HL Deb 18 June 1991 vol 530 cc45-58

1 Clause 1, page 1, line 12, at end insert "a community care supplement"

2 Page 3, line 6, at end insert ", to any one of which may be added a community care supplement payable out of the National Insurance Fund."

3 Page 3, line 36, at end insert: (5A) The weekly rate of the community care supplement shall depend on the individual circumstances of a severely disabled person. In particular it shall depend on the extent to which he is severely restricted in his ability to perform normal personal care and domestic tasks because of his disablement, on the extent of his need for help, attention or supervision from another person, on the cost of securing the required help, attention or supervision, and on such other factors as the Secretary of State may prescribe.

(5B) For the purposes of subsection (3) above—

  1. (a) a community care supplement shall not be payable in addition to a payment from the independent living fund.
  2. (b) providing his circumstances qualify him for a payment from the independent living fund, a community care supplement shall be payable to a severely disabled person in lieu of such a payment when the payment ceases on the expiry of the life of the independent living fund Trust on or before 8 June 1993; and
  3. (c) payment of the community care supplement shall be disregarded for the purposes of assessing housing benefit and community charge benefit.

3A The Commons disagreed to the above amendments for the following reason—

Because it is not necessary to introduce a regulated benefit, since other arrangements are to be made for payments to those at present in receipt of payments from the independent living fund.

Lord Henley

My Lords, I beg to move that the House do not insist on their Amendments Nos. 1 to 3 to which the Commons have disagreed for the reason numbered 3A.

The House will need no reminding of the history of the issue before us today so I shall come straight to the reason for disagreeing with the amendment which the noble Lord, Lord Henderson, moved in Committee. The Commons disagrees to the amendments for the following reason: Because it is not necessary to introduce a regulated benefit, since other arrangements are to be made for payments to those at present in receipt of payment from the independent living fund". In a nutshell, the reason is that we believe there is a better way to achieve the main stated aim of the movers of the amendment; namely, to reassure people who are currently receiving help from the ILF that their position is entirely secure after April 1993. The announcement that my right honourable friend the Minister for Social Security and Disabled People made in another place on 21st May provides just that certainty about the future which the current beneficiaries of the ILF, and those noble Lords who spoke on their behalf, have been seeking. If I may, I shall return to our proposals in more detail in a moment.

Let me first return to the amendment with which the other place disagreed. I believe that the amendment was motivated by the desire to encourage us to give the sort of guarantee that my right honourable friend has now given to the existing beneficiaries of the independent living fund. But the actual amendment went further than that; it tried to enshrine in this Bill a regulated statutory replacement for the ILF. The Government remain firmly of the view that this would do a grave disservice to the very people we are trying to help—those who are the most severely disabled. It is, I am afraid, a myth to believe that any set of regulations which the Department of Social Security might draft could possibly deliver the varied pattern of provision currently provided by the independent living fund. The 8,000 or so disabled clients for whom the ILF caters at the moment need, I suspect, 8,000 identifiably different care packages. All their needs are great, but that is about all they have in common.

Regulated systems are necessarily about common denominators. That is fine for benefits like the new disability living allowance, which, alongside attendance allowance for people becoming disabled after age 65, will be going to close on 2 million people in two or three years' time. For all the criticisms that are made of it, the benefit system is good at delivering standard weekly amounts of benefit to very large numbers of people, provided of course that the benefits are kept reasonably comprehensible so that people have an idea of whether they will be entitled to them.

But it is quite beyond the capacity of the benefit system to make highly sensitive, individual judgments about the needs of what is, as is universally recognised, a relatively small group of severely disabled people.

Sir Roy Griffiths, in his report on community care, made exactly this point when he said: Our social security system is essentially designed to provide a standard range of benefits for large numbers of people against objective tests of entitlement. It is not an appropriate system for the direct provision of individually tailored packages of support, within a finite community care programme". The Government believe that Sir Roy was right to suggest that there really had to be one single authority responsible for devising and providing these packages of care. The alternative is for disabled people to be sent from pillar to post in trying to put together the help which they need, and for all the players in the game to have perverse incentives to minimise their responsibilities at the expense of others.

