House of Commons Hansard Debates for 24 Jan 1990

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Disabled People which I, as Minister for the Disabled, appointed in 1979. Now we trail behind other countries, not least the United States.

The message from this Government is unmistakable : only an alternative Government will address the poverty and other problems of disabled people so starkly portrayed by the surveys commissioned by Conservative Ministers. They have the resources to do what the findings of their surveys now demand. I say again that the problem is one not of resources, but of political will and priorities. Our priorities are clear : the present Government's lie elsewhere. 7.44 pm

The Minister for Social Security (Mr. Nicholas Scott) : I beg to move, to leave out from "House" to the end of the Question and to add instead thereof :

"congratulates Her Majesty's Government on the fact that social security expenditure for long-term sick and disabled people has virtually doubled in real terms since 1979, to a total of over £8 billion a year ; notes with approval the greatly improved coverage of disability benefits associated with this achievement, which has increased the number of Mobility Allowance recipients from 95,000 to 615,000, the number of Attendance Allowance recipients from 265,000 to 795,000, and the number of Invalid Care Allowance recipients from 5,000 to 110,000 ; and welcomes the Government's proposals for further improvements, involving net additional expenditure rising to some £300 million in 1993-94, to help some 850,000 long-term sick and disabled people by measures which include increased premiums in income-related benefits for both disabled adults and disabled children, a new premium for carers, the extension of Attendance Allowance to disabled babies and to people who are terminally ill, the extension of Mobility Allowance to those who are both deaf and blind, increases in Severe Disablement Allowance focused especially on those disabled from birth or early in life, improved coverage of help with the extra costs of disability through a new Disability Allowance, and the introduction of a new Disability Employment Credit to assist and encourage those disabled people who can and wish to work."

I am delighted that we are having this debate today. I approach it with no feeling of backwardness ; rather, it is with relish that I take on the other side of the House in a debate about disability. That is not to say that I do not hope that at the end of the day there will be a feeling within the House as a whole about the needs of disabled people and about the necessity to make all society more aware of those needs, as well as of the ability of disabled people to make a greater contribution in the future to society as a whole and to achieve greater independence and control over their own lives. Despite what we heard from the right hon. Member for Manchester, Wythenshawe (Mr. Morris), we on this side of the House have no reason at all to be ashamed of our record in meeting the needs of disabled people. The last 10 years have seen major advances in provision for disabled people in this country, and I am confident that, so long as we keep a Conservative Government, the same will apply to the next 10 years.

The right hon. Gentleman seems to forget that the mobility allowance, which was being introduced at snail's pace by the Labour Government, was enhanced by the Conservatives when we got back into office ; that we introduced attendance allowance ; that we improved the coverage of invalid care allowance ; and that we replaced the old non-contributory invalidity pension with severe

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disablement allowance, which is a much more generous benefit. These advances have made a real impact on the lives of disabled people over the last 10 years.

Today I do not want to talk just about benefits. Indeed, the right hon. Gentleman properly made the point that disabled people need services, that they need the work of other Departments and of voluntary organisations to enhance the quality of their lives. But it would be wrong of me as a Minister in the Department of Social Security not to begin by talking about benefits and not to get some balance into the argument.

When the Labour party left office it was spending £1.8 billion on the needs of the long-term sick and disabled. This year, the figure will be £8.3 billion--an increase of £4 billion in real terms. The right hon. Gentleman fairly makes the point that, of that £4 billion, £3.5 billion is due to increased take-up of benefits and £0.5 billion is due to the increased value of benefits. I have no shame about the increased take-up. When Labour was in office, there were just as many disabled people around, but more and more of them are now getting the benefits to which they are entitled. That is something of which we can be proud.

Mr. Thomas Graham (Renfrew, West and Inverclyde) : Will the Minister give way?

Mr. Scott : Hon. Members know that on such occasions I normally give way, but Mr. Speaker has imposed a tight timetable.

