HL Deb 20 July 1999 vol 604 cc857-64

(". After section 76 of the Contributions and Benefits Act there is inserted—

"Deafblind link scheme

Deafblind link scheme.

76A.—(1) A person who has a combined sight and hearing impediment which is such as to make him unable to communicate or receive information, or virtually unable to do so, without assistance is entitled to receive deafblind link vouchers.

(2) A person is within subsection (1) if he is—

  1. (a) both blind and deaf,
  2. (b) partially blind and deaf,
  3. (c) partially deaf and blind, or
  4. (d) partially deaf and partially blind,

and he satisfies such other conditions as may be prescribed.

(3) A weekly rate of deafblind link vouchers shall be prescribed which is redeemable at a value at least equivalent to the highest rate of the care component of a disability living allowance.

(4) Regulations shall provide for deafblind link vouchers—

  1. (a) to be issued to a person entitled to receive them at such periods as may be prescribed, and
  2. (b) to be redeemable by a registered provider.

in respect of the supply of prescribed services.

(5) In this section— registered provider" means a person who provides services to persons within subsection (1) to enable them to communicate or receive information and who is for the time being listed on a register maintained by or under the direction of the Secretary of State, and prescribed services" is to be construed accordingly."").

The noble Lord said: I move this amendment in the hope that the Government will make essential provision for some of the most disabled people in our society. It is virtually impossible to visualise the effects of the combined disability of deafness and blindness. I hope my noble friend and noble Lords will make an effort so that we can address and discuss this fundamental issue.

When I lost my hearing completely, some 30 years ago, I found that my sight naturally compensated for it. I have no doubt that similarly David Blunkett, who entered the place when he was totally blind, finds that his hearing compensates to some extent for that. But deafblind people have no compensation whatever. They are without sight and hearing, they live in a world of silence and darkness. They undoubtedly need skilled specialist assistance.

In a survey by the organisations for deafblind people, Sense, and Deafblind United Kingdom, it was found that 77 per cent of deafblind people did not have specialist one-to-one support services. That is what they need. Forty-two per cent were virtual prisoners in their own homes.

At present the provision is wholly inadequate. It is certainly not given as it should be, as a right to that kind of support. The aim of the amendment is to ensure that right and the beginning of proper provision for deafblind people. It is not a lot to ask and I hope my noble friend will be able to help. What we really need is a right enshrined in law to specialist one-to-one service support, and properly funded.

The essential objective of the amendment is to provide a link scheme which is modelled on a highly successful scheme in Norway. Deafblind people would apply for vouchers worth the equivalent of the highest rate of the care component of the disability living allowance. At present that rate is £52.95, which would buy six hours of support from a specialist deafblind link worker. It is not a lot to ask, but it is the beginning of something which I hope will grow and develop in Parliament.

There are various specialists to be employed in the link scheme who are skilled in hands-on signing, finger spelling, the deafblind manual alphabet, Braille, as well as lip-reading and clear speech. Communicator-guides visit deafblind people in their homes, helping them with telephone calls or reading them the mail or newspapers. They help with interpreting television and radio programmes, doing the shopping and helping them to take exercise, sort out bills and do voluntary work.

The second group are interpreters who transmit spoken and visual information to deafblind people in formal meetings or situations such as medical or legal consultations. They also guide deafblind people to and from those meetings and during them.

The third group are called intervenors. What they do is to encourage children and adults who were born deafblind to access and learn about their environment and make decisions and choices.

This is the way it would work; it is quite simple. The deafblind person could use vouchers to book support from registered service providers who would then recoup the cost from the Benefits Agency. That agency would be responsible for the financing of the scheme. The provision of such specialists would obviously relieve the isolation and depression and enable deafblind people to socialise to some extent, to learn new skills and to enjoy contact with other people.

I must tell my noble friend that I make no bones about the fact that this is the mere beginning of a campaign to make proper provision for deafblind people. We are not asking for the millennium or the moon this afternoon, but we will be shortly.

Those worst affected will need more than six hours a week. I hope that local authorities would supplement that minimum for those in greatest need and would seek out and identify deafblind people, register them and ensure that community care assessments included checking that they had guides, interpreters and interveners. Those requirements could be defined in regulations made under the Bill.

The deafblind link scheme is not intended to replace other benefits or services. It is necessary to supplement disability living allowance because a deafblind person would use a link scheme to book one-to-one support for activities of their choice. That would include many things that are not normally included for the purposes of the assessment of the care component of DLA, such as help with domestic tasks, social and other activities.

I am sure that my noble friend the Minister will consider my points carefully and will help if she possibly can. I do not pretend that the wording of the amendment is air tight and I have no doubt that some difficulties will emerge. Nevertheless, the aim of the amendment is clear. I hope that the Government will find some way of helping. I beg to move.

6 p.m.

Lord Addington

I have a small apology to make to the noble Lord, Lord Ashley of Stoke. When we were talking about the single gateway, I suggested that advocates and people to support would be required, particularly for the deafblind. I had not seen the noble Lord's amendment at the time and I said that I did not know whether there was an amendment down.

