---

20 Oct 2004 : Column 297WH—continued

Disability Living Allowance

4.7 pm

Mr. Martin Caton (Gower) (Lab): I know that my hon. Friend the Minister is aware of the "Mobilise" campaign being run by Help the Aged and a coalition of more than 20 organisations that work in the fields of disability and ageing. The central objective of that campaign, which already has the support of 230 Members of the House, is to remove the upper age limit of 65 for claiming disability living allowance. At present, if someone becomes disabled after that age, they cannot get DLA. They can claim attendance allowance, but that benefit is much more limited. Attendance allowance has no mobility component, so there is no financial help with mobility costs, no access to the Motability scheme, no access to the specialised vehicle fund and no exemption from vehicle excise duty.

I support the "Mobilise" campaign. I believe that the current rules discriminate against older people who become disabled after 65. The rules stand in the way of that group of people living as independent, healthy and active lives as they otherwise might. In the name of justice and equality, I hope that the Government will look again at the upper age limit for that benefit.

This afternoon, however, I want to focus on the other end of the spectrum—the lower age limit for eligibility for the mobility component of DLA, as it affects some severely disabled young children. Before I do so, however, I want to pay tribute to what the Government have already done to help disabled people to live fuller lives. For children, that includes things such as the increases in the disabled child premium, the introduction of the disabled income guarantee, and the disabled and enhanced disabled child element in the child tax credit. In April 2001, the Government also reduced the age of eligibility for the mobility component of the DLA from five years to three years. That decision—taken on medical grounds—was very welcome.

Today, I urge my hon. Friend the Minister to go that bit further for some children under the age of three. To make my case, I want to tell her about the experience of a family in my constituency, Mr. and Mrs. Owen—Andrew and Alison—and their daughter, Seren. Seren was born on 14 April 2002 by caesarean section in Singleton hospital, Swansea. She was in a very poor way, and Alison and Andrew were warned after 18 hours that she was likely to die. The only treatment that could save her was at Glenfield hospital in Leicester.

A Sea King helicopter was sent to Leicester for necessary equipment and a nurse, and then to Swansea for Seren. They were told that they should name the child, in case she did not survive. As it was night when she was picked up and taken up into the sky, they called her Seren, which means star in the Welsh language. Seren was and is a fighter, and she lived, and returned to Swansea. When she was 12 days old, her parents were told that she had cerebral palsy. In fact, she has quadriplegic cerebral palsy with hypertonia in all four limbs and hypotonia in her torso. She has cerebral visual impairment and some sensory hearing impairment.

Although in her short life so far Seren has received a lot of medical attention and hospital treatment, the good news is that comparatively recent developments in
 
20 Oct 2004 : Column 298WH
 
equipment for children with her sort of condition can mean that operations and other intrusive treatments that would otherwise have been necessary as she grew up can be avoided. Her parents, like all parents, want to give her the best, highest quality of life possible. They have got hold of a range of positioning and seating equipment designed to aid postural management. I have visited the Owen family in their home; I have seen that equipment and lifted, or tried to lift, some of it. It is extremely bulky and some is very heavy.

I want to go through what the Owens need to take with them when they take Seren out for the day, or part of the day, and what they need if they want to take her away for a longer period of time—to visit her grandparents or go on holiday. For a day out in Andrew's Golf car, the first essential is the specialist car seat, which gives total posture support and keeps Seren's spine straight, hopefully helping to remove the need for operations to correct curvature at a later stage. It is extremely heavy; in the family, only Andrew can lift it, and even then it is not good for his health. Living and working arrangements mean that it has to be transferred between vehicles at times.

They also need Seren's special wheelchair for when the family reach their destination. It has been issued by the artificial limb and appliance centre at Rookwood and involves a CAPS II seating system that fits within a Blade Plus wheelchair. That is what they call an aggressive form of seating and support and, as with the car seat, gives the postural management that she needs. It is a solid piece of equipment, which does not fold down like a normal pushchair or even some wheelchairs. In the Golf, it completely fills the boot.

Add the tubes and feeding sets that Seren needs, as well as the normal baby stuff for a child of her age, and there is only room for mum, dad and Seren. If any members of the extended family, especially grandparents, want to accompany them, a second car has to be taken. I cannot help wondering what happens in a family with other, older children and a severely disabled child of less than three years. Are they denied the opportunity of going out as a family at all?

