HL Deb 20 July 1999 vol 604 cc839-46

(" .—In section 135 of the Social Security Contributions and Benefits Act, there shall be inserted after subsection (1)—

"(1A) The applicable amounts for income support for severely disabled persons shall be made by the Secretary of State following consultation with one or more organisations whom he regards as representative of severely disabled persons.

(1B) The sums first certified by the Secretary of State under subsection (1A) above shall be. in the case of a severely disabled person who is aged not less than 16 but less than 60, set at a level at no less than the higher level for those aged over 25 together with the maximum disability premiums available.

(1C) After sums have first been certified under subsection (1A) above, the sums certified in each subsequent year shall be not less than the total of the sums certified in the previous year together with the amount (if any) by which it appears to the Secretary of State that the general level of prices has increased in the course of the previous year.

(1D) In subsections (1A) and (1B) above, "severely disabled persons" means persons who are in receipt of the care component of disability living allowance at the highest rate within subsection (4)(a) of section 72 above or in receipt of severe disablement allowance."").

The noble Lord said: The amendment seeks to extend the stated weekly disability income guarantee of £128 to those under as well as those above the age of 25. The proposed new clause also seeks to redefine a severely disabled person to include not just those in receipt of the highest rate of care component for DLA, but those in receipt of the severe disability allowance.

To be eligible for the disability income guarantee a person must be on income support, receiving the high rate of DLA care component and also be over 25 years of age. The problem is the age barrier. The Government estimate that 70 per cent. of those in receipt of SDA are also claiming means-tested income support. However, according to a reply given in Hansard in November last year, only 53,000 are getting the higher rate of care component of the DLA. Some of them will be under the age of 25. That means that there is a substantial number of severely disabled people without access to the disability income guarantee of £128 per week.

Although Clause 59 allows the transfer of young, disabled people to a higher income incapacity benefit, about 95 per cent of current SDA claimants will not be transferred and will therefore be left on low incomes, most without access to the guaranteed disability income. Surely, this age barrier with an arbitrary line at the age of 2.5, is slightly ridiculous. I beg to move.

Baroness Hollis of Heigham

The noble Lord, Lord Addington, has raised some important points. I hope that I can reassure him that the amendment is not necessary. To begin with, we already consult organisations representing disabled people. When the Prime Minister launched our welfare reform programme he promised that there would be consultation and time for discussion at every stage and we have done so. I was involved in helping to set up the Disability Benefits Forum. Even though its work has now ended following the resignation of its members, detailed work with individual members of the forum continues. It has made an important contribution to our work.

We are already making sure that we provide benefits at a level which provide real support for disabled people. The disability income guarantee will be introduced in April 2001 and will provide extra help and security for the poorest disabled people with the highest care needs. It will provide help through income-related benefits to severely disabled adults and families with disabled children who get the highest rate care component of DLA. At the April 1998 rate it will be worth an extra £5.75 for a single adult or child and £8.30 for a couple. I mentioned the New Deal earlier and the Disability Rights Commission. Together I hope that that reassures the noble Lord that we are indeed listening to the views of disabled people.

The noble Lord referred to the age of 25 and pressed me on that. Amendment No. 125A is intended to provide a further enhancement of benefit to severely disabled people aged under 25 and to increase the level of personal allowance to those aged 25 and over.

As the noble Lord knows, as with JSA, which is the fulcrum benefit, in general the reason the lower rate of benefit is paid to younger people is that the majority of them live in someone else's household or share a household with other young, single people and have fewer financial responsibilities. It would be wrong for benefit levels to offer an alternative to seeking work or to training or to be an incentive to leave home or to go into independent accommodation, for example, when they can perfectly well share. We do not believe that that is a sensible use of resources.

The reforms of SDA which we have just been debating will mean that in future young people who become disabled early in life will gain because they qualify for IB. They will gain by approximately £26.40 per week, which will be a valuable enhancement.

A further requirement of this amendment would be to uprate benefit levels in line with prices. I can reassure the Committee that although that requirement is not on the face of the Bill, it already happens in practice. In the light of those responses, I hope that the noble Lord will be able to withdraw his amendment.

