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Social Services (Designation of Functions)Mr. Speaker : Order. We now come to draft Local Authority Social Services (Designation of Functions) Order 1989. Mr. Freeman.
Mr. John Battle (Leeds, West) : On a point of order, Mr. Speaker. Is it possible for the instruments appearing on the Order Paper to be taken separately? The regulations applying to housing are, in my view, different and should be discussed differently from the two instruments applying to the social services.
Mr. Speaker : Order. I have not heard any suggestion that they should be taken together, and I referred to only one order. It may be for the convenience of the House, however, to discuss the following two together, but that is for later on.
Mr. Ian McCartney (Makerfield) : On a point of order, Mr. Speaker. I would like the two instruments relating to the social services to be debated separately. Several of my hon. Friends and I feel that different matters apply to both and that they should be debated in some detail separately, especially in terms of the way in which they affect local authority resources.
Mr. Speaker : Order. I said that that would be the case, and certainly I mentioned only one order.
10.30 pm
The Parliamentary Under-Secretary of State for Health (Mr. Roger Freeman) : I beg to move
That the draft Local Authority Social Services (Designation of Functions) Order 1989, which was laid before this House on 19th December, be approved.
Following your ruling, Mr. Speaker, it may be for the convenience of the House if the two instruments--[ Hon. Members :-- "No."]
Mr. Speaker : Order. I think it is the wish of the House that they be taken separately.
Mr. Freeman : I thought that you wished both social services matters to be taken together, Mr. Speaker, but I stand corrected. I shall not detain the House long over the first order. The Local Authority Social Services (Designation of Functions) Order, which applies only to England and Wales, is to designate under the Local Authority Social Services Act 1970 as social service functions those functions of local social services authorities under the Access to Personal Files Act 1987 and under the Disabled Persons (Services, Consultation and Representation) Act 1986. The effect of this is that the powers and duties specified stand referred to the social services committee to which those functions may be delegated and the social services department may deal with that work. That is what has always been envisaged.
Mr. Andrew F. Bennett (Denton and Reddish) : I understand that children about whom a statement has been prepared and who have been under the supervision of the education department until they have completed their schooling will then be handed over to the social services department. What is the logic behind and the justification for that? It seems unfortunate that after parents have built up a good understanding with people in the education department, which prepared the statement on the young
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people in question, the children should be handed over to the social services department merely because they can no longer continue in full-time education. The new department must then establish contact with the family.Mr. Freeman : The first order relates specifically to the functions of social services departments in local authorities. The second order deals in much greater substance with access to personal files and other matters that the hon. Gentleman may want to raise. This order merely designates the functions currently performed by social services authorities under the Local Authority Social Services Act 1970. It is a necessary procedural measure, and I commend it to the House.
10.32 pm
Mr. Tom Clarke (Monklands, West) : We shall not oppose the instruments because we believe that they tidy up some parts of the legislation and show the House the Government's thinking. The Minister omitted to mention the Government's intention to allocate to the social services departments their responsibility for implementing the Disabled Persons (Services, Consultation and Representation) Act 1986. I had understood that that was to be done from information made available in the Library--
Mr. Freeman : I can confirm that.
Mr. Clarke : I display no conceit when I say that we regard that as the most important part of the regulations. The hon. Member for Roxburgh and Berwickshire (Mr. Kirkwood), who introduced the Access to Personal Files Bill in 1987--we shall discuss it in greater detail when we come to the second instrument--has made a considerable contribution to our deliberations on these matters. We welcome the Minister's clarification that access is also recognised under the disabled persons legislation, but it is important to distinguish between the Government's intention to include access to information under that legislation and their inability so far to introduce orders on the sections with which this instrument specifically deals. Many of us were heartened by the Minister's response to an Adjournment debate on 1 February, when he indicated great interest in one of the sections covered by the order. I refer to section 7, which deals with discharge from long-stay psychiatric hospitals. The Minister said then :
"My hon. Friend will be aware of the importance of that Act in strengthening and extending legal provisions for disabled people and re- inforcing their rights in society. That, of course, includes mentally ill people. Section 7 will require health and local authorities to assess the needs of people discharged from hospital after treatment for a mental disorder of six months or more, and officials from the Department are currently involved in a series of meetings with representatives of both health and local authorities, identifying the processes, procedures and costs that will make up the requirements under this important section of the Act."
I was gladdened, as I think we all were, when the Minister added : "I am taking a personal interest in those discussions, and I can assure my hon. Friend that we treat the matter seriously."--[ Official Report, 1 February 1989 ; Vol. 146, c. 407.]
