§ 3.23 p.m.
§ Lord Rix
rose to call attention to the 30th anniversary of the Chronically Sick and Disabled Persons Act 1970, and to developments in the provision and planning of community care services for disabled and elderly people; and to move for Papers.
The noble Lord said: My Lords, in a happy conjunction of circumstance this debate coincides with the inauguration of the Disability Rights Commission which for the first time provides a powerful watchdog for the rights of disabled people. We wish the chairman, Bert Massie, and his fellow commissioners every success in their future endeavours. Many of us who are to speak this afternoon have fought for those rights over the years and are delighted to have a statutory body to take on that role. We signed up to the cause of disabled people in those heady days when disability was becoming a social policy priority and social security, social services, education and public 713 attitudes were all being realigned in the interests of disabled people. I feel honoured, therefore, in this short debate to celebrate the Bill of the noble Lord, Lord Morris of Manchester, which, with the support of both Houses, became an Act 30 years ago.
The years 1970 and 1971 were particularly good. One had the Chronically Sick and Disabled Persons Act; the White Paper on learning disability Better Services, attendance allowance and invalidity benefit and the Education (Handicapped Children) Act which ensured education for children with severe learning disability who had hitherto been excluded from the education system. Looking back, I recall an anxiety to discover and explore new ways to spend money, as opposed to the disposition in recent years (fulfilled or not) to reduce public expenditure and the new orthodoxy of a lot more work and rather less welfare. If I remember correctly, we had 10-year plans at about that time. We also had the fruits of the Government Survey of Disability, in the creation of which the noble Lord, Campbell of Croy, played a significant part. It was a remarkably new experience to have some credible figures on which to base longer-term policy decisions, although the use of those figures to produce estimates of the number of people likely to qualify for the new disability benefits was as much an act of faith as a parade of knowledge.
We have come a long way in a comparatively short space of time, particularly in the field of learning disability. Noble Lordships will forgive me if, as President of Mencap, I am biased in that direction. I am sure that other noble Lords will apply the necessary touch to the tiller. The statistical baseline for the learning disability White Paper in 1971 was 1968–69, which was only a year or two after the population of the old "mental handicap" hospitals had peaked. Today only about 3,000 people with learning disabilities still live in hospitals, and the 60,000 to 70,000 hospital population has become a 60,000 to 70,000 care-in-the-community population.
The children who were denied education because the}' were deemed ineducable now almost universally attend school, and a good number have gone on to further education. Some have successfully completed Open University courses. In particular, several hundred have completed a course designed with the help of Mencap. Thirty years ago we talked about people; now we talk with people who have learning disabilities and, in the process, learn a good deal.
But some things have not changed. Much the same proportion of adults with severe learning disabilities now live with their families as they did in 1969, despite the population being older and more severely disabled. Some of them are the same people. For them and their families inevitably there is a sense that nothing much has changed, except a diminution in the ability to cope with the passing of the years.
Other noble Lords will deal in more detail with some of the themes that cluster around the Chronically Sick and Disabled Persons Act and the Community Care Act. In my remarks I want to pick out some of the main themes and say a little more about the learning 714 disability strategic review which is now in progress. There is much to celebrate. I want to highlight the goods things, not just the deficiencies, substantial though they still are.
I intended to describe those main themes as the "Munroes of community care". However, the mountaineers and Scots in your Lordships' House are conscious of the number of Munroes and therefore will be apprehensive as to the length of my speech, which is still limited to 15 minutes. I shall be more selective and pick out just seven themes in this overview: the shift from discretionary services to rights; the importance of employment in daytime occupation; the controversy over charging; the Scylla and Charybdis of funding and rationing; the role of advocacy; the focus on individuals; and, predictably, short-term breaks.
The Chronically Sick and Disabled Persons Act was about three things: the identification of disabled people, their involvement and their rights. Involvement and rights go together, in that people should be listened to and at least have the right to some of the things that they say they need to balance out the disadvantages imposed on them by society because of their impairments. Twenty years ago the NHS and Community Care Act dealt with process rather than rights, and that perhaps accounts for the gap between expectations and what has been achieved under the Act. Without the Chronically Sick and Disabled Persons Act, those parts of the Disabled Persons Act 1986 which have been implemented and our old friend the National Assistance Act 1948, the Community Care Act might be characterised as being about paper rather than people. In context, however, it offers something like a right to recognition, assessment, a statement of needs and wishes and at least an indication of what will be delivered.
My hope is that the rights agenda is now, with direct payments and the development of specific service standards, beginning to loom larger with fewer "ifs" and "buts". Across the rights path lies the shadow of the Gloucester judgment on which no doubt other noble Lords may wish to expound. Recognising that that judgment reflected the reality that local authorities cannot spend money they do not have and would be unwise to plan on the assumption that they can, I want to link it in with rationing and resources.
There is a very real dilemma here. The Government say that they are spending more money; and they are. The local authorities say that they do not have enough and are having to cut back. Clearly they do not have enough and are having to cut back. The daughter of a friend of mine is having £20,000 per annum pruned from her funding. Needs are increasing. Needs are being better recognised. Governments have consistently allocated less than most local authorities actually spend on social services; and once increased allocations cannot be topped up from other sources, the gap between needs and resources means cutbacks. When I managed a theatre, spent more on the production than I received from the audience, and 715 could not bridge the gap by selling programmes and chocolates, I had problems: the risk of having to put on "Hamlet" without the prince.
A good many people feel that their local authority has splendid plans, high principles, good intentions but no prince. That is why consultations on future developments sometimes receive a dusty response. People say, "Well, they know what we need now, and they can't deliver; why waste time asking for future developments which they won't be able to deliver either?" To try to bridge the funding gap, local authorities, under the pressure of government expectation, are charging for services. This results in family carers who are already having to carry the burden and some of the cost of community care having to carry more burden because they opt out of services, or more cost because they have to pay for services. Mencap has had people on the phone actually in tears saying that they cannot afford the cost of what they desperately need.
I hope that when Ministers make their announcements about charging, they will at last bite the bullet and standardise, if they do not abolish, charges. If charges continue, disabled people must be left with enough money to stay above the poverty line. That is not always the case today.
I want to run together two of my other themes: advocacy and treating people as individuals. If our services were to be group solutions for groups of people, we would by definition not have individuality, and we would not be much bothered about advocacy. If, on the other hand, we accept that the desired outcome is individual solutions addressing individual needs in the light of individual choices, we need advocates. I signed my contract as Secretary-General for Mencap almost 20 years ago today. As secretary-general I helped to found the Advocacy Alliance. But without effective advocacy I think it is clear that we cannot secure civil rights in line with the Disability Discrimination Act, rationalisation of decision making under the Government's "making decisions" proposals, or appropriate access to social services, lifelong education or healthcare. It is equally clear that most people who can talk for themselves cannot readily secure the attention of those who should be listening to them, and that most people who need independent advocacy simply do not have it. I hope that when replying, the Minister can offer us some glimmers of hope here.
I turn to the last of my overarching themes: short-term breaks and employment. Seen from the perspective of disabled people and family carers, both are concerned with trying to secure as far as possible a normal life. Short-term breaks give the disabled person and the family carer a chance to enjoy personal space, to do their own thing, to grow apart without falling apart. A Mencap colleague is having to give up her work for Mencap because she cannot secure decent respite for her severely disabled son while she does her voluntary work for Mencap. Employment means for family carers and for disabled persons doing what most people of working age want to do, and enjoying 716 the wider contacts and the possibility of higher income which go with that. But 90 per cent of severely disabled people of working age do not have paid employment.
I acknowledge the Government's carers initiative even if the early evidence is not terribly encouraging in terms of the extra money securing either innovation or allocation to short-term breaks. I acknowledge, too, the positive aspects of the New Deal and the awkwardly-named "One". Some disabled people are now doing paid work who would not have had the opportunity without the recent initiatives. But I would welcome two reassurances. One is that the Government will continue to encourage agencies to provide individually tailored short-term breaks and discourage doctrinaire approaches to respite, which assume that only one model, and that commonly the cheapest, is right. "We only have family-based respite" is not a principle policy to be warmly welcomed. It is an abandonment of responsibility for those for whom that model at this time is not appropriate.
On employment, I seek the assurance that this will be encouraged but not enforced on those with substantial disabilities, and that there will be recognition in day service policies of the reality that employment can only provide some of what is needed for some of the people for some of the time. Shutting the day centres on the ground that everyone has got a job would, I believe, be a little like the heady and ultimately fatal optimism of Marie Antoinette that those without bread could fill their bellies with cake.
Finally, I turn to the learning disability strategic review. I welcome wholeheartedly that the original White Paper may be replaced 30 years later by a new White Paper, and the way in which interested parties—and not least people with learning disabilities themselves—are being involved in developing the new policies. I am conscious that we shall not see the end product until the end of this year or the beginning of next year, and I recognise that the Minister will not want to commit himself firmly at this stage; but I offer three propositions for comment if the Minister feels so inclined.
First, there is clearly a case for a policy document of the White Paper kind spelling the whole range of Whitehall responsibilities, rather than something more modest such as an interdepartmental circular. Secondly, it would be in line with the focus on outcomes judged by individual experiences to build into that White Paper personal stories which show the huge progress made and personal aspirations on which the Government intend to deliver. Thirdly, it should help to maintain the impetus for implementation over the next few years to have a central advisory committee on learning disability support and opportunities backed by a research programme and network.
I conclude by hoping that I have learned over the years to avoid both the cynicism of failing to recognise what is good and hopeful and the unreasonable optimism which ignores what is palpably bad or doomed. I have seen so many people with learning disabilities achieve what it was said they never would that I have high hopes that from the legislative base of 717 the CSDP Act, and the measures which have succeeded it, and through the current review, we shall see over the next 30 years at least as many improbably successful things as we have seen over the past 30 years. I also have high hopes that we shall measure outcomes in individual lives and not just in statistics. The Chronically Sick and Disabled Persons Act made the jump from "the disabled" to "disabled people". I look forward to the contributions of other noble Lords. I beg to move for Papers.
§ 3.39 p.m.
§ Lord Morris of Manchester
My Lords, I am most grateful to my friend, the noble Lord, Lord Rix. It is highly appropriate for a distinguished Cross-Bencher to have opened this debate: for those who laboured with me to enact my Bill were not of one party. They were of all parties—and of none—but of one mind. They were determined to create for disabled people an Act they could call their own: to help to reduce their dependence on others, to help them to live as normally as possible in their own homes, with their own families, and to have the same opportunities as everyone else to contribute to the life and work of their society.
However, that was then widely seen as an impossible dream. In 1969–70 no one knew even approximately how many disabled people lived in Britain. They were mostly seen or heard only by their families or, if locked in institutions, by those controlling their lives. To talk then of as-of-right cash benefits for disabled people and their carers was to invite ridicule. Local services were wholly discretionary and often non-existent, but council leaders were serenely satisfied with the status quo. That is how things were when, against all the odds, my Chronically Sick and Disabled Persons Bill became law in 1970.
For the noble Lord, Lord Rix, to have opened this debate is most appropriate for another reason. In the Chronically Sick and Disabled Persons Act the term "disabled person" includes, and always has included, what might be called the noble Lord's constituency. The symbolism of the wheelchair is powerful, and rightly so, but the Act also embraces millions of people with impaired hearing, impaired sight, impaired intellectual functioning and learning disabilities which can affect mobility but do not involve using a wheelchair.