If we created a statutory replacement for the independent living fund—or, indeed, if we gave the new body we are creating the scope to help people whose needs arise after April 1993—that is precisely what would happen. It would be to the detriment of all disabled people. The principle that one authority should be responsible and accountable is at the heart of the Government's community care programme. It is also quite right—indeed essential—that the single authority should be locally based. The local social service; authorities are the people with the experience and the expertise in the services from which individual packages of care must be assembled. Central government simply do not have this expertise and cannot have the detailed local knowledge required to make decisions as to the most sensible way of delivering a range of services across a given locality.

A local authority is also much better placed to involve the disabled person in the decisions about his needs than any central bureaucracy. There is an opportunity now for organisations of, and for, disabled people to make sure that their local authority knows what disabled people in that area want, and to participate in providing the service. This is not a paper exercise. The introduction of community care involves a fundamental shift towards providing services that are truly responsive to the stated needs and wants of consumers.

What we do accept is that it is too much to ask of local authorities to take on all the existing ILF caseload at the same time as they are being asked to develop the new services. There is no doubt that we could have engaged in protracted negotiations with each of the local authorities concerned to ensure what we have always intended—the proper protection of all the existing beneficiaries. But while we were engaging in those sorts of discussions, the ILF beneficiaries would lave been becoming increasingly anxious about their future. That was a point made very effectively by several noble Lords in our debate in Committee. I should say that my right honourable friend and I were both very much persuaded by the force of those arguments.

That is why we decided that it would be far better to make separate arrangements for this group of people and to do so by setting up a successor body to the independent living fund to cater exclusively for them. That body will continue to operate in the same way as the ILF. It will continue to look at the needs of beneficiaries individually. Where a person's needs have increased, the new body will be able to make increased payments to enable the person to carry on living independently on the same basis as the I LF does now where that it appropriate.

We believe that these arrangements meet—indeed, rather more than meet—the points pressed on me in Committee. I say that because the guarantee of a successor body also provides for the independent living fund to continue taking on new cases during 1992–93. The new body will have significantly more than the 7,000 cases which, for example, the noble Lord, Lord Henderson, referred to in Committee on 7th March 1991 when moving his amendment. The noble Lord, at col. 1505 of Hansard, was concerned about the ability of local authorities to handle the money as intimately as the present administrators of the fund. He was anxious that the money allocated to the local authorities for this purpose could get lost in the wash. We hope that the arrangements we have now announced meet this concern head on.

The noble Lord, Lord Winstanley, was another Member of the House who argued that transitional arrangements were bound to be necessary, and enjoined your Lordships to make absolutely sure in this House that they were in place. I hope that he will agree that we have done more than make transitional arrangements: we have made a firm commitment to continue making cash payments to the beneficiaries of the independent living fund on the same basis as they are receiving them at present.

I do not want to weary the House with too many references back to our earlier debate, but I should just like to remind your Lordships of the point made by the noble Lord, Lord Carter. He made it clear that he was not asking the Government to spend any more, but simply attempting to protect current funding and, above all, to protect the people who were benefiting from the operation of the fund.

The other place say in their reason that they do not think it necessary, to introduce a regulated benefit, since other arrangements are to be made". I hope that the assurances given earlier by my right honourable friend and those I have given today as regards a successor body to the ILF will be sufficient. The concerns expressed in this House were largely for existing beneficiaries. The assurances that we have given will cover them beyond 1993, as they will cover any new cases that the ILF takes on before that time. I submit that that more than meets the concerns.

Moved, That the House do not insist on their Amendments Nos. 1 to 3 to which the Commons have disagreed for the reason numbered 3A.—(Lord Henley.)

3.30 p.m.

Lord Carter

My Lords, the Government's rejection in another place of your Lordships' amendments is most disappointing. As I shall explain, it will lead to great confusion and disarray in 1993 unless certain steps are taken. On Third Reading in this House I pointed out that the, future protection of the grants given by the independent living fund has given enormous encouragement and a sense of relief to disabled people and their carers who now benefit from that fund. I point out most strongly to the Minister that the Government's response in another place to our amendment regarding the community care component that this House has introduced into the Bill will be a sure test of their attitude towards people with severe disabilities. With the proposals for the reform of local government and the postponement of plans for the implementation of community care, it is extremely important that the amendment we have made to the Bill in that respect should remain".—[Official Report, 15/4/91; col. 1305.] I should make clear at this stage that we were concerned as much for the people who became severely disabled after April 1993 as we were for those already in receipt of grants from the independent living fund. But, of course, we must be thankful that the Government have undertaken to protect those who are in receipt of help from the ILF when we come to April 1993. It is fair to say that even this Government have found it impossible to take existing money away from the severely disabled.

