§ 2.56 p.m.
§ Lord Corbett of Castle ValeMy Lords, I beg leave to ask the Question standing in my name on the Order Paper. In so doing, I declare an interest as vice-president of Rehab UK, an honour that I share with my noble friend Lord Morris of Manchester.
The Question was as follows:
To ask Her Majesty's Government whether representations have been made by Rehab UK on the rehabilitation and training of people with brain injuries to assist them back to work; and, if so, what was their response.
§ The Parliamentary Under-Secretary of State, Department for Work and Pensions (Baroness Hollis of Heigham)My Lords, we are in regular contact with Rehab UK. We recently received its progress report, to which my honourable friend Des Browne, the Minister for Work, replied at the end of October. That was followed up by a very helpful meeting with officials on 11 th November.
§ Lord Corbett of Castle ValeMy Lords, I thank my noble friend for that encouraging reply. Will she confirm that 74 in every 100 people who complete a year-long rehabilitation course at a Rehab brain injury centre go into paid employment, training or further education, or voluntary work often leading to employment? Will she acknowledge that the £15,000 cost of the course is recouped within the first two years of employment from benefits not claimed? Is that not excellent value for money that should be expanded and encouraged better to help those 100,000 people a year left with residual problems of brain injury?
§ Baroness Hollis of HeighamYes, my Lords. I suspect that my noble friend's case is even stronger. Young men experience accidents, sports injuries, assaults and industrial accidents, and head injuries are one of the main reasons for disability for young men between 15 and 30. Given the level of effective intervention described by my noble friend, such young men have all their lives ahead of them.
On the bigger point, all of us used to think that the best way to help disabled people was to support them through disability benefits. What we are now doing as a government—and I am sure that we have support throughout the House—is to bring to the foreground the need for rehabilitation, health and safety at work and similar strategies to prevent people becoming disabled and to rehabilitate disabled people. That is why I am so pleased to remind the House about the publication last Thursday of the Government's Review of Employers' Liability Compulsory Insurance, which features vocational rehabilitation. The Government are drawing up a new strategic framework, which we expect to publish in late summer 2004. Rehab UK has been one of those urging such an approach.
§ Lord Clement-JonesMy Lords, in the Government's response to the Health Select Committee report on head injury rehabilitation, which the Government produced in July 2001, they said:
Getting people back to functional independence following illness or injury is a high priority for the NHS. This year, with the Department for Work and Pensions, we are planning Job Retention and Rehabilitation Pilots to test the best ways of helping people with prolonged illness or disability to remain in their jobs".In the light of that, why has it taken so long to get the pilots off the ground?
§ Baroness Hollis of HeighamMy Lords, I think that we are doing quite well. We have a collective budget of something like £50 million. My department has contributed about £8 million or £9 million. Much of 631 that money—perhaps three-quarters—goes to people with learning difficulties and mental health problems, some to people with visual and hearing impairments and some for brain injury. One of the purposes of the pilots is to show which modules—if I can use that language—are generic, such as those involving self-esteem and confidence building, and which are specific to the age and type of disability. So far, all my information suggests that things are going well.
§ Lord HigginsMy Lords, is the noble Baroness aware that there appears to considerable uncertainty about which is the lead department on such issues in ensuring that there is co-operation between departments? As the noble Baroness is replying to the Question, would I be right to assume that it is the Department for Work and Pensions?
Is the Minister aware that Rehab UK has complained that the statutory funders responsible for its financing have not met their obligations? Will she say what those statutory funders are and whether she shares the view that they have not met their obligations?
§ Baroness Hollis of HeighamMy Lord?, Rehab UK is one of the major charities, and two of my noble friends are associated with it in significant ways. It has been saying, as have many charities, that one of its difficulties is the existence of several different flows of finance. That is not peculiar to Rehab UK. There is no charity that I am aware of to which it does not apply.
