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6.31 pm
Mr. Andrew Rowe (Mid-Kent): I welcome this day as a combination of absolution and delight--absolution as it was because I insisted on pressing my right hon. Friend the Member for South-West Surrey (Mrs. Bottomley), then Minister for Health, about direct payments during the debates on the National Health Service and Community Care Act 1990 that she went away and discovered that the several schemes that were already in existence were illegal. The disability organisations have been extraordinarily kind to me in the long wait to re-establish what we all fondly imagined was a model which could be easily copied, and I am pleased about that. I am also delighted because this is a place where banging one's head against a brick wall is an occupational hazard and in my experience it is seldom that the wall comes off worse. I am pleased that on this occasion perseverance has paid off.
I welcome the Bill and I know that my hon. Friend the Under-Secretary of State has worked extremely hard behind the scenes to turn what at one point was a fairly adamant refusal into the Bill that we now have. That is very good.
It is always fascinating to listen to the hon. Member for Monklands, West (Mr. Clarke), who made some kind remarks about me personally. When he represents a single interest as an Opposition spokesman, he is keen to ensure that standards of national uniformity in provision are laid down, but when speaking as a representative of Scotland he is equally anxious to allow local autonomy and discretion. Those two counter-currents sometimes get him into a little difficulty.
I believe that the Bill is excellent.
Mr. Tom Clarke:
The hon. Gentleman is making an extremely good speech, but will he take some of the blame for the views that he attributes to me when I speak for Scotland since he served at the Scottish Office as a very distinguished civil servant for a long time?
Mr. Rowe:
It was an experience that I greatly enjoyed. It taught me a great deal about the pitfalls of devolution, and also the great benefits of being an administrator in a much smaller country than England. One at least gets to know people very much better. So I am ambivalent, too.
I wish to echo what one or two people have said.I also wish to draw the attention of my hon. Friend the Under-Secretary of State to the idea that the Government propose to limit the operation of the scheme partly because they are not quite confident yet that everyone who would be judged eligible for it would be able to manage it. The Government's anxieties are targeted on the wrong people: it is not disabled people who might not be competent at managing their affairs--the real anxiety is that there will be a wide discrepancy between those local authorities which already have considerable experience of running such schemes and those which do not.
Arbitrarily to exclude disabled people from the operation of the Bill in order to address those discrepancies is a serious mistake. It would be much better to require local authorities to put forward a scheme which was an effective way to use the powers in the Bill. Those local authorities which already have experience would automatically be accredited instantly and those which have not would have a chance to learn from other authorities. As my hon. Friend the Member for Brighton, Kemptown (Sir A. Bowden) suggested, local authorities would be pressured by their local disability organisations to get themselves to the starting line as quickly as possible. I would infinitely prefer that approach to arbitrary categories of exclusion.
It would be a rash Back Bencher and, I suspect, a rash Minister who would suggest that if you, Madam Speaker, were to encounter some disabling accident--one hopes that you will not--you would be incapable of managing your own services. Yet the implication of the Bill is that a person in that situation would be incapable. That is very dangerous.
Mr. Bowis:
We should have a special new clause for Madam Speaker.
Mr. Rowe:
The question of whether members of the family or the extended family could be paid for delivering care is interesting. My first inclination was that they should be paid. It is a ridiculous thought that one could not employ someone whom one knew well and trusted.I thought of hon. Members who frequently employ their wives or husbands as secretaries or research assistants. That works extremely satisfactorily. But then I read more widely and realised that the objections of the British Medical Association and many others were based on the risk that by making the household wholly dependent on that income, we would run the risk of institutionalising the care of the disabled person in a way that would reduce his or her freedom of action. Those objections have great force.
I would resist what in my youth were called tables of kindred and affinity and were printed in the middle pages of the prayer book. During sermons, I used to amuse myself by discovering which relatives were allowed to marry within the family circle. I do not want to see tables of kindred and affinity produced to show who can and cannot be paid for care, but the assurance that has already been given--that discretion will be used--should be generously interpreted when manifestly the right person is employed to provide care.
A number of organisations have asked about respite care. The consultation document appeared to suggest that only four weeks' respite care a year could be provided through direct payments. If keeping people out of expensive residential care would be assisted by more generous provision of respite care, that ought to be allowed. I hope that one consequence of this highly desirable measure will be the creation a new raft of paid caring services, which will drive up standards if--and I say this carefully--those services are subject to proper scrutiny. The opportunity to train and recruit people into demanding but often satisfying work will be greatly strengthened by the Bill, but people choosing whom to employ are more vulnerable even than if they were receiving services direct from the local authority. I am in favour of registering domiciliary care services and having them subject to proper scrutiny.
Mr. Archy Kirkwood (Roxburgh and Berwickshire):
I am pleased to follow the excellent speech of the hon. Member for Mid-Kent (Mr. Rowe). He would be a welcome addition to the ranks of civil servants we shall need north of the border when we establish a Scottish Parliament. I hope that the hon. Gentleman will consider coming back to Scotland to help in that capacity. Even a majority of 19,600 may not be sacrosanct in the next general election. We heard an excellent speech also--as one would expect--from the right hon. Member for Chelsea (Sir N. Scott). Both he and the hon. Member for Mid-Kent have distinguished experience of the subject. As a member of the Committee of Selection, I cannot resist making the observation that both the right hon. Member for Chelsea and the hon. Member for Mid-Kent were, in different ways, making an argument for extending the scope of the Bill. When the Committee of Selection meets to appoint the Standing Committee on the Bill, I will put in a word for both of them as their contributions would be most welcome.
Although I welcome the Bill, it is only a framework and does not create new rights. Hon. Members on both sides of the House have been at pains over many years to use their experience in Parliament to establish more rights for people with disabilities. I am sure that that is the way forward, but the Bill falls short. Nevertheless, it is to be welcomed for making improved provision and it will be put to good use.
When the Bill was published, Community Care commented that it was
I hope that it will be improved in Committee, when I am sure that Members will take the opportunity to press the points made in the excellent speech of the hon. Member for Monklands, West (Mr. Clarke), which set out the main concerns. We shall want to return to those issues in Committee.
All local authorities should consider implementing the provisions of the Bill. As the right hon. Member for Chelsea said, there is no presumption--let alone a legal right--to ensure that that will happen. However, I hope that such a high level of expectation will be built up that all local authorities will get around to providing schemes, even though one appreciates that local authorities are under financial pressure this year and will also be so next year.
The hon. Member for Monklands, West was right to comment that it is a shame that we do not have the advantage of the Government's reactions to the consultation process, to which there were 300 contributions. Those contributions, and the Government's reaction to them, would be of great value. Perhaps the Minister will indicate the time frame for access to the Government's deliberations. If the documents include some that would be of assistance to interested hon. Members--I am not talking about those marked for the Minister's eyes only--perhaps the hon. Gentleman would put copies in the Library. Hon. Members could then benefit from the work of pressure groups, interested parties and other knowledgeable and experienced people.
"a piece of legislation so thin it is virtually transparent".
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