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The Earl of Mar and Kellie: My Lords, to back up the remarks of my noble friend I give an example from Scotland. On Friday I was told of an appalling case history. Prior to the setting up of the local independent living scheme, a student with brittle bones had a directly employed carer who liked to receive a loan whenever the direct payment arrived. The carer would make the threatening remark, "You know, I could drop you". Not surprisingly, the student lived in terror of his carer. Subsequently, and fortunately, the student joined his local independent living scheme. After interview, the

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scheme manager was able to tackle the dismissal of that wholly inappropriate carer. The student's life improved dramatically with his next carer.

7.15 p.m.

Baroness Darcy (de Knayth): My Lords, I direct my remarks mainly to the amendment of the noble Baroness, Lady Faithfull, dealing with the regulation of individual carers rather than agencies, as in the amendment of the noble Lord, Lord Addington. I stress that this does not relate to her general point, but to individual carers in the context of this Bill. I have enormous respect for the noble Baroness. As she knows very well, normally I happily follow her through any Lobby. However, this amendment worries me, as a disabled person who is at the moment lucky enough not to need personal assistance. It also causes concern to the British Council of Organisations of Disabled People (BCODP), many of whose members were in the forefront of the independent living movement which campaigned for disabled people to employ and train their own personal assistants and direct their care according to their own particular needs and ways.

BCODP feels that to impose upon disabled people carers who are professionally trained to do the job by people other than disabled people themselves would serve only to perpetuate the professionalism and administration of disabled people's lives. That is, after all, the very thing that this Bill tries to get away from.

I should like to ask the noble Baroness, Lady Faithfull, a few questions as to how her amendment might affect a disabled employer's freedom and independence. For instance, how would a disabled person be certain that he or she would be able to employ the personal assistants of his or her choice? Those persons may not be on the register. Would the local authority then restrict employment only to those on the register? Many users recruit from other European countries. They would lose a potential source of labour if new regulations meant that such recruits had to be accredited before starting work. Would they be safeguarded? Would local authorities set dual standards for the pay and conditions of registered and non-registered personal assistants? How would a national register respond to local and cultural differences? How would the standard for going on the register be decided? There are currently no qualifications or training for personal assistants; so what criteria are being suggested? Whose interests do they serve? Did the noble Baroness, Lady Faithfull, consult disabled people and their organisations on this amendment? Did she specifically consult the British Council of Organisations of Disabled People, which has great expertise in this area?

I appreciate that the noble Baroness's amendment states that the Secretary of State should consult all interested parties before establishing a regulatory body, but it also states that, after consultation, it shall then be set up.

I very much hope that, if such organisations as BCODP were not consulted, the noble Baroness might feel able to withdraw the amendment--I do not know

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whether she put it forward at this stage only for discussion. I hope that she will not press it and will be willing to consult disabled people's organisations. BCODP says that it is very willing to consult. It would be very regrettable if a move designed to protect instead ended up forcing people back into dependent relationships.

I should like to give two brief quotes from Cashing in on Independence, written by Zarb and Nadash. They are quotes from people who use direct payments. The first is:


    "Some people impose their own ideas and I've still got mine, even if I haven't got my legs".
The other is:


    "Being able to chose the right person--personality, attitude to disability, how they fit in with the family. I'm able to retain my self respect".
Those are examples of what it is all about. I hope that the noble Baroness will think very carefully and perhaps consult.

Lord Swinfen: My Lords, the general idea behind both these amendments is admirable. The amendment of the noble Lord, Lord Addington, which aims to ensure proper standards with care agencies, is very much easier to implement than is that of my noble friend. With a care agency, as with medically qualified agencies such as nursing agencies, at the moment one can insist that the senior person in the agency has obtained certain qualifications and that the individuals supplied by the agency are working under the proper supervision of qualified people in the agency.

However, with the individual carer who is recruited on an individual basis, the standards and work required are so varied that adequate qualifications will be extremely difficult to produce. A carer may perform some very complicated tasks providing care for six, seven or eight hours a day for a very severely disabled person. On the other hand, a carer may go for half an hour or an hour in the morning to get someone out of bed, washed and dressed and possibly go in at other times just to give a bath. A great deal of professional knowledge is not required, only a certain amount of genuine common sense.

I am delighted that both the amendments have been brought forward. It is absolutely essential that we make certain that the carers who will be produced once the Bill is implemented--I am sure that agencies will spring up throughout the United Kingdom and more disabled people will seek individual carers--have the right standards.

The amendment of the noble Lord, Lord Addington, is quite easy to implement because it deals with qualifications which managers and staff may have. The amendment of my noble friend Lady Faithfull is much more difficult for the individual. I should like to hear her reply to the questions put by the noble Baroness, Lady Darcy (de Knayth), although I doubt whether she had time to take down all the questions and may have to deal with them at Third Reading--she may write shorthand, whereas I do not, so she has the advantage of me.

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I support the principles behind both the amendments.

Baroness Hollis of Heigham: My Lords, I shall be brief. Most of my points have already been made. We support the amendment moved by the noble Lord, Lord Addington, for the regulation of agencies. It seems to me absolutely right that where people operate a commercial service in a sensitive area of care, they should be registered and appropriate qualifications checked.

Like other noble Lords who spoke, I too have some unease about the amendment of the noble Baroness, Lady Faithfull. Nobody in this House can match her experience in the fields of health and social service. She is absolutely right to remind us that when we move to direct payments there is a risk of abuse. Clearly her amendment aims to offset that risk by seeking to professionalise the role of carer.

The problem is that professionalising the carer generates other problems in turn and may, but not necessarily will, displace the disabled person from the centre of the care network and again make him dependent on it. By virtue of their training, professionals bring assumptions to bear--that is what their training is about--which may not always be appropriate in the eyes of the individual. If they seek to retain their authority as employer, it can make things difficult.

Perhaps I may suggest a more appropriate route. The noble Baroness was right to remind us that there is a risk of abuse in this area and we should safeguard against it. I suggest that the right route is less through seeking a general council or regulation through that device than by revisiting the amendment so ably moved by the noble Lord, Lord Addington, a few moments ago, which seeks to ensure that local authorities have in place support and advice packages for disabled people which will strengthen them in their abilities and competences when it comes to selection and recruitment of staff. That seems to be the right way to work with the grain of what disabled people want rather than seek to meet the fears that the noble Baroness addressed along routes that they clearly do not want.

In those circumstances and given the strength of experience of the noble Baroness, I wonder whether the Minister may, on reflection, be able to move even further down the road of Amendment No. 10 moved by the noble Lord, Lord Addington, than she was previously minded to do.

Baroness Masham of Ilton: My Lords, I should like to add a few words. One needs flexibility and freedom for the individual but also one needs protection. The example given by the noble Earl, Lord Mar and Kellie, was a real one. Recently there have been some unpleasant cases of abuse in homes for handicapped people in Yorkshire. Disabled people could be very seriously abused even more so in their own homes where there are no other people around. Also there is now the growing problem of alcohol and drug abuse. Therefore, I hope that the Minister will look closely at some acceptable way of protection for the individual.


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