Apart from Alison and Andrew's determination that they should go out as a family and do the things that we all do as families, Seren needs to be transported to different places for her development: for physiotherapy and hydrotherapy, the NCH stepping stones project, occupational therapy, speech therapy and work with her vision impairment teacher.

What happens if Alison and Andrew want to take Seren somewhere and stay overnight, or over several nights? What is needed then? They need all the things that I have mentioned for a day trip, of course, as well as Seren's Jenx standing frame. She needs that because, as she cannot walk or stand, the ball and socket joint in her hips will not develop normally. The standing frame helps compensate for that, again hopefully reducing the likelihood of the need for later, restorative surgery or other treatment. She will also need her R82 Panda hi/lo chair, which is her feeding and social interaction chair. It is a sort of waistcoat design that provides total support of the torso but frees the
 
20 Oct 2004 : Column 299WH
 
arms to reduce tension. That piece of equipment, on its own, also completely fills the boot of the Golf.

Seren cannot yet take all her food by mouth. She receives food overnight through a pump feeding system that involves a stand and pump. That needs to be taken, as do the foods and medicines that she requires. On a longer stay away, Alison and Andrew would want to take the special toys that Seren has, which are designed to aid the development of children with severe learning difficulties. They would like to be able to take Seren's other, more comfortable tumble-form chair, which is made with foam sponge and in which she can spend up to half an hour without harm being done. They would want her "Wedge and Drema" sleep system that keeps her legs separated when she is sleeping, which is also important for her future development.

It is impossible for the Owen family to travel in one car on a visit overnight or longer, at least without leaving beneficial pieces of equipment behind. Fortunately, Alison manages to run another small car, so although they cannot travel as a family, they have the means to get themselves and all of Seren's stuff from A to B. How do families manage when they do not have access to a second vehicle? I suspect that some are largely trapped in their homes.

To add to the difficulties for Seren's family, she has just had Botox injections to loosen her hips. She is supposed to spend parts of her day in a plaster cast—her present cast is removable—but she is due for another series of jabs, after which she will be fitted with a full plaster cast that will not be taken off for some time. Transporting her in a normal family car will again be made more difficult.

The Owens' dream, which they cannot get near to affording, is for a specially adapted, large people-mover vehicle, with any lip on the boot removed, a ramp or lift on the back so that Seren could be wheeled straight in, and room for the other equipment. If the mobility component of DLA, and therefore access to a Motability deal, were available to under-threes such as Seren, the Owen family could have had that since they had first needed it. Through a combination of determination, superb logistical planning and buckets full of love, Alison and Andrew have made sure that Seren has had everything that they could provide that could help her, including getting her out and about.

As Seren will be three next April, the Owens realise that if even if the Government agreed to consider changing the rules now, they would be unlikely to benefit. However, they asked me to raise the issue in the hope that other families can benefit from the help that they did not receive in the first three years of Seren's life.

I first met Seren and her mum towards the end of last year. I visited them during a street surgery that I had organised in their village and neighbouring areas. At that time, they were also being denied a blue badge by the local authority. We managed to get that sorted out, and I wrote to the Minister on the issue that I am raising now—the lower age limit for mobility. In honesty, though, I did not fully understand the extent of the problem, and consequently I did not make anything like as full a case as I should. I concentrated just on the wheelchair and posture-protecting seating issue, when I should also have brought attention to the other items of necessary equipment that I have mentioned this afternoon.
 
20 Oct 2004 : Column 300WH
 

In the responses I received from the Government, the point was made very clearly and logically that entitlement to the mobility component of DLA is based on an

"inability or virtual inability to perform the physical act of walking".

I appreciate that it follows that as children in their first years of life do not walk, or do not walk to get around independently, the benefit is not regarded as appropriate for them. Put simply, for most kids until they are three, they will mostly travel by pushchair. Most kids' pushchairs fold easily, and are light and compact. Most kids do not need standing frames, special chairs, feeding pumps and the other equipment that I have mentioned, when they travel. Seren and some other kids do.

I am not calling for the three-year limit to be completely removed. For many children who are disabled, a normal pushchair or even small wheelchair will be their main means of movement, and they will not require much more equipment than an able-bodied child in their first three years. What I want is the introduction of some flexibility, so that the category of child who needs specialist equipment to travel with them can benefit from the mobility component of DLA. We are talking not about huge numbers or amounts of money from the national Exchequer, but about the possibility of making a huge difference to the lives of families such as Seren's.

