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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 take 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
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.
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
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:
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
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.
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
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.
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
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
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.
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
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.
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.
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.
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.
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.