has already 307 pointed out, in no way assist the less well-off drivers and passengers to buy a car, I see it as a first step forward in the direction of a mobility grant scheme such as the Joint Committee on Mobility have long been advocating.
Let me tell your Lordships what this mobility grant would consist of. First, there would be a five-yearly lump sum sufficient to buy a small car; secondly, a taxable allowance to cover the cost of running and maintaining a car; thirdly, a non-taxable allowance to offset motoring taxes. Given the present difficult financial situation, I feel that the most severely disabled and the least well-off should be given priority. I think that those who can well afford to buy a car should not be helped to buy one. But I must stress that I am not suggesting a supplementary benefit level based type of means test. Buying a car is a large capital outlay, so an income of £2,000 per annum or less would be insufficient to cover an expense of this magnitude. Nevertheless, those who can afford to buy a car should be allowed the taxable allowance for maintenance and repairs, and the non-taxable allowance to offset motoring taxes, because private motoring is not a luxury for disabled drivers and passengers. No public transport system, however expensively adapted and run, will ever be able to suit all types of physically disabled people and provide a realistically door-to-door service for them. Indeed, the existence of the invalid vehicle service, whatever its previous shortcomings, is proof that that is an accepted fact.
Mobility pays off in that it enables disabled people to do a job, pay their taxes, support their families and keep them together, thus avoiding additional burdens on the State. In any case, I do not believe that the numbers involved would be as great as the Department fears, and no survey has ever been carried out to find just what sort of numbers are involved. This mobility grant would at last allow the disabled passenger and driver the freedom which every able-bodied car buyer in this country unthinkingly enjoys—the right to choose the car best suited to himself, his family, his circumstances and his own way of life. We should also bear in mind that there are some disabled pas- 308 sengers and drivers who would prefer the Department to accept responsibility for administering their mobility grant. I therefore believe we should offer a three-fold choice to all who qualify for mobility help, whether or not they are able to drive themselves.
First, there should be a specialised vehicle for those who want it; secondly, a mobility grant enabling people to purchase the car of their choice; thirdly, the few who feel that they cannot cope with the mobility grant should have a small car, suitably adapted for driver or passenger, with the repair and maintenance costs paid by the vehicle service. It is very important that this service should retain its identity and not be swallowed up with other care or cash provisions for disabled people, as the invalid vehicle service involves only a relatively small proportion of those qualifying for other benefits. I firmly believe that this three-fold choice is a realistic plan which would cover the varying needs of all types of disabled people who qualify for mobility assistance, offering them freedom of choice and the chance to act as free, responsible, mature and productive members of the community.
I have one final point, my Lords. I have outlined the longer-term future, as I see it, stemming from the proposed new mobility allowance, but there is an immediate and very pressing need. Disabled passengers at present receive no mobility assistance—except the road tax exemption—and they urgently need help in the face of rapidly rising costs. I wonder whether the overworked and noble Lord, Lord Wells-Pestell, can tell me in his reply whether they will have priority when the mobility allowance is phased in, or whether, in common with disabled drivers who at present choose to buy their own cars, they might receive the £100 per annum private car allowance in the interim period to help them to remain mobile.
§ 4.17 p.m.
The Countess of LOUDOUN
My Lords, outdoor mobility is vital to people who cannot walk at all, or can walk only with great difficulty and cannot make use of public transport. The developments in the socialisation of young disabled people, in their pursuit of further and higher education, employment, marriage 309 and family commitments, all follow from the ability to travel outdoors. Outdoor mobility is equally essential for mature disabled people whose lives would be impoverished were they to be made housebound. That is why I am totally opposed to the abolition of the invalid tricycle.
I am convinced that a not insignificant number of drivers would suffer if the invalid tricycle were to be replaced by a Mini; the 16 to 17 year olds who, by law, are too young to drive a car, but who, nevertheless, need mobility in this very important year of development in their lives; the invalid tricycle drivers, who are physically unable to drive currently available adapted cars; and others who believe they cannot do so and are now reluctant to try. There are some people who now hold a licence to drive an invalid tricycle who might not pass a driving test in an adapted car. Others with provisional licences welcome the mobility they now enjoy in driving invalid tricycles. I know that some drivers find it easier to handle their wheelchairs in invalid tricycles than in cars, that some find the size of the tricycle convenient, while others enjoy the ability to drive and park where cars might be prohibited. I am not advocating the permanent retention of the invalid tricycle as it now exists. I realise there are problems with it, but surely in this technological age an improved vehicle could be produced with more research.
I should also like to see the vehicle service extended to encompass the needs of disabled passengers, and to improve the help now offered to disabled drivers. I believe this can be achieved only by offering disabled people the choice of an invalid tricycle or a mobility grant. But I understand that some disabled drivers and passengers might prefer the Department to accept responsibility for administering their mobility grant, by supplying them with a suitably adapted small car and paying its maintenance and repairs. But all this would involve considerable expenditure, whatever the number of people eligible under the scheme. There seems to be a worrying lack of information on what this number would be and on what people might opt for if presented with this choice. Would it be possible for the Department to undertake a modest survey of disabled driver;, people using wheel chairs and 310 those receiving attendance allowances, to gain some estimate of these unknowns?
