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Lord Rix moved Amendment No. 1:


Page 1, line 10, leave out from ("services,") to the end of line 12.

The noble Lord said: My Lords, I make no apology for repeating the proposals for changes to this Bill by one deletion--Amendment No. 1--and one new clause--Amendment No. 12--in which I am supported by the noble Lord, Lord Addington, and which I tabled also at Committee stage.

I thought the sweet reasonableness of what I proposed would win immediate acceptance, as indeed it did from almost everyone except the Minister. The passage of time has not persuaded me that the changes I propose are other than reasonable. I am happy to note that People First, in the briefing it supplied, support me in my attempt to deprive the Government of the opportunity to behave unreasonably and stress the need to allow people with learning disabilities to have as great a say as possible in their own lives with appropriate support when necessary.

I say "Amen" to that. But I harbour an unworthy suspicion that the Minster will be minded to respond by pleading the incomplete consultation exercise to which I referred at Committee stage. Your Lordships will be aware that those who manage those matters on our behalf have not been minded to let us have our debate after the consultation period which, ironically perhaps, has the advantage that we are again contributing to the consultation.

As I should not like to think that your Lordships are debating matters today to no purpose, I shall remain optimistic. After all, this is a House in which reason tinged by passion is thought by some to have the edge on politics tinged by passion. My aim is now, as it has been from the outset, to ensure that those people with learning disabilities for whom direct payments are an appropriate means of securing community care services should not be denied that opportunity because local or central government are prejudiced against them. Moreover, I want those who are to be covered to be

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covered from the beginning and not to be considered some way down the line once others have had the new option for a year or two.

I note all that has been said about festina lente--testing the waters before plunging into them--but I am bound to say that, since local authorities will have complete discretion in regard to introducing schemes and discretion on an individual basis as to who is admitted to a scheme, a rush to destruction seems highly improbable. We are, I would guess, talking about a relatively small group and not, certainly in the shorter term, about a huge change in the services available.

We are all anxious to get this right. Given the experience already developed I suggest that the best way of getting it right is to allow the inclusion of modest numbers from a wide range of disabilities. I share the view of People First that there is a certain illogicality in testing a scheme on one group of people to see whether it works for other totally different groups of people. I beg to move.

Lord Addington: My Lords, briefly, Amendment No. 1 touches on one important fact. The noble Lord, Lord Rix, is talking about the rights of an individual, regardless of the label, to receive benefit and to direct that benefit to wherever he or she chooses to receive care and support.

It is true that the consultation period is not over; it is true also that we shall not be in a strong position at the end of that period to be able to make a realistic contribution to the Bill. Thus I recommend that the House listens to what is being said. All we are doing is trying to ensure that groups are not excluded. Surely that is something which is beneficial to all groups and will not be damaging to the general thrust of the Bill.

Lord Hayhoe: My Lords, the noble Lord, Lord Rix, was brief in his proposal of this amendment, as he had already spoken at Committee stage in like vein. I too hope to follow his excellent example.

We are seeing one of the inexorable laws of politics; that is, if a sensible, widely agreed and desirable reform is introduced, the Opposition could not possibly oppose it and say that either it was too little or too late. Indeed, the noble Lord, Lord Rix, used both arguments: "too little" because at the moment the scope of the Bill is limited, as we acknowledged when debating this matter at Committee stage; and, if the sort of group that he has particularly in mind comes in at a later stage as a result of consultation and fully in accordance with the provisions of the Bill which allow such extensions to take place, the "too late" argument is used.

I therefore reiterate that the Government have brought forward a useful and good piece of legislation. It would be right for us to give it a run as a new scheme, starting slowly in a modest and seemly fashion with proper monitoring. We should allow the monitoring to take place always with the possibility that, following on from the consultation and monitoring, the Government--without any primary legislation and within the provisions of the Bill--will be able to make provisions for the sort of extensions which the noble Lord, Lord Rix, has in mind. In those circumstances, the arguments

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are persuasive in supporting the Government, maintaining that flexibility and taking a sensible small step forward rather than perhaps trying to take too large a leap at this stage which could in the long run be against the interests of the Bill itself.

Baroness Faithfull My Lords, I support the Government on the Bill, although in some ways I am sorry to oppose the noble Lord, Lord Rix, who does such splendid work for people with learning difficulties. With any new Bill, particularly a Bill like this which takes us into strange waters where we have not been before, there are bound to be difficulties. In fairness to those with learning difficulties, it is far better to know what those difficulties are so that people do not feel they have made a mistake in purchasing whatever it is they need and want. When working in a social services department I often found that someone with learning difficulties would come to me and say, "Why don't you help me?" One feels that one wants to help people with learning difficulties but one does not want them to make mistakes. There are bound to be mistakes at the beginning. It is far better for us to know what mistakes have occurred before giving them the opportunity to purchase these services.

Baroness Hollis of Heigham: My Lords, as the noble Lord, Lord Rix, said, the amendment seeks to avoid restricting the payment of money for the provision of services in advance and confining it exclusively, as the Government intend, to physically disabled people under the age of 65. That would mean that by category those with learning difficulties or adults over 65 with physical handicaps would be excluded from receiving direct payments. Whether they wished to or not, they would instead receive only services.