We use hearing and sight to help us to communicate. A very learned man once told me that that is one reason why mankind dominates the planet. We co-operate with each other; we are a social animal and we communicate. The deafblind have those two normal means of communication removed from them, That implies terrifying isolation. Anyone who has not tried to take that on board will go a little cold the first time they think about it. There is no more profoundly cut-off person than someone who cannot see and cannot hear. It is probably the most frightening disability that we have to deal with.

Even if the amendment is not accepted, I hope that the Minister will give a strong guarantee that the deafblind will be provided with a minimum level of assistance in basic communication to allow them to become part of the rest of the species.

Baroness Darcy de Knayth

I strongly support the amendment. There is no need to add to the graphic picture given by the noble Lords, Lord Ashley of Stoke and Lord Addington, of the problems facing deafblind people. Deafblind people have missed out and I hope that the Minister will respond positively, or at least promise to go away and look at the issue.

Baroness Hollis of Heigham

The amendment, so movingly introduced by my noble friend Lord Ashley of Stoke and spoken to by others, would introduce special help for one specific group of disabled people in the form of vouchers redeemable for services. The rate of provision would be equivalent to at least the higher rate care component of disability living allowance.

I understand my noble friend's concern. I agree that deafblind people need specialist help to access information, interact with others and improve their quality of life. Being both deaf and blind denies all other sources of communication. There are problems of definition, because we are talking about the disability caused by blindness or deafness. People who are visually impaired or have partial loss of hearing can be registered blind or deaf but manage adequately with communication. However, that is not the issue.

There are several reasons why it would not be right for the Government to accept the amendment. It would not be consistent with the aim of disability living allowance, which is a cash benefit designed to provide a contribution towards the extra costs of disability and managing that disability. It for the individual to decide how the money is used. That gives dignity and choice to disabled people. We are not keen on the shopping list that the noble Lord, Lord Higgins, mentioned on the previous amendment or on a voucher scheme.

There is also an important issue of fairness. If the vouchers were payable to people already in receipt of DLA, it would effectively double or more than double the provision available to one small group of disabled people. I recognise they have very severe disabilities, but others, such as those who are bedridden, who have no communication skills and who require round the clock care and attention, also have lives that are unimaginable for most of us. We should bear in mind the issue of equity across groups.

A voucher scheme is not necessary because we already make deeming provisions for deafblind people to receive the higher rate mobility component of DLA. The higher rate care component is also available to help towards the extra costs of their disability. I have already referred to the Mallinson and Halliday cases, which extended DLA to people with communication difficulties. We shall be helping deafblind children by lowering the age limit for the higher rate mobility component.

I am aware that some disability organisations are concerned about the effectiveness of the higher rate mobility component in targeting the most severely disabled deafblind people. My noble friend Lord Ashley of Stoke was right to make that point. The statistics are shocking. Very few deafblind people are getting the help they are entitled to. We have heard from Sense that about 3,000 deafblind people need communicator guides, yet only 362—barely more than 10 per cent—receive the higher rate mobility component of DLA through the deafblind criteria.

That problem clearly needs to be addressed. We have commissioned the disability living allowance advisory board to look at what can be done. It has identified a number of issues, including objective evidence gathering and, importantly, a review of training for adjudication officers and medical advisers. The board is aware of the interlocking nature of the two disabilities. The findings have been fed into the Benefits Agency modernisation programme. We will be monitoring the programme closely to ensure that claims for DLA by deafblind people are dealt with as fairly and efficiently as possible.

As my noble friend said, the benefits system is not the only source of help for deafblind people. Support is also arranged by local authority social services. Local authorities have a duty to assess people whom they think may require community care services and decide what services should be provided. In addition, hearing and low vision aids are available on prescription or free loan from the NHS.

The Government are determined to ensure that social services provide better support for all those with long-term care needs, including deafblind people. My right honourable friend the Secretary of State for Health published his plans to improve social services in last year's White Paper, Modernising Social Services. The White Paper sets out our view that the promotion of independence should lie at the heart of all services. It describes the major reforms in hand to ensure that there is more consistency and fairness in social care and that services are more convenient and user-centred.

I agree entirely with my noble friend that local authorities should identify all the people who need their services. In particular, they should actively seek out and contact those such as deafblind people who may find it particularly difficult to access services that they greatly need. If we can ensure that local authorities have sought out the deafblind people in their area and are providing appropriate and sufficiently generous care packages and if the Department of Social Security ensures that its adjudication officers are well trained so that they can ensure that deafblind people who apply go on to the higher rate of DLA if so entitled and it is appropriate, I hope that it may be possible to bring many more of them within the framework of the independent living fund.

Bringing someone within the framework of the independent living fund would mean that, if they were getting a care package from their local authority valued at £200, the ILF, if they were on the higher rate DLA, would then be able to add, if appropriate, a further £300 which would be very much more generous than the voucher system that my noble friend has suggested. That is one possibility that I am anxious to explore in conjunction with my noble friend to provide appropriate packages for people who are severely deafblind.