My final point is about the recent increase in the cost of motoring—the rise in the basic cost of petrol, of petrol tax and of buying and maintaining a vehicle. These increases are threatening to immobilise many who now enjoy the freedom to travel out of doors. We must not allow this to happen and let us be quite sure, before we take anything away from these people, that we have something very much better—and something which is available—to give them in its place.
§ 4.22 p.m.
§ Viscount HANWORTH
My Lords, it is always rather difficult speaking at the end of a short debate because one does not wish to take up too much time and also because a good many of the things that one might have said have already been said. This is probably particularly so in my own case as I have not the experience of many of the speakers this afternoon. I believe that we are coming to the point where we shall really be getting down to the difficult issues. In the past I think that there may have been some overstatement by the protagonists about getting rid of the trike at any price. They called it extremely dangerous: more dangerous than other vehicles it undoubtedly is, but not so dangerous that sensible people will say that it should be removed from everybody by tomorrow morning. The Government, for their part, have put out a smokescreen to cover their real difficulties. I hope that this afternoon we can face those real difficulties and that the Government will do so.
There is no doubt at all that the trike is by any standards an unsatisfactory vehicle. It may have advantages for certain people, but it is not at all a good vehicle and one wonders why it was ever put on the roads. I do not know which Government were responsible, but I suspect that it was not technological factors that influenced the decision but a puritanical and Scrooge-like attitude which insisted that this was personal transport and that under no circumstances should anybody but the disabled person be allowed to drive or ride in the vehicle.
My Lords, let us examine this attitude for one moment. I have already said that it was puritanical and Scrooge-like. 311 One must remember that, if one is disabled, to have a passenger can be of enormous help and comfort. Indeed, in many cases it is absolutely necessary to have such a passenger in order to be able to get about. There is another angle here as well: again, I speak without experience, but I think that many disabled people who fight their disability are not at all happy at going about in something which is so obviously a C3 vehicle. They want to do their best to show that they are as normal as is possible, though I know there are exceptions. So I believe that it is essential to be able to take a passenger and also, in certain circumstances, to be able to let somebody else drive the car. The disabled person may not be feeling very well and there arises the question of danger on the road, safety and so on. Of course one would not allow such a car to be taken out on joyrides by the family. In any case, we must not forget that today the price of the petrol is quite a deterrent to using a car excessively.
In Holland, we see that an adapted car is provided practically without exception. The only exception is a sort of motorised bathchair which is given in extreme cases. The most usual vehicle is an adapted Daf 44. I am sure that we should and must take a firm decision that the trike must not go on indefinitely. The sensible course is, I believe, to give a choice. A very small number of people—and I think that the evidence is that they will be well under 4 per cent. of the total— will probably take the trike. It is no , good the Government saying, "Oh yes, we will provide a mobility grant to enable you to buy and adapt a car." We must not forget that £200, or whatever the figure may be, does not provide the necessary capital. People must be given the three choices—that is, the trike if they wish to have it, a new adapted vehicle which I hope will be produced or the mobility grant. Following that, the existing tricycles should be phased out in a programme which would still allow those who wish to keep them to do so.
What is the difficulty about this? We know what the trouble is: it is a fear on the part of the Government and, presumably, the Treasury that we would be opening the floodgates whereas at this time one cannot reasonably provide extra 312 funds, however good the purpose. One could have some sympathy with that point of view, but I think that it would be better if the Government said so straight out. What I am saying to them now is that if there are difficulties, if they must keep the total expenditure down to the present level, they must, as the noble Baroness who introduced the debate said, grasp the nettle. There are ways in which that could be done without necessarily applying means tests, and in my opinion that is what must be done.
§ 4.28 p.m.
§ Lady KINLOSS
My Lords, I for one was delighted when I learnt that the noble Baroness, Lady Sharp, had been successful in the ballot and had been able to arrange the present debate. Much was said during the last debate in April, but there are still things to be said and thought about. I felt overwhelmed by the amount of research which the noble Baroness had conducted single-handed. Her Report contained a list more than five pages long of associations and persons who had given written or oral evidence. However, I wonder whether it is not always wiser to have more than one individual on a commission. Where there is more than one member each helps the others with mutual friendly criticism and a broader band of experience. The noble Baroness did valuable work single-handed and is much to be congratulated.