If that is the case, I think it will be welcome, but I have to express considerable disappointment that the Government have taken so much time in getting this far. In view of the
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Minister's personal interest, which we welcome, we look forward to a great deal more progress on the section than we have seen so far. This morning, on one of the radio phone-in programmes that we hear in London from time to time, the Secretary of State was asked by a doctor a question that is relevant to our debate. The doctor asked about elderly people with disabilities being discharged into the community. He said that it sounded as though there would be faster discharges. Where were these patients going, he asked. The Secretary of State replied that we had to wait for the Griffiths report, which he said would be dealt with "shortly". "Shortly" is not a word that he has so far used in this House, and I think it is important that we should seize this opportunity in dealing with the order to ask the Minister, especially when we are concentrating on the role of local government--the role that people see for local authorities--precisely what is to happen to the Griffiths report and to its recommendation about the enhanced role of local government.The order brings within the scope of functions to be discharged through a local authority's social services committee those functions contained in sections 1 to 5 and in sections 7 and 8 of the 1986 Act, except those appropriate to a local education authority.
I should like to refer briefly to each of those sections and to ask what is the Minister's thinking in terms of these instruments. Section 1 deals with the appointment of authorised representatives of disabled people, and section 2 with the rights of authorised representatives of disabled people. I think that that Act was seen and that those who supported it recognised it as a major breakthrough in terms of advocacy and representation. It is a pity that we have to wait for the full implementation of the Act, but we see, for example, in cities like Sheffield, that good practice already exists. Advocacy is there, and representation is there ; it is taking place. It seems to me that if, rightly in the context of the access to information Act, we make more people aware precisely of that information we will in many ways be building up people's hopes. It would be a great disappointment to many people if we simply provided the information and did not do anything effective about making sure that the representation and advocacy provisions and the other sections were implemented fully.
Section 3, as the Minister will recall--it is mentioned in the instruments before the House--deals with local authorities' assessment of the needs of disabled people, and section 4 with the duty to consider the needs of disabled people. I need hardly remind the House that when my right hon. Friend the Member for Manchester, Wythenshawe (Mr. Morris) introduced the Chronically Sick and Disabled Persons Bill of 1970 it was accepted then and subsequently by every Secretary of State that assessments, once established, should be acted upon. I think the same would be true of this order. I invite the Minister's endorsement of that.
Section 5 deals with disabled people leaving special education. We know that the section was welcome, as the order will be, to organisations like Mencap and the 19-plus groups in many parts of the country, as well as to parents who have to cope with the serious problems for young people leaving special education who wonder what their future will be. It is important that not only do we have information available for parents, representatives and the
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disabled persons but that the assessments are carried out according to the sections of the Act which are being implemented.Mr. Andrew F. Bennett : The Minister did not answer my question about section 5 when I intervened earlier. Can my hon. Friend explain the mechanism? As I understand section 5, it set out a framework for what happens when a person completes his education. I understand that the person will no longer be the responsibility of the education department but will be taken over by the social services department. If the parents of a young person have built up a good relationship with the education department, will the case have to be transferred to the social services department, or can the education department continue to carry out the necessary functions? The order refers to "Sections 1 to 5, 7 and 8 except insofar as they assign functions to a local authority".
Can my hon. Friend help me?
Mr. Clarke : My hon. Friend is right to highlight the difficulties. There is a grey area about the transfer of responsibility from the education authority to social services. This has meant that when children experiencing special education leave school at the age of 19, no plans have been made for their future. This is why there are so many 19-plus groups. Often no assessments have been made and social services departments do not accept responsibility for the future of the children. When the section is implemented, we hope that parents will be consulted about the future of their children and that the whole process will be much tidier than it is today, with tragic consequences in many cases.
Mr. Dennis Skinner (Bolsover) : Can my hon. Friend tell me whether there was proper consultation with the organisations for the disabled, such as the Derbyshire Council for the Disabled, before the order was introduced? I wonder whether groups which specialise in assisting the disabled much more than happened 10 to 15 years ago have been consulted or whether they should be consulted. These are questions which should be answered.
Mr. Clarke : It is a fundamental question. The title of the Act is the Disabled Persons (Services, Consultation and Representation) Act. So the main thrust of the Act was to involve disabled persons or their representatives in decisions affecting them which are taken by the House and by local authorities. So when my hon. Friend asks whether I agree that there has been adequate consultation, I have to reply that I do not think so. Indeed, at a later point I wanted specifically to ask the Minister what consultation has taken place, and I think it would be helpful if we heard not only about consultation as between the various Government Departments and the local authority associations, but with the kind of organisations of and for disabled people which my hon. Friend mentioned.