Let me state the comparison in another way. As I said in winding up on Monday night, over its period of government--talking in constant money terms--the Labour party increased expenditure on the long-term sick and disabled by £220 million a year. During our period of office, it has been increased by £370 million a year. Invalidity benefit, which went to 600,000 people, now goes to virtually 1.2 million. Severe disability allowance, or its predecessor, went to 150,000 ; now it goes to 265,000. Attendance allowance was going to 265,000 ; now it goes to virtually 800,000. The number of people in receipt of mobility allowance has gone up from 95,000 to 615,000. So we have made tremendous advances in take-up. In other words, we are getting through to the people who really need help. This record is substantial. It represents a sustained provision of extra resources for the long-term sick and disabled under this Government. But I am conscious that, despite this, and indeed perhaps sometimes because of the changes that we have made year by year, the balance and structure of disability benefits was less than satisfactory. That is why we commissioned the surveys of the Office of Population Censuses and Surveys. The OPCS carried out four surveys, leading to six reports. It really was the most comprehensive survey exercise ever carried out. Unlike the Amelia Harris survey, which was commissioned by the Labour Government, it covered the whole spectrum of disability.

It included sensory and mental impairment, as well as the physically handicapped ; it included people in their own homes, as well as those in institutions ; and it included children as well as adults. We have considered carefully the findings of the OPCS reports. Unlike the right hon. Member for Wythenshawe, who made allegations, we have listened to the representations and submissions of a considerable number of disability organisations. My right

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hon. Friend and I have met the Disability Benefits consortium to listen to its ideas and concerns, and we have now brought forward our proposals.

Mrs. Margaret Ewing (Moray) : Will the Minister give way?

Mr. Scott : As I have said, Mr. Speaker has imposed a very tight timetable, and I should like to get on.

We brought forward our responses. As my right hon. Friend the Secretary of State has said, we envisage a three-stage progress. In October, he made an announcement about annual uprating. He also announced the increase in real terms in the disability premium for adults ; the doubling of the premiums for disabled children, thereby giving extra help to about 20,000 families ; extending attendance allowance to disabled people and to babies under two ; making attendance allowance available without the normal six-month waiting period for the terminally ill ; extending mobility allowance to deaf and blind people ; improving incentives for rehabilitation for employment by increasing the earnings disregards ; and introducing the carer's premium into the system, thus helping about 30,000 carers in society.

Those important changes were widely welcomed. I remember watching Opposition Members' faces as my right hon. Friend announced the proposals and the gloom and doom with which they regarded those considerable advances in meeting the needs of disabled people. Looking ahead into the longer term, we set ourselves three strategic aims in formulating our proposals. They were to improve the coverage of help available for the extra costs that disability can bring to those of working age and below, to improve the balance of benefits available to disabled people who are unable to work, in particular to do more for those who are disabled at birth or early in life, and to help disabled people who are capable of and wish to work, and to make it easier for them to get and to keep jobs.

The steps that we are taking to provide extra help by the autumn of this year for about 500,000 disabled people and their carers through the existing benefit system will come into effect soon. The Social Security Bill which received a Second Reading on Monday will carry forward the change to make attendance allowance available without any waiting period for the terminally ill.

On Second Reading, the hon. Member for Bristol, South (Ms. Primarolo) raised several issues. I make it absolutely clear that the terminally ill will get attendance allowance for the rest of their lives. The qualification will be a prognosis that life is unlikely to last longer than six months, but, if people live beyond six months, they will continue to get attendance allowance for the rest of their lives.

It will be possible for a third party to apply on behalf of a terminally ill person. I understand the hon. Lady's worry that it might not be sensitive or sensible to tell a person, or even his or her close family, that he or she is terminally ill. In those circumstances, it will be possible for an application to be made on behalf of a disabled person.

This is a sensitive matter. We consulted widely and carefully among the organisations most directly concerned with the terminally ill. I believe that they are satisfied with the arrangements that we are making.

This important measure honours a commitment that we made to the House last summer, and it will be much

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more than just the extra payment of £37.55 in attendance allowance. Extra payments of invalid care allowance will also be payable, as will extra payments of income support or housing benefit via disability premium and the carer's premium. The Bill will also introduce an age-related addition to the non-contributory severe disablement allowance at the same rates as the present additions paid with contributory invalidity benefit.