I should like only to examine a small number of aspects of this matter. There was a Somali boy whom I used frequently to see near the Steamer Point Market when I lived in Aden. He had lost both legs and what remained of his thighs was strapped to a rough wooden board mounted on roller skates. He paddled himself around with his hands, singing and laughing. He had extraordinary gaiety and courage. I mention him to illustrate what seems to me to be the nub of this matter: what he wanted above all was to get about and to talk to people and within his limitations, to live some sort of ordinary life.
My Lords, I am not an expert on invalid carriages or, specifically, Invacars. In the hamlet of Lilling near York, next to the village where I live, there is a Mr. Mason, who has been using invalid carriages for some 22 years. He is crippled in both legs from spinal meningitis. I 313 am grateful to him for a long talk in which he told me some of his problems, some—but not all—of which are mentioned in the Report. He showed me the very useful little handbook for Invacar users. This gives instructions about what to do in the event of a breakdown. One has to flash the lights or hang a white handkerchief out of the window. Last November he broke down during daylight between Wetherby and York and waved his handkerchief. At various intervals no less than five police cars passed him, but not one stopped. Eventually, he was rescued by a tractor driver who was pulling a load of sugar beet. His rescuer went back two miles down the road to telephone for help for him. It has always been easy to criticise the police, but one wonders why not one out of five police curs stopped. Had the police really been told the significance of the white handkerchief? Is the display of a white handkerchief a sufficient signal? It is perhaps something that one would not easily notice.
Mr. Mason told be that a mechanic in a Government-approved repair garage in York suggested a wooden sign with the letter "H" in orange luminous paint, which he could hold out of the car. This seems a useful and simple suggestion. I am told that this garage is most efficient in looking after Invacars. Again, not long ago Mr. Mason had a puncture. The Invacar has no spare wheel or jack or wheelbrace. Even if one wanted to help him, one could not. He had to bump home on a flat tyre. Of course he could not change the tyre himself, but no doubt plenty of other road users would have been happy to help him.
Mr. Mason thinks of this car as his legs: otherwise, he would be housebound. He has a wheelchair indoors and in this way he is able to be completely independent and live by himself. He can do what he likes. He said it would be nice to have a car, particularly if it were cheaper to run. It would be nice to go out in company and not always by himself, but he would not be able to take his wheelchair with him, unless the front passenger seat of the car was removable and a slide made available for his own seat so that he could follow the wheelchair through the doorway. I think, my Lords, that he has drawn attention to a very important point. It is an argument 314 not so much about three-wheeled or four-wheeled vehicles, but about what can be done for the four-wheeled vehicle, so that a man could manage it and get in and out by himself. He says he could manage only sliding doors.
Mr. Mason let me have a good look at the vehicle. I am not surprised that it is draughty, because there is a gap near the front of the door and an even larger gap at the back. I cannot think what on earth these gaps are for—it quite defeats me. I asked him how he was managing as a result of the increased cost of petrol. Recently, he was given an increased allowance for which he is very grateful. I know that it is very hard for the Government to be open-handed with money these days. Invacars consume a mixture of petrol and oil which costs 81p per gallon, which is more expensive than 4-star petrol. I wonder whether the Government could consider relieving Invacar users of VAT altogether? These are some quite simple suggestions. Mr. Mason is very thankful to be able to have an Invacar. He understands very well the problems created by wind. The simple answer I am told is simply not to try to drive too fast, and to watch for the direction of the wind. But one has to do that, of course, with any car. He hopes that the criticisms and suggestions he has made to me may assist the Government to help other users.
§ 4.33 p.m.
§ Lord MAYBRAY-KING
My Lords, I was late in handing in my name for the list of speakers and I thought it would be better if I did not let my name stand, but rather intervened only briefly if time allowed. May I first take the opportunity of congratulating an old Parliamentary colleague, the noble Lord, Lord Wallace of Coslany, on an excellent maiden speech. We are fortunate to have in this debate Front Benchers, on both sides of the House, of ability and humanity in the person of the noble Lord, Lord Aberdare, and the noble Lord, Lord Wells-Pestell. I congratulate the noble Baroness, Lady Sharp, on initiating this debate, on her speech and on the work that she did on the Sharp Report. I believe that the Sharp Report is a landmark in the history of the provision of mobility for the disabled. I speak as a Vice-President of the Disabled Drivers' Association and I would 315 echo and remind your Lordships of some words spoken by the noble Earl, Lord Snowdon, in his maiden speceh in this House on 10th April 1974. He said: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?"— [Official Report, 10/4/74; col. 1245.]My Lords, there ought to be no need for pressure groups for the disabled. The DDA is a pressure group and as long as it remains a pressure group that is wrong.
I remind your Lordships of the fundamental issue of the tricycle versus the motorcar. Again, I pray in aid the noble Earl, Lord Snowdon, who has made himself an expert in this field, and who described the tricycle in the same debate. He said: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 antiroll 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 appailing accident record."—[Official Report, 10/4/74; col. 1264.]This is the instrument we seek to replace by motorcars.
