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Mr. Tom Clarke (Monklands, West) : For the most part, this has been a constructive debate. I was pleased that my hon. Friend the Member for Liverpool, West Derby (Mr. Wareing) referred to the speech by the hon. Member for Eastleigh (Sir D. Price), who described the rights of people with disabilities as unique. He was absolutely right. I am sure that hon. Members would wish to highlight the individual needs, rights and demands of people with disabilities and their carers. That is a big priority.

The hon. Member for Exeter (Mr. Hannam) gave a fine outline of the Disabled Persons (Services, Consultation and Representation) Act 1986. So convincing was he that the Chancellor of the Exchequer rushed to the Chamber. Opposition Members welcome the Chancellor's presence. He is a former Minister with responsibilities in these matters. If the necessary political will exists in the Treasury, we can do a great deal for disabled people. In particular, we can implement the Disabled Persons (Services, Consultation and Representation) Act 1986 because the good will that the Minister for Social Security introduced into the debate might be shared by the Chancellor, and, if that good will is matched by political will in the Treasury, we can make real progress.

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Mrs. Margaret Ewing : Does the hon. Gentleman agree that, in addition to good will and political will, he should clearly spell out that the sum involved is equivalent to one-fifth of a penny in income tax and that it pales into insignificance compared with the giveaway Budgets that we have had in the past?

Mr. Clarke : I agree with the hon. Member for Moray (Mrs. Ewing). The Chancellor does not need to be reminded that, in one of the many opinion polls that were held before the 1987 general election, an overwhelming majority said that the Treasury should have found the necessary funds for the implementation of this important measure. My right hon. Friend the Member for Stoke-on-Trent, South (Mr. Ashley) referred to the Beverley Lewis case. He was right to ask for a public inquiry. There are many lessons to be learnt. The debate has been dominated by the 1986 Act, and I intend to make further references to it. Many organisations, including the Spastics Society and the 40 voluntary bodies in the Act Now Group, support the implementation of the 1986 Act. They take the view that, in at least two respects, the Beverley Lewis case demonstrates that had the Act been fully implemented, some of that tragedy might have been avoided.

My right hon. Friend the Member for Manchester, Wythenshawe (Mr. Morris) outlined the Labour party's alternatives to the Government's policy. I was sorry that the Minister was somewhat abusive. Hon. Members will recall that, when in office, my right hon. Friend actually exceeded the Labour party manifesto commitments on disability. I look forward to the time when he will repeat that performance.

The motion could not be more appropriate because the House has been considering--at the moment Standing Committee E is actively considering-- the Government's proposals on health and community care. There can be no effective policy unless there is a structure involving the consumer. The Government speak of consumer rights, but if consumer rights in terms of the disabled, carers and advocates are truly embraced by the Government, they should accept their responsibilities under the 1986 Act.

The Minister said that the Government will soon be meeting again with local authorities. I hate to sound ungracious, but we have heard that before. It has been said since April 1986. Time after time, we have been told by the Prime Minister and by other Ministers that the 1986 Act will be implemented when resources are available. My hon. Friend the Member for Wakefield (Mr. Hinchliffe) reminded the House that the Government have no difficulty in finding resources for other purposes. Their priorities are clearly not those that my right hon. and hon. Friends and I would endorse. I suspect from the tenor of tonight's debate that our priorities would be endorsed by most right hon. and hon. Members in a free vote.

The hon. Member for Eastleigh, in referring to the uniqueness of the disabled, was conscious of the fact--as are all right hon. and hon. Members --that the OPCS reports reveal that 6.5 million of our fellow citizens experience some form of disability. Many, many carers are trying to cope with the most difficult situations but they receive little support. Their difficulties ought to be recognised. Instead of a strategy for community care of the kind that we are told is Government policy, there is a great deal of fragmentation. Certainly joint planning is very

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much missing in Scotland. Its absence is almost as evident as the absence of a Scottish Minister on the Government Front Bench tonight.

The Government say that, in the absence of joint planning, they are making arrangements to discharge long-stay patients from psychiatric hospitals and to place them in the community. On 12 July 1989, the Secretary of State for Health told the House :

"I will ensure that discharges of seriously mentally ill people from hospital will take place only when adequate medical and social care is available for them outside hospital."--[ Official Report, 12 July 1989 ; Vol. 156, c. 978.]