The successor body to the ILF, which has already been dubbed "the son of ILF" by the disability organisations, will have a crucial role to play. It is important that its role and functions are clearly spelt out. It would be helpful if the Minister could tell the House whether the successor body will be set up along similar lines to the ILF; whether it will be an independent trust; what its term will be and how many years it will have to run; how it will obtain its funds and whether they will be indexed in any way. The Minister referred to an increase in the cost of care for an individual, but inflation must be taken into account. Who will decide upon the quantum of the annual expenditure of the successor body and the disposal of that money? Satisfactory answers to those questions are essential if the interests of existing recipients of help from the ILF and the interests of those who will obtain help from the ILF between now and April 1993 are to be safeguarded properly.

I turn now to the real problem of those who become severely disabled after April 1993 or those who, although severely disabled, are not in receipt of grant from the ILF when we reach April 1993. The Government propose that those people should become the responsibility of local authorities as part of the implementation of community care plans in April 1993. As it stands, we believe that that proposal is unworkable. We believe that direct payments by local authorities to individual disabled people to finance care packages are unlawful. The funds available to local authorities for community care are not ring-fenced. Few local authorities have the experience or expertise to design and manage the care packages required by the severely disabled. The Disability Alliance has pointed out that we shall end up with a patchwork quilt of community care for the severely disabled because, if there is a discretionary system, everything will hinge upon the principle of equity.

From 1993 there will be people in similar circumstances, with similar needs and with the same degree of severe disability who will be treated differently according to when their need arose—whether it was before or after 1993—and depending upon the services available and the resources allocated to other forms of community care support in their local authority area and the level of demand for services in that area. As I said, we shall end up with a patchwork quilt of community care for the severely disabled.

I should like to deal first with the possible unlawfulness of direct payments by local authorities to severely disabled people. The issue came to light during the passage of the National Health Service and Community Care Bill. I dealt with the community care sections of the Bill and attended a meeting with the Minister responsible, the noble Baroness, Lady Hooper, and officials. It was clear that the Government were aware of the problem and would have liked to deal with it; but they did not seem to know how to do so. We were told that further consideration would be given to the problem and some solution found. So far as I am aware, nothing has happened. How does the Minister propose to deal with the problem? Local authorities are required to take responsibility for the care of those severely disabled after April 1993 but direct payments by the authorities, along the lines of those made by the ILF, may be unlawful. It will be interesting to learn how the Government propose to get around the problem. In the light of that, how will local authorities administer and implement care packages? We know that the funds available to local authorities are not ring-fenced. So how will the money required for that care be protected from leaking away into other, no doubt worthy, local authority activities? Where are the local authorities to obtain the experience and expertise to design and manage care packages?

I have posed the problem under the three headings of legality, funding and expertise deliberately because the answer to all three could be found in the ILF successor body if properly constituted in the first place. Will the successor body's trust deed restrict its activities to those in receipt of grants in April 1993, or could it be drawn in such a way that at some future date it could be used for new applicants? Even if the trust deed is drawn wide enough to allow the newly disabled to be helped eventually, the operation of the successor body in April 1993 could still be restricted to existing recipients if the Government so determined. Thus, all the Government have to do is to provide funds for existing grants and not for the newly disabled.

From these Benches we have made it clear that the Labour Party is committed, when in government, to ring-fence funds for community care. If the successor body were allowed to act as the local authorities' agent, rather along the lines of the purchaser/provider relationship upon which the Government are so keen for the NHS, in the implementation of community care for the severely disabled and the successor body's trust deed is drawn widely enough, the new organisation, especially if local authority community care funds are eventually ring-fenced, as they will be under a Labour Government, would provide the means to solve the three problems of legality, funding and expertise.