5 p.m.

Lord Addington

The Minister gave two answers: one was technical and the other philosophical. Technical answers should always be taken away and read carefully. The philosophical answer concerned the age barrier. We received the arbitrary line of response that the Government's terminology was focusing. But when we focus strongly on something we al ways blur the edges; we always miss something.

I am not happy about the response, but at this time I beg leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Clause 62 [Disability living allowance]:

[Amendment No. 125B had been withdrawn from the Marshalled List.]

Lord Addington moved Amendment No. 126:

Page 69, line 8, leave out ("5"") and insert ("3"")

The noble Lord said: Again, with the leave of the Committee, I shall move an amendment in the name of my noble friend.

Amendment No. 126 concerns a more straightforward issue. It seeks to make the test which is applied to decide the correct level of mobility payment available to children under the age of five because those who are less severely disabled also incur extra costs. Although the Government will probably say that those under that age are not usually regarded as living independently, if one has a four or five year-old who is deaf, it may be extremely difficult to take them, for instance, on a bus. If they cannot hear, they may run off the bus and into the road, so extra travel costs to keep them safe may be incurred.

The provisions refer to a lower level of disability. I am always rather terrified of the idea of defining a "lower level" of disability. Extra costs may be incurred because of the necessity of using a car or a taxi because a hearing impaired child, for instance, cannot be controlled and easily given guidance. That is the nub of the matter. I beg to move.

Baroness Hollis of Heigham

Amendment No. 126 seeks to replicate for the lower rate mobility component what the Government are proposing to do for the higher rate; that is, to bring it down from the age of five to three. I am sure that Members of the Committee will be aware that it is not that the lower rate mobility component is a lower financial level of mobility allowance for the same group of people; it is designed to help very different people.

The higher rate of mobility component is for people who are virtually unable to walk. It is literally concerned with physical mobility; it is for people who cannot walk easily more than a few yards. It involves the "virtually unable to walk" test. The lower rate mobility component does not involve people who have a physical incapacity to walk, but those who, when they walk, need supervision by virtue of severe learning difficulties, behavioural problems, severe mental illness or the like. So these are not, as with the care elements, a step down in severity of need; they are two different groups of people, as I am sure the noble Lord, Lord Addington, will be aware.

Lord Addington

I thank the noble Baroness for giving way. I was trying to point out that the problems implied in that assessment of the definition often do not fit the categories which all governments have to use.

Baroness Hollis of Heigham

That is where I was going to dissent from the noble Lord, Lord Addington. We recognise that with the higher rate MOB, where somebody is physically unable to walk—for example, a child who has had severe cerebral palsy from the age of four—they may still need pushchairs or, with a different form of illness, oxygen cylinders and so forth. That means that to obtain any mobility the family will need personal transport.

In the past the child at the age of five may have needed that to go school, which is why the old, higher rate mobility component started at five. We are now reducing that to three because now that is when children go into playgroups or go through the national childcare strategy into nursery school. The same does not apply to those people on the lower rate mobility component. The lower rate mobility component is intended to help people who need extra guidance or supervision as a result of their disability.

The vast majority of children under five need constant supervision when out walking, whether or not they are disabled. That is particularly true when children are in unfamiliar places. None of us would allow a three or four year-old to run in a busy street without constant supervision. That is the difference. If a child has a physical disability and needs heavy equipment, it cannot run in the street; it has to be carried. From the age of three or four onwards it may be physically too heavy to be carried and therefore access is needed to a mobility car.

A child with a behavioural problem needs constant supervision, but that would apply whether or not the child had a behavioural problem. That is the basis of why we are unable to accept the amendment. The analogies are not similar. The needs in lower rate mobility component for an able-bodied child and a child with this level of disability do not engender any different needs for mobility, whereas they do if the child has a severe physical disability. In the light of that explanation I hope the noble Lord will not press his amendment.

Lord Addington

There does not seem to be much between us when it comes to the types of problem involved; it is just that we believe that children who can respond to their own name can at least let the parent know where they are. They will be easier to keep an eye on, to control and communicate with. Thus it will be easier to travel with them on a bus; one will not need to have a hand on them all the time.