When the Sharp Report first came out, there were members of the Disabled Drivers' Association—disabled people themselves—who were afraid that they might lose their tricycle before they got a motorcar. There were others who were so accustomed to the invalid tricycle that they even preferred it to the novelty of seeking to learn to drive a motorcar. But as the noble Baroness, Lady Sharp, has pointed out, in BLESMA practically everybody who has a choice selects the car rather than the tricycle, and I have been asked by the Disabled Drivers' Association to say that it is now firm in its demand for the motorcar as opposed to the tricycle—not only for disabled men; not only for disabled drivers, but, as the noble Baroness pointed out in her Report, for disabled men who need somebody to drive them in such a car.
My Lords, I believe that this debate is one of a number of steps forward in the long history of making adequate provision for the disabled, and especially 316 now, in the field of mobility for the disabled. We may have to move gradually, but I believe that this debate, as are others before it, is helping to create the climate for when those moves will take place. I know that in the Minister who is to reply to the debate we have one who is a friend of the disabled, and I look forward to hearing him.
§ 4.37 p.m.
§ Lord SOMERS
My Lords, I apologise for rising when my name is not on the list, especially in a short debate. I have timed the speeches so far and we are not bound to finish it before 5.40 p.m.; and I shall be very brief. This has been a very important debate and it was the subject of a great deal of discussion in the Council of the Institute of Advanced Motorists, to which I belong. A short time ago—I think it was in the spring of last year—there was a rally of drivers of three-wheeled invalid vehicles somewhere in the South-East of London—I cannot remember exactly where. I was persuaded by one of the members of the Institute to attend the rally. Previous to that time I had felt very much like my noble friend Lady Sharp about the three-wheeler. I was only too anxious to see it off the roads altogether. But when I went to the rally, I must confess I was tremendously impressed by it. One of the things that impressed me most was the fact that no two of the vehicles are exactly alike. They are all completely tailor-made to the needs of their particular drivers. There was present one pathetic little driver, who could not have been much more than 3 feet 6 inches tall, and the seat of her vehicle had been raised and the controls brought forward so that it was perfectly easy for her to handle her car.
One must remember that these cars have certain features that even an adapted Mini or normal car would not provide. First, most of them—not all of them, but I should say a good 90 per cent. of them—have handlebar steering instead of wheel steering. This is to enable the driver to keep both his hands on the steering and still have the controls under his fingers. That would not be so with a wheel; and, of course, if you were to adapt a handlebar to a four-wheeled car, it would be so heavy that a great many invalid drivers could not handle it.
317 There is also the point that a great many severely handicapped drivers— those who are perhaps very deformed and who do not like to have other people with them too much—prefer to be on their own. I admit that it is quite true that there are many handicapped drivers who want passengers with them and who, perhaps, even need passengers with them. Therefore, I am entirely in agreement with the noble Baroness, Lady Darcy de Knayth, when she urges the need for a three-fold choice. This I think is absolutely right. There should be a choice according to the degree of disablement. If one is only slightly disabled and strong enough to drive a four-wheeled car, then well and good; but there are many who are not. This car also has been criticised for its lack of stability; but most of them do not do much more than 30 m.p.h. and stability is not really a very great element at that speed. I do not think that any driver would try to round a sharp corner at 30 m.p.h. Therefore, I think that this three-wheeler still has a very necessary place on the market; but I also think, with the noble Baroness, Lady Darcy de Knayth, that there should be a choice for those who are able to drive something better.
§ 4.41 p.m.
§ Lord WELLS-PESTELL
My Lords, first of all, I should like to express my gratitude to all those who have taken part for their brevity. I say that because I want to take up perhaps a little more time than most noble Lords who have spoken in the debate, so that I can discharge a responsibility that the noble Baroness put upon me; that is, to set out in very precise terms Government thinking on this matter. I am grateful to her. She was very persuasive and, if I may say so, very moderate. I came to the Front Bench not expecting her to be so and I wondered whether I should be able to remain moderate. But this has been a very valuable debate and one which has taken place in a low key. Because of the importance of it, because there are so many people in your Lordships' House who are either disabled now or who, in the past, have been very disabled, it is important that we deal with this matter not only with a great deal of sincerity but also with a great deal of 318 knowledge—and I think that has been present this afternoon.
My Lords, I hope that I shall have time to deal with the individual points which Members of your Lordships' House have raised today. Many have specifically asked to be dealt with. But before answering, may I make a general statement on Government policy on mobility for disabled people. I want to stress that our thinking about this matter starts from the point of view of the individual disabled person, for whom everyone in this House wants to do something—not of one section, not of another, but of every disabled person. All those, I think, are the concern of your Lordships. Let us get this quite clear: policy starts with people and not with hardware. That has been our starting point ever since we first grappled with these problems as a Government a year ago.