Mr. McCartney : My hon. Friend confirmed that the recently published Local Government and Housing Bill will include a section in relation to curtailing the rights of local authorities to co-opt on to various council committees. If it is confirmed that that is the Government's intention, many social services committees, including my own local authority's, who provide special places by co-option of disabled representatives will have to exclude them from consideration in voting in meetings of the social services committees.
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Mr. Clarke : Again, I think my hon. Friend makes an excellent point, and I wonder whether, when the Minister or the Government consulted the local authority association which speaks for my hon. Friend's authority, that point was put to it. Certainly I think that we will be hearing a great deal more about it.
I was about to deal with section 7. On this point, especially when the Minister, I know, is discussing the whole issue of resources with the organisations involved, I think it is important that we should reaffirm the need, especially when informaton has been made available to people but not necessarily followed by either assessment or services, for adequate bridging funding to be made available and that that is again seen in the context of the Griffiths report, and indeed of the fairly overwhelming criticisms of discharge from hospital, not matched by either assessment or arrangements for people who are leaving hospital, criticisms which were made very strongly and profoundly by the Audit Office report and accepted unreservedly by Griffiths.
Therefore, we want to avoid the sort of issue which organisations like MIND remind us of time after time, such as the "revolving door" syndrome. We know that many people move out of hospital and then back again, perhaps into another hospital or into a local authority home, without any real assessment being made of their needs, and indeed of their place in society. So, in making the information available in the way the order would do, we want to ensure that those who wish to face the problem of proper assessments for people leaving hospital avoid the kind of problems we have seen and are properly resourced, because otherwise, as Sir Roy Griffiths has clearly indicated, the problem will continue and will be as unacceptable in the future as it has been in the past.
Mr. Bob Cryer (Bradford, South) : One of the concerns about this order is that it is not much good designating local authorities if they do not carry out the functions my hon. Friend is talking about. Would he perhaps refer to the primary legislation which gave the power to introduce this order to see whether there is a means of making local authorities carry out their duties?
Mr. Clarke : My hon. Friend is absolutely right to call for monitoring, and my view, especially when we talk about consultation, is that there are no better people to monitor precisely what is going on than disabled people, their carers and the representatives themselves.
Section 8 deals with the duty of local authorities to take into account the abilities of the carer. In many ways in our society today, we exploit the good will and commitment of millions of carers, mainly women, in many parts of the country. Were they not as committed as they are, in many cases 24 hours a day, seven days a week, it would cost the Treasury millions of pounds to fill the gap. Therefore, I think we ought to hear a great deal more from the Government about the role of the carer, because if local authorities cannot take on board the carers' needs in relation to the disabled people that they are looking after, the whole relationship can break down as between the two people and, instead of avoiding extra cost, two people--the carer and the disabled person--are hospitalised, and institutionalised, and costing more money. Also, that is, socially quite unwise and unacceptable.
The order also brings the function in section 1 of the Access to Personal Files Act 1987 into the duties to be
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discharged through a local authority's social services committee. The Minister made it quite clear that that is where the responsibilities lie.I extend a cautious welcome to the order. We shall not oppose it, but we believe that scrutiny is important. As my hon. Friends have made clear in their interventions, the role of the consumer is absolutely essential, information should be provided and there should be adequate consultation at every stage. We are dealing with the rights and needs of millions of people in Britain, and hon. Members should recognise those rights and needs and make it clear that we associate urgency with those objectives.
10.50 pm
Mr. Ian McCartney (Makerfield) : Prolonging tonight's debate beyond the normal procedure provides an opportunity for those of us who are involved in local authorities, social services and the voluntary sector. I am involved in the care of the mentally disabled and the mentally ill.
Although we shall not divide the House, it is clear that the Government seek to give an impression that they are extending the ability of disabled people and other client groups needing the assistance of the social services to gain access to a whole new range of resources and facilities. However, the day-to-day running of social services departments reveals that their budgets are continually under stress to provide resources for their current obligations. In many local authorities, particularly in areas of urban deprivation, the staffing of social services departments is in crisis. In many instances, people involved in social services are continually hounded when crises occur and difficulties arise because departments are unable to provide an adequate service for their disabled clients and to carers in the community.