The right hon. Member for Wythenshawe understands the position, but did not quite state it correctly. It is not the age of a person at the time which governs the amount of benefit or enhancement that he gets under the age- related additions : it is the age at which that person is disabled. It is part of the strategy to try to shift the balance of extra help to those who are disabled earlier in life and do not have the ability to build up contributory benefits or occupational benefits and savings in their working lives. We are doing that in precisely the right way.

The current Bill contains two other measures that arise directly from our determination to improve the structure and balance of benefits for the disabled. I refer to the reduced earnings allowance provision and the additional pensions provision. I do not want to go into them in detail today. We will be locked in conflict in Committee in the not-too-distant future. and there will be ample time for discussion.

I now refer to the third phase of the programme that we set out in "The Way Ahead". We intend to legislate at the earliest practicable opportunity to introduce the disability employment credit and the disability allowance. I told the hon. Member for Birkenhead (Mr. Field) that I would refer to this matter.

The hon. Gentleman wrote an article in The Sunday Times suggesting that, by extending the entitlement to mobility allowance and attendance allowance, the Government were somehow to pay all those in receipt of those benefits at a lower level. That is quite untrue. We will introduce a new lower level of benefit for mobility allowance and for attendance allowance. Those at the top two levels of attendance allowance and mobility allowance will continue to qualify and will be uprated in the normal way. We are taking the threshold further down the scale of disability, so that more people will be able to qualify at the lower level. It is important that that is clearly understood.

The allowance was explained on Monday. I do not want to go into it in detail, except to say that it is important that, when we come to the allowance, which will effectively combine and extend the mobility and care elements of support for disabled people, we aim to improve the assessment--

Mr. Graham : Will the Minister give way?

Mr. Scott : No, I will not give way, for the reasons that I explained earlier.

The assessment and adjudication procedures should also be simplified and speeded up. The other new benefit of disablement employment credit will make it easier for disabled people to take and keep work.

As I said, I speak first as the Minister for Social Security with responsibility for the disabled, but it is absolutely clear that the Government as a whole are committed to improving the lives of disabled people. I do not want to weary the House by stating the work of every single Department, but, in my role as Minister, I keep in close touch with other Departments and occasionally snap at

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their heels to make sure that they respond to the pressures in society. I am sure that the right hon. Member for Wythenshawe did the same when he was in office. I agree with the right hon. Gentleman about the importance of employment and action to get people into work and enable them to carry out their employment in a satisfactory manner.

Last year, the Department of Employment spent about £350 million helping people with disabilities to obtain and to keep work. Jobcentres and disablement resettlement offices are increasingly successful in their job of finding work for disabled people. Over the past five years, the figure has increased from 62,000 to 77,000 last year. The Disablement Advisory Service tells employers about the facilities that need to be provided for disabled people. The code of good practice and the sheltered employment placement schemes are all increasingly successful.

Special schemes, too, are run by the Department of Employment and its agencies. They provide special aids and equipment for disabled people to work in employers' premises or at home, help to adapt to an employers' premises if necessary, personal readers, and assistance with fares if people find it difficult to get to work. The job introduction scheme enables employers to give trial employment to people with disabilities. All that is important work and aids disabled people in acquiring the independence that many of them want.

I have time to mention only a few other things done by other Departments. All hon. Members recognise that, in recent years, the Department of Transport has made important advances in bus, coach, air and taxi travel. The Motability scheme has been a tremendous success. Last year, 31,000 disabled people had access to vehicles under that scheme.

Mr. Michael Meacher (Oldham, West) : They did not have access to rail services.

Mr. Scott : British Rail is gradually extending its stations and platforms on main-line routes to make them more accessible to disabled people.

Mr. Robert Hayward (Kingswood) : And its carriages.

Mr. Scott : And its carriages, too. There has been a tremendous improvement on the primitive facilities that existed 10 years ago. Towards the end of last year, I re-established the Access Committee for England. We know about the still unsatisfactory access to many public buildings and facilities. I want to make more rapid progress in that matter.

