House of Commons Hansard Debates for 7 Feb 1991

(ii) the need to follow a special diet ;

(iii) the need for help with cleaning, shopping and other domestic work ;

(iv) incontinence or other disabilities that cause extra laundry or a need for extra baths ;

(v) communication ;

(vi) heavy wear and tear on clothing or a significant need for extra or special clothing ;

(vii) attendance needs ;

(viii) other needs which result in additional expenditure which he would not incur if he was not physically or mentally disabled.'.

Mr. Morris : It is fitting that the first amendments for debate are among the most crucial. That is acknowledged by the Secretary of State for Social Security in his foreword to "The Way Ahead", which identified as the first main need

"better coverage of assistance with the extra costs of being disabled."

Would that the Bill lived up to that laudable aim, and that the Government's legislative performance matched the precepts embodied in the right hon. Gentleman's foreword.

The Bill's failure to meet the broad range of additional costs incurred by the disabled provoked strong and sustained criticism from all the main organisations that represent them. They were led to expect that the Office of Population Censuses and Surveys' findings would pave the way for a comprehensive review of benefits. Disabled

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people also hoped for full and meaningful consultation between the Government and their own organisations about a workable system to address their unmet needs.

Instead, the Government chose merely to tinker with the existing attendance and mobility allowances and to cobble together, with a public relations flourish, the so-called disability living allowance.

The very title of that allowance is a cruel misnomer, which plays on the aspirations of disabled people for an income on which they can live with some dignity. In fact, it leaves a huge area of unmet need by recognising only the extra costs that arise from attendance or immobility.

Even the attendance and mobility needs of many disabled are met only in part ; yet the Government publicly admit that the current savings made by their policies for the sick and disabled should not be seen as "saving money". In an interview published in The Times on 29 September 1990, the Minister for Social Security said that the Government's long-term savings would give his Department "powerful cards to play" with the Treasury. My experience is that to let the Treasury pick one's pockets once is to invite them to pick them again. I have never seen in print a franker admission that the Government's current policies for the sick and disabled will take them into profit.

I make no apology for reminding the House that average earnings have increased by more than 20 per cent. since 1979, whereas disability benefits are only 1 per cent. higher. That is the truth behind the Government's claims to have targeted the disabled for special help.

The disabled incur a wide variety of extra costs, and there are many examples of the magnitude of the unmet need that the Bill will do nothing to redress. Norah is 67 years old. She has complete lesion paraplegia due to an absess on her spine. She lives alone and uses a wheelchair. She has to buy in domestic help and occasional physiotherapy, and pay someone to shop for her. She needs cotton wool, soothing creams, vitamins and disinfectant--but frequently cannot afford to buy them.

Norah also has to meet extra laundry costs due to incontinence and catheter -changing while she is in bed, and because of her use of special creams and medication. Her clothes wear out more quickly, and she needs more clothing because she feels the cold more than others. Because of wear and tear and frequent washing, her bedding must frequently be replaced. Norah is also on a special diet that costs more. Because she spends so much time at home, and needs to keep warm, her fuel costs are high. Needless to say, her phone is a lifeline--but the bills are a worry.

The extra costs that Norah incurs because of her disability are estimated at £108.46 per week. She now has the unenviable task of choosing between two competing necessities. She says

"I would rather be hungry than cold."

That such a disabled person should have to choose between food and warmth is scandalous by any reckoning.

I have dealt at some length with that case because it helps to illustrate the very wide range of extra costs which the amendment seeks to meet. They are costs that some hon. Members and non-disabled people may find it difficult to imagine. Innumerable other examples can be cited. The National Association of Citizens Advice Bureaux report the case from Greater Manchester of a 20-year-old disabled women who has to drag her feet

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because of her disability, and wears her shoes out very quickly. With the £27.40p. she receives on income support she cannot afford to replace them.

Age Concern gave the example of a 65-year-old man receiving attendance allowance. He needs three bags of coal a week, each costing £8, to keep warm. From his attendance allowance of £25.05p, he is left with barely £1 for other costs. He writes :

"Clothing and footwear are a thing of the past for my wife and me."

