---

Column 458

I am not convinced that to date the Government have done all they could to help those with special needs. We have all had superb support from the voluntary organisations in briefing us for these debates, but I should prefer to refer to a case in my constituency. A lady, Mrs. Ager, suffers from an obvious mobility difficulty. She applied to Norcross in Blackpool for a mobility allowance. She was turned down. Arthritis Care, a voluntary organisation, provided her with superb back-up and support. The medical evidence that she has provided cannot be questioned, so she intends to take her case to appeal.

6.15 pm

Mrs. Ager received a letter from Blackpool which said that her file could not be found. She came to see me in my surgery--with tremendous difficulty, because of her disability. As a new Member of Parliament, I was staggered that the letter from Blackpool she showed me was a circular letter. Obviously, many letters have been prepared to send out to people, claiming that their files have been lost and that no progress can be made with their appeals. I ask the Minister to ensure that local authorities or Government Departments do not send circular letters to people saying that their files have been lost. It is three and a half weeks since I wrote to Blackpool, and I have not yet received a reply.

It would be extremely helpful if carers received an additional allowance. Many hundreds of thousands of people are caring for others. They will be doubly penalised unless an additional allowance is made available to them. Many of them give up earning their own living in order to care for someone else. Unless the person who is disabled is able to claim the maximum allowance and the additional costs incurred, the person who has given up earning his or her living in order to care for someone else will be unable to benefit from the family income that is available to the disabled person.

That will lead to a double penalty for many people who care for others and for the many others who are in partnership with local and central Government. Without the help of such wonderful voluntary organisations as Mencap, Age Concern and the Spastics Society, both local and central Government would have very much more to do. I was intrigued by the reference to index-linking by the hon. Member for Eastleigh (Sir D. Price). My mind went back to the beginning of our debates, when the hon. Member for Exeter (Mr. Hannam) referred to local authorities. About a year ago, appearing as a local government representative before a Select Committee, I suggested that the money that is available ought to be ring-fenced. The view expressed about local authorities by the hon. Member for Exeter might be somewhat better if the money available could be ring-fenced. That would meet the objective. If we also adopted the suggestion of the hon. Member for Eastleigh, that the money should be index-linked, I am sure that every local authority would be able to meet all its future responsibilities.

There is no moral justification for introducing any age limits on any matter. It seems ridiculous and immoral that someone who might lose a leg and become immobile at the age of 66 should be treated differently from someone who loses a leg at 64 or 59. The immobility is the same. Our task must always be to see that those who have special needs can enjoy the maximum quality of life, similar to those of

---

Column 459

us who do not have special needs. I hope that, as the Bill proceeds, that will be one of the matters that the Minister will bear in mind.

Mr. Peter Bottomley (Eltham) : Clause 1 seems to be almost a Bill in itself and I congratulate my right hon. Friend the Minister of State and my hon. Friend the Under-Secretary who have had to persuade colleagues that this is a shortish Bill. My reason for saying that is that, although I share the concern for the carers as well as for those for whom they care, I wish to ask whether my right hon. Friend would have power under this or some other legislation to make additional payments for additional costs if the Government chose, after negotiation with the Treasury, to do that. I do not necessarily expect a reply today, but perhaps my right hon. Friend will reply by letter and place a copy in the Library. Do we require the introduction of an amendment such as amendment No. 4 to allow the Minister to have that power? This issue may become more relevant when the Bill is considered in another place. Although I am prepared to listen to what my right hon. Friend has to say today, some hon. Members will want to know whether the additional costs provision could be met in another way if the amendment were unsuccessful. My second question is whether my right hon. Friend is willing to give an assurance to the House that if further and more direct evidence on additional costs is introduced and considered alongside the OPCS evidence--I am not casting aspersions on the OPCS, which works professionally--the Government will consider it. Obviously, they may not be willing to accept it immediately, but will they have an open mind? At the moment, we may be relying too much on the OPCS evidence.

Even if the amendment were passed tonight or in another place, or was introduced by the Government, I do not believe that it is rational to expect to meet all the additional costs that disabilities may bring with them. It is important to concentrate on the most significant and obvious. I accept that one person in 10 in this country has a disability, but I do not think that it is practical to have files on so many of us. We need to ask to whom we can give the greatest help at any one time. I am not saying that we should make a decision in 1991 and then forget about it, because I hope that, as we resume growth, we will see a doubling or quadrupling of our help for those with special needs as part of the social market economy, on which there is growing agreement across the House. We want to create the wealth and ensure that we use as much of it as possible to bring the greatest help to those whose needs should be recognised just as much as those who have company cars or big mortgages.

Mr. Scott : I have sympathy with the closing remarks of my hon. Friend the Member for Eltham (Mr. Bottomley). Since coming to office we have increased expenditure on the long-term sick and disabled by more than 120 per cent. It is a record of which we can be proud. However, as my hon. Friend said, that still leaves us with difficult choices about priorities.