The Department of the Environment will publish a consultation paper soon on building regulations as they affect access for the disabled. Last September, my right hon. Friend the Minister for the Arts launched ADAPT in co-operation with the Carnegie foundation, to improve access to entertainment and artistic facilities. Also, I announced £500,000 for the British Paralympic Association, to encourage sport among the disabled, and I know that my hon. Friend the Minister for Sport is keen on developments in that area. Other Departments are playing their part in enhancing the quality of life for the disabled.

I am delighted that it was possible in the Children Act 1989 to make it clear beyond peradventure that local

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authorities can pay for young people to receive the benefits of conductive education in Budapest. My right hon. Friend the Prime Minister announced that we are making a contribution to the new national institute in Budapest, so that, in the long term, British children can be educated there and British adults can be trained as conductors. In due course, we shall have a facility for conductive education operating effectively in this country.

I am anxious, as are my colleagues in the Department of Health, that we do not simply cope with the disabled but try to prevent disability. Increasing resources are being made available for that purpose.

In the few minutes remaining to me, I shall respond to some of the worries that have been expressed in respect of our response to the OPCS surveys and to the situation as it currently affects the disabled.

The independent living fund was perhaps not as well received as it should have been, but it now has widespread acceptance. It has helped some 3,000 severely disabled since it was launched. Its budget was doubled for the current year and will be doubled again for the forthcoming year. With the introduction of new arrangements for community care in 1991, there may be some overlap between the provisions of the independent living fund and the work of local authorities in producing community care packages. I shall shortly be considering with the fund's trustees the role that they envisage for it in the new circumstances, and I shall make an announcement in due course. I pay the warmest tribute to the fund's trustees and to its staff, who respond flexibly and helpfully to the needs of a wide range of disabled people.

One of the criticisms of our proposals is that they do nothing to help disabled pensioners, but that is far from true. We certainly have not ignored them. The removal of the mobility allowance upper age limit will benefit many disabled pensioners, as will attendance allowance for the terminally ill. Our October package of about £200 million will provide extra help for 2.6 million more pensioners. Our social security expenditure on the elderly as a whole has increased by 25 per cent.--a real increase of £5 billion.

I acknowledge that there was anxiety among organisations representing the blind, but the new disability allowance should prove of considerable help to many blind people. The severe disablement age additions will assist those who were blind at birth or who became blind in their early life. The employment credit should allow more blind people to work, and the mobility allowance for the deaf-blind was widely welcomed, as were the increases in the adult and child disability premiums.

The hon. Member for Monklands, West (Mr. Clarke) has asked particularly about what I call the Clarke Act. I think that everyone understands what I mean when I use that phrase, rather than refer to the legislation's full and rather cumbersome title.

Mr. Tom Clarke (Monklands, West) : As long as we are not talking about Mr. Kenneth Clarke's acts.

Mr. Scott : I think that the House knows which Mr. Clarke is meant.

Sections 1, 2 and 3 of that Act are the most complex and expensive, and represent the main outstanding business to be implemented. Within a matter of weeks, we shall start consultations with local authorities on implementing those three sections, which I hope the House will widely welcome.

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Mr. Clarke : The Mr. Clarke to whom the Minister refers is certainly not the same man who is currently mentioned in BMA advertisements. However, although the Minister's intentions are not in doubt, history supports the view that there remains doubt about whether the Treasury will allow the Minister to go as far as the House would wish. On 11 April 1989, the Minister said that section 11 of the 1986 Act, dealing with reports to the House, would be introduced shortly, but that has not happened. When will that section be enacted?

Mr. Scott : We are going out to consultation on that important issue. Obviously we shall discuss the level of resources that is necessary. We shall also have to examine--as did my Health Department colleagues in relation to section 7, which they decided was overtaken by other arrangements--the interaction of sections 1, 2 and 3 of the 1986 Act with the new arrangements for community care. At least the process has begun, and I hope that the hon. Gentleman is pleased with that.