When the noble Baroness, Lady Sharp, made her valuable and—and if she will not mind my saying so—closely-reasoned Report which was published in March of last year as one of the first acts of the present Government, the noble Baroness recommended that if a person were otherwise eligible but could not drive, he should have a car if he could nominate a person to drive it for him. The noble Baroness recognised that this would enormously increase the cost and that she had been asked to have regard to the resources available. It may well be that she was perhaps not able—because of the limitations placed upon her—to say exactly what she wanted to say. I do not know. Her recommendation—to keep the costs within bounds—was that eligibility for the future should be restricted to people who needed a car to get to work or to enable them to run a home. As I understand the Report, Government spending and support were to be switched, from people who were too disabled to work or to help support their families, to those (including many less severely-disabled people) who were useful in these ways.
I am sure that the noble Baroness will not take this amiss; but we found that criterion quite unacceptable. It is a functional criterion, which divides the disabled people into two groups, the useful and the useless. You cannot have this in a fair society; you cannot even consider it in a fair society. If you have disabled people, then their wants and needs are, 319 to a large extent, identical. You have to provide for them, but to provide a little extra for those who need a little more. The terms of reference of the noble Baroness were clearly set out; and, with respect, she had to work within those terms of reference. The Government firmly rejected that policy of increased help to the economically useful and what amounted to virtually nothing for the rest. I believe that there is widespread support for this view not only among the disabled but among the community.
This means that for all its value as an analysis of the problem and as a source of wise comment on many matters other than road vehicles, the Report does not get us very far on this central problem. This is not a criticism. This is how I see it. We had, I think, to start from scratch. The vehicle scheme benefits only a small proportion of the people who could qualify if the degree of disablement were the only criterion. A very large number cannot drive but would be in a position to nominate a driver, and a further large number can neither drive nor have they anyone they could nominate as a driver. Their position must be very carefully considered. By bringing in one of these excluded groups, the disabled people who cannot drive but who could nominate a driver, we should clearly increase the cost. Neither the Government nor anyone else has the detailed information about disabled people to make precise costings; but the noble Baroness, Lady Sharp, estimated in her Report that, even with the age limit at 70, the numbers and cost would be in the region of three times those applicable to National Health Service clients in the present scheme.
Yet even by spending so much more money on vehicles we should still have left out those who cannot drive and are not in a position to nominate a driver. These are the people we believe most at risk of being socially isolated by their difficulties—and this is a matter which concerns us. If a vehicle scheme could be used to help people in this group it would have pushed up the cost still further. But a vehicle cannot help them. This is a fundamental limitation on the "hardware"approach, and this is something we must always have in the forefront of our minds.
320 The Government were firmly resolved not to absorb all the resources which could be made available and still leave out this group whose need of mobility help is arguably the greatest of all. We therefore turned to a cash benefit as the main way of helping severely disabled people to be more mobile. It is estimated that it would bring in about 100,000 more people by 1978–79. I believe the noble Baroness mentioned the figure of 150,000. These figures must be compared with the 50,000 beneficiaries under the vehicle scheme—twice as many on our figure; three times as many on the figure given by the noble Baroness. The estimated cost will be more than double the total spending, cash and vehicles together. I believe that this is far more radical—it is far more expensive and far more radical—than anything that has ever been suggested in the past for disabled people. It is to this mast that the present Government nail their flag and they are not going to bring it down very easily.
The introduction of a cash benefit has been warmly welcomed by representatives of disabled people, but many of them have said: "Why cannot we have a choice of cash or invalid three-wheeler or car?" This is a perfectly reasonable question to put to any Government The objection—let me be quite frank about it; one cannot hide these facts these days—is partly one of cost. Cars for all those eligible who want them, with a cash equivalent for others, would bring the total cost to far more than the Government, indeed any responsible Government, could plan for at the present moment. There are many unmet needs, as your Lordships know, in our social services. We are reminded of them week after week. What the Government tried to do yesterday did not find favour in some parts of your Lordships' House because the benefits did not go far enough. But there is nothing between us on this. We know it. But we have only a certain amount of cloth to deal with, and there are, as I have said, many unmet needs in our social services, including particularly disabled people themselves.
Mobility is very important but it is not the only need of the disabled, and we must keep a proper sense of priorities in this matter. In face of the many 321 pressing and justified claims for improvement, there is necessarily a limit to the amount we can devote to mobility. But we are going to increase that very substantially. If I remember rightly, the recommendation in Lady Sharp's Report said that the provision of cars would cost something like £3 million a year. If there are 100,000 people who are not in the scheme at the present moment but are going to be brought into this scheme and be given a mobility allowance of something like £4 a week, this is going to cost £20 million. If the noble Baroness's figure of 150,000 is right the cost will be £30 million a year—in one case six times as much, or, if the higher figure is right, 10 times as much as was envisaged in Lady Sharp's Report— although it was restricting cars to particular groups.
