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Mr. Bowis: There is nothing in the Bill that restricts anything. Regulations will outline how the system should be put in practice to begin with; once the initial implementation has been made effectively, the House will, with the minimum of inconvenience, bring forward regulations to extend it further.
Mr. Clarke: The Minister cannot have it both ways. The Government's consultation document makes it perfectly clear that the Government intend to exclude people with learning difficulties. We have had consultation and we have a Bill, but we have been told absolutely nothing about the Government's views on or responses to the consultation document. I listened to most of the debate in another place and the Government would not give one inch on that issue--the Minister ought to worry that that may be the instruction to him as we proceed with the other stages of the Bill.
Mr. Berry: What would have happened if the Minister had suggested that these provisions should apply to people who have learning disabilities but not to those who have physical disabilities? Is not the obvious answer to that question a reflection of the fact that the Bill, in the light of the proposal that will come forward in regulations, is systematically discriminating against people with learning disabilities--they are being treated like second-class citizens?
Mr. Clarke: My hon. Friend has enormous experience in these matters, and he has got it absolutely right. Until the Government offer us a different explanation of their approach to each individual who is assessed, the Minister will have a great deal to do in the House and in Committee to clarify the issue.
The situation is further complicated by the intention to exclude those who are over 65. However, more anomalies will arise along these lines when the issue of what kind of disability a person has is crossed with the issue of whether the person is over 65 when first seeking a direct payment. No doubt, the Government's proposals will create anomalies and fly in the face of the Government's support for local authority discretion. They have missed the opportunity to have a genuine piloting of the new scheme.
If Ministers are really concerned to limit provision to the capacities of local authorities to meet demand, they should give more, not less, discretion to local authorities. That is precisely what Labour Members argued in the House of Lords. My colleagues in another place made the case against blanket exclusion on principle, and went so far as to offer the Government a compromise position, whereby Ministers could ensure that only those councils most experienced in cash payments could offer them to those with learning disabilities or to those over 65. In that way, the majority of councils would have to live with the Government's blanket exclusions for only a year or two, but those that were already geared up for making direct
payments could do so right away if they could satisfy Ministers that they knew what they were doing. That compromise was offered to Ministers in another place, but they were not prepared to take it. I hope the Minister says why his colleagues in another place rejected that compromise and whether he is prepared to accept it or why he is not prepared to do so.
Today, the Minister has been unable to say what conclusions he has reached as a result of the consultation exercise. It is a great pity that this legislation has been rushed and that it began in the wrong place at the wrong time. Members of the House of Lords found themselves considering a Bill without having had sight or knowledge of the results of the consultation with the interested parties--that is totally unacceptable. In spite of the protests of noble Lords, the Government insisted on completing the House of Lords stages of the Bill before the consultation was completed--never mind the findings being published.
Proper parliamentary scrutiny of the measure would have been assisted had the Bill been introduced in the House a week or two from now. That would have allowed the Government to publish their conclusions after consulting interested parties. The House would then have been able to consider the Bill with full knowledge of the relevant facts and the House of Lords could have played its proper role of reviewing the legislation after it had been considered by hon. Members.
Instead, the Bill has completed half its parliamentary consideration and all we know of Ministers' intentions is what their preferred options would be. We do not have firm commitments on the contents of regulations and guidance on which the Bill is heavily based. It appears that their preferred options remain the wrong ones. They are too cautious, too conservative and too unwilling to learn the logic of local authority discretion and to permit different authorities to progress at different speeds, yet they continually talk about choice.
I focused on the blanket exclusions that Ministers intend to put in regulations, but that is not our only problem with the Government's intentions. Ministers want to maintain the distinction between formal and informal care, and we agree. We accept that direct payments must not result in making informal care and support structures provided by family and friends into formal paid employment; few disabled people would want it to work that way. So we recognise that it is important to avoid the danger of disabled people or their carers being locked into such a relationship against their will.
Again, the Government's intentions, as outlined in the consultation paper, go beyond what is necessary to achieve those ends. They propose to place a general prohibition on the employment not just of members of the immediate family within the same household but of all members of the recipient's extended family wherever they live. It makes no sense to treat in-laws or the partners of nieces and nephews in the same way as a husband or wife living in the same house.
The Government's approach to the measure is clear. They have at long last conceded that direct payments work and that the individual life styles of disabled persons and elderly disabled persons can be met by the services that local authorities provide. However, the Bill, which we all welcome, diminishes the impact of direct payments by its approach. It represents a dilution of the measures that the Government promised and excludes people with learning difficulties and those over 65.
Happily, the Bill, which I hope will receive a Second Reading tonight, will be considered in Committee where there will be a thorough examination of its contents.In due course, it will return to the House for consideration and, one would assume, Third Reading.