Therefore, it is important for the Minister to recognise that it is not simply a matter of setting down in an order the duties and responsibilities of local authorities, but that resources must be provided to enable those commitments to be carried out. Unless those resources are provided there will not be one additional facility for carers, one additional place for the mentally disabled, one additional hostel for the mentally ill, or one additional aid or adaptation, training place or employment place for the mentally disabled, nor will there be any additional resources for special educational needs for disabled persons when they reach the age of 19. The order will be absolutely meaningless if it is not coupled with a commitment to provide additional resources for local authorities to carry out their obligations.
Assessing the needs of disabled people without acting on that assessment is one of the greatest disincentives to carers in the community. Many hon. Members on both sides of the House through advice centres or through local authorities encounter cases of stress in which carers can no longer meet their obligations and reach the end of their tether because of the lack of respite care or additional assistance to help them to meet what they consider to be their family obligations.
I will give some personal examples of the problems that have arisen, are arising and will continue to arise unless the Minister provides the resources to go with the order. For the mentally ill, one of the great problems, as my hon. Friend the Member for Monklands, West (Mr. Clarke)
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said, is that at the end of their treatment, whether it is 28 days of treatment or a three six months stay in a National Health Service hospital, they are immediately back in the community, sometimes with an adequate assessment and sometimes not. Often there is no assessment. They find themselves back in the stressful situation that brought about their mental collapse in the first place. They often go back to a hard-to-let local authority housing estate with no heating or cooling facilities and without resources to maintain themselves. They quickly find themselves back in a stressful position, and then back in hospital for a short or longer stay.Care in the community for the mentally ill requires that in the assessment period of leaving the hospital and going back into the community there must be resources for hostel care and for day care. One great boon to people in my area is the local authority's commitment, along with the Grosvenor housing association, to build a number of core and cluster arrangements. Mentally ill people are thus not simply passed out of one hospital and back into the community and a stress situation. They come into the community either through the day care facilities or through the hostels, where the assessment of their needs can continue to be monitored and where assistance is given with jobs and other treatment that they require to ensure that they remain outside the hospital once their need has been assessed. They can then be brought back into the community.
It is a tragedy that many, especially those who suffer from schizophrenia, find themselves in hospital one day and the next day are given a bus pass and ticket back to the community from which they came and where there are few or no resources for the social services to cope with the problem. In many instances, the first stop is the magistrates court or Greater Manchester police, neither of which want or should be expected to cope with the problems caused by the inability of local authorities to provide for the needs of the mentally ill. On some occasions, magistrates send mentally ill people to prison for short or long periods simply because no resources are provided to treat mental illness or stress during a period of mental illness. Many people whose only crime is to suffer from mental illness are incarcerated in prisons as a result of the Government's failure to provide local authorities with the resources to care for the mentally ill.
That failure on the part of the Government is a scandal. The hon. Member for Derbyshire, South (Mrs. Currie), the former
Under-Secretary of State, met me last autumn to discuss the crisis in the north-west region in terms of facilities for the care in the community of the mentally disabled. We have two of the largest mental institutions in Europe at Brockhall and at Calderstones outside Blackburn. Over the next 10 years, there is to be a process of bringing back into the community many mentally disabled people from throughout the north-west. Local authorities such as Wigan, Manchester, Oldham, Bolton, Preston and Blackburn have produced plans and resources to bring back into the community over 10 years either individuals or groups and to allow hundreds of people who have been unnecessarily maintained for 20 or 30 years in those large institutions to leave them. Yet that programme is in a state of collapse in the north-west because of the Government's inability to fund it properly, both in terms of the criteria for funding for the young mentally disabled and the criteria for dealing with the elderly or people who have a physical and mental handicap. In Wigan, the local
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authority is prepared to take about a dozen people from Brockhall and Calderstones hospitals over the next three years, but the programme has ground to a halt because of the inability to obtain assurances about the long-term funding of the programme.What about the position of vaccine-damaged children? They are a product of society and the responsibility of all those of us who are committed to the principle of mass vaccination. In committing ourselves to that principle, we must bear in mind that even with today's improved vaccines a small proportion of children are at risk and will end up permanently brain damaged. Indeed, in most instances vaccine-damaged children are not just brain-damaged but due to the nature of the damage suffer physical as well as mental deprivation. Many of the children who were vaccine damaged in the 1960s and 1970s are now reaching their teens and young adulthood. A young vaccine-damaged lad in my constituency is coming out of a special education establishment this week at the age of 19. Because of lack of resources and the inability and failure of the North Western regional health authority to provide additional care, the family will have to keep that lad at home seven days a week because no facilities are provided for him. The local authority is still prepared to try to assess and to give some day-centre care, but that is totally inadequate in relation to the order. The order places a requirement on the local authority to assess disabled persons leaving special education, but having carried out that assessment and stated the requirement of that young vaccine-damaged lad to have regular five days a week day-centre care the local authority does not have the resources to provide that care, purely and simply because of the Government's lack of commitment to providing the necessary resources for local authorities.