I welcome the hon. Member for Eastbourne (Mr. Bellotti) to our deliberations on disability and hope that he will continue to take an interest. He said that he does not like the age limit of 65 as it applies to mobility allowance. It would cost about £2 billion to abolish that age limit. I do not know whether he would accord such a priority to

---

Column 460

that, but it would involve massive expenditure. We have sought to reinforce a philosophical justification in the Bill for concentrating help on and giving priority to those who are congenitally disabled or disabled early in life and do not have an opportunity to build up contributory benefits, savings or occupational pensions in the same way as those who have had a full working life and who encounter mobility or other difficulties in their old age. We have to make choices all the time.

Mr. Thurnham : Does my right hon. Friend accept that there is unfairness in that one in 10 children with cerebral palsy can obtain an average of nearly £1 million in damages if it can be proved that the cerebral palsy was caused by the doctor at delivery, when the other nine out of 10 get nothing except what can be provided through the benefits system?

Mr. Scott : I do not want to enter into that debate. Essentially, it is not a matter for me. There is a capricious element in some medical settlements that many people find disturbing. I do not wish to pursue that argument. I feel that the House wants to come to a conclusion fairly rapidly on this set of amendments. If I am tolerably brief, it will be through no discourtesy to the House but because we thoroughly covered this ground in Committee and I do not wish to weary hon. Members.

Whatever shortcomings the OPCS survey may have, it was the most thorough piece of work that has ever been done in this country on the extent, nature and circumstances of disabled people and we have largely, though not exclusively, to rest on its findings. It was followed up by the family expenditure survey, which tended to reinforce the findings of the OPCS. Of course, we will continue to research and monitor the situation and ensure that the new benefits that we are introducing in the Bill meet the needs of those who really need help.

If I am honest with the House, I should say that I will be surprised if we get matters right first time. We are introducing two new benefits that substantially extend the help available and bring, with associated measures, extra help to some 850,000 people who suffer from disabilities of one sort or another. We will have to research and monitor the impact of all this and see whether we need to make any adjustments.

The hon. Member for Eastbourne spoke about the service that we provide for the disabled. We are anxious to improve that. When we looked at the Department of Social Security's delivery of service, we recognised that it was frequently not of the standard that we would want. We have taken substantial steps to improve that, not least through the operational strategy, at a cost of about £1.7 billion for the computerisation of our service and the dispersal of jobs outside London to provide a more sustained commitment. We have a rapid turnover of staff in London and that makes life difficult. The error rate has come down, the speed of service has improved and the new assessment and adjudication procedures have been widely welcomed. I want us to build on that.

The OPCS showed that attendance allowance and mobility allowance were effectively targeted on those who had extra costs. The right hon. Member for Stoke-on-Trent, South (Mr. Ashley) mentioned mobility allowance in particular. It is worth saying that the Government have not just uprated mobility allowance in terms of inflation,

---

Column 461

but one year provided a substantial increase over and above inflation and removed the allowance from tax, which was a great help to a substantial number of people.

Many people spend their attendance allowance and mobility allowance not just on coping with their care or mobility needs but on a whole range of other needs. As I pointed out in Committee, of those disabled adults under the age of 65 who are in receipt of attendance allowance, more have needs which relate to disabilities such as continence, intellectual functioning, consciousness, communication and behaviour than have personal care needs. So the benefits have a much wider cover than we normally assume. As I have already indicated, we will need to flesh out in due course the findings of the OPCS and not rest exclusively on them or treat them as a bible. There will be more research, and we will have an on-going survey on whether the benefits are meeting the needs of the people who have them. A point was made about the use by the Department of Mrs. Anita MacDonald's research. I have often referred to the study as evidence of the cost of a high-protein, high-calorie diet, which is recommended for AIDS patients in particular. The research is in the public domain, and people can make their own judgment about what Mrs. MacDonald says. I shall certainly respect her wishes about the treatment of her research in future if she is upset by the use that we have made of it.

6.30 pm

Our policy on provision through income support for extra costs such as special diets does not rest on Mrs. MacDonald's single piece of research, although, as I said, I have quoted it from time to time, as have other Ministers. The supplementary benefits system of providing for the extra cost did not work. The people who got extra help were the ones who knew their way around the system rather than those who needed help.

The income support approach, which delivers a significant amount of money-- the disability premium is currently £15.40 for a single person--is a more effective way of getting help to the long-term sick and disabled to cover extra costs. The premium is paid on top of the basic rate of income support, which already covers the cost of a normal, healthy diet, which is usually recommended for those with HIV infection. Those who develop full- blown AIDS from the HIV infection are immediately entitled to the higher rate attendance allowance of £37.55 a week. They get that immediately, without having to serve the usual six-month waiting period, which will become three months when we introduce the new benefits.

