---

Column 865

I look forward to attending the launch on 22 March of the clothing initiative for people living in National Health Service hospitals. I hope that the hon. Gentleman, given his interest, will be interested in coming. I will ensure that an invitation is sent to him. I know that his remarks were specifically directed to those living in the community, but his concerns could, and should, extend to people in hospital. The findings of the working party formed by the Disabled Living Foundation, the Royal College of Nursing and the King's Fund highlight the Department's concerns in this area.

The provisions for laundering, storage and purchase of patients' personal clothing for people in long-stay hospitals--especially mental illness and mental handicap ones--are often unsatisfactory. Sometimes laundry services are not available, which means that carers have to take home soiled washing. Sometimes clothing may be ruined because inappropriate laundering facilities are used, or lost when it is sent away to commercial or off-site facilities. Patients frequently have to wear stock clothes, which may be ill-fitting or of poor quality. The common usage of clothing is not a practice that maintains a sense of dignity and well-being in a patient.

The right to their own clothing is of great importance to patients living in National Health Service institutions. All health authorities should explore every avenue possible to implement or upgrade systems to enable people to wear their own clothes. A conference to be held on the day following the launch--23 March--will help Health Service personnel to improve their systems.

I now come back to the providers of clothing for disabled people and I shall seek to answer the hon. Gentleman's two questions. I acknowledge the services offered by workshops such as Bassetlaw Fashion Services to disabled people who have special requirements. But I must emphasise that, for the majority of disabled people, the need to exercise a personal style can be met by adaptations of the standard garments produced for the general market. That is not always the case--

Mr. Meale : The Minister referred to the Disabled Living Foundation. That body estimates that disabled people have to spend nine times more week by week than the Office of Population Censuses and Surveys suggested. I seem to recall that the figure was almost £50. The Minister mentioned the availability of goods. Earlier I talked about Charlotte Henshaw. When her parents buy her clothes on the open market, they have to buy clothes two sizes larger than she would need if she were not disabled as, clearly, she needs longer skirts to cover her artificial limbs. Instead of costing £13--the nominal average cost--the garment may work out at £18. In addition, there are dressmaking costs of £5 to £7 for the alterations that need to be made. That adds up to a 90 per cent. increase in the cost of that garment. We are talking about people on low wages, who spend all their money helping their disabled child. It is ridiculous for us to force conscientious parents to go to such lengths. They should be able to go to a workshop and look at fashions which can be made up from scratch from basic patterns and adapted to suit their child's need.

Mr. Freeman : Of course, the hon. Gentleman is right that it costs very much more to purchase clothing for disabled people than clothing for people who are not disabled. One can approach the problem of the high

---

Column 866

relative cost in two ways--first, by helping the purchaser and, secondly, by seeking to assist the supplier. Let me deal with the purchaser--the patient--first.

The hon. Gentleman will know that income support now provides extra help for disabled people in the form of premiums. The disability provision--from April 1990 worth £15.40 a week for a single person and £22.10 a week for couples--goes to disabled people under 60 years of age and £15.40 a week extra also goes to families for each disabled child. This additional benefit is now paid, automatically, as soon as the disabled person or child satisfies the criteria. There is no intensive questioning on the individual's personal affairs. Disabled people over the age of 60 years who qualify for it get the higher pensioner premium. From April this will provide an extra £17.05 a week for single people and £24.25 for couples.

The hon. Gentleman also referred to the cost of production. Perhaps in the time that remains, I can deal with the question of supply. The hon. Gentleman knows that my Department has no statutory power to assist, through section 64 grants, the workshops to which he referred. Section 64 of the Health Services and Public Health Act 1968 enables funds to be provided mainly to assist with the central administrative costs of national voluntary organisations in health and personal social services, and even if we wished to do so, my colleagues and I could not assist the workshops under the law as it stands. Nevertheless, as the hon. Gentleman is aware, it is open to local authority social services departments to help those organisations and they can do that under the Chronically Sick and Disabled Persons Act 1970. Local authority associations can make representations to the Department of the Environment in terms of the setting of revenue support grant levels to take into account the need, as they see if, for financial assistance or grants for workshops. On a slightly more constructive note, I can state that under the National Health Service we provide free footwear. While that was not specifically covered by the hon. Gentleman, we provide footwear for disabled people, where that has been prescribed by doctors or physio-therapists, at a cost of £20 million a year to the taxpayer. I know that many of those items cannot be described as high fashion. However, in widening the debate about clothing, we will be considering our arrangements for the supply of footwear under the NHS to see whether we can help patients a little more, particularly with regard to their fashion desires, and perhaps acquire less standard items of production. We must consider those matters to see whether we are getting value for money and whether we are satisfying patients' demands. I cannot give the hon. Gentleman a timetable for such a study, but we will be launching one.

Mr. Meale : All disabled people are grateful for the excellent service that is provided for them. However, footwear provision is slightly different from clothing. There are many ranges in every size of shoe and those are easily manufactured and supplied. On the other hand, clothing must be specially designed, particularly for severely disabled people to meet their living requirements. A man suffering from cerebral palsy who drags himself round on the floor in his home needs specially adapted clothing to help him. Shoes and clothes are entirely

---

Column 867

different, although I welcome the Department's concept of at long last trying to develop a fashion approach to the needs of disabled people.

Mr. Freeman : The hon. Gentleman anticipated my final remarks. I agree with him. I clearly said that shoes are not clothing, but it is a step--to use a perhaps inappropriate expression--in the right direction. The hon. Gentleman made a well-argued case and stressed the need for the Department to research the activities of the 22 workshops around the country.

The Department's research management division can mount studies to examine the features of those workshops

---

Column 868

which appear to contribute to their success. For example, they can study the good relationship between workshops and local authority social services departments. The research management division can do that with a view to establishing guidelines for further support and ways in which financing might be augmented.

Given the hon. Gentleman's arguments, I will undertake to see how the Department could assist in research. That is a sensible and modest first step to help people whom, I agree with the hon. Gentleman, need our consideration, sympathy and support.

Question put and agreed to.

Adjourned accordingly at two minutes to Three o'clock.

---