The Royal National Institute for the Blind cite the example of Mr. Cox, who is registered blind. He spends more than £30 a week on extra costs. They arise from the frequent cleaning of his clothes, due to falls and spillages, and much more than average wear and tear of clothing. Transport costs are also a major problem. Blind people living alone face even higher costs than Mr. Cox as they have to rely more upon paid help.

Deaf Accord say that :

"Being deaf does not currently entitle you to any benefits and this will not change under the Bill. We believe that there should be an additional costs component to the DLA for deaf and deaf-blind people, this would include the extra costs they incur to overcome their communication problems."

I urge hon. Members who have not done so to read details of the cases documented in briefings from Disability Alliance, the Disablement Income Group, the RNIB, Mencap, the Spastics Society and RADAR, among other organisations, where they will see that the examples that I have used are by no means isolated.

Why, then, have the Government chosen to disregard the overwhelming evidence of hardship among disabled people? Ministers have relied heavily on findings by the Office of Population Censuses and Surveys which suggested that the average weekly extra costs of disablement were only £6.10p per week, with no more than half a million people spending more than £15. OPCS researchers have themselves said, however, that respondents estimates of their costs are :

"Sensitive to the interviewing techniques used."

They are not entirely satisfied about the reliability of the figures and advised :

"Because of all the problems in obtaining reliable estimates of expenditure, all the results presented in this chapter should be treated with some caution."

Far from following that advice, the Government have used the results to make fundamental policy decisions. Ministers brush aside conflicting evidence presented by disability organisations. Using the OPCS reports more carefully than the Government, the Disablement Income Group found that the extra weekly costs of disability were £41.84p. Using their own questionnaire, the figure rose to £65.94p. The independent living fund also provides irrefutable proof of the Government's very seriously mistaken view of the extra costs of disability. In fact, the independent living fund average weekly payment is £72.

The Government have also chosen to use information from the family expenditure survey in spite of the caution advised by its authors, who say :

"the evidence for substantial, unavoidable costs' of disability, to be met without regard to costs or priorities, is not to be found in research based on expenditure comparisons such as this." Any calculation of the "true" costs of disability is complicated by the low incomes and often low expectations of disabled people. Many have no opportunity to spend money on items that non-disabled

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people regard as basic needs. They cannot spend what they do not have. It can be hard even to conceive of spending which for most people is commonplace. One young disabled person with cerebral palsy, who is incontinent and uses a wheelchair, short not of luxuries but of necessities, says :

"Because I haven't got the money I go without ; it's as simple as that."

5.45 pm

The Government should long ago have heeded the advice of the Social Services Select Committee which recommended Ministers to work with disability organisations to conduct and publish research on the actual and potential costs of disability.

Instead, the Government not only misuse the OPCS reports but make further misplaced assumptions. They argue that the existing attendance and mobility allowances make "generous allowance" for the extra costs of disability and that any money not used on attendance or mobility costs can be used for other costs of disabled living. That is deeply resented by disabled people and their organisations. They strongly refute the argument that existing allowances are generous and point out that blind people like Mr. Cox, for example, despite the extra costs, do not qualify for attendance or mobility allowance.

One finding of the OPCS is that digestion disabilities cause the highest extra expenditure, but how can people with such disabilities, who are not entitled to attendance or mobility allowance, use any part of either of them for their extra dietary costs?

In regard to people with high extra dietary costs, I challenged the Government at the Committee stage of the Bill about their misuse of research by Anita MacDonald, chief paediatric dietician at the Children's hospital at Ladywood in Birmingham, when calculating the dietary needs of people with HIV and AIDS and others with long-term disabilities. Her work was used to contradict my submission on Second Reading and in Committee about the extra dietary costs and also the submissions of the Terrence Higgins Trust.