This is an argument we could debate for a long time, quoting examples of cases where people have found the situation to be extremely difficult. However, the Minister indicated that she is not prepared to accept the amendment at this time. I shall take it away and consider whether it merits further attention. In the meantime, I beg leave to withdraw the amendment.

Amendment, by leave, withdrawn.

[Amendment No. 127 not moved.]

Lord Rix moved Amendment No. 127A:

Page 69, line 10, at end insert— ("(5) In determining entitlement to the mobility component of disability living allowance, no account shall be taken of where or by what agency a person is accommodated.")

The noble Lord said: In moving Amendment No. 127A I shall speak also to Amendment No. 127E in the name of the noble Earl, Lord Russell, and others.

Amendment No. 127A seeks to reverse the change made in 1996 which took away or reduced the DLA mobility component for those living in NHS accommodation. That was, of course, a change made by the previous administration. But the Minister will agree that it has not been a rule adopted by her administration that they should simply accept uncritically what was done by a previous administration. With reform in the air, it seemed to be a good opportunity to look at this again.

The 1996 change was remarkable in a number of ways. It attracted one of the largest responses ever received by the Social Security Advisory Committee—almost every representation being firmly against the change. Unsurprisingly, it attracted the opposition of the advisory committee itself. It led to debates in Parliament in which hardly anyone other than government Ministers had a good word to say for the change. Finally, it was defended by the then Ministers with what must rank as quite the lamest collection of arguments ever dredged up to defend an indefensible policy.

We were told that people in hospital were by definition in bed and could not conceivably benefit from a mobility benefit. We were told that the beneficiaries included detained mental patients whose mobility had been restricted by due process of law. We were told that health authorities were responsible for funding any mobility required by patients and that the mobility component constituted double funding. We were told that some NHS trusts had accumulated large sums of money for long-stay patients and paying benefits would simply add to the funds without adding to the welfare of the patients.

Mencap and other disability bodies produced real cases involving the threat of real hardship to counter all this nonsense; but we argued in vain. I hope that on this occasion we shall not argue in vain. Should the Minister's brief not be as helpful to her as she would wish, I trust that at least it will contain evidence of the actual effects of the 1996 change which governments have so far failed to produce, having so far failed to ask for that evidence.

I should like to earth my argument in a real situation. The people who suffered from the change three years ago are not people confined to bed and unable to benefit from mobility money. If they were, they would not be eligible for the mobility component since the basic eligibility criteria would exclude them. For the most part, they are not even in anything called a hospital. Fewer than 3,000 people with learning disabilities now live in units on hospital sites; around 5,000 live in NHS community homes.

Mary lives at No. 1 in a home staffed by an NHS trust but leased to a housing association. She gets her mobility component in full, and getting it means that she can get out and about, with someone to accompany her, doing the things she wants to do—meeting the people she wants to meet and visiting the places she wants to visit, Jean lives at No. 2, in a home not yet leased to a housing association. She gets one-third of what her next-door neighbour gets, because of the 1996 change, and, effectively, as the household budget does not fill the gap, gets one-third of the opportunities enjoyed by her next-door neighbour, although her disability and her needs are almost identical.

Had these same people lived, for example, in a Mencap home, as well they might, their entitlement to the mobility component and their enhanced quality of life as a result of it would never have been in question.

When mobility allowance was introduced, those living in any form of residential setting were deliberately included because of the overwhelming evidence that they needed it at least as much as, and probably more than, those living in the community. When DLA mobility component replaced mobility allowance, the same logic was followed. But. in 1996, some misguided person decided that here was a soft target for savings, perhaps because as many as 60 per cent of those affected had no actively involved relatives to defend them, and many were not well able to speak for themselves to defend their own interests. I hope that we may see justice restored today. I beg to move.