The order also places on local authorities an obligation to assess the needs of disabled persons. In radical authorities which deal with social services departments, much of that assessment will relate to training and employment opportunities. Thank God the days when people with mental and physical handicaps were shunned and pushed aside are over.
Mr. Andrew F. Bennett : As I understand it, these are affirmative orders introduced by the Government after the passage of the relevant Act, and the whole argument for doing this by affirmative order was that the Government were not prepared to implement the Disabled Persons (Services, Consultation and Representation) Act 1986 until the resources were available. I assume that by bringing the order forward at this time, although the Minister did not say so, the Government are making some commitment to providing those resources now.
Mr. McCartney : The Minister may wish to intervene to reply to that, and I hope that he will do so in the affirmative. My current experience and knowledge of constituents cases and the assessments that are taking place suggests that is not the case, but I shall be glad if the Minister can prove me wrong. I should be even more glad if he would give a commitment that once an assessment is carried out under the order local authorities will be given the resources to carry out the requirements of the assessment.
I assume that one of the areas of assessment of the needs of disabled persons--again, the Minister may
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intervene to say whether my assumption is right--will be the assessment of the ability of mentally or physically disabled persons to undertake training and employment. Local authorities with a commitment to ensuring that mentally and physically disabled persons are given an opportunity to play a full role in society and are not simply placed on one side in day-care facilities already assess them for training and employment.My local authority has such a training and assessment centre--the Fourways training assessment centre. The Department of Health has used that centre's facilities for training its staff in techniques for assessing mentally and physically disabled persons. Given that there is a care in the community policy and that the Government have given local authorities such as my own the commitment to provide facilities in the community for those discharged from hospital, it seems to follow that part of that discharge assessment should be an assessment for training and employment purposes. That being so, let us suppose that my local authority is left in the next financial year with about two dozen assessments of people coming out of hospital, and that those assessments show that some form of training must be provided--a small proportion of those persons have prospects of employment--where do the Government stand in terms of providing resources for my local authority to carry out its commitment? From the Minister's rather short statement, it appeared that no such resources would be forthcoming, so the assessments will lie in a social worker's desk not acted upon, and the disabled persons and their carers will be in the same position as they are now--scrubbing about for a meagre share of the local authority's resources. What about respite for the carers? Section 8 of the Disabled Persons (Services, Consultation and Representation) Act 1986 provides that a local authority should take into account the abilities of the carer. My hon. Friend the Member for Monklands, West made an impassioned and, in my experience, a genuine plea for carers. There are more than 9 million people looking after people with all forms of physical and mental disabilities--an aunt, an uncle, a son, a daughter, a brother, a sister, a father, a mother or a husband. They are nursing someone either on a short-term basis or on the basis of long-term care in the community. That nursing can be sustained only if the local authority can provide resources to ensure that the carer is protected and assisted.
Many of the cases on which local authorities must take emergency action are those where carers cannot cope any more, because of the pressures and the nature of the disability of the individual concerned or because there has been insufficient care taken about their needs--which could be the facilities provided in the home for the disabled person or additional assistance. For example, a local authority, when considering the needs of a carer, may say that the assistance of a home help is required for a period. The Government have indicated that there will be a few resources for those carers. When the system breaks down, the local authority must provide emergency services at great and additional cost to ensure that the disabled person and the carer are not put at risk.
What about aids and adaptations? There is a commitment in this order to assessing the needs of a disabled person in that respect. Many local authorities
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over the past 10 years--through the Chronically Sick and Disabled Persons Act 1970--have identified tens of thousands of people in the local community who need assistance in the form of aids and adaptations. Those are personal aids or adaptations to their properties or even to a child's school, and other types of physical assistance to protect and enhance the life of a disabled person and sometimes the carer. As a result of Government cuts in resources, more and more local authorities are using the technique of reassessing criteria, whereby criteria are implemented in such a way that many disabled persons, who believe that they are entitled to assistance through aids and adaptations, find themselves turned down by a local authority agency. I believe that the provision for access to information will enhance the ability of a disabled person, or his or her representative, to challenge the sometimes unfair, impractical and downright unjust decisions of some social services departments, especially those controlled by Conservative local authorities, which want to cut back on the provision of aids and adaptations.Mr. Skinner : My hon. Friend has been concentrating on the way in which local authorities will have their work cut out to carry out this provision. I wonder whether my hon. Friend has paid any attention to those people who currently live within the curtilage of the Tory-controlled Westminster city council who would be designated under this order. Those are the hundreds, perhaps thousands, of people sleeping rough, many of whom are disabled. We see them every morning and night. Is there any way in which they would be catered for under the order? Can my hon. Friend conceive of a situation where an authority such as Westminster city council, which is more concerned with selling off cemeteries than with this sort of provision, does not pay much attention to ensuring that people living rough, among whom would be many disabled, are taken into account?