In a letter that I have now received from Anita MacDonald she says :

"I consider that the information in my paper has been inappropriately used by the DSS against the case made for additional dietary support for people with HIV and AIDS. In fact, I feel very dismayed that the DSS has apparently chosen to use the information quoted in the paper out of context, particularly as I had discussions with an official of the DSS in the Autumn of 1987 I would be grateful if my paper would not be used against the Terrence Higgins Trust as it is not intended to apply to patients with AIDS and HIV infection, nor can the costings be interpreted as being the average costs of a healthy diet."

That is a most serious refutation of ministerial statements, and I hope the Minister will now apologise to the House and address the very serious unmet needs of people with AIDS. The help that they need, and which the amendment would give them, is help to keep them alive. That is what this debate means to them.

This is an important debate also for Mrs. Christine Saltmarshe, a distressed mother whose 19-year-old daughter is severely disabled. As the Minister knows--although he has made no response and I must now recall her letter--she wrote to me in November to say :

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"My daughter was 19 three days ago. She is severely disabled and her problem is epilepsy which is caused by severe food intolerance or allergy. Because of this she is on a very strict and, therefore, expensive diet. When she was 16, in November 1987, she was awarded the whole diet allowance under the Supplementary Benefit rules. In April 1988, when the new system came in, she was given £30 transitional addition, but of course this is being rapidly eroded as her income has been frozen and inflation soars. She got no rise at 18, and now has had a letter from the DSS stating that, in December, the Severe Disablement Allowance will go up by £10 a week, but that she will get nil. I have put in an appeal to a Tribunal, but I know the regulations are against her. I have written to my MP John Major and have had letters back from him and Nicholas Scott expressing sympathy, but saying she can't be helped, because of the regulations." Mrs. Saltmarshe concluded :

"I wonder if you can tell me where we go from here?"

I have told the Government that it is simply not good enough for Mrs. Saltmarshe to be informed that her daughter cannot be helped because of the regulations. Ministers have the power to alter regulations. Indeed, the social security changes of April 1988, to which my hon. Friend the Member for Nottingham, North (Mr. Allen) referred, were legislated for by them. The fact that Mrs. Saltmarshe's Member of Parliament is now the Prime Minister makes the replies that she received all the more curious.

I regard the case as one of undoubted, unmerited and unnecessary suffering and hardship, which the Minister and the Prime Minister can bring to an end by accepting the amendments. As they know, Mrs. Saltmarshe's daughter is but one of the more than 1 million disabled losers from the social security changes of April 1988 which the amendments seek to undo.

In further support of the amendments, I emphasise that the OPCS survey was conducted before the cuts imposed in April 1988. The importance of the amendments was reflected in Standing Committee where they had support from both sides of the Committee. The vote was initially tied until, in keeping with precedent, the Chair's casting vote was given to the Bill as drafted.

The Minister has suggested that a costs allowance would involve complexity. Yet his new disabled living allowance introduces 11 new permutations of benefits. What could be more bewilderingly complex for disabled people? Simplicity is important but so, too, is meeting need. In "The Way Ahead" the Government set themselves four objectives, including improving the structure of benefits to bring it more into line with the needs of disabled people and giving more to those most in need.

Our proposal for a cost component is completely in line with those objectives. It has the support of the Disability Benefits Consortium, an umbrella group representing all the major disability organisations, including the British Council of Organisations of Disabled People, the Disability Alliance, the Disablement Income Group, RADAR, the RNIB, the Spastics Society and Age Concern. It also has the support of people in all parties and is eminently deserving of the backing of the House. After all, the House has irrefutable proof from victims of the social security cuts of April 1988 that even many severely disabled people are being made to go hungry by the loss of benefits on which they so crucially depend.

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Sir David Price : I am sure that the whole House is grateful to the right hon. Member for Manchester, Wythenshawe (Mr. Morris) for bringing to the Floor of the House the whole problem of the extra costs of disability. As the House will know, the ninth report of the old Social Services Select Committee considered disability in relation to care in the community. A section of that report dealt with the cost of disability. I can be mercifully brief, because all the evidence is in our report. It struck the Committee that the Government rested their case on the OPCS reports. Surprisingly enough, we received a great deal of evidence that the OPCS estimates of the extra cost were not correct.