For a Back-Bench MP, first place in the Private Members' ballot is the most coveted prize in the lottery of parliamentary life. But Ministers whose departments are affected by a Back-Bencher's Bill may not share their delight. The late Richard Crossman, then Secretary of State for Social Services, was not best pleased when he heard that I intended to present a Bill to improve the well-being and status of disabled people and their carers. As Tam Dalyell, then Crossman's PPS, writing to me some years later recalled,I well remember Dick trying to bully you into either changing drastically or dropping the Bill at more than one point—in vain.Dick Crossman was not the only Minister who initially wanted me to drop the whole idea. Education Ministers asked why my Bill proposed help for people with dyslexia—a condition which they said "simply 718 doesn't exist". To which I replied "Then it won't cost you anything!" Official reaction to my Bill's provisions for helping deafblind children and those with autism, like the proposal for an institute of hearing research, was even less supportive. Thus the Bill's prospects looked bleak.
The pessimist, they say, is an optimist who has been given the facts. Happily there were those all across Parliament who, despite knowing all the facts about the extent of ministerial opposition and the heavy odds against my ever securing a money resolution, remained optimistic that the Bill could succeed. In another place they included my very good friend Jack Ashley, as he then was; the late John Astor; Lewis Carter-Jones; the late Sir Neil Marten; the late Laurie Pavitt; and the late Maurice Macmillan; and in your Lordships' House there were my noble friend Lord Longford, then a recent former Leader of this House, who sponsored the Bill with all his customary kind humanity; my friends, Lady Masham and Lady Darcy de Knayth; my noble friend Lady Serota; the noble Lord, Lord Cullen; and the late Lady Pat Lewellyn-Davies.
Everyone who worked to enact our Bill will remember how often and how close we came to disaster. But it was Dick Crossman's main Bill of that parliamentary session which hit the rocks while ours sailed safely by. The Bill became an Act of 29 sections. It imposed new duties and responsibilities on 12 departments of state and became the model for legislation across the world. It amended 39 existing Acts of Parliament in the interests of disabled people, including such major statutes as the Public Health Act 1936, the Education Act 1944, the National Health Service Act 1946 and the Housing Act 1957. Moreover, it was in debates on our Bill that the terms "social exclusion" and "community care" first came into vogue.
In the decade after the Bill's enactment huge leaps were recorded in the numbers of people identified as disabled; millions were helped by the provision of aids, by adaptations to their homes and by the Act's five sections on access to the built environment, the first such legislation anywhere in the world. It is estimated that, in its first 25 years, 12 million people in England were helped under Section 2 of the Act alone. In Scotland, over a shorter period, 1.9 million were helped. Those are minimal figures, since they do not, for example, include 1.7 million Orange Badge holders and countless millions more beneficiaries, here and abroad, of its access provisions.
But this debate is also about what is happening now. In the very short time left to me I want to comment, as promoter of the Act, on the perverse—in fact bizarre— judgment in the case of Regina v. Gloucestershire County Council and the Secretary of State for Health, ex parte Barry (the so-called Gloucester judgment). Since that judgment, the provisions of Section 2 of the Act have been trampled on in many parts of Britain. Those responsible for the judgment seemed to think I drafted it on the back of an envelope. In fact, it was drafted with unfailing help from the leading parliamentary draftsman of his day, the father of a disabled child, whose expertise was gifted in his own 719 spare time. The policy intention of ensuring that help for disabled people would in future depend not on where they lived but strictly on the extent of individual need was made utterly clear at all stages of the proceedings of the Bill. The drafting is also clear—as clear as Britain's foremost parliamentary draftsman could make it.
Section 2 opened up the opportunity for a life of dignity for disabled people. Now it has been put in abeyance by judge-made law in direct defiance of a statute that was far better drafted than most legislation I have seen in my 36 years of parliamentary life. The result is documented in graphic detail in Out of Service, a dossier of distress published by the Needs Must coalition of disability organisations, which shows that one shameful consequence of the Gloucestershire judgment is the denial to many housebound disabled people even of the right to a bath, now one of the most fundamental of human rights and well respected in our prisons.
As the noble and learned Lord, Lord Lloyd of Berwick, saw—clearly after studying the parliamentary proceedings on Section 2—it was no part of our intention to turn services for disabled people into a postal code lottery. For others to suggest the contrary was a crude and ludicrous distortion of the parliamentary record.
I know that my noble friend the Minister recognises that the current crisis in community care—for which disabled people and their carers all over the country blame the Gloucestershire judgment and the now almost equally notorious Powys judgment—is placing an increasingly daunting strain on the NHS. It is a crisis that demands urgent action. Not to act now to reverse the immense damage of these judgments would be to dishonour those in all parties who worked long and hard and with deep commitment and sincerity to achieve the enactment 30 years ago of a measure that a senior French legislator was soon afterwards to describe as a moment critique for disabled people everywhere.
§ 4.47 p.m.
Lord Campbell of Croy
My Lords, I first declare an interest. I was wounded and partially disabled in the Second World War, and have received a war disability pension since leaving hospital more than a year after the war.
I congratulate the noble Lord, Lord Rix, on initiating this debate. He did dedicated work leading Mencap, and we worked together in 1981, when we were both playing parts in the International Year of Disabled People.
I am also glad to follow the noble Lord, Lord Morris of Manchester, because the 1970 Act would never have reached the statute book without his resolve and skilful piloting.
I am glad to speak on the Motion recording the 30th anniversary of the Chronically Sick and Disabled Persons Act 1970. As I am limited to seven 720 minutes, I shall concentrate on that part of the Motion, in the hope that that is the most useful contribution I can make.
I was much involved over 30 years ago, when I was in opposition and in the shadow Cabinet, and later when I had become a Cabinet Minister, in putting parts of the Act into effect.
The Act started as a Private Member's Bill introduced in the other place by the noble Lord, Lord Morris, after he had come first in the annual ballot in November 1969. The noble Lord deserves the greatest credit. As he has publicly announced, and repeated today, the then Secretary of State for Social Services, Mr Richard Crossman, disapproved of what he was doing and tried to stop the Bill going forward. The noble Lord received no help from the Government in drafting the Bill, although such help can normally be expected. But he persevered with determination and, I am glad to say, with success.
I had experienced similar, but worse, treatment a year before, when I was successful in the ballot in 1968. My Private Member's Bill, entitled the "Disablement Commission Bill", was lost when a Division was forced by the Government, a Labour government, at the end of a Second Reading debate, with the government's whipping applied.
The only excuse that can now be given for such treatment is that my Bill was 30 years before its time, particularly as in the past two years we have helped to pass the Disability Rights Commission Act—and the Disability Rights Commission begins its life today, more than 30 years after I introduced my Bill!
I entered the other place five years before the noble Lord, Lord Morris, and at that time had been depressed by the absence in the country of help with disabilities not caused by war or industrial injury. However, I was on the Back Benches for only a year and a half, after which I had to apply myself to other subjects from the Government Front Bench.
Owing to the limited time available, the Bill which the noble Lord introduced in 1969 applied only to England and Wales. During its Committee and Report stages, I managed to arrange for parts of it to be extended to Scotland. A year or two later when I was Secretary of State for Scotland, I was able to complete its application to Scotland.
The Bill had almost completed its passage through Parliament when a general election was called for June 1970. Other Bills fell by the wayside in the normal way, but I am pleased to say that inter-party agreement was reached for this Bill to be reintroduced early in the following Parliament. The Conservatives won the election and honoured the agreement. The Bill was reintroduced and was quickly passed into law. I became Secretary of State for Scotland and, because both health and local government were totally devolved to the Scottish Ministers and the Scottish Office, I had the welcome duty of putting parts of the Act into effect north of the Border.
The 1970 Act was a bright beacon on the way to improving ordinary life for disabled people. For the next 24 years, further legislation on disablement was 721 attempted but only in Private Members' Bills. However, in 1994–95, a giant step was taken when for the first time a government introduced a Bill on the subject. It became the Disability Discrimination Act 1995; the DDA.
I am sorry sometimes to hear derogatory remarks that the DDA is "flawed". When asked why, the reason given is that it does not cover enough. That criticism is a misuse of English. To give the impression that the DDA is defective because it does not deal with every part of the huge range of issues affecting disabled people is misleading and a disservice to disabled people and their carers, who are already discovering much in it to help them.
No Act could have covered the whole field. We should have still been waiting for the DDA if that had been attempted. But I confidently expect another government Bill to be brought forward in due course to continue the process. In 1995 the DDA carried out more than 20 Private Members' Bills could have achieved. It even tackled the difficult and complex subject of transport; and it was the first government measure on disablement.
As I have one minute left, I turn to the services made possible for local authorities to provide under Section 2 of the 1970 Act. I agree with what the noble Lord said about the decision in the Gloucestershire case. I am greatly concerned about the many reports of the reduction and withdrawal of services that are necessary for disabled people to live independently. Furthermore, I refer the Government to the "Needs Must" campaign and to its recent report, Out of Service. I earnestly hope that the Government will take that report fully into account.
§ 3.54 p.m.
§ Baroness Barker
My Lords, during the comparatively brief time I have been a Member of your Lordships' House I have come to appreciate that the noble Lord, Lord Rix, often has the best lines. We know well that he has great timing but never more so than today. When the cast list for the debate appears, my name will probably appear down near that of third electrician or someone similar, but none the less I want to thank him for raising this timely debate today.
When I noted the title of the debate I wondered whether several current Members of your Lordships' House who were responsible for the passage of the Bill 30 years ago might line up to take a bow. I am glad that they did and I salute collectively what they did. It set a mark from which all services for disabled people will be measured.
Today, as we enter the era of PCGs, clinical governance and national service frameworks, it serves us well to reflect on the intentions set out in the Chronically Sick and Disabled Persons Act, to assess the effects of the National Health Service and Community Care Act and, learning lessons from both, to state clearly not only what are acceptable levels of services and social care, but how such standards should be determined and by whom.
722 The Chronically Sick and Disabled Persons Act refers to the provision to a disabled person of,adaptations, services and any additional facilities to secure his greater safety, comfort and convenience".It refers to services such as practical assistance at home; assistance obtaining access to wireless, television, library or other recreational facilities; games or outings, or other recreational facilities outside the home; and the provision of, or assistance with, travel to or from such facilities.
That list, were it to be reproduced in a community care plan or health improvement plan today, would look out of place not because of the language but because items such as those simply would not appear in a list of priorities for any social services department. Individual older or disabled people may realise the importance of leisure and transport, but it is doubtful whether the community care budgets for older people would stretch that far.
Over the past 30 years a paradox has developed in which the direct involvement of older and disabled people in the planning and evaluation of services has greatly increased. The National Health Service and Community Care Act placed upon local authorities and health authorities a requirement to consult users about the planning and provision of services. Consult they did, zealously so in some cases, and involvement of older and disabled people became, first, an expectation and then the norm. However, at the same time, the right to services was eroded as eligibility criteria were drawn ever tighter. Mary people, although more involved, witnessed the demise of services which they saw to be important; services such as home helps.