It has been alleged that there is no new money in the package. There is new money available, amounting to £88 million in 1990-91, £141 million in 1991-92, £214 million in 1992-93, and £300 million in 1993-94. That is real new money. Two of the present occupants of Labour's Front Bench have served in government and know perfectly well that the first things that confront Ministers when they return from their summer holidays are the public expenditure estimates and the Autumn Statement. When my right hon. Friend the Secretary of State for Social Security was able to persuade our Treasury colleagues to produce that new money, it was genuinely new money and quite properly included in the Autumn Statement. I give the firm and clear undertaking that it is new money.

The right hon. Member for Wythenshawe concluded by describing Labour's plans. As my hon. Friend the Member for Bolton, North-East (Mr. Thurnham) once said, one can promise the earth, and then one delivers the IMF. The cost of the programmes to which Labour has committed itself must be at least £3 billion. Frankly, Labour would never be able to afford that sum even if it got into office. The Opposition are arousing expectations among the disabled that they will never be able to fulfil if re-elected.

Whatever right hon. and hon. Members can do in their own constituency, the House has an important role to play in increasing awareness of disability and promoting a greater understanding of the needs and abilities of the disabled.

A cause was recently launched that some may feel is on the verge of disability, but which relates to a condition that causes tremendous frustration and bitterness among those who suffer from it. I refer to the new dyslexia awareness campaign. I hope that greater awareness of that condition and of the need for diagnosis, assessment and treatment as early as possible in life will remove a great deal of the frustration from those who suffer from that distressing condition. I commend that campaign, as I commend all the campaigns run by the large number of voluntary organisations--many of them generously supported by Government money--to increase awareness of the needs, abilities and potential of the disabled.

Society as a whole must also play a part. I freely acknowledge that this debate in Opposition time will serve to create greater awareness of the matters about which I have spoken. I commend the amendment to the House.

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Several Hon. Members rose --

Mr. Deputy Speaker (Mr. Harold Walker) : It should be clear to the House that, unless remaining speeches are brief, a number of right hon. and hon. Members wishing to participate will be very disappointed.

8.8 pm

Mr. Geoffrey Lofthouse (Pontefract and Castleford) : I shall be brief, as I realise that many hon. Members wish to speak. I do not want to generalise, but I wish to draw the House's attention to a certain section of disabled people, as I have done on many previous occasions.

Since 1982, I have presented five Bills on behalf of mineworkers suffering from the dreaded disease emphysema. On each occasion, they went the way that I expected them to go, like most ten-minute Bills. That has not helped the miners in my constituency.

The Industrial Injuries Advisory Council reported recently, after in-depth investigations. It was unable to recommend that the disease should be prescribed, saying that there was insufficient evidence. I have always refuted that, because the evidence is there in the mining communities, where miners spend their lives in agony and their families suffer. I rely not only on that information, but on in-depth, learned research from the past 20 years. I have presented 20 learned papers to the House. On two occasions I drew the attention of the House to reports in The Lancet that stated that miners are 10 times more likely to get emphysema than other members of the public. Unfortunately, the Industrial Injuries Advisory Council seems to think that there should be absolutely implicit evidence-- which it will never get in a miner's lifetime. The evidence that I have presented, after in-depth, learned research, is as much as we shall get. Miners are suffering and anyone can see that--if they wish to.

In the Pontefract area, between 1982 and 1986, when I first started this campaign, there were 634 deaths from chronic bronchitis and emphysema. It is realistic to think that, four years on, the figure will now have doubled. From hospital records, we know that 80 per cent. of the 1,200 people who died from the disease were mineworkers.

I was interested to hear the Minister's reference to terminal illness. I should like him to define, as far as possible, what he meant by that. In my view, mineworkers who are suffering from this terrible disease are terminally ill. Evidence shows, beyond a shadow of doubt, that mineworkers are suffering. There have been recent campaigns by local newspapers to draw the House's attention to the state that miners are in--for example, in the Yorkshire Evening Post and the Pontefract and Castleford Express. Men have to live a lifetime in oxygen masks as a direct result of their work in the mining industry.