This is not the occasion to go into methodology. Certainly, no one disputes the integrity of the OPCS. If we had time, I could describe some of the reasons why the methodology was inappropriate and why the range was too wide. I give the House just one quotation from Mr. Ian Bruce, the director- general of the Royal National Institute for the Blind :

"so many disabled people have low incomes, if you say to them : How much more money do you spend on things because you are disabled?', they may never have had the opportunity to spend the money to start with A lot of blind people do not go out very much because they cannot afford taxis. Now if you ask them how much extra they spend on travel or transport, they might say not very much but that is because they have never had the money to do it".

The phrase :

"they have never had the money to do it"

is important.

We made a recommendation as a result of our study, and the right hon. Gentleman quoted it. We asked for more research. In our report, we quoted the set of figures given to us by the OPCS, taking category 3 to category 10 of disability. We also took the figures provided by the Disablement Income Group. There is not a minor but a substantial and marked variation between the two sets of figures. I am not saying that one or other is correct, but there is sufficient disparity to worry the House.

Our recommendation was :

"the Government conduct and publish ongoing research on the actual and potential costs of disability,"

and--this is important--

"in conjunction with organisations representing disabled people, to inform future policy decisions about assistance for disabled people."

I wish briefly to put three proposals to the House and to my right hon. Friend the Minister. First, can we have general agreement that the OPCS figures--which were referred to in the Select Committee report and several other reports--on the estimated extra costs of disability should not be taken by the Government or the House as the truth, the whole truth and nothing but the truth?

Secondly, we should carry out more research along the lines of the Select Committee recommendation, and the Government should implement proposals based on it. Thirdly, research should lead to a permanent on-going survey of the extra costs of disability, involving, on the Government side, the OPCS and possibly some appropriate academics, and the voluntary organisations which are in day-to-day touch with the more severe cases. I suggest that that on-going survey should be the basis for future determination of the rates of disability living allowance and should be used in all further calculations of upratings and readjustments, as the case may be.

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I draw an analogy with the cost of living index, which is determined by surveys of family expenditure and is more or less accepted across the House. It is a fair way of determining the effect of inflation on ordinary people's incomes. A similar system should be adopted in future for determining the extra cost of living with a disability.

My proposal is modest. It does not involve doing anything in the Bill today or during its future stages, but it would help the people to whom I talk in the disability organisations to feel that the Government have a commitment to do what they ask in the future. If my right hon. Friend rejects that proposal entirely, on what basis will future upratings of allowances be made?

My proposal is so modest that I am astonished at my moderation on a cold night. I hope that, as always, my right hon. Friend will find my logic devastating.

6 pm

Mr. Ashley : I endorse what the hon. Member for Eastleigh (Sir D. Price) has just said. There has been a great outcry among disabled people about the lack of provision for the extra costs of disablement. We have had a great deal of information from fervent researchers. I take this opportunity to pay tribute to them. They contribute so much to our speeches.

Diana Sutton has done so much for the all-party disablement group and has been helpful on this issue. Mary Holland has also been helpful, as has Peter Large, whose work is of enormous benefit. I will not go so far as to say that those people write Members' speeches, but they certainly help a very great deal. If I may be forgiven for introducing a personal note, I would refer to my wife, Pauline, who makes a major contribution to my work. Sometimes I feel like a spare part. The fact is that we receive a mass of information about these problems.

I do not see how the Government can retain the name that this Bill carries. It simply is not possible to have a genuine disability allowance with only two components and with vital costs excluded. Exclusion of these costs makes a mockery of the legislation. I suggest to the Minister that the Bill might be renamed the Exclusion of Vital Allowances Bill. That would be far more appropriate. A costs allowance should be included. There is anecdotal and statistical evidence from organisations for the disabled, there is statistical evidence from the OPCS, and there is common sense. In the Standing Committee, the amendment had all-party support. There was a tied vote, and the Chairman voted for retention of the status quo.