I informed the Minister before the debate that I should be putting those points to him. He could go a long way towards assuaging the fears of many of us by providing satisfactory answers to those questions. We are grateful to the Government for suggesting the successor body to look after existing recipients, but we are worried about what will happen after April 1993 to the newly disabled or those who are not in receipt of a grant from the ILF. If the Minister cannot provide a satisfactory answer to the point I made on Third Reading about the future of the ILF and the newly severely disabled, our fears will undoubtedly be borne out and the Government will bear a heavy responsibility for the unfairness, inequity and muddle that will ensue after April 1993.

Lord Henderson of Brompton

My Lords, I hope that the Minister will not consider me churlish if I say that I cannot give wholehearted thanks for his concession, because he has only given us half a loaf. For that half, however, we are truly grateful. The decision to keep the ILF until 1993 and thereafter to create a successor body is a humane one. I congratulate the Government on making it. It will relate to those severely disabled people who are and will be until April 1993 beneficiaries of the fund. There are about 7,000 only, but they are some of the most deserving and bravest of our fellow citizens. The Government have confirmed the concept of making direct payments from central government funds. I am glad about that. What is more, disabled people will be able to direct those funds as they wish. That will ensure that they do not return or go to institutions. They will thus be able to live an independent life. For that relief, much thanks.

However, it is disappointing that those who become severely disabled after April 1993 will not be beneficiaries of that fund or its successor body. We fear that they are likely to receive different and inferior treatment through local authority agencies. That will be the case unless the Government agree to the important amendments which were adumbrated by the noble Lord, Lord Carter.

I can see the merits of locally based assessments. Mr. Alf Morris in another place also conceded that benefits could flow from local assessment, but those who are most knowledgeable in that field doubt the ability of local authorities to deliver the generous treatment that present funds deliver. To put it in a nutshell, that is due to the varying record of local authorities. If they had a uniformly good record upon which they could base their experience, people would be relatively happy with the Government's proposals.

The important changes should be, first, that central government funding is dedicated, or ring-fenced, as the noble Lord, Lord Carter, suggested. I have read the proceedings in another place, and the Minister for the Disabled said: Local authorities have a statutory duty to prepare plans, and submit them to the Department of Health".—[Official Report, Commons, 21/5/91; col. 815.] Again, he said that: they must also show that they are able to respond to local needs". That was intended to be reassuring but I do not think that any of us who are interested in the welfare of these severely disabled people feel that that is enough without dedicated money from central government.

We should be reassured and feel that local authority funding could work, and has a real possibility of working, if the money from central government were ring-fenced, but not otherwise.

Secondly—and we all feel strongly about this—local authorities must be able, after 1993, to provide direct payments to severely disabled people in the same way as the independent living fund does. Then those people can spend the money as they think fit for their personal needs and not be at the mercy of the local authority as to when or whether they can obtain personal assistance.

As the noble Lord, Lord Carter, said, local authorities have been told that direct assistance of this kind is illegal. I ask the Minister to reply specifically to two questions under this heading. What is the position in law about direct payments by local authorities to severely disabled people? Further, if the local authorities have been correctly advised as to the law, will the Government take steps by 1993 to make direct payments by local authorities to severely disabled people legal? I should be most grateful if the Minister could answer those two questions, together with my earlier point and that made by the noble Lord, Lord Carter, about dedication of central government funds to local authorities.

Lord Winstanley

My Lords, the Minister will recollect, as will the House, that these amendments, which were moved by the noble Lord, Lord Henderson, and which we are now asked to relinquish, were all-party amendments. They were supported by and bore the names of noble Lords from all parties and no party in your Lordships' House. They were supported in the lobbies by members of all parties. Thus in a sense this is a sad occasion. With the abandonment of the amendments we clearly see the end of the ILF. I believe that I am right in saying that nobody could have paid a warmer tribute to anything or anybody than did the Minister, Mr. Scott, to the ILF when, in the discussions in the other place on the Bill, he spoke of the wonderful work it has done. It is fair to say that the noble Lord, Lord Henley, and Ministers in our House have paid similar tributes to it. Of course, we always knew that it was only intended to exist until June 1993. Nevertheless, it is sad that it is now going.

Like the noble Lord, Lord Henderson, I accept some of the arguments as to why it should be replaced. However, the Minister, Mr. Scott, said in the other place on these matters on 21st May 1991, at col. 794: We intend to put in place a successor body to the ILF which will take on all existing beneficiaries and make cash payments to them in the same way as the ILF does now. The details of that body will have to be worked out during the coming months, but the principles are clear—the successor body will function in the same way as the ILF". As a rather simple person, it occurs to me to ask, if the ILF is functioning so well, why do we need a successor body? Why do we not just keep it in existence until it is no longer needed? As the Minister himself thinks so highly of it, that seems to me to be sensible. It is rather sad, in a sense, that we are not doing that.