4.19 pm

The Parliamentary Under-Secretary of State for Work and Pensions (Maria Eagle) : I begin by congratulating my hon. Friend the Member for Gower (Mr. Caton) on raising such a tremendously important issue. He rather modestly said that he did not make as full a case as he should have when he originally wrote to me. Whatever he feels about his original letter, he has certainly made a full and proper case today.

I start by saying how much we can all appreciate the difficulties that Seren and her family have faced as a result of her disabilities. This debate gives me an opportunity to explain the basis of entitlement to the mobility component of disability living allowance. I understand my hon. Friend's points, and I thank him for the balanced way in which he set out his case and explained his understanding of the Government's position on the benefit as a whole.

The DLA provides a contribution towards disability-related extra costs for people who are severely disabled early or relatively early in life. That is the raison d'être of the benefit, which focuses on severely disabled people because they have reduced opportunities to work, earn and save, as compared with people for whom the onset of disability comes later in life and, perhaps, with the increasing frailty of old age.

There is a care component and a mobility component to the DLA, as my hon. Friend explained. In broad terms, entitlement to the care component depends on the effect that physical and/or mental disability has on a person's need for personal care from someone else. Entitlement to the higher-rate mobility component depends on whether a person is so physically disabled that they are unable or virtually unable to walk. Entitlement to the lower-rate mobility component depends on whether a person needs supervision or
 
20 Oct 2004 : Column 301WH
 
guidance from someone else when walking out of doors on unfamiliar routes because of a physical and/or mental disability. Those are the entitlement conditions.

Entitlement is not, therefore, based on specific medical conditions or particular physical conditions. It is based on the effects that a disability has on the personal care needs of each individual who claims it and on their ability to walk. For the DLA care component in cases involving children younger than 16, the need for personal care must be substantially in excess of that normally required by a child of the same age. That is the law. We recognise that some very young disabled children need substantially more care than non-disabled children. That is why there is no age limit at all on entitlement to the care component. However, entitlement to the higher-rate mobility component depends primarily on whether a severely disabled person is unable to perform the physical act of walking.

Identifying the likelihood of walking difficulties arising at some point in the future is not enough for entitlement. Decision makers who make such decisions on behalf of the Secretary of State must consider the person's ability to walk out of doors at the time a claim is made. They cannot anticipate later problems, but must consider the entitlement conditions on the date that the claim is made. Decision makers must take account of the distance over which, speed at which and length of time or manner in which a physically disabled person can make progress on foot without severe discomfort. Although the vast majority of children will be able to walk by the age of three or even two and a half, many will be unable to walk significant distances until the age of four. I describe such matters not to sound callous, but simply to set out what the law says and to remind hon. Members that the law must be applied equally in every case.

In the instance that my hon. Friend raised, we can all see that Seren has had significant difficulties, and will continue to do so. Given that it is clear that she will not be able to walk when she turns three, it is perfectly understandable for my hon. Friend to ask whether it does not therefore also seem clear that she ought to have the help that the benefit is meant to convey as early as possible. We can all understand the logic of that argument.

We have, fairly recently, considered carefully at what age the mobility component of the DLA should become available. As a result of that, we extended the higher rate to severely disabled three and four-year olds who are virtually unable to walk, with effect from 9 April 2001. The decision to lower the age from five to three was based on the views of the Government's medical advisers that three years is the earliest age at which it could be reasonably established that inability or virtual inability to walk is the result of physical disability rather than late, normal development.

I do not say on the basis of that that Seren might have late, normal development—that is clearly not the case. However, we must of course have rules that apply across the board, fairly and sensibly. At any one time, the change—reducing the age at which the DLA higher-rate mobility component and mobility components in general become payable—helps around 7,000 families
 
20 Oct 2004 : Column 302WH
 
with three or four-year-olds who either cannot walk because of their severe disability or have very limited walking ability.

I understand the issues that the Owen family face. I appreciate that they have problems transporting both their daughter and the necessary but bulky equipment that my hon. Friend described, including the heavy wheelchair. I am pleased that Seren gets the higher-rate care component of the DLA, which provides much-needed help to the family. However, I am powerless to intervene in individual awards—I know that my hon. Friend realises that but I want to make it clear. Awards can be made only if the entitlement conditions are met. I have no scope to waive those conditions and allow extra statutory payments or discretionary payments, however difficult the case may be.