The Industrial Injuries Advisory Council has followed a practice of taking evidence every 10 years, but that has not applied since 1973. Before the 1988 report, the last time that it took evidence was in 1974--a gap of 15 years. In the latest report it says that it will continue to monitor the situation. It said the same in the 1973 report, and since that time thousands of men have died in agony, their families watching in agony, without compensation or financial assistance.

It is worth drawing the attention of the House to the fact that, in recent times, doctors sometimes recommend that these men--used-up men in some cases--should move

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to accommodation where solid fuel is not burned because it can affect their chest. However, if their families apply to move to a new tenancy, they are in danger of losing their concessionary allowance because of present British Coal policy. They have to decide whether to move to more suitable accommodation, on the recommendation of the doctor, and lose the allowance. Some of the old lads cannot afford to do it. Some of those people cannot lift a cup of tea to their lips. Once, they were strong and able miners. I could get emotional in the House tonight, because I have seen the condition of some men deteriorate.

The evidence is irrefutable. I hope that the Minister will consider two points. First, will he request the Industrial Injuries Advisory Council not to wait another 10 years while 1,200 more people die? If it does that, the problem will be solved--they will all be dead and it would be bordering on criminal to allow that to happen.

Secondly, will the Minister define "terminally ill"? I suggest that men such as Bert Lee and George Hartnell, who are obliged to live in oxygen masks, and others like them, are terminally ill. I hope that the Minister will be able to identify whether such cases will be covered in the National Health Service and Community Care Bill, which may increase benefits.

8.16 pm

Sir David Price (Eastleigh) : Severe disability is a condition so profound and so complete in its consequences that it amounts to a different way of life, albeit an enforced way of life. Nobody chooses to be disabled.

My only reason for speaking this evening is that I have had some personal experience of sharing that way of life, and that may assist the House to advance public policies that may ameliorate the hurt and the frustrations of disability.

I need not remind the House that disability comes in many different forms, both of mind and body. It is even more important to remember that every disabled person is different and requires different remedies and understanding, not only because his disabilities are different but because, by virtue of being a human being, each disabled person is unique.

One does not cease to be a human being when one becomes disabled. Yet I detect that some people approach the disabled as if they were members of a different species. The disabled become objects of their good works, but are not treated as real partners in the human adventure.

The biggest hurt that can be done to the disabled is to patronise them. At times, I am tempted to adopt the famous outburst of Shylock on the condition of the disabled. I shall forbear tonight because you asked us to be brief, Mr. Deputy Speaker, but I commend that famous passage to hon. Members.

Disability has been with us since the beginning of time. It is part of the human condition, and there is nothing new about it. What is relatively new is society's recognition of disability, and its determination to do something about it.

In the 36 years in which I have been a Member of the House, considerable progress has been made in the development of public policies towards the disabled, but a great deal still needs to be done. It is only fair to recognise that progress has been made. I am reminded of the words of Arthur Clough :

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"For while the tired waves, vainly breaking,

Seem here no painful inch to gain,

Far back through creeks and inlets making

Comes silent, flooding in, the main."

When I first came to the House there was no attendance allowance, no mobility allowance, no severe disablement allowance and no orange badge. The tide is coming in, and it is in favour of the disabled. If we are to develop more effective policies, however, we must be able to assess better both the scale and the degree of disability in our nation. We must therefore be grateful to the OPCS for the massive survey that it completed last year. Those reports provide ample statistical raw material on which to work, but we must interpret that material carefully and correctly.

The OPCS identified at least 6.5 million disabled people. That is a daunting figure, but we should remember that the OPCS used a relatively low threshold of disability. If we exclude the adults on the lowest two points of the severity scale, the number becomes 4 million--although that is a daunting enough statistic. My particular concern is with the 1.5 million who fall into the four most severe categories. Their disabilities are so severe that their ways of life are very separate and distinct from those of the generality of their fellow citizens. In our desire to help all disabled people, we must not lose sight of the needs of the most severely disabled, and especially those of the quarter of a million or so in the top category. Our priorities must be related to the severity of the disability.