In essence, the ideas which we are developing for the disability living allowance, based on moving away from the use of medical assessments towards the concept of self-assessment by claimants, mean that it will be a better targeted benefit which will be more extensive than those it replaces. I accept that we will need a doctor's input into some of the judgments, but as far as possible we want to depend on self-assessment. That will be a substantial improvement.

Over the Government's period of office, the take-up of attendance allowance has multiplied by a factor of three, and the take-up of mobility allowance by a factor of six. The two new benefits will be better than those which they replace. We will monitor their implementation carefully.

---

Column 462

Because of the points I have made about attendance allowance and mobility allowance, I cannot commend the amendments to the House.

Mr. Alfred Morris : We divided in Committee on the amendments because of the extent of strong feeling in the country about their purpose. We do so again on the Floor of the House, for the same reason.

Question put, That the amendment be made :--

The House divided : Ayes 132, Noes 231.

Division No. 61] [6.33 pm

AYES

Abbott, Ms Diane

Adams, Mrs. Irene (Paisley, N.)

Allen, Graham

Anderson, Donald

Archer, Rt Hon Peter

Armstrong, Hilary

Ashley, Rt Hon Jack

Ashton, Joe

Banks, Tony (Newham NW)

Barnes, Harry (Derbyshire NE)

Barnes, Mrs Rosie (Greenwich)

Barron, Kevin

Battle, John

Beckett, Margaret

Beggs, Roy

Bellotti, David

Benn, Rt Hon Tony

Benton, Joseph

Bidwell, Sydney

Blair, Tony

Bray, Dr Jeremy

Brown, Gordon (D'mline E)

Brown, Nicholas (Newcastle E)

Brown, Ron (Edinburgh Leith)

Buckley, George J.

Campbell, Menzies (Fife NE)

Campbell, Ron (Blyth Valley)

Campbell-Savours, D. N.

Clarke, Tom (Monklands W)

Clwyd, Mrs Ann

Cohen, Harry

Corbyn, Jeremy

Cox, Tom

Crowther, Stan

Cryer, Bob

Davies, Rt Hon Denzil (Llanelli)

Dixon, Don

Dobson, Frank

Doran, Frank

Dunnachie, Jimmy

Dunwoody, Hon Mrs Gwyneth

Fearn, Ronald

Field, Frank (Birkenhead)

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

Foot, Rt Hon Michael

Foster, Derek

Foulkes, George

Fraser, John

Fyfe, Maria

Garrett, John (Norwich South)

Garrett, Ted (Wallsend)

George, Bruce

Golding, Mrs Llin

Graham, Thomas

Griffiths, Nigel (Edinburgh S)

Griffiths, Win (Bridgend)

Grocott, Bruce

Hardy, Peter

Haynes, Frank

Heal, Mrs Sylvia

Hinchliffe, David

Hoey, Ms Kate (Vauxhall)

Hood, Jimmy

Howarth, George (Knowsley N)

Hughes, John (Coventry NE)

Ingram, Adam

Johnston, Sir Russell

Kennedy, Charles

Kilfedder, James

Kinnock, Rt Hon Neil

Leighton, Ron

Livingstone, Ken

Lloyd, Tony (Stretford)

Loyden, Eddie

McAllion, John

McAvoy, Thomas

Macdonald, Calum A.

McFall, John

McKay, Allen (Barnsley West)

McKelvey, William

McLeish, Henry

McMaster, Gordon

McWilliam, John

Madden, Max

Mahon, Mrs Alice

Marshall, David (Shettleston)

Meacher, Michael

Meale, Alan

Michael, Alun

Michie, Bill (Sheffield Heeley)

Michie, Mrs Ray (Arg'l & Bute)

Mitchell, Austin (G't Grimsby)

Molyneaux, Rt Hon James

Morgan, Rhodri

Morris, Rt Hon A. (W'shawe)

Mowlam, Marjorie

Oakes, Rt Hon Gordon

Orme, Rt Hon Stanley

Owen, Rt Hon Dr David

Patchett, Terry

Prescott, John

Primarolo, Dawn

Quin, Ms Joyce

Rees, Rt Hon Merlyn

Reid, Dr John

Richardson, Jo

Rooney, Terence

Ross, Ernie (Dundee W)

Ruddock, Joan

Salmond, Alex

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)

Smyth, Rev Martin (Belfast S)

Spearing, Nigel

Steel, Rt Hon Sir David

Thompson, Jack (Wansbeck)

Turner, Dennis

Wallace, James

Wareing, Robert N.

Wigley, Dafydd

Williams, Alan W. (Carm'then)

Wilson, Brian

Winnick, David

Wise, Mrs Audrey

---