Many people's 65th birthday is not a time of celebration. In terms of social care, they move from social services' "younger adult" budget to the "older people" budget. At that time, although their physical and health needs may not change, the services which they receive and their right to receive them fall dramatically. We know that the Department of Social Security and the Department of Health, among others, use age as a defining criteria. People who become disabled after 65 do not qualify for the disabled living allowance. Although many of them receive an attendance allowance, there is no mobility component to that benefit.
At the beginning of this decade, against a background of economic prosperity and in the context of the Government's policy of combating social exclusion, basic questions about the social care of older and disabled people remain to be addressed. Why are thousands of older people losing their mobility because there is no one to cut their toe-nails? Why are so many people with moderate disabilities having to pay for the help they need, such as home help, than was ever the case in the past?
The noble Lord, Lord Morris, raised a very important question: is a bath a social bath or a medical bath? It is neither; it is a human right. That is a most important answer. When the Human Rights. Act 1998 723 comes into force later this year, many of the issues which noble Lords have raised about levels of care will become challengeable in the courts.
My suggestion to the Minister today is that we should avoid the need for individual older and disabled people to suffer indignities and take their cases to court by saying now that we have learnt one of the most important lessons from the Chronically Sick and Disabled Persons Act: that rights without resources do not mean very much. We do older and disabled people no favours by giving them frameworks and approaches which are inclusive and contain the terminology of inclusion if, at the end of the day, there are simply not enough resources to make something happen for them.
Thirty years ago, many noble Lords put down a marker that social care was concerned with the safety, comfort and convenience of disabled and older people. Today, we talk about social inclusion. The best thing we can do is to put on record in the House today that, 30 years on, we have a clearer understanding and can employ better words to express the rights of disabled and older people to be included in society. It is not only for their personal and individual better health; it is for our greater benefit.
I thank the noble Lord, Lord Rix, for his very timely debate, and I exit the stage.
§ 4.1 p.m.
§ Baroness Darcy de Knayth
My Lords, I congratulate my noble friend Lord Rix, both on winning the ballot so that we can celebrate the 30th anniversary of the Chronically Sick and Disabled Persons Act and on the masterly and comprehensive portrayal that he has given of life for disabled people over the succeeding years.
When the noble Lord, Lord Morris of Manchester, won the ballot in 1969, he could have taken the easy road to fame with a pre-written, non-controversial Bill. However, as noble Lords have already heard from the noble Lord and from the noble Lord, Lord Campbell of Croy, by his unstinting efforts he instead transformed a Bill, strenuously opposed by many and without a money resolution, into an Act of considerable importance for people with disabilities.
I was honoured to make my maiden speech at Second Reading of the Bill when it was introduced into this House by the noble Earl, Lord Longford. My noble friend Lady Masham also made her maiden speech, as did Lord Ingleby. The fourth Member of the mobile Bench was Lord Crawshaw, and I should like to pay tribute to them all for working tirelessly for disabled people over many years.
I spoke then on the need for improved outdoor mobility help for disabled people, including those too disabled to drive themselves. Therefore, I was particularly delighted when, a few years later, as Britain's first Minister for disabled people, the noble Lord introduced the mobility allowance. I should also like to mention the huge contribution made over the 724 years by Sir Peter Large. He briefed me for my maiden speech and I am much indebted, too, for his thoughts today.
The Act did not solve every difficulty faced by disabled people but it helped to solve many. It put disabled people firmly on the map; it gave them confidence; and it established a sound basis for further progress. Lately, however, that progress has slowed down and in some cases has even gone into reverse. The emphasis now seems to be on children and child poverty and elderly people and pensioners' poverty. Regrettably, the Government's grand design for tackling poverty does not appear to cover the poverty of disability.
If that sounds carping on a day when the Disability Rights Commission makes its debut, in the year that all black cabs become accessible, and access and education opportunities have improved, I would ask noble Lords to consider. We have seen the abolition of the severe disablement allowance and the introduction of means-testing for incapacity benefit. That means that for single people aged 45 or over the means test will take effect when their annual income reaches a mere £7,900. How can anyone on that income be an appropriate target for means testing? The entitlement to a contributory benefit of a married man under 45 will be completely wiped out when his annual pension income reaches £15,500.I ask noble Lords to contrast that with the upper earnings limit of the new children's tax credit, which will be approximately £38,500. How can one reconcile that with the proposals that every pensioner, regardless of health or wealth, be issued with a free half-fare bus pass, an annual £150 winter fuel bonus and a free telly, to boot, for everyone over the age of 75?
As the Needs Must coalition report shows—as I am sure the noble Lord, Lord Morris of Manchester, has already said and as I am sure the noble Lord, Lord Ashley, who is to follow, will make very plain— services for disabled people who try to live independently in the community are being inexorably reduced. The introduction of both the minimum wage and holiday entitlements has increased the cost of care. That extra cost must sometimes be paid for by cutting the total amount of care received. As many local authorities increase those charges, too many people are finding it impossible to afford all the personal help that they need.
Although it is true that there has been some additional expenditure on carers, the concentration on carers is not always to the benefit of the disabled people themselves. If we are to be true to the spirit of the Chronically Sick and Disabled Persons Act, we must redress that imbalance. On 17th April, in winding up the Second Reading of the Child Support, Pensions and Social Security Bill, the noble Baroness, Lady Hollis, described the Bill as,an attack on the poverty of children and pensioners".—[Official Report, 17/4/99; cols. 520-521.]The poverty of many disabled people is crying out for a similar attack.
725 Finally, on a more cheerful but equally important note, I return to the subject of my maiden speech: mobility. I welcome the Government's announcement of a review of the Orange—now Blue—Badge scheme introduced by the 1970 Act. It has been a huge help to disabled people who are dependent on cars to escape the confines of their home and who wish to travel. In recent years, as traffic and traffic restraint measures have increased, so, too, has the demand for badges. Many local authorities and some GPs have been lax and over-generous in issuing badges to people. Some badge-holders have been careless in allowing them to be used by others. Enforcement of the rules is at best half-hearted and often non-existent.
I firmly believe that we need legislation to allow the police and traffic wardens to inspect badges. I had not realised that they are not allowed to do so. They can ask someone only to show them the details on the inside of the badge. If the person refuses, they can check whether the sex of the person matches the name on the badge. The Disabled Persons Transport Advisory Committee (DPTAC) made a number of important recommendations to improve the operation of the scheme. I very much hope that Ministers will adopt those so that disabled people in genuine need can remain mobile and move around with freedom.
§ 4.7 p.m.
§ Lord Ashley of Stoke
My Lords, I thank the noble Lord, Lord Rix, for initiating this debate so splendidly, and I warmly endorse all the proper tributes paid to my noble friend Lord Morris. I had founded the All-Party Disablement Group some time before he won the ballot for his Bill. Together with a wonderful Tory MP, John Astor, we worked with my noble friend Lord Morris on that Bill. We discovered then that disabled people were held almost in contempt. They were pitied and patronised and had no rights whatever. That was a time when we needed legislation and that is precisely what the Bill, which became an Act, did. It provided new rights for disabled people which they had never had before, and it imposed obligations on local authorities. That was the great achievement of my noble friend Lord Morris.
It is great to see the Labour Government carrying on the tradition of helping disabled people. I am sure that many noble Lords will have heard the various announcements made in this House by the noble Baroness, Lady Hollis. I congratulate the Minister for disabled people, Margaret Hodge, on the marvellous work that she is doing for disabled people. Only this morning I was with her for the launch of the Disability Rights Commission. That is a marvellous step forward. Thanks to the Labour Government, the commission will do more in the next three years to transform the lives of disabled people than we have managed to do in 30 years. That kind of tough organisation was needed to enforce the Disability Discrimination Act.
Despite progress made, there is still much to do for disabled people at present. There are two examples that I should like to mention: first, the postcode lottery for personal services; secondly, the means assessment 726 of personal care. It is interesting that when the postcode lottery in the National Health Service was exposed, the Government said that they would tackle it and resolve it as soon as possible. That is fine; we all admire that kind of stance. There is now a postcode lottery for personal services but the Government do not say, "Right, we will solve this. We will deal with it immediately". They are making some attempts but nothing like the kind of vigorous, almost sustained attack that they are making on the National Health Service. Why do they not do that for personal services? I believe that too few people appreciate how vital are these personal services. I hope that the Labour Government will change their tack and attack the problem of personal services being postcoded with the same kind of vigour that they are using for the National Health Service.
The Gloucester judgment has been mentioned. That allowed local authorities to take resources into account. I interpret that differently. I regard that as an opportunity to plead poverty and to cut or remove the vital services for disabled people. It is all very well to speak about "rights without resources"—in that admirable speech made by the noble Baroness. That was a very good phrase. We have to provide the rights and it is up to government, national and local, to provide the resources. I admit they may be short of resources but I object to selecting disabled peoples' services as the scapegoats, as the very first people and the very first line of attack. If they are short of resources, they should look all across the board and not select disabled people as the first victims. Let them deal with disabled people and then solve the problems in the best way they can. That is the plea I make.
The Government display a curious attitude as regards the Gloucester judgment, especially the Department of Health. In a recent Parliamentary Question that I asked, the Government indicated that they were content that local authorities should take account of their resources when providing those services. The Minister then assured me that local authorities were under a duty to arrange the services. The Government cannot have it both ways. If local authorities take account of their resources, that is absolutely incompatible with a duty to provide the care—utterly incompatible. The Government must make up their mind; are they standing by their original interpretation that resources should be taken into account? If so they should bring forward legislation to change the law. If they adopt the idea that the provision should be made anyhow, that the rights should come first, then they do not accept the law as it stands. One way or the other the Government are wrong. One way or the other they should ensure that disabled people really have those rights.
My final point is on the Independent Living Fund. I cannot understand why the Government should means test the Independent Living Fund. Why do they do that? I find that disabled people working, especially severely disabled people working, are conforming with what the Government want. They have gone from welfare to work. But what do the Government do? They hit them with a means test. It is quite 727 unreasonable. I believe that the personal care which severely disabled people receive should be given to them as a right and they should not be hit in the way that the Government are hitting them.
I have to leave it there as my time is up. All I would add is that I hope the Government will think again and do what they can for disabled people far more in the future than they have done in the past on those two issues.
§ 4.14 p.m.
§ Baroness Masham of Ilton
My Lords, I thank my noble friend Lord Rix for having chosen this subject for debate. Thirty years ago I made my maiden speech on what became the Chronically Sick and Disabled Persons Act. I am told it was on this very day 30 years ago. I also celebrate 30 years as a Member of your Lordships' House this year.
When I look back over the years I often compare facilities and services for disabled people with a game of snakes and ladders. There are advances and cooperation, cutbacks and fragmentation, and bad communication, forgetting disabled people exist.
Last night I took my usual route to have supper in the Home Room, through the Royal Gallery, down in the Sovereign's Staircase lift, across Royal Court, avoiding the puddles, and up the ramp. I managed to wriggle under the scaffolding only to find the entrance door locked. A helpful member of staff crossing the courtyard unlocked the door. However, when I came out, the door was locked again. Fortunately, some guests were leaving a reception. Together with a security guard they lifted me down the steps. I told them that when some other work had been undertaken a ramp had been provided. I am sorry to say that this incident is so typical of what happens throughout the country. People do not have a foolproof system of checking accesses, which is covered by Section 4 of the Chronically Sick and Disabled Persons Act 1970.