Most disabled people live in the community, as they always have. That applies even to the OPCS's category 10, the most severely disabled, of whom over half live in the community. It therefore follows that we should consider the Government's two recent documents, "Caring for People" and "The Way Ahead : Benefits for Disabled People", together. An hour or two ago, my right hon. Friend the Minister and I made a start on that in the Select Committee on Social Services.

The idea of care in the community, which is very much the flavour of the moment, means different things to different people. The Select Committee considered the matter in depth in 1984 and 1985, with reference to mentally ill and mentally handicapped adults, and came up with some firm guidelines. In my view, those guidelines apply to all disabled people--indeed, to all clients of care in the community. The Committee concluded :

"Appropriate care should be provided for individuals in such a way as to enable them to lead as normal an existence as possible, given their particular disabilities, and to minimise disruption of life within their community".

The House will observe that that definition, although imperfect, has certain immediate policy consequences. First, it must mean providing for the basic needs of those affected by physical or mental disabilities--as far as possible--in ordinary domestic housing, in ordinary occupational settings and through the use of ordinary recreational amenities.

Secondly, the fact that clients are affected by physical or mental disabilities means that they have special needs of different kinds, caused by a wide variety of illnesses and disabilities, which must lead to individual and highly personalised solutions rather than general ones.

Thirdly, care must be provided in many different locations : there is no reason to exclude hospitals or institutions, especially when asylum is needed.

Fourthly, the assessment of those special needs, the provision of skilled treatment and care and, where

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necessary, the allocation of appropriate special environments is the statutory responsibility of both the local health and the social services authorities. Although my right hon. Friends intend to place the main responsibility with the social services departments, the role of the primary health care team should not be diminished or bypassed. I still regret the fact that family practitioner committees have not been merged with district health authorities in England ; in Scotland things are managed better. We must also have an "open door" policy, especially for the mentally ill and the psychogeriatrics. It is clear that a common feature of all disabled people is the financial disadvantage from which they suffer. They cannot earn what they could be earning if they were not disabled ; furthermore, additional costs are imposed on them as a result of their particular disabilities. The OPCS has made a brave attempt to identify that gap in income. It has demonstrated that, at 1988 prices, the average disabled person--although we know, of course, that no one is average--was nearly £40 a week worse off than an able-bodied person. Its research also shows that that gap in income was much greater for those under pension age than for those who were retired.

I welcome the efforts that the Government are making to bridge the gap : in themselves those efforts are inadequate, but the Government are moving in the right direction. I must tell my right hon. Friends, however, that I shall continue to press them to do more to improve financial benefits for disabled people. Like Oliver Twist, I shall always be there with my bowl asking for "second helpings" for the disabled.

There is also the problem of private carers, who are essential to a severely disabled person's way of life. As I have spoken about them and their needs at length in previous debates, I shall not repeat tonight what I consider to be telling arguments. I am delighted that the Government have acknowledged the importance of the private carer ; I am simply disappointed that they have proposed so few new measures to assist them. Let me remind my right hon. Friends of a chilling fact identified by the OPCS : two thirds of the 1.75 million live-in carers receive no help from any of the statutory services. We really must do better than that.

When tonight's debate is over, the vast majority of us will go home and, for tonight, leave all the problems of disability behind us. If we were disabled, however, we should not be able to take off our disability like an overcoat when we arrived home. There is no rest or holiday from disability ; disabled people cannot even take a sabbatical. That is what I mean when I say that disability is a way of life, and the understanding that it is a way of life--a disabled way of life--is the key to better and more effective public policies for the disabled.

8.26 pm

Mr. Archy Kirkwood (Roxburgh and Berwickshire) : Although the debate focuses principally on benefits, I feel that chapter 8 of "The Way Ahead"-- relating as it does to other services for the disabled and those with similar difficulties--is, in its way, as important as questions relating directly to benefits. I hope that the Minister will not allow matters to rest as they are, but will redouble his efforts to ensure that the disabled have access to public buildings, the job market and transport systems. The work done in

Scotland--especially by the Scottish Council on

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