In this case, my understanding is that, probably, the local authorities are among the major funders. In addition, there are, as I have said, resources available from DWP, the Department of Health and the Department for Education and Skills. Also, something like a quarter of their money comes from the EU. It is a complex matter for charities such as Rehab UK to juggle those streams of finance, co-ordinate the flow and make sure that they can take in referrals who will benefit most from rehabilitation.
We are considering the issues. One of the functions of the strategic review is to address the problem raised by the noble Lord. He is right.
§ Lord Morris of ManchesterMy Lords, I share my noble friend's appreciation of the response to his Question by my noble friend Lady Hollis of Heigham. Would she agree that, while her department has been increasingly supportive and encouraging of Rehab UK's humane leadership in this policy area, some local social services authorities could do much more to get new schemes off the ground and that, while they drag their feet, crucially important rehabilitation is delayed and people stricken by traumatic brain injury suffer? Is there any further action she and her colleagues can take?
§ Baroness Hollis of HeighamMy Lords, my noble friend will understand that it would be inappropriate for me to comment on individual local authorities, although I know that there is a troubled history in 632 some areas. Obviously, behind-the-scenes discussions are pursued at official level to see how the problems can be resolved.
The document came out only on Thursday. A framework for vocational rehabilitation that defines the scope, develops a framework for intervention, provides an overview of the work and seeks to integrate the work of various bodies will, I hope, address the issues raised in your Lordships' House today.
§ Viscount UllswaterMy Lords, does the Minister share my concern about the number of people employed by Remploy, many of them, as the Minister described, young men with head injuries caused by motorcycle accidents? Can she reassure the House that Remploy is still required to provide opportunities to those with head injuries, to help them back into regular employment?
§ Baroness Hollis of HeighamMy Lords, I am not sure whether the noble Viscount's concern is about the funding that Remploy has for that task. I look to him for help on that.
It is certainly the case that Remploy has two main pathways for helping people back into work. One is their sheltered workshops, and that grant has been frozen for a number of years. Increasingly, however, disabled people are being encouraged back into supported employment with what I would call mainstream employers. For that, the Remploy grant has gone up from £95 million in 1999 to £119 million this year. That is an increase of £24 million in three years. In that sense, Remploy should have the resources to do the work.
§ Baroness Thomas of WalliswoodMy Lords, does the Minister agree that early intervention after trauma is the greatest indicator that successful rehabilitation can take place? I know that she is not a Minister for the Department of Health, but will she encourage her colleagues in that department to take note of the cost-benefit analysis provided by the noble Lord, Lord Corbett of Castle Vale, and encourage health professionals to send cases that arrive as accidents to the post-traumatic treatment centres as soon as possible rather than depriving those useful units of their livelihood? There is one such unit in my home town, Dorking.
§ Baroness Hollis of HeighamMy Lords, I share the noble Baroness's perspective. One of the difficulties— the House will understand what I mean by that—is that the Department of Health must give priority to clinical need. My department is more concerned with the cost-benefit. That is, perhaps, a cold way of putting it, but we are concerned with the capacity to help people to return to the labour market. Sometimes, those things are in conflict. However, given the effective outcomes produced by Rehab UK—over 633 70 per cent back into employment or education—we should be able to get our act together in dealing with young men with head injuries.
§ Baroness Howarth of BrecklandMy Lords, I recognise that there are difficulties with cross-departmental responsibilities, but will the framework to which the Minister referred build on existing services? How will those services be identified?
I declare an interest, as president of John Grooms, which recently produced a futures report on the needs of disabled people and runs a special brain injuries unit. We discovered that that unit does not fit into any registration programme—the National Care Standards Commission or the Commission for Healthcare Audit and Inspection. How will such services be identified and properly enmeshed in the new framework?
§ Baroness Hollis of HeighamMy Lords, one of the motives for having the review is to present an overview of the work currently being done. I give a particular assurance that we will check that John Grooms and other organisations have access to input, but I would be very surprised if, following today's discussion— triggered by my noble friend's Question—the organisations were not aware of the review. I suspect that major players such as John Grooms and Rehab UK will be quick to give us their views. We will need views not just from disability organisations but from employers, trade unions, local authorities and other players.