Where are those arrangements?

If section 7 of the 1986 Act has suddenly been dropped, despite previous assurances that its provisions were being actively discussed with local authorities to ensure their implementation, what arrangements are the Government making in their place? During Question Time yesterday, the Government were seriously criticised on both sides for discharging psychiatric patients into community care that does not exist. Apart from the problems that that creates for families and communities, it places a tremendous strain on social services departments.

We are told that local authorities will have to defend themselves in terms of the poll tax, and I hope that the obligations that have been placed upon them will be remembered. I hope that we will hear not about extavagant overspending councils, but about under-servicing councils. If the 1986 Act means anything, it is that we should dispense with the accidents of geography, where assessment and services may be provided in one area but not another. There should be national standards that genuinely respond to the needs of physically disabled and mentally handicapped or ill persons, their carers and their advocates. We believe that the 1986 Act offers that opportunity for individuals' rights.

The Minister referred briefly to education in his opening speech, and I hope that hon. Members will remember the importance of that to young people who live in special schools. It is a traumatic time for them and for their families. We must ensure that proper arrangements are made so that they feel part of the community.

The Minister referred to the Peto institute. The Government were right to ensure that whatever opportunities existed in eastern Europe were available to benefit our people. Many parents, including those who were delighted that their children benefited from going to the institute, asked why that opportunity is not available in this country. Why do they have to go to eastern Europe? Why are those facilities and services not resourced here?

There have been many splendid speeches tonight, but few hon. Members would disagree that my hon. Friend the Member for Pontefract and Castleford (Mr. Lofthouse) made a telling impression on the House when he described disability in a mining community. We should recognise that we are talking about people with rights, including the right to dignity.

In my constituency, in a little village called Crowood which is also a mining community, lives Mary, a lady whose husband was injured in the Auchengeach disaster of 1959. He now has a heart condition and her son, Gerry, is a spastic, in his early thirties. In 1986 she visited the House when the Act was going through. Her sister helped her come to London, and it was her only visit from Scotland

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since Gerry was born. She told me that her arm was black from top to bottom through coping with her son and because of her commitment and love for her child. She asked--and I conclude by putting it to the House and to the Minister--"What happens to Gerry after I have gone?" That is a reasonable question that many thousands of people ask. I want a policy for disability and community care that will respond to that question and to the needs of disabled people, their parents--people like Mary and Albert--and others who care so much for them.

9.53 pm

Mr. Scott : I cannot do a traditional wind-up speech in the time available, and the hon. Member for Monklands, West (Mr. Clarke) was not able to do that in his speech. However, I want to deal with several issues raised in the debate.

I shall begin with the Peto institute, and what I intend to do in relation to that. For the time being, Budapest is the centre for conductive education. We have a modest facility in Birmingham, but if we are to build up a facility which will deliver conductive education properly to the young children in these islands who require it, the conductors will need a period of training. I am trying to achieve that, but in the meantime we expect British children and trainee British conductors to go to Budapest, and to draw on the experience and the expertise there.

In a sense, I share the view of the hon. Member for Monklands, West. This has been a good debate, and a quiet debate. Of course, the Opposition have said that we are not doing enough, and of course I have said that we are doing better than they could imagine. I suspect, however, that the debate has been so good because those who have taken part are a kind of fellowship : we all care about disabled people and want to do as much as we can, as quickly as we can, to enhance the quality of their lives.

I had hoped for a better attendance on the part of hon. Members who are less directly involved in such issues ; I expected word to spread around the Palace of Westminster rather more quickly. Nevertheless, let me pay the warmest possible tribute to the right hon. Member for Stoke-on-Trent, South (Mr. Ashley), to my hon. Friend the Member for Exeter (Mr. Hannam) and to all the members of the all-party disablement group. They work hard to maintain contact with groups of and for disabled people, and to make hon. Members aware of their needs.

There is, I believe, recognition--mostly among Conservative Members, although it occasionally ebbs from Opposition speeches--of the real progress that is being made, not just through benefits and a more coherent delivery of services, but in a range of ways, some of which I outlined in my opening remarks. I take the point made by the hon. Member for Monklands, West that we must pay increasing attention to the issue of carers : in the coming weeks we shall discuss that with various organisations and campaigners, and we shall listen carefully to what they say.