Lord Addington

The noble Lord, Lord Rix, has done a very thorough job on his amendment. We are at least trying to do the same thing with our Amendment No. 127E. I hope that the Government will listen to what has been said and that the Minister will have something positive to say. It does not matter where you happen to be, you are still entitled to have some basic movement; indeed, freedom of movement is something of a human right. I believe it has been argued that you could be confined to a bed. I do not remember such arguments being used. However, if they were, I agree with the noble Lord that they are pretty lame.

Baroness Hollis of Heigham

The effect of this amendment and Amendment No. 127E is that the mobility element of DLA should continue to be paid to people admitted into hospital, or resident in other similar institutions. However, I should make it clear that, as drafted, Amendment No. 127A would not alter the current entitlement conditions for the mobility element of DLA. Entitlement to the mobility component of DLA, is not affected by a person's accommodation but, once entitlement is established, payment is suspended after four weeks of free in-patient treatment. Nevertheless, in speaking to the amendment, the noble Lord made clear his intention that the current legislation withdrawing payment of the mobility component of DLA from hospital in-patients should be revoked.

Withdrawal of the mobility component from hospital in-patients reflects the Government's policy of targeting help on those people with the greatest need, DLA is paid to help people meet the extra costs of disability. However, most of the needs of people in hospital, including care and basic mobility needs—I am not now talking about people who are necessarily confined to bed—are funded by the NHS, which has that responsibility. It cannot be considered best use of scarce resources to overlap with the help already available. The NHS pays for it and, in addition, people have their own personal mobility component.

Indeed, the principle of preventing duplication of public spending has always been a key factor in social security legislation. For this reason, most social security benefits are withdrawn or reduced after a period, commonly six weeks, following a person's admission into hospital. This has been a fundamental principle of the benefits system since 1948. Attendance allowance and the care component of DLA have always been withdrawn after a period in hospital. Given this fact, it is clearly difficult to justify the continuing payment of the mobility component to people, many of whom are physically immobile, or virtually so, and all of whom are receiving basic mobility costs from the NHS. Therefore, we do not think it right to restore the previous situation at an additional cost of £30 million a year, much of which would duplicate existing provision. We do not believe that that is a priority in the disability field.

However, while the situation in respect of hospitals and other places traditionally run by the NHS is clear, the broader picture is not as straightforward as it used to be. In my view, the noble Lord, Lord Rix, was entirely correct in the description he gave. There is now a wider range of care options available through the care in the community programme than was the case even when the relevant legislation on mobility and hospitals took effect in 1996, let alone in 1948 when the concept of "half-way houses" was not part of our landscape. This has led to many people being transferred from hospital and into other accommodation in the community but still being maintained by the NHS—for example, in so-called "half-way houses" and other sheltered and residential care settings.

The noble Lord, Lord Rix, is correct. There are gaps in our knowledge about the needs of disabled people in such settings and about how the mobility component of DLA is spent, where it is payable in these circumstances. We think that this is an area which may well be appropriate for research, and we are examining options for what might be done, and when.

The noble Lord asked me to outline whatever evidence we may have of the effect of the 1995–96 changes. Following representations from the disability lobby, as I said, we shall be considering commissioning research to look at the whole issue of residential care, local authority-funded care and NHS-funded establishments, including the way in which people's mobility needs are met. The noble Lord identified a range of anomalies. Because we are caring for people in the community and the legislation has not fully reflected this, we shall be examining options for research. But I must emphasise that our position on hospitals is clear in our traditional understanding of that concept. We believe it right that people in hospital settings, having all their basic needs met in line with the free provision of care and other services, the key feature of the NHS since its inception, should not retain an extra costs benefit. On this basis, I hope that noble Lords will not pursue their amendments today.

5.15 p.m.

Lord Rix

I am extremely grateful to the Minister for that most sympathetic response. Clearly, I would like to consult my colleagues between now and the Report stage. However, on the understanding of what I now believe to be the future position and bearing in mind the fact that the Government are seeking evidence, and so on, to back up their current findings, I am happy to beg leave to withdraw my amendment.

Amendment, by leave, withdrawn.

Clause 62 agreed to.

Lord Higgins moved Amendment No. 127B:

After Clause 62, insert the following new clause—