NHS Residential Care and Mobility Allowances (Hansard, 13 February 1996)

§ Lord Mackay of Ardbrecknish
My Lords, the proposals are currently being considered by the Social Security Advisory Committee. We will, of course, consider carefully any recommendations the committee may make. There are no plans at present to withdraw the proposal.

§ Lord Rix
My Lords, I understand the reluctance of the Minister to go further, although I do not sympathise with it. Can he confirm at this stage that the advice of the Social Security Advisory Committee will be accepted rather than just examined by the Government? Can he also confirm that all the voluntary bodies and major charities concerned with disability, together with the NHS trusts, unanimously supported the continuation of the mobility allowances saying that the mobility of disabled people would be severely curtailed if they are withdrawn and that social security benefits would be put hack nearly a quarter of a century?

§ Lord Mackay of Ardbrecknish
My Lords, I am aware that there have been reactions to the request for consultation from the SSAC—the Social Security Advisory Committee. However, the end date for observations was only yesterday. The committee will now have to meet and consider before it makes its recommendations to the Government. I am sorry that I cannot give the noble Lord an assurance that we will necessarily do what the committee wishes. We shall certainly consider carefully what it says. However, we will have to wait to see what the committee says and then deliberate upon it.

§ Lord Renton
My Lords, perhaps I can declare a family interest in that I have a severely handicapped daughter who is in receipt of the mobility allowance. Is my noble friend aware that the allowance is not easily 502 obtained? Its issue is strictly administered and if it were to be withdrawn it would cause hardship and a great deal of inconvenience in many families.

§ Lord Mackay of Ardbrecknish
My Lords, the point made by my noble friend is one of the issues we shall need to take into consideration when the Social Security Advisory Committee reports. But it is fair to point out that the mobility component of the disability living allowance is the only benefit of this nature which somebody keeps when they are in hospital for any length of time. For example, the care component ceases after four weeks; the attendance allowance ceases after four weeks; and other benefits are downrated or withdrawn after six weeks. It is only this benefit which continues after people are in hospital in the care of the NHS, which provides from the public purse for all their needs.

§ Lord Ashley of Stoke
My Lords, is the Minister aware that this plausible proposal for cost cutting founders in the light of clear evidence that disabled people in hospital have mobility needs? Those needs will not be met if the allowances are withdrawn. That is why the leaders of 11 major disability organisations have written to the Secretary of State to say that withdrawal of the allowances will cause considerable hardship to extremely vulnerable people. If that is so, they should not be withdrawn.

§ Lord Mackay of Ardbrecknish
My Lords, as the noble Lord, Lord Ashley, knows, the mobility component is primarily intended to help disabled people be independently mobile. We are dealing with patients in National Health Service hospitals whose needs are met by the health service and where every other benefit bar this one is actually withdrawn after four or six weeks. In addition, in the past we have seen examples of hospitals accumulating large balances of patients' funds coming from those allowances. For example, one hospital said that it was not uncommon for patients to have balances of unspent benefits of over £8,000. In that hospital the total size of patients' balances actually exceeded £3 million.

§ Baroness Hollis of Heigham
My Lords, does the Minister agree that over many years the mobility allowance has permitted severely disabled people in residential hospitals nonetheless to remain members of the community, to build new relationships, to experience new things and to develop as people? Does he agree that cutting off mobility allowance will confine disabled people to isolation? Will he not think again?

§ Lord Mackay of Ardbrecknish
My Lords, there is also some evidence, as the noble Baroness may know, that this money is not just used for mobility but is in fact used for other things—to buy goods and services which are otherwise supplied free by the National Health Service to its patients. As I said a little while ago, if the noble Baroness was being totally logical, she would be urging me not to withdraw those benefits which are already withdrawn—the care component, 503 attendance allowance and other benefits, like income support, which are downrated or withdrawn when people go into hospital.

§ Lord Mackie of Benshie
My Lords, can the Minister tell us what happened to the £3 million which the hospital accumulated?

§ Lord Mackay of Ardbrecknish
My Lords, it was a little time ago and the hospital has taken steps to reduce those balances. But this has been a problem for a long time in many hospitals. They have been more careful recently. However, the point I made a little while ago was that the money is not always spent directly on mobility; and that is what it is intended for.

§ Lord Rix
My Lords, like the noble Lord, Lord Renton, I, too, must declare an interest in that I have a daughter who is in possession of the full mobility component. Does the Minister not consider it ludicrous that she, who receives her mobility component direct through social security because she lives in a MENCAP Homes Foundation house, could indeed be living next door to a house funded by the NHS where a person with exactly the same disabilities as my daughter would be denied the maximum amount of the mobility component? Does the Minister agree that that is a ridiculous anomaly and one which certainly is not solved by reducing the mobility component or removing it altogether in the case of hospital care?

§ Lord Mackay of Ardbrecknish
My Lords, I understand the noble Lord's point, but it is equally anomalous that people in long-term hospital care should receive a benefit which they may not be using for the purpose for which it is intended—and it can be accumulating or it can be used for other things. In addition, some of the observations made to the Social Security Advisory Committee have been from special hospitals, where patients' mobility outside the hospital is something we would wish to discourage because they are put into those hospitals to keep them secure.