I want to say something about the invalid three-wheeler which is really the main subject of this debate. I make no apology for first describing the broad policies at some length, because the three-wheeler must be seen in the context of the Government's policy. The Government Statement of 13th September 1974, to which the noble Lord, Lord Airedale, made reference, made it clear that it is the Government's intention to continue to make these vehicles available. It follows therefore (I think this will answer a question put by a noble Lord) that the supply arrangements must stand, including placing contracts for vehicles as and when necessary. There are three main reasons for this. First, many people want them. We must understand that this is so. It is all very well for it to be said that disabled people do not want them. If I had the time I could convince your Lordships that there is a vast army of disabled people who have three-wheelers and want to keep them. Last Friday week I was in Shropshire visiting a training centre for the disabled where there were 160 badly disabled people. Before I left—apropos of nothing at all; the subject had not been mentioned—the medical superintendent said to me: "You are not going to take the three-wheelers away, are you?" I asked why not, and he replied: "You do not know the harm it would do psychologically to the young men and young women I have here if they were not able to propel themselves." Do not let us think that this vehicle is 322 so awful and so bad that the vast majority of the disabled want to "get shot of it". This is not so at all.
Secondly, it appears to us that there are people for whom a specialised invalid vehicle can bring independent mobility which cannot be achieved in any other way. Invalid three-wheelers are used by people with a wide range of disabilities—the person who has completely lost the use of his legs but who otherwise has full normal capabilities; the kind of disabled person critics seem to have mainly in mind in contending that hand controlled cars are the complete answer. But they are not our only clients; they are not society's only disabled people. Indeed, they are not nowadays a majority of all those being provided with vehicles. Many people, for example, have lost their ability to walk by reason of degenerative arthritis affecting hip or knee joints; there is generalised rheumatoid arthritis; there is spondylitis and a whole range of other disabilities. People with these conditions have to some degree lost the ability to bend their joints. Some are quite unable to bend their joints at all. If they are tall they may be quite unable to get into the driving seat of an ordinary car. Three-wheelers are so constructed that people in that position can get in them and drive, not sitting down but virtually standing up. They could not do that with a car.
Quite apart from the fact that to provide the controls on a private car would be considerably more costly, it would be impossible to adapt some private cars to meet the physical conditions of many of our disabled people. Many other users of the vehicles suffer from diseases of the central nervous system, causing marked debility, or slowing down of the reaction times and co-ordination. Some of those who are most severely disabled in these ways could not safely manage a vehicle with the performance of a motor car—and, I would readily admit, not even a vehicle with the performance of the latest model, the Model 70 three-wheeler which is being used at the present moment. However, they can be provided with an electrically-powered version of the three-wheeler.
A further substantial group of users are those who have lost the functions of 323 both legs and one arm as well. Many such people can control perfectly competently a three-wheeler with tiller steering and special controls, but they could not use a steering wheel. For many of these people the choice is quite clear: either an invalid three-wheeler or no driving at all. Whatever may be hypothetically possible, with unlimited financial and technological resources, there is no practicable way of getting them on to the road in an adapted car—at least, not at the present moment, having regard to some of the disabilities. That, I submit, is a powerful reason for keeping the three-wheeler where we can do so much more for them.
There is yet another cogent and important reason. We know that many users value the three-wheeler for its ability to go where cars cannot go. You cannot take a car into a shopping precinct or into a pedestrian precinct, but you may be able to take a three-wheeler there. There are many ways in which a three-wheeler can be used when one cannot use a motor car. This is, of course, an important consideration to people who cannot get out and walk, or whose walking range is very limited, and it is becoming of increasing relevance as restrictions upon vehicle access are extended.
May I make one other thing clear. The Government do not see the provision of cars and the possibility of abandoning the three-wheeler as linked matters. I have stated the Government's reasons for not providing cars. They are concerned with cash being the main benefit. Any question of dropping the three-wheeler would be a quite separate matter. We do see a place for the specialised vehicle. The Government's role in providing it is essentially the same as in the provision of other highly specialised needs of disabled people, such as artificial limbs and wheelchairs. The three-wheeler is an elaborate aid; it is not a car. It is an elaborate aid in the same way as artificial limbs form part of the body to help it to function.
The Motion that we are debating refers to the uncertainty about the future of the vehicle service. I am not quite sure what is meant here, because the Government's Statement last September of their intention to continue to provide three-wheelers 324 was, I think, clear enough. However, if there is any uncertainty, I hope that the amplification of that Statement which I have just given will help to dispel it.
That brings us to the question, what kind of specialised vehicle? Here I must go, just a little, into technical characteristics. Steering is one important problem. The technical requirement here is that it must be possible to move the I steering from lock to lock by means of arm movements which may be limited in both power and range. It must be possible to accomplish this when the driver cannot gain the mechanical advantage of using several turns of the steering wheel. Most invalid three-wheelers, even though they can be fitted with steering wheels— and a small number of them are so fitted —have either handlebars or tillers which are operated by one arm, because these are more suited to the driver's capabilities. Such devices would simply not provide the leverage, to use a technical term in what is probably a hopelessly untechnical way, to operate the steering of a conventional car, with two front wheels carrying about half, or even more, of the total weight of the vehicle.