As I say, the Government are consulting on proposals for a charter for long-term care, "You and Your Services". This charter is intended to ensure that services meet the standards that users want and expect. Later this year, we will consult on draft guidance on fair access to care services and we will certainly consider my noble friend's comments in that context. I would also urge him to encourage the voluntary organisations with which he works— the two leading ones are, I understand, Sense and Deafblind UK—to play a full part in those consultation exercises and particularly to work with local authorities to ensure that deafblind people are brought within the ambit of their services.

I hope that what I have said has convinced my noble friend that there is no need for this amendment. We do recognise that many deafblind people are not getting the help they are entitled to, either from local authorities or through DLA. We are taking steps to address that problem. We are also taking action to improve the support that is available from social services for people who need long-term care, but I do not myself believe that a voucher scheme is the right way forward. I hope that, in the light of my reply, my noble friend will withdraw this amendment.

Lord Ashley of Stoke

I do recognise the practical difficulties outlined by my noble friend. I must say that it is extremely rare for a Minister to offer something better than that offered by someone who has proposed an amendment to a Bill. I appreciate my noble friend's suggestions for investigating and bringing it within the ILF. That would indeed be marvellous if it worked. I look forward to working with my noble friend and discussing this suggestion which will be of enormous value to thousands of deafblind people. I am very grateful. I am absolutely delighted. I beg leave to withdraw the amendment.

Amendment, by leave, withdrawn.

[Amendment No. 127E not moved.]

Clause 63 [Certain overpayments of benefit not to be recoverable]:

[Amendment No. 127F not moved.]

Baroness Buscombe moved Amendment No. 127G:

Page 70, line 10. leave out paragraph (a)

The noble Baroness said: In moving this amendment, we are seeking clarification from the Minister of the interpretation of the word "review" in the Bill. On 28th January 1997, the Secretary of State said in another place: The review process will involve gathering information by postal inquiry and home visits".—[Official Report, Commons, 28/1/99; col. WA321.]

We have a number of questions on this matter. Can the Government confirm that the reviews they have in mind are very similar in kind to reviews carried out at home by administrative personnel from the Benefits Agency or by postal inquiry? If the reviews are going to be of a different kind, we would like to know what procedures the Government have in mind. In addition, Clause 63 refers specifically to the disability living allowance, incapacity benefit and severe disablement allowance. But what about disability working allowance, industrial injuries disability benefit or the disability premiums in income support?

Furthermore, what will happen if someone still owes money from a previous review? Will there be an attempt to reclaim that money? Will DLA claims be dealt with on the same terms and subject to the same regime as beneficiaries of incapacity benefit or severe disablement allowance? What will be the financial consequences and will that depend entirely on the outcome of the reviews?

In essence, we would like reassurance that the review process will be a positive one, such that it will not alienate people while ensuring that it achieves the right objective, which is to make sure that entitlement is fair. We want to safeguard the integrity and effectiveness of the review process. This is a probing amendment and I beg to move.

6.15 p.m.

Baroness Hollis of Heigham

Amendment No. 127G has the effect of removing that part of the clause that defines the word "review". Debates in another place have made it clear that the word "review" can be interpreted in many ways, so I am happy, in response to the probing amendment of the noble Baroness, to make clear the meaning attached to the use of the word in this clause. It was helpful of the noble Baroness to put the amendment in this way.

The provisions of the clause are all about overpayments. It is well established that a recoverable overpayment of benefit can only arise after someone's benefit has been altered to a lower rate, or their benefit has been stopped. The legal mechanism for doing this is a review by an adjudication officer. Awards of benefit are made by adjudication officers and only an adjudication officer, following the proper procedures, can alter such an award by conducting a review.

The Social Security Administration Act 1992 sets out the precise circumstances when an adjudication officer can conduct a "review" and alter someone's benefit. This provision applies whether benefit is being increased or reduced. The definition in Clause 63(5)(a) which this amendment seeks to remove simply lists those provisions that allow someone's benefit to be altered.

There is nothing sinister about this. These provisions allow benefit to be reviewed as a result of a change in someone's circumstances, or the correction of a misunderstanding of the facts of the case or because the law was applied incorrectly. Obviously it would be wrong for benefit to continue unaltered in any of those situations.

Such a review could follow from any situation where an award was found to be no longer correct. The term "review" is not linked in any way to any particular initiative such as the benefit integrity project that may have been lurking in the mind of the noble Baroness.

I hope I have explained that, as it stands, the subsection does nothing more than refer to the relevant provisions under which an award for benefit can be changed. The same provisions apply whenever an award is changed, for whatever reason. I urge the noble Baroness to withdraw her amendment.

Baroness Buscombe

I thank the Minister for her very clear explanation of the position and I think she understands the spirit in which my questions have been asked, given the debates that took place in another place. I agree there is nothing sinister about it. We merely wanted to seek clarification as to the proper meaning in this context. I thank the Minister and beg leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Clause 63 agreed to.

Clauses 64 and 65 agreed to.

Schedule 8 agreed to.

Clause 65 [Welfare benefits: miscellaneous amendments]:

Earl Russell moved Amendment No. 128: After Clause 65, insert the following new clause—