I was speaking to one of the elderly and distinguished Peers in your Lordships' House yesterday. He told me that he now lives in an Abbeyfield House because he is elderly and infirm. Everything is fine, except that the last meal of the day is at 5 p.m. If someone has been used to having dinner at 8 p.m. this seems early. Could it be that it is at this hour for the convenience of the staff? Is it not time that the wishes of the elderly and disabled people take priority?
I was sorry not to be able to take part in the debate last week on the critical report by the Audit Commission on the provision of disability equipment by the National Health Service. I had an important prior engagement. It has been found that the withdrawal of services, the long delays and the refusal to provide equipment affected carers and other family members as well as the disabled person. I am pleased that the Prime Minister has taken an interest. I hope it will not just be a flash in the pan. For a long time this has been a Cinderella service, with a few people working in miserable conditions, struggling with lack 728 of funds for developing pleasing prosthetic limbs and equipment. The noble Baroness, Lady Lockwood, who has to use an artificial foot, told me that the feet used for women, such as herself, are modelled on men's feet and filed down to fit into a woman's shoe. Another friend who uses callipers had to have boots made specially to support her ankles. She waited for months and when they arrived there were two boots for the same foot. Surely we can do better than that. With so many young people having lost limbs due to contracting meningococcal disease, it is important that prosthetic limbs fit well, are comfortable and are cosmetically attractive. There needs to be a national service framework for disablement services throughout the country so that disabled people have a first-class service.
In the past 30 years, the new disaster of HIV/AIDS has hit the world. Patients with AIDS became empowerers. Patients and doctors worked closely together. They have been able to achieve new triple drug treatments and have led the way in better group services and being able to express their needs. We should all work together to prevent all forms of conditions which cause severe disability. Research and better services for all with severe disabilities are needed.
Without good reliable help in the home, there will be disasters. During the past 30 years, there have been many tragedies. One young man who broke his neck in a rugby scrum told me, when he was getting older and his mother became very disabled with arthritis, that he could never go into a residential home. Some time later, he was found drowned in the lily pond in his garden.
Another tetraplegic who had sustained his injury in the Army was recently involved in a car accident with his wife. Not being able to stay longer in hospital and his wife not being able to cope at home, he had to have a residential place until his wife was better. He became depressed and, with the bandage from his arm, somehow managed to hang himself. There is a desperate need for more sensitive understanding of the needs of such people who are a great loss to those who know them.
I conclude on a note of hope. Last week, I attended a parliamentary launch of the Parkinson's Disease Society for specialist nurses. It was heartening to witness three Members of Parliament—one Labour, one Conservative and a Liberal Democrat—all speaking out for better services and understanding. It was good to see three enthusiastic MPs united in a cause.
I hope that the voices of disabled people and their supporters will be heard and that the Audit Commission will continue to produce reports which bring forward a better quality and standard of life for all disabled people.
§ 4.22 p.m.
§ Baroness Pitkeathley
My Lords, as the noble Baroness, Lady Barker, reminded us, in a previous life, the noble Lord, Lord Rix, was noted for the magnificence of his timing. I am glad to see that he has 729 lost none of his touch by enabling us to debate this issue, not only because it is important but also because this is the day on which the Disability Rights Commission is launched.
Looking down the list of speakers today, I am aware that by the standards exemplified by your Lordships' House, I am something of a new kid on the block in these matters. I want to pay sincere tribute to all noble Lords and in particular to the noble Lord, Lord Morris of Manchester, not only for the part that he played in relation to the 1970 Act but also for the other legislation and initiatives which he has spearheaded. I pay tribute also to other noble Lords and Baronesses who are speaking today who have such a fine record. In particular, I wish to mention Lady Seear, Sadly, she is no longer with us but she made a seminal contribution to the development of community care, particularly in relation to carers.
I came into this field only in 1986, when I joined the carers movement. That was just in time to participate in the ultimately successful campaign to extend the invalid care allowance to married women. Also, I was an adviser to Sir Roy Griffiths, as he developed his report on community care, Agenda for Action.
I remind noble Lords of a definition that Kathleen Jones gave of community care in 1972. She said:To the politician, community care is a useful piece of rhetoric; to the sociologist, it is a stick to beat institutional care with; to the civil servant, it is a cheap alternative to institutional care which can be passed to the local authorities for action, or inaction; to the visionary, it is a dream of a new society in which people really do care; to social services departments, it is a nightmare of heightened public expectations and inadequate resources to meet them. We are only just beginning to find out what it means to the old and the chronic sick".We might still agree with some of the observations made in that quotation, but we have made progress. There are areas in which improvements have been made and we should celebrate that.
In my judgment, the most significant change is the emphasis now placed on users and carers. I believe that that is the biggest change in 30 years. That is a major contribution and will continue to influence future developments.
When Sir Roy Griffiths said in 1988 that,the starting point has to be to identify and respond reasonably and appropriately to the needs of individuals in their particular circumstances",he was not setting out a truth which was universally acknowledged at the time. The word "user" was unknown and the word "carer" even more so. I have vivid memories of going to conferences where the most unlikely people turned up to hear me speak because the word "carer" had been mis-spelt as "career" and people came to hear me talk about training and professional development, and not the 6 million carers who at that time were completely unrecognised.
When I was a young social worker in the 1960s, people who came to us for help were called "applicants". Some people who worked there had administered the Poor Law and remembered when they were called "supplicants". Then they became "clients", then "recipients", then disabled people and 730 their carers and eventually became users and carers. But applicants do not become users or carers or customers just by changing their name. It is necessary to change the systems with which they come into contact and above all, the attitudes of the professionals with whom they deal.
I believe that we have made progress with those changes in 30 years and that the policies and legislation which have followed are both the result of those changes in attitudes and also have lead them.
The milestones along the way are well known. I have a particular interest in the Carers (Recognition and Services) Act 1995 and in the national carers strategy launched by the Prime Minister last year. The Carers and Disabled Children Bill will shortly come to your Lordships' House and will give us more opportunities for debate.
What the carers movement and all those associated with it in the past 30 years have done—-and I believe it is a record to be proud of—is to turn a private trouble into a public issue. There have been radical changes in community care and the way it is delivered not only in organisational and financial terms but also in terms of professional thinking.
It is one thing to say that users and carers should be at the centre of decision-making but it is another to implement that because that requires a change in the attitude of professionals in relation to sharing; allowing people to make choices that others may not think are appropriate; it is also about risk-taking; and about managing conflict. It is also about developing the confidence of users and carers so that they have enough self-esteem to participate in the consultation processes that are now sometimes offered in a way which is not tokenistic and which result in changes in practice.
It requires too that professionals are prepared to address the imbalance of power which exists in that relationship; to divest themselves of stereotyped images; and perhaps to ask some very difficult questions that we as society must also address. For example, do adult children always have a responsibility to look after their parents and do children have a right to inherit their parents' resources and so on?
The carers movement has an admirable history of pushing us all to address those issues and to look at the rights and needs of carers, recognising them as prime providers of community care but never looking at their needs in conflict with those of the disabled person even though they are inexplicably entwined with them.
I believe that power of the users and carers movement is one of the most important lessons that we have learnt in 30 years. But something else which we have learnt and of which we must take heed is how quickly policy matters change in that area. One example is that the Griffiths review of community care in 1988 made no mention whatever of GP fundholding because it was not even a gleam in anyone's eye in those days. By 1993, it had been introduced and had 731 had a major effect. By 1998, it was gone. So we must remember how quickly circumstances change in that area.
The Care Standards Bill currently passing through another place, the Royal Commission and the Government's response to it—I might even say lack of response to it thus far—and the repercussions of the Gloucester judgment are other matters that we must consider.
In planning for future community care, I plead that we think always of three particular issues. The first is that community care is not and will never be a cheap option. Good quality community care is expensive to provide and resources must be made available to provide it. Secondly, successful community care depends on co-operation and partnership between all the agencies involved: health, social services, the voluntary sector and families, each recognising the value of the contribution made by the others. Thirdly, and lastly, but certainly not least, it is predicated on the unpaid care of families and communities, given willingly and with an amount of love and duty which offers a shining example to any society.
§ 4.29 p.m.
§ Baroness Gardner of Parkes
My Lords, I thank the noble Lord, Lord Rix, for the debate today. It is one further addition to the excellent work he has carried out so often on the same subject in this House. We all welcome the opportunity to discuss the matter.
I was a dentist in general practice when the Act was introduced. My only awareness of disabled people was in terms of patients who came for treatment. I found that they were a remarkably independent group. Often, they had their own ways of getting in and out of the chair or from the waiting room to the surgery and they could manage better without one trying to help. Interference was not always the most useful policy. I remember in particular one woman who was blind and wore a heavy calliper on her leg. She managed her life so well and was such a marvellously happy person.
We tend to believe that anyone disabled might not necessarily be such a happy and forward-looking person. That has not been my experience. I have found that such people often have a remarkably strong will and a great, good spirit that keeps them going. Sadly, there are a few, as the noble Baroness, Lady Masham, mentioned, for whom things go wrong. That is not so good.
At the time of the Act, I was also a young councillor. We were absolutely staggered when it landed on our doorstep. We were terrified about the cost. The noble Lord, Lord Morris, was absolutely right in saying that no one knew how many disabled people there were. We were told that we must carry out a survey to discover the number. This was in about 1973. We had had the oil crisis and everyone was worried about his financial situation. No one knew how much the survey would cost. We decided that if we found a huge number of people requiring help, we could not possibly deal with the situation. Eventually, the 732 council decided to carry out a 10 per cent survey immediately from which it could work out needs and thus develop provision. But even the 10 per cent survey was a major exercise.
At that time disabled people seemed almost to conceal the fact that they were disabled. Noble Lords have described how no one wanted to be pitied and no one wanted to feel embarrassed by asking for something from others. Fortunately, over time we have seen a complete change in that attitude. My recent experience of self-assessment of disabled people—which I have quoted in your Lordships' House before—worries me in terms of the National Health Service. If one applies to be considered for a board, one may tick that one is disabled and one will be granted an interview.
I interviewed one such person. We had actually interviewed several, but we had to reconvene because one whom we had omitted, believing him to be totally unsuitable, demanded to be seen and there was an obligation to see him. When he came in he looked fit. We said, "What's your disability?" and he replied, "I suffer from asthma." One of the interviewing panel was a doctor. He said, "But you seem to be in very good health." The patient replied, "Oh yes, it is just for a couple of days in the summer." That did not seem to justify his right to tick the box by which he was guaranteed an interview. That kind of fiddle, or whatever it was, does not help those who are genuinely disabled. But it is a rarity and it is not something we need to discuss too much.
The terminology has changed too. People used to be called "registered disabled". I remember when there were two Bills going through your Lordships' House; one abolishing the term "registered disabled" and the other containing a whole lot of clauses to cover the registered disabled. In the debate I asked the Minister why we were putting into one Bill what we were abolishing in the other. The matter was discovered and put right.