The technical solution we have is the invalid three-wheeler which is a small, light vehicle, with a single, lightly loaded wheel at the front. With such a vehicle, stability poses unavoidable problems. The Government recognise this. These problems cannot be solved simply by keeping the building of the vehicle low to the ground. As I described it a moment or two ago, many disabled people need a fairly high and upright seating position, and one which will facilitate transfer from a wheel chair. This, and the need to provide for special groups—for example, people who cannot bend at the hips—makes it necessary for the door to be considerably higher than in normal production cars. Because of these two factors—steering requirement and height —a specialised invalid vehicle cannot be made as stable as a four-wheeled car. It can be overturned more easily, and its handling is more affected by cross-winds. These are the unavoidable drawbacks which go with the necessary characteristics of a vehicle which is designed for the special need the Government are seeking to meet.
This does not mean that the Government are complacent in any respect about 325 the safety problems. We realise the difficulties, and we are aware that we must always concentrate on the safety factor. We are producing, and studying jointly with the Department of the Environment, analyses of the accidents to Ministry vehicles—by that I mean cars and three-wheelers—by reference to such factors as the type of vehicle, the type of steering, and the age, the disability and the degree of experience of the driver. We hope that lessons from this study will help us to enable these vehicles to be used in the future with far greater safety. We are not in any sense going to try to keep these figures dark. Let me make that perfectly clear. When this study is complete, the findings will be made available, and the Department will invite representatives of the disabled to discuss the findings with the Department.
At this stage I do not want to say much about the analysis of accidents, because we are in the middle of the exercise. However, the Model 70—which is acknowledged, even by its critics, as being an advance in every way, including handling characteristics relevant to safety, on its predecessors—nevertheless has an apparently greater liability to accidents than the older models. This is something we are looking into. Indeed, the older models have a substantially lower incidence of accidents relative to the number on issue than either the Model 70 or the cars which the Department provides for war pensioners. There is some indication here that a very important part is played by the disabled driver who is new to driving, or to driving the particular vehicle he has, because all the new drivers are being given Model 70s, whereas virtually all the drivers of older three-wheelers are people who are used to them and know how to handle them. The factors to be studied are complex and, as I have already assured the House, when we have concluded our investigation and research, the findings will be made known.
There is one other point I wish to make. The Model 70 is the result of a direct line of development of earlier models, aimed at improving the vehicle in ways which had long been felt to be desirable. It may be that in some ways this was over-simplified. The Department aimed at a vehicle which incorporated automatic transmission to make 326 it very much easier to control, as compared with earlier models, and had better all-round performance. That in itself necessitated the provision of a better and more powerful engine, and brought the vehicle nearer to the standards of performance which people have become accustomed to expect from cars. This has not. only made the vehicle capable of control by those with disabilities which preclude them from driving the earlier model, but has also invited comparisons to the detriment of the three-wheeler. But bearing in mind the special purpose of these vehicles, we now feel that the main emphasis in development should be in making a vehicle capable of safe use by people who, because of their disability, are near the limit of ability to manage even a specialised vehicle. This may well entail deliberate acceptance of limitations on performance, in the sense in which we apply that term to the normal motor car. The Ministers directly responsible are keeping these points in mind in planning for the future. There is a good deal of discussion going on at the moment with various individuals and organisations, to see whether it can be improved still further.
I will try very quickly, if I may have your Lordships' indulgence, to deal with one or two points which have arisen out of the debate. I want to emphasise, as a result of something said by the noble Baroness, Lady Sharp, that the Central Council for the Disabled has set up a Working Party after consultation with the Minister for the Disabled, to consider a vast number of matters relating to the three-wheeler and the mobility allowance which we are bringing in fairly shortly. I think it was the noble Baroness, Lady Sharp, who asked whether, when the mobility allowance is payable, the three-wheeler driver will be able to opt for the mobility allowance and give up his three-wheeler. I understand that he will.
I am grateful to the noble Lord, Lord Aberdare, for his comments and observations, and I suppose it is because I largely agreed with him that I thought it was a most balanced speech. But he brought to this debate this afternoon a tremendous amount of knowledge of the subject—certainly, a great deal more than I myself possess—and he was speaking from knowledge of this matter. I am grateful to him for his support. I should 327 like to congratulate my noble friend Lord Wallace of Coslany—I am sorry that he has to have my back and not my front, although there are many people who prefer that—and to say how delighted we all are with his maiden speech. It is quite clear that he has considerable experience in the field of social affairs. This is one matter in which we are often not divided but joined, and is very much a function which shows your Lordship' House at its best.
