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Jim Sheridan (West Renfrewshire) (Lab): It is right that during this debate we focus on the individuals and the financial implications for them, but does my right hon. Friend also accept that organisations such as Macmillan Cancer Relief struggle day in, day out to supply their service? It is now time for the Government to consider tax exemptions for such organisations.

Mr. Clarke: I am grateful to my hon. Friend. I am sure that the Chancellor and his colleagues in the Treasury will take his important point on board.

I want cancer victims to have automatic representation to tribunals. Again, the best people to do that would be welfare rights officers. I want an end to cancer patients and their families worrying about coping, and I trust that our debate has made a helpful contribution to that.

I conclude with a quote from Mr. Forth, who was interviewed for the Northern Ireland report. He said:

"People with cancer shouldn't have to fight for benefits, when all effort is in fighting cancer itself."

7.45 pm

The Parliamentary Under-Secretary of State for Work and Pensions (Maria Eagle): I begin by congratulating my right hon. Friend the Member for Coatbridge and Chryston (Mr. Clarke) on securing the debate and on putting his points in way that we have all appreciated. I also pass on my thanks and admiration to Ann Muir, Bill Wright and other constituents of my right hon. Friend who run Lanarkshire Speakeasy. I do not believe that any Minister who deals with these issues could find any way of replacing the sort of work that Ann and Bill do in their local communities. We have national systems, but the sort of work done by volunteers in local communities is irreplaceable. I pass on my thanks for the work that they do. They have also given my right hon. Friend valuable information to help with his preparation for the debate. There is no better way for Members to find out what it is really like than to talk to people in their own constituencies.

Laryngectomy is indeed the severe and radical procedure that my right hon. Friend has graphically illustrated. There is no doubt—the Department does not dispute it—that many of those who have undergone it will be eligible for disability living allowance. One of the consequences of laryngectomy is total loss of speech,
 
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although voice production can, as my right hon. Friend and my hon. Friend the Member for Monmouth (Mr. Edwards) explained, be reacquired.

Disability living allowance is a tax-free, non-contributory and non-means-tested benefit, the purpose of which is to provide a contribution towards the extra costs faced by severely disabled people as a result of their disabilities. Entitlement to the allowance, as my right hon. Friend is well aware, is not linked to a specific diagnosis of particular disabling conditions. It is not a medicalised benefit in that sense. It is based on the requirements of people with disabling conditions for additional care or mobility help, so it is a very individually based benefit, depending on the effects of a disabling condition rather than its diagnosis. However, there is no doubt about the fact that people who have undergone laryngectomy qualify for the benefit on the same basis as any other disabled people—in other words, they have to meet the entitlement conditions.

DLA has a care component and a mobility component, and the care component is most relevant to the particular condition. The care component has three rates. There is a higher rate for people who are so physically or mentally disabled that they require from another person any of the following: frequent attention throughout the day in connection with their bodily functions; continual supervision throughout the day in order to avoid substantial danger to themselves or others; prolonged or repeated attention at night in connection with their bodily functions; or watching over for a prolonged period or at frequent intervals at night in order to avoid substantial danger to themselves or others. There is a middle rate for people who have those needs during the day or at night, and a lower rate for people who require attention in connection with their bodily functions for a significant portion of the day, or who cannot prepare a cooked main meal for themselves if they have the ingredients.

Whether or not those entitlement conditions are met on individual claims is determined by decision makers on the basis of the facts of the case. The forms to which my right hon. Friend drew attention are there by way of self-reporting packs, which are designed to enable our decision makers to understand the particular needs of any individual. I recognise and have frequently said that forms of the length and complexity illustrated by my right hon. Friend can undoubtedly prove a barrier to people applying. However, help is available. It is not the case that our staff will not assist. Our increasingly sophisticated information technology, which the Department has recently acquired, enables staff to present individuals with a much shorter form, based on their individual needs as determined by questions from staff to elicit which sections of the form are most relevant. That is usually done through telephone helplines, but I take on board my right hon. Friend's point that those who have had laryngectomies cannot be expected to answer reams of questions on the phone. It would not be comfortable or indeed possible for many of them to do so.

The Department is committed to making its services accessible. Indeed, we are required to do so under the Disability Discrimination Act 1995. If clients have difficulty with communication, as many people with laryngectomies clearly do, we will make appropriate arrangements to ensure that they can access our services
 
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properly. Those arrangements may include home visits or other methods, but it is not in doubt that the Department is committed to ensuring that everybody who might benefit from our services has access to them. I would be more than happy to discuss with my right hon. Friend's constituents the ways in which that can be achieved in their area or how we could do it better. The point that my right hon. Friend made about access is very important. The last thing we want is for people to worry about how they can let us know about their requirements and we have got much better at providing an individual service tailored to those who wish to apply to us.

However, not everybody who applies will succeed. People's needs vary, not only based on their diagnosis but based on other factors. I am not saying whether those who have had laryngectomies are likely to succeed or fail, because applications will be decided on individual assessments by decision makers. My right hon. Friend is correct to say that staff in the Department—the decisions makers—have access to doctors and advice to ensure that they sufficiently understand the implications of laryngectomy to make proper decisions about the applications received. The Disability Living Allowance Advisory Board also provides guidance—it was last updated in 1999—that gets across the seriousness of such cases and the care that someone who has had a laryngectomy may need.

I hope that there is no excuse for our decision makers getting decisions wrong in a vast array of cases. I would expect them to get the decisions right more often than they get them wrong. However, I take on board my right hon. Friend's point that it is important that clients themselves and those who wish to apply can do so in any way that they find comfortable and helpful, and it is certainly our intention to ensure that they can do so.

To respond to some of my right hon. Friend's other points about bringing together agencies and joined-up government, all of us in government aspire to making central Government services more accessible locally and more meaningful to the individuals who are trying to gain access to them. As he made it clear, they have enough difficulties in their lives, in dealing with laryngectomy and the health implications of living with cancer, so they should not have to negotiate the obstacle course that they can face in their dealings with various Departments and local government—and who knows
 
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which other type of local public service they can come across? We do our best to ensure that such things are improved.

I do not pretend that we have achieved perfection—no hon. Member would believe me if I tried to suggest that we had—but, none the less, we recognise that it is important that our services exist for the benefit not of my staff or anyone else's staff in a different Department, but of our customers and clients. We are for ever trying to find new ways to ensure that people such as those to whom my right hon. Friend has drawn our attention today have every opportunity to get what they need from us. We are committed to ensuring that those who are entitled to such benefits receive them speedily and in a way that is relevant to them.

I agree with my right hon. Friend that more information is required. We can always do better in that respect. There is often fear among disabled people and those who have acquired a disability or who are living with cancer or another serious condition, and they want to concentrate on getting better and on living with their condition, not on trying to work out the finances. We understand that we always need better information about where individuals can find the relevant help.

On some of my right hon. Friend's other points—I realise that time is escaping us—I am more than happy to write to him to ensure that I deal with any issue that I have not covered. I assure him that those who are living with laryngectomy have just as much entitlement to disability living allowance as anyone else and that we are not just administrators of the benefit. We are committed to ensuring that those who are entitled can gain access to their entitlement.

My right hon. Friend drew the attention of the House to the forms that are used, and we are committed to reforming the way in which those forms work in a way that helps those who may have an entitlement to claim properly and to pass the information on to us. We are more than happy, where necessary—it clearly is necessary in some cases—to make proper arrangements to enable people to complete those forms in a way that is comfortable and useful to them. May I finish by saying how grateful I am to my right hon. Friend for raising this important matter on the Adjournment today?

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