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Mr. Bowis: I am grateful to my hon. Friend. I have tried to explain that there will be a timetable. However, I cannot say exactly when the Bill will become an Act of Parliament or exactly how long it will take for the regulations and guidance to be agreed having taken into account the advice of the technical advisory group among others. I know that he understands that, but when the legislation has been in operation for one year, we shall take evidence from the experience of the social service departments that have been operating the scheme for a year and at that point we shall see whether it is possible--as we want--to move forward with the next wave so that people over 65 become eligible. My only criterion is that we must reserve the right to see whether any serious problems have emerged from the first year's experience which would lead to the scheme needing to be reviewed and perhaps refined and reformed in some way.
Mr. Tom Clarke: I am extremely grateful to the Minister for giving way once again, but, as he has said, this is the kernel of our discussions. The Government were originally far from keen and sought to exclude people with learning difficulties from the Bill. They eventually changed their mind without a 12-month trial, so why is that not possible for disabled people beyond the age of 65?
Mr. Bowis: It is not true that we were opposed to including people with learning disability. In consultation, we put forward an option that we should include them, but they were not in the first proposition, which came from people of working age who were physically disabled. All the pressure came from that quarter so we said, "Fair enough. We will start with you." As a result of that comparatively small add-on of, potentially, 4,000 people or families, we felt able to include those with physical and learning disabilities in the first wave. That 4,000 is quite different from the potential 700,000 people or families should we take the proposal a stage further.
Mr. Alfred Morris: The Minister spoke of his consultation with the voluntary organisations. How many of them wanted the exclusion of people over the age of retirement?
Mr. Bowis: It is interesting to note that many of the schemes now in operation originally excluded people over the age of retirement. Some lifted that exclusion once the scheme was up and running. We have learnt a lesson from those schemes.
Among the voluntary groups, everyone agrees that there should be phasing, but no single preferred route has been suggested as to how that should be done. It is
perfectly fair to say to the right hon. Member for Wythenshawe that I accept that, in all honesty, those groups would prefer phasing not to be exercised on an age basis. Those voluntary organisations agreed that there should be phasing, however, and I asked them how to go about it. A lot of ideas were put forward, but no single, preferred option. I have mentioned some of those ideas that would cause too many anomalies and unfairnesses.
Mr. Heppell:
I must take exception to the idea that everyone agrees with phasing. The Minister referred to the views of those at the sharp edge of social services. I have the comments of those at the sharp edge in my constituency, including the head of health and disability policy in the social services department of Nottinghamshire county council. That briefing does not talk about phasing, but states:
"This Bill is generally welcomed (although there are some reservations)"
because it puts an end to third-party involvement. It also expressed concern
"that the recommendation is likely to be piloted for people under 65 only . . . In Nottinghamshire, we currently fund 128 schemes where people wish to administer their own care support, of which 78"--
well over half--
"are over 65."
That briefing continues:
"In short"--
Madam Deputy Speaker:
Order. This is becoming a long intervention. It would be better if the hon. Gentleman sought to catch my eye a little later.
Mr. Bowis: I am glad that the hon. Gentleman's authority welcomes the proposal. I believe that I noted two errors in what it perceives the measure to be when he read out the briefing paper. Should he refer to that document later, I am sure that we could discuss it in more detail.
Mr. Thurnham: The Minister has been extremely generous in giving way. He spoke about consulting local authorities that have had experience of running schemes. I am having some difficulty in understanding exactly what problems he has in mind, because I have a copy of the response from Avon social services. It makes it clear that it has not been swamped with requests and has, so far, just been contacted by 50 people who want to take advantage of the scheme. It feels that the Government are being "excessively cautious" and it states:
- "To set an age limit of under 65 years is ageist and again over-cautious."
Mr. Bowis: I am grateful to my hon. Friend for that information. I hope that we are being responsibly cautious, but cautious only in the sense that we want to set a responsible pace for implementation. I know that my hon. Friend also wants that. I shall deal with my hon. Friend's specific point once I have made some progress.
We are discussing a sensitive matter, and it would not take many examples of people failing to cope with managing the money, being abused by a cowboy operator, or being taken advantage of by an unscrupulous neighbour for the tabloid presses to run and the news cameras to roll and for blame to be put on Parliament for letting that happen without due care and attention.
We have heard, of course, that we should be reassured by the fact that schemes have been around for 14 years. That is true, but in only one county--Hampshire. I am not aware of any others that have anything approaching that length of experience. Most of those of which we are aware have been set up only in the past few years, and most are, and have been, extremely small.
My officials visited Hampshire last summer and even there just 260 clients were using the scheme, compared to the total of more than 9,000 households receiving support from social services home care in that county. It is by far the largest scheme; most others have up to 50 clients--the one I saw the other day had 40--and many are making payments to just a handful of people. Some have an age limit. Other schemes, including that in Hampshire, have had one in the past but have now removed it. Whether there is no age limit, the majority of clients are, nevertheless, under 65.
I am not suggesting for one minute that there are not valuable lessons to be learned from those schemes, but we must not exaggerate their importance. My hon. Friend the Member for Bolton, North-East should note that the research by the Policy Studies Institute found 48 local authorities were operating some form of scheme; 34 which were not; and a further 46 that did not respond to that survey. Clearly, many local authorities have no experience on which to draw. Most authorities that have schemes are not administering the payments. The arrangements that they have made to comply with the current law may give them some experience that may be relevant when they come to make direct payments themselves, but I suspect even then that there will be lessons to learn. There are therefore good reasons for treading carefully but positively.
The new power to offer direct payments will apply to any community care service with the exception of permanent residential care. There is no lower or upper threshold for the value of services somebody must be assessed as needing before he can be considered for direct payments. No non-residential services are excluded. The power would be available throughout the United Kingdom. We estimate that the numbers in the first wave to be around 40,000. A subsequent wave, should it include all those over 65, would increase the numbers to around 700,000.
I appreciate, of course, that by no means all the people in either of those categories would be able to manage direct payments, or, indeed, wish to do so. Equally, there will be some people currently paying for their own direct services who might seek access to the schemes.
What we are proposing is that all disabled people under the age of 65 who are willing and able, with help if necessary, to manage direct payments should be eligible for them from the start: that is to say, all disabled people whether they have physical disabilities, sensory disabilities or learning disabilities or whether they are disabled by mental or other forms of illness, including HIV and AIDS or any combination of disabilities.
The numbers may turn out to be quite small, as forecast by many people, but I ask my hon. Friend the Member for Bolton, North-East to look carefully at the report of Policy Studies Institute, which concluded that current demand is restrained by lack of awareness and uncertainty about the legal status of payments schemes. The Bill will change both those factors. The report also found that two thirds of people in the study who were receiving services were unaware of the existence of a local payment scheme. When they were told that such a scheme existed, just over half expressed an interest in using it.
We cannot be certain therefore that demand will remain at current low levels once the Bill is implemented. I do not see that as a threat. I see it as an encouraging sign that the legislation will benefit a larger number of people than we may have supposed. I see it, however, as an overwhelming argument for treading steadily at a phased rate of implementation.
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