Many people were surprised when the Minister implied that those receiving mobility allowance could spend it on something else. He knows that that is nonsense. He knows that what is allowed does not cover even the costs for which it is intended. How then could it be used to cover other costs? I suspect that disabled people will think that the Minister is living in Alice's Wonderland.

They are concerned about such comments, but they are even more concerned that their requirements are not being met. They are living in deficit, and they are very anxious about that. They receive no help to meet those special costs, and naturally, as a result, they are suffering hardship. The Minister speaks of favouring coherent structures. I go along with that, but we must not have

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coherent structures at the expense of justice. Making provision for the extra costs of disability would indeed be providing justice. Those, like most hon. Members, who have their faculties and adequate income do not appreciate what a burden these extra costs impose. I should like to conclude by spelling out some of them, though not in actual cash terms. I know that this has been done before, but I shall take 30 seconds to do it again.

Handicapped people, especially handicapped children, cause excessive wear to their clothes ; those who are incontinent need extra washing ; those with stomach complaints and associated disabilities need special diets ; those who are immobile--the very severely crippled--need extra warmth ; deaf people--not myself, so this is not special pleading--need expensive communication aids ; those whose bodies are frail are incapable of "do it yourself". Actually, as I am pretty ham-fisted, I am incapable of "do it yourself" anyway, so I get my wife to do the jobs.

Disabled people who cannot do such jobs have to pay to have them done. They also find it difficult to do shopping. All these things, although they may sound simple, are profoundly important. I hope that the Minister will take account of this argument and think again.

Mr. Peter Thurnham (Bolton, North-East) : I want to speak on amendment No. 4, which deals with the extra cost component. I believe that its wording is exactly the same as that of amendment No. 6 in the Standing Committee, on which we had a very good debate. We have had another good debate today, and I welcome the contribution of my hon. Friend the Member for Eastleigh (Sir D. Price), who speaks from such experience, as well as that of the right hon. Member for Stoke-on-Trent, South (Mr. Ashley), whom I congratulate on the very good work that he does for the all-party group. The right hon. Gentleman does a great deal to ensure that that group promotes the cause of the disabled.

It is very important that we should recognise the extra costs that disability involves. From personal experience, I can say that there is great validity in all the points that have been raised in the debate on this amendment. I am thinking of such things as the need for extra heating and for special diets. People who are mentally handicapped tend to want to eat only certain kinds of food. It can be quite difficult and expensive to get them to change their habits. Certainly, my household gets through a large number of Kit-Kats as an inducement to our son Steven, following the meal, to go upstairs and start the next stage of the day's routine.

People who are disabled may need help with shopping, cleaning and other domestic duties, and there are such problems as incontinence. When we were on holiday abroad, our son refused for a whole month to go to the lavatory, and we had to buy incontinence aids.

So far as communication costs are concerned, I am not quite sure what is involved in our case, because Steven, while he likes to listen on the telephone, seems to be struck dumb. Then there is heavy wear and tear on clothing. Very often, disabled people have feet of different sizes, so two pairs of shoes have to be bought, and two shoes thrown away.

Attendance needs are one of the most important aspects of this matter. The home help care that we are offered

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amounts to just three hours a week during holiday periods. When one considers that care is necessary 24 hours a day, seven days a week, that is very little.

My hon. Friend the Member for Maidstone (Miss Widdecombe) said on one occasion that she thought that friends and neighbours would be very keen to help. That is not our experience. Indeed, one's friends and neighbours tend to shun one. I think they are frightened of what might be involved. One is glad to have such help on occasions, but I do not think that friends and neighbours are desperately anxious to rush in. Many people are frightened of mental handicap, and others may be worried about the possibility of being drawn into a commitment that might prove too burdensome.

I have no doubt that, in my constituency, families who are struggling to look after children--many of them, indeed, not now children but adults, and many of them profoundly mentally handicapped--constitute one of the greatest areas of unmet need. Such people do not get the help and respite care that they require, and it is not readily supplied by friends and neighbours.