The quotation I have given raises two points. To emphasise what has been said by the noble Lords, Lord Carter and Lord Henderson, perhaps we may take the ring-fencing of the funds. Mr. Scott said in the passage which I have already quoted that the successor body would make cash payments to the beneficiaries, in the same way as the ILF does now". That means that the successor body will be able to make cash payments direct to individuals. That is what he said, but it does not deal with the question of whether or not it is ultra vires for local authorities to make those kinds of cash payments. We have an assurance that the successor body —the details of which the Minister said would have to be worked out later—will be able to make direct cash payments to beneficiaries. Perhaps we may have that confirmed.

As regards ring-fencing, it is right to say that since the Minister stated in another place that the successor body would function in the same way as the ILF, the ILF is ring-fenced. Its funds are vested in trustees under a trust which itself ring-fences those funds for a specific purpose.

I merely ask the Minister to confirm, first, that the successor body will be able to make direct payments to beneficiaries without any intermediaries. Secondly, I ask that the funds for that purpose shall be ring-fenced. If the Minister can give me reassurance categorically on those points, I shall be content and we shall not persist with our amendments.

3.45 p.m.

Baroness Darcy (de Knayth)

My Lords, all I wished to say has been said. I regret very much that the other place could not agree to the amendments but I welcome the successor body and the fact that payments will still be made direct to disabled people. I endorse all that has been said by noble Lords, particularly my noble friend Lord Henderson, about the need for direct payments and for local authorities now to be empowered to make direct payments. I look forward to hearing what the Minister has to say in reply to my noble friend. I wonder whether he can agree that we should have a two-tier system to enable two-tier treatment for people in the way that they manage the most intimate and personal aspects of their lives.

Lord Swinfen

My Lords, I too am disappointed that the other place has not seen fit to agree to these amendments. I agree with the noble Lord, Lord Winstanley, that this is a sad occasion. It is important that the severely disabled should have control over their own finances and be able to spend money as they think fit, not as some body feels it ought to be spent for them. They should be able to make their own arrangements. That will be much more difficult if the amendments are not incorporated in the Bill. I am very disappointed indeed.

Lord Henley

My Lords, I am sorry that my noble friend is disappointed. I should have thought that we had come a long way since the Committee stage. My right honourable friend the Minister of State has come forward with a very good concession which meets a great many of the points that were made in the House at Committee stage. The concession certainly meets the principal point that the House sought protection for the existing beneficiaries of the ILF and the new beneficiaries who may appear before the ILF comes to an end in 1993.

The noble Lord, Lord Winstanley, asked why we needed "son of ILF", as the noble Lord, Lord Carter, called it, if we already have ILF. The reason is simple and straightforward: ILF is coming to an end, as was always the case. It had a finite date, the trust deed said that it would be wound up at that date and therefore it comes to an end. Accordingly, my right honourable friend has come forward with an alternative which, for the sake of argument, we will call "son of ILF", "new ILF", or whatever else we wish to call it. In effect, it will continue in exactly the same way or much the same way as the existing ILF. The important point is that my right honourable friend and I have given a cast iron guarantee and assurance from the Dispatch Box here and in another place that the new body will be set up and funded to enable it to operate in much the same way as the ILF does at the moment. There is the one exception that it will be restricted to those who are recipients—

Lord Winstanley

My Lords, perhaps the noble Lord will allow me to intervene. Twice he has used the phrase "in much the same way". However, the Minister said "in the same way" twice. He said that it would: make cash payments to them in the same way as the ILF does now …the successor body will function in the same way as the ILF". However, now the noble Lord says, "in much the same way". That seems to me to be not quite the same.