Mr. McCartney : I have two things to say in reply, neither of them helpful to the disabled or to those who live rough in the community. Westminster city council has already redefined its criteria for dealing with its homeless so that it is rare that the mentally or physically ill who roam the streets of Westminster are catered for. Secondly, the Department of Social Security has almost completely removed funding for hostels for the mentally ill and disoriented in inner-city London. Many people sleeping rough in London tonight are doing so because of mental or physical disabilities. The Government have rejected those people and have withdrawn any funding to assist them, leaving it to the Salvation Army and other Christian organisations to look after those who, under the order, should have their needs assessed and catered for. That is the reality in 1989. In London tonight, as we talk here, people are not having their needs assessed and where they have been assessed cuts in Government resources mean that those assessments cannot be acted upon to the benefit of the disabled person.
Because of advances in medical technology, people with Down's syndrome are reaching middle age and even their 60s or 70s. The order will place a requirement on local authorities to give special consideration to the needs of the elderly disabled. They are a special and growing group of people with specific needs such as day care and respite care. They may have carers who are themselves elderly. A constituent of mine in his late 80s cares for his
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mentally-handicapped son who is a pensioner. He is still caring for his son in the community, as he has done throughout his life. The assistance comes from the Labour-controlled authority in Wigan, but not all local authorities provide the same facilities. There is a patchwork of facilities throughout the country. The level of service and commitment often depends on the local authority.I hope that the Minister will try to ensure that, whether the people who require the services through these assessments live in Wigan, Brighton or some Tory shire, the necessary resources are provided. Why should a disabled person in Wigan have day care and respite care while down the road in a Conservative-controlled authority that care would be denied because of cuts in local government budgets? If we are to look after the elderly and disabled in the community, there should be a minimum level of services based upon their assessments, irrespective of where they live.
The Minister should give the House a clear idea of his intentions on resources. Down's syndrome children may have educational, physical or training needs. Where are the resources for a planned programme of assessment during the development of such children? We do not want such a child to be assessed in its first months of life and then to be dependent on the commitment of the parents and the whim of the local authority throughout its life as a toddler, school child, teenager and adult. We require an ongoing assessment.
Madam Deputy Speaker (Miss Betty Boothroyd) : Order. The hon. Gentleman, throughout a good deal of his speech, has gone very wide of the order. I have been tolerant, but as other hon. Members are waiting to speak I now ask him to return to the order before us.
Mr. McCartney : I was referring to assessment needs, especially those set out in the order, but I take the point, Madam Deputy Speaker. An assessment should not happen just once during a disabled person's childhood, but should continue to identify and monitor the needs of the child or the carer. We are not undertaking crisis management for the disabled, but providing resources and types of services based on an assessment of that child's needs as it develops in the community.
I take what you say, Madam Deputy Speaker. That is why I attempted to look at the assessment set out in the order. I thank you for giving me that leeway and I shall now give the Floor to one of my hon. Friends.
11.16 pm
Mr. Andrew F. Bennett (Denton and Reddish) : I must congratulate my hon. Friend the Member for Makerfield (Mr. McCartney) on making the point firmly that the Government ought to make resources available when they are designating these functions.
I was very disappointed that the Minister introduced the order in such a perfunctory way. Before I deal with the Disabled Persons (Services, Consultation and Representation) Act 1986 and the designation of that measure, perhaps I could ask the Minister about the Access to Personal Files Act 1987. It says at the bottom of the order :
"Section 1 insofar as it applies to personal information held for any purpose of the local authority's social services functions" shall be carried out by a social services committee.
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But as I understand it, a social services function does not have to be carried out by the social services department itself, and may be taken on an agency basis.I am aware that in the Greater Manchester area the National Society for the Prevention of Cruelty to Children has taken on some of the functions of the local authority in child abuse cases. It has done an extremely good job. It carries out agency work for the city of Manchester and perhaps Rochdale and one or two other authorities in that area.