Access to buildings—which we all believe is essential—is still not 100 per cent, even in new buildings. Buildings are still going up which do not have access. Nowhere is really much worse—unless it has improved miraculously recently without my knowledge—than Heathrow airport. When I have arrived at Heathrow and the escalators have been out of order, I have asked people, "How do you get down?" and they have replied, "You've got to walk down." A non-working escalator is of course much worse than one which is working. The gradient on the escalator is not really suitable for walking. I said, "What about a disabled person? How would they get down?" They replied, "Oh, we have no way they can get down." In the newer terminals, improvements have been made. But the difference between that and the new Waterloo station where there is splendid wheelchair access shows how progress is being made in terms of improvements.
I have almost run out of time, but I must comment on the comments of the noble Lord, Lord Ashley. I am sorry that he is not here to hear me. He congratulated 733 the Labour Government on everything they had done. I cannot let him get away with that, because, after all, the Act about which we are talking went through under a Conservative government. We have just been told how they allowed it to come back again. It was stated earlier that it started under the Labour government, then came the election of the Heath government and it was carried on by the Conservative government. I see noble Lords looking at me and wondering—
Lord Campbell of Croy
My Lords, will my noble friend give way? I believe that I was the person who spoke about the matter. Pretty much all the work happened under the Labour government, but against the wishes of the Labour Minister responsible. The Bill had almost completed its progress through Parliament when the election was suddenly called and it was agreed that it would be reintroduced, if necessary. All the work was done when a Labour government were in power.
§ Baroness Gardner of Parkes
My Lords, I understood that. It is the point I am making. The Act was actually passed under a Conservative government. I shall read my noble friend's remarks, because I have never heard before what he said. Because the debate is time limited, I cannot spend longer on the subject.
§ Baroness Gardner of Parkes
My Lords, as I said, we shall not go into that.
More recently, the Disability Discrimination Act 1995 was passed. That was certainly under a Conservative government. The noble Lord, Lord Ashley, congratulated his Government at the beginning of his speech but then attacked them, saying that they too were not right. I quote him when I say, "One way or the other, the Government's wrong." It is not a question of government. It is a question of people and how much there is to be done. The postcode matter described by the noble Lord is a matter of concern. I asked a Question in the House about the position when postcode prescribing was done away with. How would it be ensured that those who were already benefiting, for example, from beta interferon for multiple sclerosis, would not be disadvantaged? I am sorry to say that the Minister did not provide any satisfactory Answer at all and gave no assurance that at least the few people who are benefiting at present would not be disadvantaged.
There is a great opportunity for respite care, which is a real essential. I have run out of time, but I have seen cottage hospitals being converted for respite care. That is marvellous.
§ 4.38 p.m.
§ Lord Lipsey
My Lords, it is a humbling experience to speak this afternoon when the House is hearing from so many noble Lords whose efforts for, with and as disabled people have achieved so much. I thank the 734 noble Lord, Lord Rix, for the opportunity. We have just touched on the history of the Bill, which I was discussing with my noble friend Lord Morris only yesterday. He reminded me that it was an example— some noble Lords will believe it an example only too rare—of a case where the press did signal good in our national life.
Although it was welcomed on all sides in both Houses, the Bill was threatened when Harold Wilson called the early election, as we have heard. It was at that moment that Harold Evans, the then editor of the Sunday Times, penned a brilliant leader, which said that of all the government's legislative programme, that Bill deserved to survive. As a direct result of his pleadings the party leaders agreed to let it through under the special procedure that applies at election times and through it went, on the very last possible day before the election.
As we celebrate the Act, I want to ponder on the paradox that the noble Lord, Lord Rix, referred to in his speech. Why has an Act that appeared to be such a signal advance at the time, nevertheless today left us in a situation where many people with disabilities are frustrated at the level of provision for them?
In relation to major social advances that situation is not totally unusual. When Aneurin Bevan founded the health service he honestly believed that it would work itself out of business. When those on the waiting lists had been treated, he assumed that there would no longer be a need for a health service on the same scale and that the Government's budget would fall. The House does not need me to tell it that matters have not worked out that way.
As with all social changes, this is a Sisyphean labour, like trying to push a boulder up a hill, but the hill goes on and on and it is difficult to avoid the boulder falling back down. Recognising social rights adds to the demand for rights; reacting to need flushes out need; and responding to demand creates demand. Arguably the great triumph of the original Act was that it recognised disability and the needs of disabled people. The Act removed them from their hole in the corner, where they had been hidden away, and we row know how much has to be done to put them at the centre of our social provision.
On the subject of resources, in this debate we have heard of many such problems, including those arising from the Gloucester judgment and means testing. I do not want to comment directly on either on those matters. However, resources will always be scarce and priorities have to be struck.
Recently I was a member of the Royal Commission on the Long-Term Care of the Elderly, a response to which is due from the Government in July. A terrible dilemma arose because of the difficulties and the injustices experienced by people. People were means tested for the care that they needed but that care was inadequate and more resources were needed. The most disabled elderly people living at home received precisely four hours care a week. I shall not enter into the debate about the majority and the minority in the commission, but members of the commission felt 735 differently about that. Those dilemmas will exist as long as we live in a world of finite resources—and on this planet resources will always be finite. Those matters will have to be followed up and we should not insult those who hold different views as to whether the priority is better services or getting rid of means testing. Decisions of priority have to be made.
Returning to the paradox, the key is not just that things come out from the corners, but that when one considers basic needs and deals with them, other urgent and important needs emerge from behind them. One example of that is an area of which I know a little as my wife specialises in it. That is disabled people and sex. Incidentally, that was the subject—again I praise the press—of a most sensitive article in the Saturday magazine of The Times last week.
Thirty years ago I do not suppose it occurred to most people that disabled people had sexual needs. The Minister reminded me yesterday that in 1971, in Oxford, SPOD (Sexual Problems of the Disabled) was created. Even now such appreciation is advancing only slowly.
My wife's special interest is in sex education for people with learning difficulties. If we consider the matter for a minute, we can understand the importance of this subject. It is of vital importance that people with learning difficulties should know how to protect themselves. That protection may be against unwanted pregnancy and sexual disease in consensual relationships; but, more darkly, that protection may be against the tiny minority of carers who seek to abuse those who rely on their help. After the scandals of recent years we have become much more aware than we would like to be of such problems. More cheerfully, it may be that we simply want to enhance the lives of people with learning difficulties so that they can enjoy the same sexual choices as the rest of us.
Perhaps it is not easy to sustain such work because of an embarrassment factor. My wife was based in a wonderful project in Southwark, called People to People, but that has just had to close due to lack of funds. That is dreadfully sad.
Such areas of unmet demand will always crop up. They will crop up because the needs of disabled people are great and because the resources that society devotes to them tend to be less than we would want ideally. The resources may be less than ideal, but they are far more than if the original Act had not been passed 30 years ago, thanks to the efforts of my noble friend Lord Morris and other noble Lords who have been mentioned in the debate. Public consciousness of and sympathy for the needs of disabled people is now out in the open. Disabled people and all of us owe a great debt to those who have made that possible.
§ 4.45 p.m.
§ Baroness Greengross
My Lords, I add my voice to those noble Lords who have thanked the noble Lord, Lord Rix, for facilitating this debate on such a special day and to the other noble Lords who have worked so hard over the years to bring us to the present situation.
736 I want to refer to someone whom I know well, a relative who is a little older than I am, and to talk about the change in attitudes that has affected him so dramatically. At the age of five he was diagnosed as having a tubercular hip. He was sent to a children's hospital outside London where he spent two years on his back without being able to move. His leg was stretched. He was given no special equipment with which to eat. He had a teacher about one day in every 10. He had visits from his parents once a month—the only time that they were allowed to visit him. When he left the hospital he was sent—as others were routinely sent—to a segregated school peopled only with children in a similar condition to himself; children who had either severe physical difficulties or severe learning difficulties.
Since then we have come a long way. Attitudes have changed and there has been legal change and service development. I suppose I have spent most of my adult life trying to speed up the process of change so I am particularly pleased to be taking part in this debate.
The success of the Act and the difference in the quality of life that it has brought to many people cannot be over-emphasised. However, I believe that there are still problems to be faced—problems that arise partly from the lack of adequate resources, largely based on mistaken assumptions. We never seem to get right what we take for granted once we know a little more. I too have undertaken a lot of work with Sir Roy Griffiths, who became president of my organisation. With the best will in the world, everybody believed that more community care existed than was in fact the case, so the planning was not adequate.
Over the years we have also suffered from a lack of clarity between the powers and the duties of local authorities. Many of the problems encountered by particular groups of people with disabilities or by the chronically sick or disabled are because of that ability to shift from a duty to a power, and therefore the people are pushed from one set of circumstances to another. We must remember that because of that there is quite a lot of discrimination among the one-third of disabled people who are elderly. Somehow they receive less in the way of consultation, involvement and advocacy. The assumption seems to persist that they have fewer rights.
The noble Baroness, Lady Barker, pointed out that the age at which one becomes disabled is important. Everybody should be advised that they have to become disabled by the time they reach 64 or their whole entitlement changes. We had an interesting debate last week on access to equipment and the difficulties experienced by many people in that regard. Setbacks have occurred due to a lack of clarity; for example, as in the Gloucester judgment, which was referred to so movingly today. That has led to more rationing and discrimination on the grounds of age.
The need for help in taking a bath is important. But for elderly people, the need to have one's home kept clean and the windows shining is perhaps more 737 important for their dignity and pride than other sorts of service provision that may be given priority by those with different points of view.
The noble Baroness, Lady Barker, mentioned also the effects that may be felt when the Human Rights Act comes into play. It may challenge the present lack of clarity in the system and I look forward to it helping many chronically sick and disabled people. Article 3 states that no one will be subjected to inhuman or degrading treatment, and everyone has the right, under Article 8, to respect for their private and family life, their home as well as their correspondence. Article 14 relates to the right to non-discrimination in the application of the other convention rights, which will have a big impact on this country.
I am pleased that the Government will be consulting on fair access to care services. One of the reasons discrimination continues is because of the lack of consistency in eligibility criteria for community care services. Consistency in the assessment of everyone throughout the country rather than the postal code ballot, and recognition of the links between physical and mental illness are vital. Sometimes the links are obvious, but sometimes they are not and we should not try to lump people together as a block.
The noble Lord, Lord Lipsey, discussed long-term care. I echo the words of the noble Baroness, Lady Gardner of Parkes, in relation to intermediate care. But I add a word of caution. It is a good step. We have talked for years about the need for convalescence. But intermediate care hospitals may be used to deprive older people of access to high level specialist medical care. If they are returned to cottage hospitals, then we may be perpetuating the discrimination. We must be careful that that does not happen, and that rehabilitation is included in the care plan of everyone who is admitted to those hospitals.
Finally, as so many noble Lords have said, the Government must recognise the link in the Act we are celebrating today with the need for long-term care both at home and in care settings. It requires adequate resources or, again, the unintended consequences of benevolent legislation may be negative.
§ 4.55 p.m.
§ The Earl of Longford
My Lords, speaking as the oldest Member who attends the House, it is a special pleasure to follow such a splendid champion of the elderly as the noble Baroness, Lady Greengross. I shall let her into a secret, though she probably does not need me to tell her this. The problem is that, as we get older, we decline in energy but become wiser; everyone notices our decline in energy but nobody notices that we become wiser. I am sure the noble Baroness will do all she can to put that right.