Lord Henley

My Lords, I can assure the noble Lord that it is the same. For me to say that the successor body will operate in exactly the same way would not be right because the trust deed of the ILF states that body can take on new people. The new trust deed—what, for the sake of argument, we are calling "son of ILF"—will apply only to the existing beneficiaries of the old ILF. Therefore to say the new ILF is exactly the same as the old one would be wrong. We are trying to give an assurance to those beneficiaries of the ILF that they will continue to be beneficiaries of something that is in effect the same as the ILF after 1993, but that that scheme will be restricted—I hope this answers one of the points made by the noble Lord, Lord Carter—to existing beneficiaries and will not be extended to new beneficiaries. The noble Lord, Lord Carter, quite rightly wanted to know why the scheme was to be restricted. Our paramount concern is that existing beneficiaries of the ILF should not suffer groundless fears. It is important that they should know their future is secure.

As I have already said, for new beneficiaries there will be community care. If we are to make a successful reality of care in the community, we must place the responsibility for that in the hands of a single authority—that is, the local authority—which is accountable for delivering the care. As I said in opening this debate, it would be wrong to have two bodies to which people could apply, as that would lead to the confusion which the noble Lord accused us of creating.

The noble Lord, Lord Carter, also asked about the provision for the expenditure incurred by the ILF and "son of ILF". It would be wrong for me to pre-empt future decisions. Provision for 1992–93 has not yet been decided but we intend that it should be sufficient to service the existing case load adequately and to take on new cases.

The noble Lord, Lord Carter, was concerned about how long the successor body would continue. We have announced our plans for the successor body without specifying an end date. However, I can assure the House hat we have no intention of winding up that body in the foreseeable future. Obviously I cannot commit a future government to maintaining a fund for time immemorial when that fund will eventually support only a small case load.

I come now to the question of ring-fencing community care funds. As the noble Lords, Lord Henderson and Lord Carter, will be aware, we discussed this matter last year. The noble Lord, Lord Winstanley, inquired whether the funds for the ILF would be ring-fenced. They will be ring-fenced within the ILF'. Ring-fencing entails dividing one section of local authority expenditure from another and only allowing a local authority to spend on a department the funds that have been allocated for that department.

I doubt whether I shall convince noble Lords opposite of the validity of my argument, as I know we argued this point long and hard last year. However, in my view, it is the worst of all possible worlds to give responsibility for services to local authorities but then to tie their hands as regards how they use funds to deliver services. I hope all Members of the House will agree that the best way to ensure that local authorities deliver the kinds of services which disabled people want is for disabled people to take the opportunity now to make their views known. Every local authority is required to publish its community care plans by April 1992. Over the coming months the best thing we can do is not to complain in advance about what local authorities will or will not deliver—the noble Lord, Lord Henderson, implied that they would not be able to deliver certain services—but rather to encourage local groups of disabled people throughout the country to make sure that in their areas the people who are responsible for delivering community care services are left in no doubt about the kinds of services disabled people and their carers want.

The noble Lords, Lord Henderson and Lord Carter, made some further points. They wanted to know whether cash payments by local authorities are unlawful. Legislation does not provide for local authorities to make payments in cash to disabled people. To allow both central and local government to make cash payments for the same purposes would be both confusing and impractical. Again we rehearsed this argument last year during the passage of the National Health Service and Community Care Bill through both Houses. The Government firmly rejected that idea then and remain of the same view. What is important is that the services must be in place and available to those who need them. The services must also be delivered in a way that is responsive to the needs and preferences of the individual.

Lord Carter

My Lords, how exactly are the local authorities to administer and implement the care package? A newly severely disabled person cannot apply to the ILF successor body because the Government have said that body cannot help those who are newly severely disabled. The Minister has confirmed that it will be illegal for local authorities to make direct payments to severely disabled people to organise and manage their care packages. How exactly wilt a newly severely disabled person obtain help from his local authority after April 1993?

Lord Henley

My Lords, local authorities will put together care packages. However, a local authority cannot act in the way the ILF acts and make direct payments to the severely disabled person. The local authority will put together a care package but it will not have the power to make grants. I do not think it would be right for a local authority to start acting in effect like a mock social security department. Local authorities will put together packages but they will not make grants. It is the role of local authorities to ensure that the full range of services is in place for all the disabled people in their areas under the community care proposals and then to monitor the effectiveness of such services to ensure that people are receiving them.