Will the Minister explain to me, if the local authority has an agency such as NSPCC to carry out its functions, how far that body must make its files and records available to a person as a result of the measure. A social services committee might have to make available information that it holds, under rules laid down in the order, but can the Minister tell me the position where a body is carrying out a function on behalf of a social services committee?
Mr. Skinner : As my hon. Friend is asking that question of the Minister, who is not prepared to tell the House what the order is about-- and that necessitates a lot of probing questions from my hon. Friend-- perhaps he might also ask the Minister whether, within this broad remit, it would be possible to include, say, private residential homes for the elderly and the disabled? We might get into a lot of controversial areas, where people make large sums of money, in Tory-controlled council areas in the main, farming out these elderly and disabled people, and making a killing out of the taxpayer and the state. The net result is that in many cases some of those disabled and elderly people in places like Kent are not getting the proper treatment, as has been shown on television recently. Do those homes come under the order?
Mr. Bennett : I am not sure of the position, and I ask the Minister to explain what it is. Like my hon. Friend, I deplore the use of such facilities by local authorities. I see no justification for a local authority to subcontract its responsibilities for caring for the elderly. However, the role played by the National Society for the Prevention of Cruelty to Children is unique, and it may be able to perform a useful function in the prevention of child abuse. There remain a number of problems concerning access to information, non-accidental injury registers, and so on. I hope that the Minister will respond to the many questions asked by my hon. Friends, and those that I want to pose, and that he will throw some light on who is responsible for allowing access to information when delegation takes place. The Minister will appreciate that where non- accidental injury is suspected a whole series of complications arise about to what extent one reveals that information. He will also be aware of the problems created by the difference in attitudes between social workers, who generally favour declaring information, and members of the medical profession, who are often reluctant to divulge anything. The other part of the designation order concerns the Disabled Persons (Services, Consultation and Representation) Act 1986. I hope that when the Minister replies he will expand on the question of statements relating to young people. When I served on the Committee dealing with the Education Act 1981, which set up the whole framework for statementing, concern was expressed at the way in which families often needed to contact the health visitor, social services department, and education
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department. The Act established that it is the education department's responsibility to prepare the statements on young people.That system works reasonably well, though from time to time I receive complaints that the preparation of statements does not proceed fast enough, and that some children wait a considerable time. I am very conscious that, occasionally, local authorities appear to prepare statements in relation to the facilities that they have available, rather than to the needs of the child in question, which is most unsatisfactory.
Concern was also expressed that, the statement having been prepared, there was doubt over what would happen to the young person on reaching 16 or 19 years of age. The point pressed home in the Education Act 1981, and in the Education Reform Act 1987, was the need to make statutory provision for the disabled from age 16 to 19. The Government resisted that proposal, which was a sad feature of their policy. The Government should make it clear that when young disabled people wish to stay in full-time education until age 19, they must have an absolute right to do so, rather than let it be a matter of local authority discretion. However, many local authorities have produced imaginative schemes offering education up to age 19, and in some cases well beyond that.
Section 5 suggests that at the point at which young disabled complete their full-time education, there should be a duty on the local authority to make a decision as to whether they should be designated as disabled and appropriate provision made for them. I feel certain that all right hon. and hon. Members want appropriate facilities to be made available--though I am equally certain that, at present, no such facilities are provided.
I should like the Minister to explain why, as I read section 5 and the order, responsibility should be handed over from education officials to social services officials. It seems to me that what upsets both parents and the young people themselves is to be passed on from one person who is supposed to be offering advice and assistance to another. Once contact has been established and they are on first-name terms with the person visiting, the family does not want to be introduced to someone else and have to explain all the difficulties again. This is particularly the case with regard to handicapped children. A detailed knowledge of what a young person can and cannot do is necessary. It gives offence if that has to be explained to somebody else who blunders in and asks whether the young person can do a certain thing, when anyone who had read the files carefully or knows the family well would know that the child could not manage to do that thing for himself or herself. This is something that causes the family anxiety and embarrassment.
I hope the Minister can explain why it is absolutely necessary to pass responsibility from the education department to the social services department at this moment. It would have been much more imaginative to leave the responsibility with the local authority. It could then decide whether it was more appropriate for these functions to be carried out by the education people or by the social services people within the local authority.
Mr. Skinner : Has my hon. Friend noticed the early-day motion that I have put down relating to the Derbyshire county council and the way in which it has managed to
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introduce and increase help to what is called the Centre for Independent Living to enable disabled people to look after themselves? To what extent will they be covered by this order? Can my hon. Friend explain this or shall we have to ask the Minister?Mr. Bennett : I am afraid my hon. Friend will have to ask the Minister.