Sir Nicholas Scott (Chelsea):
I thank the hon. Member for Monklands, West (Mr. Clarke) for his gracious remarks earlier. We understand that it is the duty of the Opposition carefully to examine legislation and other Government proposals, but the hon. Gentleman made quite a meal of his objections today. The vast majority of hon. Members will welcome the Bill, introduced by the Under-Secretary of State for Health, my hon. Friend the Member for Battersea (Mr. Bowis), who deserves congratulations. Having been through part of the process some years ago, I suspect that some of the constraints that may be apparent in the present proposals may have come not from his Department, but from another Department on the other side of Whitehall--an experience that I frequently had during my time in office.
I certainly welcome the Bill, and I shall briefly explain to the House why. We may have some reservations about the way in which regulations may put constraints on the operation of the Bill. It will be up to those of us who take a close interest in these matters to keep a careful eye on them. I hope and trust that the scheme proposed in the Bill will expand and develop in future years, as did the independent living fund, which was launched in a modest way and then grew at a tremendous rate over the years of its existence. That may have been a cause for concern in the hearts and minds of those who keep the books, which may have had an impact on the plans of my hon. Friend and his colleagues.
I cannot claim direct responsibility for the ideas contained in the measure, but perhaps I can claim some grandparental responsibility, because the independent living fund was the precursor and the proof that such an approach to cash payments was a feasible way of meeting the needs of disabled people.
It is worth recalling that when we proposed the independent living fund, virtually all the organisations of and for disabled people were hostile to it. The Disablement Income Group was almost alone in supporting it. Pauline Thompson, its director, showed great courage in responding to and rejecting the opposition and complaints of many other organisations. It enabled us to launch the independent living fund and make it a growing success over the years. Other organisations tended to stand aside.
The Disablement Income Group has done a great deal to encourage the spread of third-party schemes, which play an important role. I doubt whether there are any legal problems, because I cannot think that any local authority would have launched such a scheme without taking careful legal advice from its own legal advisers, the town clerk and others. The schemes have not been challenged, so my
suspicion is that they will all turn out to be soundly legally based and could provide a pattern for provision under the Bill.
The success of the independent living fund has undoubtedly shown that disabled people can be trusted to use the power given to them by such an approach to control their own lives. Before the independent living fund--and the practice continues in many parts of the country--disabled people had the choice between institutional care and services provided by some local authorities that said, "We shall get you out of bed at 10.30 in the morning and you have to go to bed at 4.30 in the afternoon, as that is the only way we can fit you into our pattern of provision." Disabled people do not want that. They want to be empowered to control their own lives and to make their own choices about their life style and the pattern of their activities. Cash payments have made that possible for thousands of disabled people over the years. I am delighted that the Bill will extend and develop that concept.
By 1993, when the original scheme was replaced, some 23,000 disabled people had benefited from the work of the independent living fund. That in itself is a tribute to its success.
In summary, inadequate statutory provision by local authorities for all those people was replaced, enabling them to make their own choices about their lives. The other important aspect of cash payments and the way in which the independent living fund, third-party schemes and the new schemes will operate is that they are between 30 per cent. and 40 per cent. cheaper than the provision of sometimes inadequate services by local social services departments.
Of course, some disabled people require not only cash to buy services for themselves, but support and guidance on how to deploy the resources with which they have been provided. I was particularly grateful to the Minister for making it clear that the Government will play a part in the provision of that guidance and support. I hope that they will stay in close touch with the Disablement Income Group, which has already produced two excellent documents on how people can purchase packages for personal care. If the Government stay in close touch with that organisation, they will not go far wrong.
The Government produced some advice under the old scheme, and they are prepared to play their part in the new arrangements. Of course, books and pamphlets can help, but I hope that the Government, in addition to such advice and support, will be able to encourage, through local authorities, the development of local support groups of disabled people and their carers. Those groups could develop plans locally, to enable disabled people to make the best possible use of the cash help that they receive through this system, by sharing their experiences and providing advice and help to those who are contemplating accepting cash-based services rather than opting for the pattern of social services provision. They will require help in developing ideas on how to recruit care assistants, how to cope with payroll problems and on the other little detailed matters in relation to employing care assistants, which will enable them to live a full life.
Direct payments have substantial advantages over present provision. As I said, they are cheaper to administer and cheaper for the local authority to provide. I very much hope that schemes that will be supportive of disabled people will develop throughout the voluntary sector.
I rejoice that the Bill has come before the House. I do not mind if I have to limit my rejoicing slightly because of some of the scheme's constraints, as I believe that, as it is developed, it will increasingly become a common pattern across the country.
I should like to put three points to my hon. Friend the Minister. The first is that, where there is real local demand for the service, there ought at least to be a presumption, if not an obligation, that local authorities should have to provide schemes that are cash-based--in addition to or in replacement for the social services schemes that are currently the common pattern.
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