The hon. Member for Liverpool, West Derby (Mr. Wareing) mentioned workplace facilities. When, in the summer, I involuntarily rendered myself disabled for two months, I was relieved that Parliament was in recess and that I did not have to hobble around the House on crutches. I shall mention the matter to my right hon. and

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learned Friend the Lord President, but I suspect that the possibility of amending the geography of this building may be somewhat limited.

Let me say to the hon. Members for Monklands, West and for Wakefield (Mr. Hinchliffe) that I accept the need for a better delivery of services to enable people to live in their own home. The thrust of our present policy on community care is to dispense with the perverse incentive to put people into residential care--at vast public expenditure cost--which is often not what the individual concerned would have chosen. Instead we aim to provide packages of individually tailored care in the community to enable such people to live their lives as they wish. As my hon. Friend the Member for Eastleigh (Sir D. Price) will recall, I spent this afternoon discussing that with the Select Committee.

The hon. Member for Pontefract and Castleford (Mr. Lofthouse)--whose speech demonstrated his passion and commitment to the cause as well as his expertise--talked about the sufferers, especially miners, whose needs are not being met on the advice of the Industrial Injuries Advisory Council. According to the definition of terminal illness in the new arrangements for attendance allowance, it will be necessary to show that someone is suffering from a progressive disease and that his lifespan is unlikely to exceed six months. We are taking the advisory council's advice on the matter referred to by the hon. Member, but I shall take an early opportunity to draw its chairman's attention to his speech and to ask for it to be given careful consideration.

Several hon. Members mentioned the Beverley Lewis case. A local inquiry has been carried out, and the social services inspectorate is considering the lessons to be learnt from it. Although there are no plans for a public inquiry, I can give an absolute undertaking that my right hon. and learned Friend the Secretary of State for Health is also considering the lessons to be learnt, as well as the recommendation by the coroner's inquiry that the law relating to mentally disordered people and mandatory care be re- examined. Some important points have been made about the problems and needs of disabled people. We have listened to them all. I cannot reply to them now, but I shall read carefully the report of the debate. Question put, That the original words stand part of the Question :--

The House divided : Ayes 221, Noes 273.

Division No. 46] [10 pm

AYES

Abbott, Ms Diane

Allen, Graham

Alton, David

Anderson, Donald

Archer, Rt Hon Peter

Ashley, Rt Hon Jack

Ashton, Joe

Banks, Tony (Newham NW)

Barnes, Harry (Derbyshire NE)

Barnes, Mrs Rosie (Greenwich)

Barron, Kevin

Beckett, Margaret

Beith, A. J.

Bell, Stuart

Benn, Rt Hon Tony

Bennett, A. F. (D'nt'n & R'dish)

Bermingham, Gerald

Bidwell, Sydney

Blair, Tony

Blunkett, David

Boateng, Paul

Boyes, Roland

Bradley, Keith

Bray, Dr Jeremy

Brown, Gordon (D'mline E)

Brown, Nicholas (Newcastle E)

Brown, Ron (Edinburgh Leith)

Buchan, Norman

Buckley, George J.

Caborn, Richard

Callaghan, Jim

Campbell, Menzies (Fife NE)

Campbell, Ron (Blyth Valley)

Campbell-Savours, D. N.

Carlile, Alex (Mont'g)

Cartwright, John

Clarke, Tom (Monklands W)

Clay, Bob

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Column 986

Clelland, David

Clwyd, Mrs Ann

Cohen, Harry

Coleman, Donald

Cook, Frank (Stockton N)

Cook, Robin (Livingston)

Corbett, Robin

Corbyn, Jeremy

Cousins, Jim

Cox, Tom

Cryer, Bob

Cummings, John

Cunliffe, Lawrence

Cunningham, Dr John

Dalyell, Tam

Darling, Alistair

Davies, Rt Hon Denzil (Llanelli)

Davies, Ron (Caerphilly)

Davis, Terry (B'ham Hodge H'l)