I rise with a great sense of humility. We dwell on so much suffering and on the devoted labours of the many who try to relieve suffering. And we do it in the presence of those who themselves have suffered; those who have risen above their suffering and done so much to help others. Naturally, I think first of the noble Baronesses,Lady Masham and Lady Darcy de 738 Knayth, both of whom made maiden speeches 30 years ago when this Bill came before the House. If anyone asked me, "What is the House of Lords like nowadays?", I would say, "It is the kind of place where, when one had to vote for one of 200 independent Peers, it was a lady in a wheelchair who turned out to be the champion, the top one". If the noble Baroness, Lady Masham, had been in the competition, I do not know who would have won. That is the kind of place the House of Lords is today.
Then there is my noble friend Lord Ashley of Stoke. I pay tribute to him and his gadget which sits in front of him. Someone must have paid for it, and did so because they respect him so highly. That is a wonderful tribute. I am sure no one would pay for me to have a gadget!
There are others; the noble Lord, Lord Campbell of Croy; I am glad that he is now a kind of relative of mine. He has had to put up with a good deal. He has used two sticks for around 50 years That is heroism too in my eyes. I hesitate to say this; I am not sure whether the noble Earl, Lord Snowdon, wishes to be put in the category of sufferers. But I know that he has had troubles and I am glad that he has found time to come here. We do not see him often enough in this House; that is my message to him.
When I find myself before St Peter in the near future, he may say to me, "Did you do any good down there?" I shall be able to murmur a little bit about the honours I have received. And he will say, "I do not want to know about that. I want to know, did you do any good?" I shall be able to say, "I played a small part in helping to carry the A1f Morris Bill through the House of Lords 30 years ago". He will probably say, "OK, you can take a day off purgatory for that".
But coming now to the present question, I am glad that it was the noble Lord, Lord Rix, who opened this debate. When I introduced this Bill 30 years ago, I was not sure the extent to which mental handicap was covered and raised that question in my speech. The noble Lord, Lord Rix, has given the answer: of course it is covered and no one has done as much, or ever will, for the mentally handicapped as the noble Lord, Lord Rix. Of course we are all aware of that. I cannot help having one other thought, though it may be a little frivolous. People sometimes say no actor has ever succeeded in politics. Some may say, "What about Reagan?"; I say, "What about Lord Rix?" It shows how unwise it is to make generalisations.
At any rate, the noble Lord, Lord Rix, has done this great work for the mentally handicapped and we come to this Bill. Here I am in a slightly different position from that I was in 30 years ago. I am so sorry that my old and dear friend Lady Serota cannot be here this afternoon. She took part in that debate all those years ago, and said, "In the end, we all become geriatric". That is true. Some of the younger Members on the Front Bench will find eventually that they become old and groggy; that is the way it goes. When I opened this debate 30 years ago I was a fine, upstanding young fellow of about 64. Now I walk with a stick—I am always losing it I am afraid—am partially sighted and 739 registered as blind. But that is the way life goes. Theoretically we all come to it eventually. Perhaps that makes us more aware of, and gives us a sense of sharing the sufferings of the disabled.
I put the obvious questions but I believe that they are being answered as the debate progresses. Thirty years ago I said that for the first time we were helping the disabled to be, and to feel, second-class citizens no longer. For the first time we ensured in administrative terms that there were not nine different divisions but one big division for the whole thing. The measure constitutes a fundamental human Bill of Rights.
Until today I did not realise the problems that my noble friend Lord Morris had experienced with my dear old friend Dick Crossman. Dick was the most brilliant man of my time at New College. However, the noble and learned Lord, Lord Wilberforce, who was his main rival in those days, might contradict that. Dick Crossman was brilliant but he often got things wrong. In his diaries he referred to me as a farcical figure when I was a Cabinet colleague. Dick did not always get things right! However, I am sure that the noble Lord, Lord Morris, knew how to cope with him. The Act was a tremendous triumph.
I shall listen to what everyone has to say but I shall listen for all time—including in the next world—to what the noble Lord, Lord Morris, has to say. I pay tribute to the achievement of Alf Morris. He was backed up by many others, but in the last resort it was his achievement.
§ 5.1 p.m.
The Earl of Snowdon
My Lords, I am grateful to the noble Lord, Lord Rix, for this opportunity for me to add my congratulations to the noble Lord, Lord Morris of Manchester, on his pioneering legislation, which paved the way for so many innovations and changes over the past 30 years. He was, of course, the first Minister in the world to look after the physical and social problems that faced disabled people— problems that were often totally unnecessary.
I must admit that I used to believe that legislation was not necessary, thinking rather that everything could be achieved by education and persuasion. I was quite wrong; there had to be legislation. We certainly continue to need it today to secure the great progress that has been made in recent years. This is perhaps best summarised in the words of Martin Luther King:Morality cannot be legislated, but behaviour can be regulated. Judicial decrees may not change the heart but they can restrict the heartless".As I mentioned in my maiden speech in your Lordships' House some 26 years ago, the barriers to access and acceptance are frequently needless. We have come a long way in those 30 years, and so we should have. A great deal of that is thanks to the enlightened leadership, encouragement and enthusiasm on both sides of your Lordships' House.
When I was the President for England of the International Year for Disabled People in 1981 I emphasised that this was, 740a celebration of a beginning not an end".Sadly, some of my more recent experiences illustrate that that end is still a long way off.
Only the other day there was the damning Audit Commission report which showed how far we still have to go. It specifically highlighted the poor quality and design of equipment for disabled people, which is outdated, uncomfortable and unusable. This is how the Audit Commission described services which cost the NHS and local government some £400 million a year.
The report also criticised long waiting lists, ill-fitting artificial limbs—which are so frequently needed for the victims of landmines or war or road accidents— inefficient hearing aids that end up in the bottom drawer and Heath Robinson-like wheelchairs. It stated that 80 per cent of community disability equipment was lost as proper records were not even kept. Even if one is not concerned with the importance of good design, we must surely be concerned with this horrific waste of money. The report is a real shocker; it made the inside pages of some of the national press. However, as a national disgrace it should have been front page headline news.
I turn from the Audit Commission to what was British Rail. Fifteen years ago I objected in the strongest possible terms to disabled passengers being shoved into the unheated luggage van with no facilities, not even a lavatory. Yesterday I telephoned Connex South Central's Disabled Persons Travel Department to find out how things had progressed since it took over the business. I had to endure 10 minutes of recorded Vivaldi and taped directions. Eventually I was told by a real live voice that the department was too busy to discuss disabled people's travel problems.
If we conducted the travel arrangements of our livestock in this way there would rightly be a national outcry. First-class citizens appear to matter rather less in certain mindless boardrooms. Let us hope that there will be serious improvement without further delay. I find these day-to-day uncaring barriers most disagreeable and totally unacceptable.
For example, I understand that the noble Lord, Lord Tebbit, recently inquired about the accessibility of the cinema at Marble Arch to be informed that while it was fully accessible a wheelchair user still constituted a hazard and could not be accommodated as that would break the fire regulations. Cinemas throughout the country still have an extremely poor record on access compared with theatres, for example.
I was also appalled to read that some minicabs in London charge as much as 60 per cent more for carrying guide dogs with their owners. This clear discrimination needs to be eradicated forthwith. It was the noble Lord, Lord Morris, as Minister for Disabled People in another place, who won the battle to get both guide dogs and wheelchairs into the Chelsea Flower Show, where they had previously been banned. The excuse was that it was too crowded and the dogs might get trodden on. However, that is for the visitors to decide, not the organisers. Disabled people must have 741 the right to choose to go where they want, when they want, how they want, not as a favour or an exception but as of right.
The setting up of the Disability Rights Commission announced to the media this morning will, I hope improve many of the injustices that still exist and stop the powers that be from making excuses to the detriment of disabled people.
Today we are here to applaud the many achievements of the noble Lord, Lord Morris, who I know would be the first to agree that there is still a long way to go to reach our goals of total integration, equal opportunities, equal rights and for society to applaud the abilities and achievements of disabled people.
§ 5.8 p.m.
§ Lord Addington
My Lords, I should declare an interest in that the 1970 Act is the first to mention dyslexics and acute dyslexics. I suspect that without that provision it would have been virtually impossible for me, an acute dyslexic, to receive an education under the state system.
I have made many speeches on this subject. I have come to the conclusion that it is an advantage to be dyslexic in your Lordships' House as I do not like reading out speeches! But, enough of that.
All the speeches that we have heard so far have had the same recurrent theme—the noble Earl, Lord Snowdon, summed that up succinctly—namely, that disabled people must be regarded as individuals who have a right to every facility that is available in our society. They have a right to sex lives; to social lives; to be able to travel to work; to choose where they eat; to choose the way in which they organise their lives. Where they are capable of so doing with assistance, it should be made possible for them to do so. Of course, arbitrary decisions may have to be made and occasionally that may not be possible, but, by and large, disabled people must be given the choice. They must be given assistance to achieve this, so that they do not become a category but remain individuals.
Whenever we run into the problem of "What do we do with these people?", once we start to remember that they are individuals the answer occurs to us very readily. If we remember that, what we are doing here becomes obvious. But most of the time we do not remember that; many of us have to remind ourselves that every single group is made up of individuals. Once we take that on board—whether it be in terms of disability, race discrimination or sex discrimination— the path forward, the ultimate goal, is clearly seen.
But the path to that goal changes over time. The argument about resources has been carefully rehearsed and the Gloucester judgment weighs heavily in the background. It basically states that, yes, people can receive help, but resources play a factor in deciding what help and when. I shall not go into the exact words—I cannot remember them—but that is the essence of it. This means that people should receive social care within their own homes, but under certain criteria it can be decided what that care should or 742 should not be. It varies—the definition is rather confusing—but basically resources curtail the amount of help given.
I doubt whether such a system ultimately makes any great difference to the amount of money saved as the health service often ends up holding the baby for what goes wrong. Often the right kind of social service help and assistance is not given. We have heard, for instance, that the correct mattresses to relieve pressure sores are often not provided, and carers are not available to turn people in bed to prevent pressure sores developing, with the result that people have to be treated for pressure sores, a damaging skin condition which can require long-term and expensive help. If we do not turn things around and get properly organised, we shall ultimately end up increasing costs. We must always look at what is going on.
The independent living fund and the fact that it is means tested was mentioned. It will come as no surprise to hear from a Member of these Benches that we think that means testing benefits is usually counter-productive in terms of social help. One has to go through a bureaucratic process and therefore, on the margins, that will probably waste money—through reassessments and so on—and incur greater costs. The bureaucratic system does not help.
As I said, we are talking about a process of ensuring that people can take part in life on an individual basis. There is no point in going on at great length because there have been many good speeches on this subject. Indeed, the speech of my noble friend Lady Barker made me look to my laurels and to wonder whether I will still be leading on this subject in the near future.
§ Lord Addington
My noble friend tells me that I will. Evidently she has her eyes set on greater prizes.
We have to bear in mind that disabled people are individuals. If we do not, we shall fail them. The struggle with Government seems universal. What the noble Lord, Lord Morris, said about dealing with departments rings true for every single Minister and for every single person applying pressure on Ministers. It is true of the Treasury and it is true of those who think that their slice of the Treasury cake should be protected. It will always exist. Unless we in this House who have an interest in this subject are prepared to apply consistent pressure, we shall lose.