I have had the opportunity of visiting several colleges in Derbyshire where they have been making very imaginative provision for young people between the ages of 16 and 19, and in some instances beyond 19. It is a very good example of a way to encourage people with handicaps to integrate within the student body. It is very interesting to see how the other students are, on the whole, supportive of people with multiple handicaps. It is of tremendous benefit to the young people themselves, to the other students and, of course, to the parents. What causes the parents concern, however, is that when these courses finish there is so often nothing available for the young persons. Therefore, it is very good that under this legislation the local authority should have a duty to plan what is to be available for the young people thereafter. It may not be the most appropriate thing suddenly to say that their education must stop at 18, 19, 21 or 23 and from then on somebody else has to deal with them. It may be that a young person will get sheltered employment ; then it is a question of the Department of Employment and the opportunities that it can give. Or it may be that a young person will not be able to get paid employment of any sort, which may well mean a sheltered workshop or something provided by the local authority. I assure my hon. Friend the Member for Bolsover that I very much appreciate the work that Derbyshire is doing.
Moving on to the question of carers, it is an important function of the local authority to ensure that an assessment of the carers in its area is carried out. I want the Minister to explain how he sees this assessment being carried out in those areas where local authorities and local health authorities are working together. I am very well aware that several of the joint-funded schemes which were to set up facilities for people returning to the community or for supporting carers have had their money progressively reduced on the basis that those schemes were to pump-prime and, once they were completed, the local authority would take over responsibility. The difficulty is that the Government have created major funding problems for local authorities.
Mr. McCartney : May I give an example of the capital and revenue consequences for local authorities taking on such joint functions? A scheme is currently being operated in Scot lane, Wigan, involving three children-- severely mentally disabled--who have reached the age to leave their special school. The local authority has adapted a bungalow and provided resources through the regional health authority. Having taken on the commitment, the authority now finds, in the first financial year, that the cost of care is not £14,300 but £35,000 per child. The regional health authority has said, "Take it out of any surpluses in your budget."
Mr. Bennett : I accept my hon. Friend's point, and I am sure that the Minister, when he replies, will turn his attention to the problem of resources. It is good for such
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legislation to exist, but it is nevertheless important for the Government to make money available, otherwise people's expectations are raised when they should not be.Section 8 of the original Act--the Disabled Persons (Services, Consultation and Representation) Act 1986--is entitled
"Duty of local authority to take into account abilities of carer." That is very important. But there is nothing worse than someone going around and asking carers what they are able to do and what support they need and then saying, "We cannot give you that support, because we cannot afford it." That, I am afraid, happens time and time again. I find it very distressing when people come to me in my constituency saying that they want their accommodation adapted and that the local authority, having made imaginative suggestions, then says that it cannot afford such adaptations.
Local authorities often delay payment. I sometimes suspect that they do so because they know that the way to avoid paying is to wait for the people concerned--particularly those who are elderly or disabled--to die before their accommodation can be adapted.
Mr. Skinner : I have listened carefully for about an hour to my hon. Friends, in the main--the Minister has not said much--and have come to the conclusion that there is something very sinister about the order. I am now convinced that it involves not only a transfer of designations but a question of passing the buck and the resources. My guess is that under the order local authorities will be burdened with having to carry out functions which will cost a hell of a lot and, because of demographic changes, will become increasingly burdensome. The net result will be that the Government will not provide the money.
I think that the proposal is merely cosmetic. It started off as a tiny little order, and we were supposed to believe that it did not really matter. There is a little explanatory note on the back. The Government do nothing unless it is part of a grand strategy, and I suspect that the present plan is to shift the provision of resources from taxpayers in the top bracket--who will be relieved of paying tax over and over again--and shove it on to the ratepayers. I think that my hon. Friend's last remarks hit the nail on the head.
Mr. Bennett : Indeed, every constituency in the country will be affected. My hon. Friend ought to know the history.
One of our hon. Friends was successful in the ballot and, in 1985-86, introduced a Bill to help disabled people. The Government did not have the courage to vote against it ; they worked hard to water it down, but had to allow it on to the statute book. They then inserted at the end a provision that the legislation would not come into force until this and other orders were implemented.
Mr. McCartney : My hon. Friend made an interesting analogy referring to the period between assessment of a person's needs and implementation of the requirement of that assessment. Many local authorities find that, having decided that someone needs a downstairs bath or bedroom extension, they must wait until the end of the financial year to see whether there is any slippage in the capital programme so that they can shift resources from one head of expenditure to another. Without such an arrangement
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