Dewar, Donald

Dixon, Don

Dobson, Frank

Doran, Frank

Dunwoody, Hon Mrs Gwyneth

Eadie, Alexander

Eastham, Ken

Evans, John (St Helens N)

Ewing, Harry (Falkirk E)

Ewing, Mrs Margaret (Moray)

Fatchett, Derek

Faulds, Andrew

Fearn, Ronald

Field, Frank (Birkenhead)

Fields, Terry (L'pool B G'n)

Fisher, Mark

Flannery, Martin

Foot, Rt Hon Michael

Foster, Derek

Fraser, John

Fyfe, Maria

Galloway, George

Garrett, John (Norwich South)

Garrett, Ted (Wallsend)

Gilbert, Rt Hon Dr John

Godman, Dr Norman A.

Golding, Mrs Llin

Gordon, Mildred

Gould, Bryan

Graham, Thomas

Grant, Bernie (Tottenham)

Griffiths, Nigel (Edinburgh S)

Griffiths, Win (Bridgend)

Grocott, Bruce

Hardy, Peter

Harman, Ms Harriet

Hattersley, Rt Hon Roy

Haynes, Frank

Healey, Rt Hon Denis

Henderson, Doug

Hinchliffe, David

Hoey, Ms Kate (Vauxhall)

Hogg, N. (C'nauld & Kilsyth)

Home Robertson, John

Hood, Jimmy

Howarth, George (Knowsley N)

Howells, Geraint

Howells, Dr. Kim (Pontypridd)

Hoyle, Doug

Hughes, John (Coventry NE)

Hughes, Robert (Aberdeen N)

Hughes, Roy (Newport E)

Hughes, Sean (Knowsley S)

Hughes, Simon (Southwark)

Illsley, Eric

Ingram, Adam

Janner, Greville

Jones, Barry (Alyn & Deeside)

Jones, Ieuan (Ynys Mo n)

Jones, Martyn (Clwyd S W)

Kaufman, Rt Hon Gerald

Kinnock, Rt Hon Neil

Kirkwood, Archy

Lambie, David

Lamond, James

Leadbitter, Ted

Leighton, Ron

Lestor, Joan (Eccles)

Lewis, Terry

Litherland, Robert

Livingstone, Ken

Livsey, Richard

Lloyd, Tony (Stretford)

Lofthouse, Geoffrey

Loyden, Eddie

McAllion, John

McAvoy, Thomas

McCartney, Ian

Macdonald, Calum A.

McKay, Allen (Barnsley West)

McKelvey, William

McLeish, Henry

McNamara, Kevin

McWilliam, John

Madden, Max

Mahon, Mrs Alice

Marek, Dr John

Marshall, David (Shettleston)

Martin, Michael J. (Springburn)

Martlew, Eric

Maxton, John

Meacher, Michael

Meale, Alan

Michael, Alun

Michie, Bill (Sheffield Heeley)

Michie, Mrs Ray (Arg'l & Bute)

Mitchell, Austin (G't Grimsby)

Moonie, Dr Lewis

Morgan, Rhodri

Morley, Elliot

Morris, Rt Hon A. (W'shawe)

Morris, Rt Hon J. (Aberavon)

Mowlam, Marjorie

Mullin, Chris

Murphy, Paul

Nellist, Dave

Oakes, Rt Hon Gordon

O'Brien, William

O'Neill, Martin

Orme, Rt Hon Stanley

Owen, Rt Hon Dr David

Parry, Robert

Pike, Peter L.

Powell, Ray (Ogmore)

Prescott, John

Primarolo, Dawn

Quin, Ms Joyce

Radice, Giles

Randall, Stuart

Redmond, Martin

Rees, Rt Hon Merlyn

Reid, Dr John

Richardson, Jo

Robertson, George

Rogers, Allan

Rooker, Jeff

Ross, Ernie (Dundee W)

Ruddock, Joan

Sedgemore, Brian

Sheerman, Barry

Sheldon, Rt Hon Robert

Short, Clare

Skinner, Dennis

Smith, Andrew (Oxford E)

Smith, C. (Isl'ton & F'bury)

Smith, Rt Hon J. (Monk'ds E)

Smith, J. P. (Vale of Glam)

Soley, Clive

Spearing, Nigel

Steel, Rt Hon Sir David

Steinberg, Gerry

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