On certain occasions we get diverted and pushed sideways—it happens all the time. We even had a brief discussion about which government should lake certain amounts of credit. I can safely say that all governments deserve credit and that all governments deserve blame. None go as far as they should; none go as far as they promised in opposition. But we can still apply pressure to them. The Conservative Party can take credit for making sure that the 1970 Bill got on to the statute book; the Conservative government that brought in the DDA can take credit for that; but they can also take a considerable degree of blame for blocking the Private Member's Bill. The jury is still out 743 on the present Government, but I congratulate them on having the commission up and running now. That there was only a council was one of the major drawbacks of the DDA. Hopefully the commission will lead to further steps forward in this area.
But unless we continually push the Government, unless we continually remember that we are talking about individuals and their rights, unless we ensure that we do not get ourselves pushed into dark corners, we shall not continue to make progress. We shall end up returning to this subject more and more often and having debates like this. Ultimately we want to be able to stop looking back and saying what we have done; we want to be able to say that that subject is over and done and finished. When we have done that, we shall all be much happier.
§ 5.16 p.m.
§ Lord Astor of Hever
My Lords, I, too, congratulate the noble Lord, Lord Rix, on initiating this important debate and on attracting so many of the heroes of the 1970 Act to speak today. I agree with my noble friend Lady Gardner, who pointed out how hard the noble Lord has fought for the disabled in this House.
I happily join other noble Lords, from all Benches, in celebrating the 30th anniversary of the Chronically Sick and Disabled Persons Act, which was a historic landmark in the progress of disabled people towards taking their full place in society. I pay tribute to the architect of the Act, the noble Lord, Lord Morris of Manchester. I am proud that my uncle, the then Member for Newbury, worked closely with him throughout the passage of the Bill and was one of the original signatories of the Bill.
I also salute my noble friend Lord Campbell of Croy, who, as Secretary of State for Scotland, enabled the achievements of the Act of the noble Lord, Lord Morris, to be extended to Scotland. I pay tribute to the noble Lord, Lord Ashley of Stoke, who played a key role during the passage of the Bill—indeed, he wrote movingly in his book Acts of Defiance of how work on the Bill helped to restore his confidence after losing his hearing; to the noble Earl, Lord Longford, who piloted the Bill through this House; and to the noble Baronesses, Lady Masham and Lady Darcy de Knayth, who made their maiden speeches and both introduced important clauses and amendments. Since then they have worked tirelessly and successfully in this House on behalf of the disabled.
The Act was groundbreaking in its time and served as a model for legislation in many other countries. It was the first legislation anywhere in the world to deal with disabled people's access to buildings. Last year I had personal experience of disability. I agree with the noble Baroness, Lady Gardner, that access must still be improved.
Access, of course, goes hand in hand with mobility. The Orange Badge scheme introduced under Section 21 of the Act was of immediate and enormous benefit. However, some local authorities still make only a limited number of parking spaces available to Orange 744 Badge holders. That, added to constant abuse, causes endless problems for the disabled and their carers. I very much hope that pressure can be put on inflexible local authorities in this matter. The noble Baroness, Lady Darcy de Knayth, mentioned problems of enforcement. I support entirely what she said.
Under the Act, autism and dyslexia entered into statute for the first time. As the father of a daughter with autism and two others with dyslexia, I am eternally grateful to the noble Lord, Lord Morris, and to the noble Lord, Lord Ashley, who introduced Sections 26 and 27 of the Act. I am also enormously grateful to the noble Lord, Lord Rix, for what he has done for those with learning difficulties.
Thirty years on from the passing of the Act, our task is to address what is the unfinished agenda of unmet need among disabled people. Several noble Lords have mentioned the Gloucestershire case. In essence, the Law Lords' decision has decimated the care assessment and services part of the Chronically Sick and Disabled Persons Act. Thirty years on, many local authorities are ignoring their responsibilities under the Act.
The impact on service provision has been catastrophic. Several noble Lords have mentioned the Needs Must survey. Its findings shocked me; 90 per cent reported a reduction or total cut in help with housework; 72 per cent in help with bathing; 70 per cent in help using the toilet; 79 per cent in help dressing; and 89 per cent in help with preparation or consumption of meals. Those are shocking figures. Statements such as the following are found throughout the report:All care was withdrawn all over the Christmas and New Year period. I went without food as there was no one to cook it for me. All baths stopped and my hours were cut by two thirds without letting me know. I wouldn't go through that again. I would take an overdose rather than put up with this".We have a crisis in community care that the Government must address. Last Friday's debate on the Deafblind Person's Bill was proof in point of the crisis, when the most disadvantaged in our society are being ignored and neglected. Will the Government therefore consider a debate, in government time, on community care in crisis?
One of the main problems facing the disabled and elderly is accessing equipment and assistance. Contrary to Section 1 of the Chronically Sick and Disabled Persons Act, which places a duty on local authorities to publish information about the services they provide for the disabled and ensure they are informed, the Disabled Living Foundation reports that a disturbing number of people do not know who to approach. The noble Earl, Lord Snowdon, and the noble Baroness, Lady Masham, mentioned the Audit Commission report, Fully Equipped, published last month. It discovered that standards of disability equipment services are unacceptably low in some parts of the country and that patterns of service provision lead to inequality and inefficiency. Would the Government consider a national advertising 745 campaign, co-ordinated by the Department of Health, to inform people how to access equipment and assistance?
The Audit Commission recommends that the Department of Health should raise the profile of disability equipment services through the National Priorities Guidance, and specific reference should be included in the forthcoming National Service Framework for Older People. Can the Minister confirm that his department will give this matter serious consideration?
This has been a fascinating debate. We have a duty to safeguard the Chronically Sick and Disabled Persons Act against erosion and evasion by those who would dilute or deny services they are under a duty to provide. I very much hope that the Government will be scrupulous in monitoring progress in implementing the 1970 Act and the legislation on disabled people that followed so that disabled people can enjoy equal citizenship.
§ 5.25 p.m.
§ The Parliamentary Under-Secretary of State, Department of Health (Lord Hunt of Kings Heath)
My Lords, this has been a most moving debate and I consider it a great honour to have the responsibility of winding up on behalf of the Government. Like other noble Lords, I start by thanking the noble Lord, Lord Rix, whose track record over so many years speaks for itself and who, I know to my cost, has been so successful in wringing out concessions from government during the passage of Bills.
It is a particular pleasure that so many noble Lords who took part in those momentous events of 30 years ago are able to debate this Motion in your Lordships' House today. I am very happy to associate myself with the word "hero" used by the noble Lord, Lord Astor. Like other noble Lords, I want to pay tribute to my noble friend Lord Morris, who was so instrumental in achieving the successful passage of the Chronically Sick and Disabled Persons Act, which, I am reliably informed, though I am open to correction, was passed on the day the Parliament was dissolved in 1970. My noble friend has been a consistent and powerful champion over so many years for the rights of disabled people. It is right that we all acknowledge what he achieved against so many odds. It is also a particular pleasure for me that the noble Earl, Lord Longford, spoke in the debate and reminded us of his own substantial role in taking the Bill through your Lordships' House, a Bill he described as a fundamental Bill of Rights for disabled people.
It is indeed a unique occasion for the sponsors of that Bill in both Houses to be in your Lordships' House, as is my noble friend Lord Ashley, who was a leading supporter of the Bill. He himself has been such a doughty fighter over many years.
It is invidious to single out names because every noble Lord who has spoken in the debate has brought a wealth of knowledge, experience and commitment to the cause of disabled people. But I would just express my delight that the noble Baronesses, Lady Darcy de 746 Knayth and Lady Masham, have spoken, as 30 years ago they made their maiden speeches in your Lordships' House on the Bill. My understanding is that during the passage of the Bill both noble Baronesses were successful in making changes to it. It certainly shows that some things do not change in your Lordships' House.
There can be no doubt that the Chronically Sick and Disabled Persons Act 1970 was, as the noble Earl, Lord Snowdon, put it, an extraordinarily significant milestone in the history of welfare legislation. Section 2 in particular represented a major step forward in the provision of services to disabled people by local authorities. Section 2, for the first time, gave local authorities specific duties towards disabled people. It required local authorities to make arrangements for the provision of a range of services for disabled people provided they were satisfied that it was necessary in order to meet that person's assessed needs. As noble Lords will know, the services to be provided included: practical assistance in the home; the provision of recreational facilities; assistance in arranging adaptations to the home; holidays; meals; and the provision of a telephone and any special equipment needed to enable the disabled person to use it.
The Chronically Sick and Disabled Persons Act was undoubtedly a major step forward for disabled people. But it was more than that. As the excellent RADAR publication, Be It Enacted, pointed out on the 25th anniversary of the passing of the Act, before 1970 disabled people were rarely allowed to contribute to society. For the most part, they were closely controlled, looked after in institutions or hidden within the protection of family homes.
In the whole field of social policy",wrote the authors of As of Right in 1985,there was no disadvantaged group so utterly neglected".So the 1970 Act was a watershed—as my noble friend Lord Morris said during the Second Reading of the legislation in another place—increasing the welfare, improving the status and enhancing the dignity of chronically sick and disabled people.
As the noble Lord, Lord Rix, pointed out, the Act was a prelude to other measures to ensure that disabled people should be able to live as normal lives as possible, in their own homes wherever possible, no matter what their care needs or their disabilities might be. I strongly agree with the noble Lord, Lord Addington, that the care and support given to those people needs to enhance their independence, not take it away.
That is certainly the aim of the Government as we take forward work to support disabled people. Since 1997 we have taken a number of significant steps. The Care Standards Bill, which recently completed its passage through this House, will introduce major regulatory reforms to improve the protection of vulnerable adults and children. The national charter, Better Care, Higher Standards, sets out clearly the support that users and carers can expect from housing and social services. The Fair Access to Care Services 747 initiative aims to provide a more consistent approach across the country to eligibility for services. That point was raised by a number of noble Lords.
We have also extended direct payments to people aged 65 and over. There is also provision to extend them to disabled 16 and 17 year-olds and parent carers of disabled children in the Carers and Disabled Children Bill. We have given specific funding, amounting to £750 million, to support preventative and rehabilitative services to help people to continue to live in their own homes. We have taken forward a major programme to ensure that carers receive the support that they need to carry out their caring responsibilities.
I recognise and understand some of the concerns that have been expressed by noble Lords. There is no doubt that we need to do more to tackle problems in services for disabled people, to improve quality and reduce delays. In that context, I think it right to refer to the Gloucestershire judgment.
Let me say right away that I understand the concerns that have been expressed by many speakers in the debate. The Government do not believe that the Gloucestershire judgment should have led to changes in the provision of social services. The House of Lords judgment confirmed what had long been the Department of Health's understanding of the law.
The department did, however, after the judgment remind authorities of their duties under the Chronically Sick and Disabled Persons Act. The circular that was issued in November 1997 made clear that the judgment does not give authorities a licence to take arbitrary decisions on the basis of resources alone. It also emphasises that the judgment does not mean that authorities are not under any duty towards disabled people. Once an authority has decided that it is necessary in order to meet the needs of a disabled person for it to arrange a service listed in Section 2 of the Act, it is under a duty to do so. Where individuals consider that their authority is not satisfying these requirements, it is open to them to make a complaint through the social services complaints procedure.