The amendment ends with a reference to "other needs". Of course, there are very many other needs. We have found it necessary to get a powered wheelchair because my wife has difficulty pushing the ordinary one uphill. I was absolutely staggered at the cost. The price of an ordinary wheelchair is £130, and it can be supplied through the social services, but an indoor/outdoor powered wheelchair costs over £1,500, and is only now being considered as something that should be provided by the social services. So the extra cost is very substantial.

As has been said, we had quite a surprising vote in the Standing Committee. It was the hon. Member for Cumbernauld and Kilsyth (Mr. Hogg) who came out with the result that left the Government in control of the position. I should like to remind my right hon. Friend the Minister of the words that he himself used in that debate. I listened to them very carefully. On the first day of the Committee's deliberations, he said :

"The hon. Member for Caernarfon will remember our previous debates, especially those about children under the age of two. Having resisted amendments in support of that for two successive years, I was not prepared to go through that experience again and we introduced the change. Who knows what might flow from our discussions on the Bill, but not today!"--[ Official Report, Standing Committee E, 6 December 1990 ; c. 26.]

The Minister went on to say that I could make up my own mind. Having been given what I interpreted as a tiny inducement, I was carried away and decided to express my personal view when it came to the vote. I did not foresee that we should end up with a tied vote, so it was an interesting result.

Mr. Alfred Morris : The hon. Gentleman's support in that tied vote in Committee was not only widely remarked upon but was also appreciated. It was not just his vote. As the House heard tonight, the hon. Gentleman has deep personal experience of the realities of life for families with disabled children. In my view, it was a very important contribution.

Mr. Thurnham : I am grateful to the right hon. Gentleman. I thank him in turn for the way in which he led the Opposition in Committee. It was a very constructive debate all the way through the Committee proceedings and

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the right hon. Gentleman's own contributions were excellently put. Again, he has spoken very well today, and I thank him for his contribution to the debate.

The right hon. Member for Stoke-on-Trent, South said that he thought that my right hon. Friend the Minister for Social Security and Disabled People was living in Alice's Wonderland. I am almost inclined to agree with him. The figures show that, compared with what used to be spent on disabled people, spending is approaching "Alice in Wonderland"--although, of course, a lot more money is needed. Expenditure on disabled people was about £10 million a day when the Government came to power, in today's money terms. We have increased that spending at the rate of £1 million a day every year that the Government have been in power. We are now, therefore, spending over £20 million a day on disabled people. I very much look forward to another decade in which we yet again double our expenditure in real terms on disabled people. My right hon. Friend is to be congratulated on helping to bring about this large increase in spending. We might not yet be in "Alice in Wonderland", but I think that we can look forward to something far more like Wonderland than anything that we enjoyed when the Opposition were in power. They do not have the ability to manage the economy well enough to produce the wealth that can be spent on the disabled.

I very much support my right hon. Friend's management of the Government's programme of spending on disabled people. The Bill will bring about the spending of another £1 million a day on them. The Government have an excellent record. Therefore, I am pleased to support the Bill.

Mr. David Bellotti (Eastbourne) : I join those who congratulated the hon. Member for Nottingham, North (Mr. Allen) on his first appearance at the Dispatch Box. I wish him well for the future. Last Friday, I visited Hazel Court school in my constituency for the first time. It caters for young people with severe learning difficulties. As they grow older, they will benefit from the provisions of the Bill. The school has a high reputation for pioneering work in sensory education. Schools such as Hazel Court are to be found throughout the country. The Bill is important to the work of those teachers. They, supported by the parents and other people in the community, will enable us in partnership to deliver the programmes that are so needed.

Many of the children at that school suffer from severe brain damage, which leads to many of them having no sense of danger. Severe brain damage can also lead to hyperactivity. They need intensive help for much of the time. Additional money would go a long way towards helping parents to cope with difficulties over travel, health, welfare, eating, shopping and clothing. The rest of us do not experience those difficulties.

The additional allowance would also help those who cannot walk properly. In the past they have not always been able to benefit from additional allowances. Those who need to be regularly bathed or who face extra laundry and clothing costs as a result of their special needs would also be helped by the additional allowance.

During the short time that I have been a Member of Parliament, a few cases have been brought to my attention.

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