Lord Carter

My Lords, I wish to get this matter absolutely clear. Before April 1993 a severely disabled person who is in receipt of help from the ILF is deemed to be responsible enough to organise his own care package and receive his money directly, but after April 1993 the newly severely disabled person will not be allowed to do this even though he may live next door to a person who, due to this fluke in the law, is receiving a care package. During the passage of the National Health Service and Community Care Bill we were told that the Government proposed to deal with this problem. It seems extraordinary to me that they are not able to do so.

Lord Henley

My Lords, this is not a fluke in the law. We believe that the paramount concern is to protect the existing beneficiaries of the ILF. We do not regard local authorities as being appropriate bodies to make payments, nor do we believe that there should be two bodies after 1993 other than the successor body to the ILF. That successor body will continue to look after existing beneficiaries. I believe this is the only fair way forward even though, as the noble Lord quite rightly says, some people who have applied to the ILF before 1993 will be treated differently to those who apply after 1993.

Lord Henderson of Brompton

My Lords, the provision is manifestly unfair. The Minister has just said that it is fair but it must be unfair that one severely disabled person may receive direct payments while his next door neighbour who is severely disabled too may not. That situation is manifestly unfair. I do not understand the argument that local authorities should not be able to make direct payments on the basis that only central government should be able to make direct payments, as, after all, the money comes out of taxpayers' pockets. Why should a differentiation be made between two people who are perhaps disabled in an identical way? Why should one receive direct payments and all the convenience that goes with that in terms of independent living while the other does not? That position is manifestly unfair.

Lord Henley

My Lords, the noble Lord is starting at the wrong point. The important point to remember is that we feel it is wrong that after 1993 both the ILF and local authorities should deliver new grants. If that were the case there would be the perverse incentive—I mentioned this in opening this debate—for all authorities to try to shift the burden from one body to another body. However, because of the anxieties expressed in this House, particularly in relation to existing beneficiaries of the ILF, we recognise that those beneficiaries may be in an invidious position after 1993 in that local authorities would not necessarily want to take them on. Therefore, we have provided a package to protect existing beneficiaries of the independent living fund. Those who have to seek such help after 1993 will go to their local authority, which will produce a package to look after them. I appreciate that that is different but it is the only way round the problem without preserving a system such as the ILF for new beneficiaries after 1993, which I do not believe is the right way forward.

4 p.m.

Lord Henderson of Brompton

My Lords, I understand how the noble Lord and the Administration have come to that conclusion. However, perhaps he will consider the other end of the process and the intrinsic unfairness of the arrangement to the recipient. If the noble Lord would say that he will keep an open mind about the matter or reconsider it in the light of what I have said, I should be most grateful.

Lord Henley

My Lords, I am certainly prepared to keep an open mind. However, the noble Lord is asking that we should allow the local authorities to make direct grants rather than provide services. That is something that I and my right honourable friend and the Department of Health would be prepared to keep in mind, but I can give the noble Lord no assurances whatever. I appreciate that the noble Lord may think that the system is not as fair as he would like it to be, but if he starts from the premise that only one type of body should exist after 1993 he will reach the same position as I have.

There were complaints that we had given only half a loaf in reaching this compromise after your Lordships' House passed the amendment moved by the noble Lord, Lord Henderson, at the Committee stage of the Bill. I feel that we have come back with more than half a loaf and with a very generous compromise which meets the demands of the noble Lord, Lord Henderson, and the noble Lord, Lord Carter, both of whom said that they were particularly concerned about existing beneficiaries and could not understand why we objected to the amendment at Committee stage if it would not lead to increased cost. Bearing that in mind, I maintain that this is the full loaf, or very nearly the full loaf, which the noble Lord sought.

Perhaps I may briefly remind the noble Lords, as I think I did at Third Reading, that your Lordships' House also achieved considerable success on many other aspects of the Bill. Noble Lords will remember the longstanding problems of definition that we had in relation to the 9,000 or so severely mentally handicapped people on which the Government were able to come forward with a concession. Noble Lords will also recall that we accepted representations made on behalf of blind people to ensure that the new provisions for the lower rate of mobility component would not disadvantage those independently minded people who had learnt to cope out of doors on familiar routes. Noble Lords will also remember the concession that I was able to make on doubling the capital limit of DWA.

Bearing that in mind and the virtually full loaf—and certainly more than half a loaf—that we have been able to bring forward, I hope that noble Lords will accept the reason of another place and not insist on the amendments.

On Question, Motion agreed to.