I want to say to my noble friend Lady Masham of Ilton that, strangely enough, we are already looking into the question of the repair of wheelchairs, and we will look into the point about ambulance men to see what the situation is. I think she asked why, when we chose a car, we chose a Mini. I hope I am right about this but, first, there is the cost factor— the Mini is cheaper. Also, I think I am right in saying that it is the only British small car available with automatic transmission. If I am wrong about that I will write to the noble Baroness.
The noble Lord, Lord Airedale, raised the question of the document. I am grateful to him for having done so, because it gives me an opportunity of explaining to your Lordships—in case you felt that you had been badly dealt with—that the statement was, in fact, made by the Secretary of State for Social Services to the Press on 13th September 1974. It was not a statement made in Parliament; it was made outside as a corollary to a Command White Paper entitled Social Security Provision for the Chronically Sick and Disabled People. We had to publish that rather quickly and I would accept any strictures from the noble Lord. It should have gone into this document. It was our intention to put it in, but the time factor made it impossible and so my right honourable friend made the statement to the Press and my information is that 20 copies of it were sent to the House of Lords. Where they went to I do not know.
The noble Lord raised the position of passengers and asked whether a driver would be in breach of his policy. It so happens that the Department is already in touch with insurance companies and will discuss with them what can be done. The noble Lord also raised the question of the flat rate. The only reply I can 328 give is that we are anxious to avoid introducing anything which appears to be a means test and we feel that the flat rate is perhaps better. With regard to the 4 a week, there is nothing magic about that figure. I think it is a compromise figure which represents an amount which can make a useful contribution, and relates tolerably to cash benefits and payments that one finds in other fields.
I am grateful to the noble Baroness, Lady Darcy de Knayth, not only for her qualified approval—I think it was qualified approval—of what the Government are doing and of the scheme, but also for her suggestions which I should like to study. I know she is anxious that I should say something about when the mobility allowance is to be introduced. It will be introduced in the forthcoming financial year 1975–76, but it will have to be phased in and obviously we cannot include in that year the whole 150,000. That would be quite impossible. If the noble Baroness asks me what kind of yardstick we are going to apply at this stage, I can say only that it is being discussed with people who are able to advise the Department about who shall come first, second and third. I do not think I can go beyond that at the moment.
§ Lord WELLS-PESTELL
My Lords, there will be legislation and it should be this Session. For a moment, I thought the noble Lord meant before Easter. The answer to his question is, Yes. I would like to deal with a whole number of other questions, but I think I have gone on long enough. There is another debate and an Unstarred Question, and I hope your Lordships will forgive me for dealing only with the Government's attitude towards this subject and for not answering all the questions which have been put.
§ Baroness SHARP
My Lords, I shall not keep your Lordships more than a very few minutes. The noble Lord, Lord Wells-Pestell, said that the Government had decided that the first and most important thing was the mobility allowance, available to a much larger number of people than ever trikes had been. I think we all accept and welcome the allowance. In fact, if it had been operat- 329 ing when I was reporting, it would have enabled me to write a different kind of Report in some ways. But what we are talking about now is the vehicle service which the Government still have, and which apparently they propose to go on with on the present unsatisfactory basis. That is really the issue; and my contention is that the introduction of this welcome allowance gives the Government an opportunity to make a more sensible, rational and, I would say, humane disposition of such resources as they are able to spare for vehicles.
The noble Lord accused me of having in my Report divided the disabled who should get cars into two categories; the economically useful and the useless. It was, as I think he admitted, a fairly offensive way to describe what I said. What I was saying, in fact, was that since one must make the choice—and it is, the Government's responsibility to make choices—it should be between those to whom the vehicle is most useful, and those to whom it is not so useful, although still much desired.
My Lords, what do the Government do? They also divide those who can have vehicles into two groups; those who can drive and those who cannot. Is that humane? This is a great part of what we are talking about; the priorities one should have, trying to be humane, admitting and recognising that one cannot spend much on the vehicle part of the service, and should not—at least not yet. I submit that the present way of doing it is just about as bad a way as one can choose. And the sole reason is that the Government dare not make decisions about the right priorities for the car. It is difficult; but they have the chance now with this mobility allowance. They ought to face this, and not go on as they are.
My Lords, what is the argument advanced? That there are some disabled who cannot drive a car and can only drive a trike. There are a few, but only a few. To test this, let the Government adopt the suggestion made by some speakers—that a choice should be offered of car, trike, or cash. Then they will find out what is the preference for the trike or the car. It is trying to pull the wool over our eyes to say that preference for the trike is a big argument. It is a difficult one. It would 330 be nice to think we could provide a specialised vehicle for the few; maybe it is possible maybe not. But the real point is that most of the disabled are asking for a car, and a car is cheaper. I think the Government will hear more and more about this until something is done. I beg leave to withdraw the Motion.
§ Motion for Papers, by leave, withdrawn.