Having said that, I listened carefully to the noble Lord, Lord Astor, when he quoted the Needs Must campaign. I want to assure noble Lords that the Government were very concerned by the findings of the campaign in the recently published Out of services report. The report undoubtedly highlights problems in a number of areas, including delays in carrying out assessments, poor quality services and excessive waiting times for adaptations. I believe that the coalition of voluntary organisations which make up Needs Must are to be commended on bringing these very important issues to our attention. I assure noble Lords that the Government will give the most serious consideration to the report's findings.
Inevitably, reference to the Gloucestershire judgment leads to the question of resource availability. The noble Baroness, Lady Barker, referred to the matter in an extraordinarily penetrating speech. My noble friend Lord Lipsey talked about resource 748 dilemmas faced by local authorities; the noble Baroness, Lady Greengross, also made some valid points on the matter.
The Government make the funding of social services a priority. That is clear in the Comprehensive Spending Review which we undertook two years ago and for which the settlement was announced in July 1998. For the first time we guaranteed that the funds available nationally would increase over the following three years, so that local councils could plan ahead knowing what resources would be available. In the three years covered by the spending review, social services will receive an additional £2.8 billion, which is an average of more than 3 per cent above inflation each year.
It is one thing to have the resources; it is quite another to ensure that they are spent wisely. That brings me back to the criticisms made by noble Lords of the variable performance of local authorities. The Government are strongly committed to a more active approach to assessing the performance and monitoring the progress of local authorities in delivering social services. The new performance assessment system that we have developed will produce comprehensive in-year and end-year information on the delivery of services. That will allow concerns about performance to be identified quickly. Alongside a more powerful Social Services Inspectorate and our ability to take action where local authorities are not performing well, it offers a great deal of hope for the future.
Our approach is beginning to bear fruit. Last week, my honourable friend Mr John Hutton announced that five of the 16 poorly performing councils with social services authorities have improved enough to be removed from the list of those subject to special measures.
In talking about resources, one has to come to the issue of charges. In opening the debate, the noble Lord, Lord Rix, asked me a number of questions about charges. It is for each local authority to decide whether to make charges for non-residential services and, if so, how much to charge. The Government's White Paper, Modernising Social Services, recognised that the current scale of variation in discretionary charging is unacceptable. We are considering the recommendations in the report of the Royal Commission and we shall consider the survey of local authority charging that is being undertaken by the Audit Commission and the report that it is due to publish shortly. I assure noble Lords that our aim is to move, as far as possible, towards greater consistency and fairness in charging. Fairness is a philosophy that must also underpin access to care, as a number of noble Lords pointed out.
We have a Fair Access to Care initiative. We are putting out guidance for consultation in May 2000. The intention is to review all people with care plans at the start of April 2002, completing that project by April 2003. The aim is to ensure that adults with similar social care needs living in similar circumstances will receive services designed to achieve broadly similar outcomes.
749 It would not be right for me to let this moment pass without referring, as the noble Lord, Lord Rix, did, to the launch today of the Disability Rights Commission, which will come into operation on 25th April—30 years late perhaps for the noble Lord, Lord Campbell of Croy.
There is no doubt that the commission will play a key role in achieving our manifesto commitment to establish enforceable civil rights for disabled people. The commission will provide much-needed and long-awaited services for disabled people. It will give them advice and information and support them in pursuing individual cases, and it will play a key role in challenging the outdated and unnecessary attitudes, to which a number of noble Lords have, quite rightly, drawn attention, that still exist in society and among train operating companies and other private and public service providers. Where necessary the commission will take steps to enforce the law. It will also have an important role to play in supporting business and public bodies to fulfil their obligations under the Disability Discrimination Act.
The noble Lord, Lord Rix, referred to a number of matters that affected people with learning disabilities. He described in graphic detail the enormous changes that had taken place over the past 30 years in the provision of services to people with learning disabilities. One has only to think back 30 years to the enormous Victorian institutions, in which so many people with learning disabilities were almost incarcerated, to note the profound change that has occurred. People with learning disabilities are a particularly vulnerable group. The report Facing the Facts published in November last year showed that there was a wide variation in the quantity and quality of services provided to that group. Just before Christmas we started work on the development of a new learning disability strategy. I note the helpful comments of the noble Lord, Lord Rix, and I shall ensure that they are considered as we take forward the work on the strategy.
I should like to turn to a number of points raised by noble Lords in the debate. The noble Lord, Lord Rix, raised the important question of advocacy. I assure the noble Lord that we encourage local authorities to use and support local advocacy schemes, or to set up their own, to meet particular needs. We are fully committed to working with the Disability Rights Commission on the issues identified by the Disability Rights Task Force. We are also looking at advocacy for people with learning disabilities as part of the learning disability strategy. The noble Lord, Lord Rix, also asked about short-term breaks. I fully appreciate just how valuable short breaks can be for disabled people and their carers. To that end, we have introduced a new special grant of £140 million over three years to promote flexible breaks for carers.
My noble friend Lady Pitkeathley and the noble Baroness, Lady Barker, made some important points about the need to ensure that users and carers are fully brought into the picture when we develop new services, particularly at local level—there must also be emphasis at national level—to ensure that those who 750 manage and run services are fully acquainted with the expert views that users and carers can bring to the process. I agree with my noble friend that sometimes there is a gap between rhetoric and action, and we must redouble our efforts to deal with that. I believe that that message is as relevant to the National Health Service as it is to local government and other statutory agencies.
A number of important points were raised about the elderly. The National Service Framework for Older People which we shall develop will look closely at some of the issues that have been raised in relation to healthcare services for older people. I share the view of the noble Baroness, Lady Barker, that greater investment in money and people in chiropody services may avoid the necessity for older people to go into hospital to undergo much more severe interventions in future.
I shall resist the temptation to discuss with the noble Baroness, Lady Gardner of Parkes, the question of NHS appointments. We have debated that matter many times in your Lordships' House. The noble Baroness is absolutely right to refer to access to buildings. We should acknowledge progress; much has been achieved. However, a good deal more needs to be done, as the noble Earl, Lord Snowdon, rightly reminded us. In response to the noble Earl's points about access to buildings and taxis, those matters will be covered by the Disability Discrimination Act, Part III of which requires agencies to make reasonable adjustments to enable people to access services. The remaining part of the Act, which is to be implemented by 2004, introduces new requirements on access to buildings.
I believe that it was only three weeks ago that noble Lords debated a number of social security and welfare issues. My noble friend Lord Ashley again raised the question of means tests in relation to the Independent Living Fund. I can only repeat what my noble friend said in that debate. The fund has always been designed for those on low income, and that intention is reflected in the fund's trust deed. The maximum amount paid by the extension fund is £625 per week, or over £30,000 a year, tax free. In addition, the Department of Social Security announced in January measures to relax the means test. This allows ILF clients who work to keep 45 per cent of their earnings between £30 and £200 per week. Therefore, the maximum earnings disregard has been increased more than three times from £30 to £106.50 per week.
I was glad that my noble friend Lord Lipsey referred to the outstanding work of Duncan Guthrie in establishing SPOD, which I believe is now described as an association to aid the sexual and personal relationships of people with a disability. When I was a manager at the Nuffield Orthopaedic Centre in Oxford I met Mr Guthrie a number of times since he held meetings at the hospital. That work is extraordinarily valuable and is a visible indication of how the passing of the Act in 1970 broke through a number of barriers and enabled people to think afresh of the needs of disabled people in a much more holistic way.
751 The noble Lord, Lord Rix, asked me to confirm that employment was encouraged but not enforced. The Government's position is that work is the best route out of poverty, including for those with disabilities. Many disabled people would like to work and need support to be able to do so, but we recognise that some cannot. It is a key feature of any civilised society that disabled people have the service and support to enable them to lead good quality lives.
I note the comments of the noble Baroness, Lady Darcy de Knayth, and the noble Earl, Lord Snowdon, about the Orange Badge scheme. I shall ensure that the DETR is fully acquainted with those comments. The noble Baronesses, Lady Barker and Lady Greengross, were right to make reference to the Human Rights Act. The Government are undertaking a broad assessment of the likely impact of the Human Rights Act. My department aims to mainstream human rights in health and social care so that they are at the heart of policy, legislation and service delivery.
I refer next to the report of the Audit Commission on disability equipment services, which we debated last week. I assure noble Lords that the Government accept the thrust of the report, which is that disability equipment services need to be improved. We are determined to do better. I echo the remarks of the noble Earl, Lord Snowdon, that it is essential to provide equipment that is of good design and quality.
Time presses. I conclude by thanking the noble Lord, Lord Rix, for giving us this opportunity to reflect on the considerable developments in care for disabled people. As the noble Lord said at the beginning of the debate, we have come a long way since 1970. This debate has allowed us to pay tribute to the remarkable efforts of many noble Lords in your Lordships' House today, along with so many other dedicated people, in ensuring that the Chronically Sick and Disabled Persons Act reached the statute book. It was a watershed in this country's approach to disabled people. It laid the foundations on which further progress could be made. It led to a sea change in attitudes towards disabled people.
Much has been accomplished. More remains to be done. I can assure noble Lords that this Government are determined to ensure that disabled people receive reliable and highly effective services and that we shall continue to do all we can to enhance the independence, well-being and rights of disabled people.
§ 5.50 p.m.
§ Lord Rix
My Lords, I have just received a note from the Table that I must end my speech at 5.53 p.m. I feel privileged to have initiated a debate which has attracted such a high calibre of speakers today. I am most grateful for all the kind words spoken about me. I humbly accept them on behalf of my daughter and so many other people with a learning disability.
We have heard today from some of the most experienced and eminent representatives of disabled and older people, their families and carers, including the noble Earl, Lord Longford, who, as the noble 752 Lord, Lord Pakenham, was the chairman of Mencap—then the National Society for Mentally Handicapped Children—way back in the late 1950s when I was the chairman of the first ever fund-raising committee of that organisation.
The noble Lord, Lord Morris of Manchester, whose original Act of Parliament inspired this debate, has demonstrated his ongoing concern and sensitivity to issues related to community care support for disabled people, while a number of my noble friends from the Cross Benches, and others—I count them as my friends—from all sides of the House were most generous in their support and unstinting with their expertise in relation to personal services, family carers and disabled people, both elderly and those of younger years.
Other noble Lords highlighted issues raised in the Out of services report. It is an important and timely report which focuses on how our current system of social services measures up to the markers of entitlement established in the CSDP Act. But the Gloucester judgment hangs like an odious miasma over the question of financial resources. I am glad that the Minister gave some positive reaction to that. He kindly sketched ways in which his department seeks to rise to the challenge in particular—in regard to the Gloucester judgment—on the question of charging and advocacy.
Those who work with disabled and older people, their families and carers, will look forward to seeing a palpable improvement in the way the services are delivered on the ground.
Finally, my thanks to all noble Lords for their most valuable contributions. I am certain that if they are noted in the corridors of power they will be responsible for providing not only happy Easters, but happier days and years ahead for at least 20 per cent of the population: those oft-forgotten—although not by us—millions who are disabled, their families and their carers. I beg leave to withdraw the Motion for Papers.
§ Motion for Papers, by leave, withdrawn.