What is the nature of the Government's objection to the amendment? Local authorities, voluntary organisations and disabled people wish to see the possibility of direct payments being made to all disabled people. What is the nature of the Government's argument? It cannot be that the Government oppose the proposal on financial grounds. It is clear from all the research that for local authorities direct payments are cheaper than services. The average cost of direct payments is around £5 an hour; the cost of services, with overheads, is around £8 an hour. Direct payments are cost neutral and certainly far cheaper for local authorities than the alternative of offering residential care. So the Government cannot resist the proposal on financial grounds. Direct payments are likely to be cost neutral and may very well save us all money. So the argument is not one of cost.

What is the next government argument? It appears to be the floodgates argument, on which the noble Lord, Lord Hayhoe, touched. The argument is that local authorities would be overwhelmed and that therefore we should start slowly and gradually build up. That assumes that all local authorities are coming new to the issue of direct payments. They are not. Some schemes have been in operation for 14 years and already extend to far wider groups of disabled people than the Bill envisages. Without the amendment, in some local authorities fewer people will be eligible for direct payments as a result of the Bill than they are today. That is what it means. Some

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people will lose direct payments which they are currently receiving through third-party agencies and may have to go back to residential care--certainly the evidence of Kingston suggests this--even though they are currently enjoying and experiencing direct payments from a well-run and well-managed scheme funded by the local authority. Far from the noble Lord, Lord Hayhoe, being right, he is profoundly wrong. The Bill will narrow and take away opportunities which disabled people are currently enjoying.

Is it true, nonetheless, that if the amendment were passed the floodgates would open? All the research shows that only a small proportion of disabled people are likely to want and to take advantage of the scheme. The suggestion is that only around 100 of every thousand physically disabled people under 65 are likely to take up direct payments. The number could be more--I hope very much that it will be--but that is the evidence so far. Far from local authorities being overwhelmed, the problem is much more that unless we have adequate support and advice systems in place they will be underwhelmed and will need to build up the confidence of disabled people to take up these packages. The Government need not fear the floodgate factor any more than they need fear the cost factor.

The third argument the Government have adduced has been repeated by the Minister's supporters on the Back Benches. It is that local government must go slowly and build up confidence. Local authorities are already running such schemes. There are 60 in existence. Most have a remit to help far wider groups of people than the Bill envisages. I have every confidence that directors of social services who are starting direct payment schemes from scratch will not seek to extend them to people beyond the capacity of their authority to deliver them. The directors of social services are not stupid. They will not arouse expectations which they cannot deliver. They will not try to encourage demand which they cannot meet. Being professional, skilled and highly responsible people, they will want to ensure that people's needs and people's demands and authorities' ability to cope are aligned.

What does the Bill as it stands do? What it does is stereotype. The noble Lords, Lord Rix and Lord Addington, are exactly right. The Bill says that irrespective of the needs, the abilities, the desires or competences of the individual person, the Secretary of State will say, "Certain categories of disabled people will be discriminated against. They will not be eligible to receive direct payments even though some of them are receiving them now." That is ruling out direct payments, not by assessment, not by judgment, not by demand, not by need, but by category and by discrimination. That is not proper. It is right that the local authority should exercise its professional judgment in conjunction with the needs and views of the disabled person. We do not need the Secretary of State double thinking the local authority. Trained professional social workers are always making fine and difficult judgments on issues like child abuse. We trust a social worker to make a judgment about child abuse but the Bill is saying that we do not trust a social worker to make a judgment about direct payments to disabled people who may

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already be enjoying them. We do not need the Secretary of State to prejudge the situation in advance when local authorities wish to extend direct payments, when disabled people wish to receive them, and when it is at no additional cost and may very well save money for the taxpayer and council tax payer alike.

Let us not have discrimination by category. Let us recognise the human potential of every disabled person to be at the centre of the care system by organising services. Let us respect the local authority's professional judgment. Let us ensure that all disabled people who in the judgment of the local authority can benefit from direct payments and so take autonomy and control over their own lives are enabled to do so. Let us support the amendment today.

3.30 p.m.

Lord Campbell of Croy: My Lords, I and I believe others understand the principle that the Government follow in introducing a totally new system, except in Scotland, and taking certain categories to start with: that is to say, they do it gradually. No doubt that is what my noble friend will say in reply.

The noble Baroness, Lady Hollis, has raised a point to which I hope my noble friend will reply. Unless I misunderstood her, she indicated that the present local authority schemes, which were carried out through third parties, would come to an end. My understanding is that during the introduction of the new system local authorities will not have to bring to an end schemes that they have operated up to now. I should be grateful if my noble friend could comment upon the point. Is the noble Baroness right to suggest that at a certain stage the existing schemes will have to come to an end or, as I had supposed, will they continue while the new direct payments schemes are brought into effect? If that is correct, there should not be a situation where there will be fewer disabled people who receive payments than there are now.


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