Nevertheless, we recognise that the costs associated with disabled children can put extra pressure on families with low incomes. That is why we have introduced measures to improve financial support for families with disabled children. For example, we increased the additional elements for disabled children in the income-related benefits and tax credits since April 2001 by £17.40 above the normal cost of living increases to the current rate of £42.49 a week. We introduced the disability income guarantee in April 2001, through the enhanced disability premium. Families with severely disabled children benefit from an extra £17.08 in addition to the disabled child element or premium for each disabled child in their child tax credit or income-related benefit assessment, so additional help is available.

There is also a range of measures to help the least well-off families with disabled children. For example, help is available from the national health service with fares to hospital, and from the local authority social services with transport. A fund called the family fund may offer an avenue of help for exceptional cases such as this one. It can help with transport costs and may be able to give a grant if a child needs help getting out and about but does not get the higher-rate mobility component of the DLA. It has no waiting list for assistance, but the normal time taken from the application for such a grant to payment being made is about three months. In cases of urgent need, it may be able to work more quickly—applications can be fast-tracked and processed quicker. It buys vehicles to transport young children, but decisions made about grants from the family fund are a matter for that organisation, and I cannot promise that an application would be successful.

My hon. Friend is aware, as we all are, that Seren will be eligible to claim the higher-rate mobility component from her third birthday on 14 April 2005. It is possible for her family to apply for that up to three months in advance of her birthday to try to ensure that the award and the additional help is available to the family as soon as possible. I do not make the decisions, but judging from what my hon. Friend has said, I would be surprised if Seren was not eligible.

The specialised vehicle fund, which Motability uses to provide adapted vehicles of the sort that my hon. Friend suggested was the Owen family's dream, does not have a waiting list for applications. I would have high hopes that if and when Seren receives her higher-rate mobility component award—I hope that the family will apply three months before her birthday—the additional help
 
20 Oct 2004 : Column 303WH
 
offered by that award, by Motability and by the specialised vehicle fund could be put in place as soon as possible.

I also note that my hon. Friend referred to the "Mobilise" campaign and early-day motion 953. I have noticed that a significant number of hon. Members have taken a similar view to that expressed by my hon. Friend and have signed the early-day motion on the subject of people aged over-65 being denied access to the mobility components of the DLA in addition to the care components that they can get by applying for attendance allowance. My hon. Friend the Member for Kingswood (Mr. Berry) tabled that early-day motion on 31 March and I recognise the undoubted level of concern among hon. Members who have signed it.

The campaign was launched in April by Help the Aged with the support of a range of other charities and interested groups. Its aim was to extend the provisions that were introduced to help those severely disabled people who were disabled early in life and to extend the mobility components beyond age 65. The key message of the campaign is that the current benefit arrangements are unjust and that the upper limit of 65 for claiming disability living allowance is discriminatory.

While I recognise the genuine concerns expressed by hon. Members and supporters of the "Mobilise" campaign, I do not accept that interpretation of the provisions. It is normal and sensible for pensions and benefit schemes to contain different provisions for people at different stages of their lives. Child benefit is not paid to adults, and pensions are not paid to children. It is normal for social security schemes to contain age-related rules. Government resources are not infinite and it is essential for help to be focused where it is most needed and most effective, in ways that reflect varying priorities and circumstances.

For example, we provide child benefit only for people with children, working tax credit for people of working age and state pensions to those over state retirement age.
 
20 Oct 2004 : Column 304WH
 
In many cases, people disabled after age 65 will have had fulfilling lives in work, with opportunities to earn and save, unlike those who have been disabled early in life. The aim of the benefit is to give additional help to those experiencing the onset of disability at an early stage. They have less chance to work and save, although we are making some inroads into that situation. For that reason, once awarded, disability living allowance can continue to be paid after age 65 if the conditions of entitlement continue to be met.

We believe that we are right to focus the most help on those disabled earlier in life, for the reasons that I have set out. Therefore, we currently have no proposals to change the rules. Of course, I understand the concerns that hon. Members have expressed. The mobility component of the DLA is part of the extra assistance that we focus on disabled people of working age, who face significantly more difficulties than those who have worked all their lives and develop mobility problems after the age of 65.

The DLA age 65 rule, if I can call it that, gives effect to that policy. It was originally set out in the legislation that established the benefits, and the preceding White Paper, and it has been endorsed by successive Governments. The purpose behind the benefits has not changed and the rules in respect of age have not changed. Nor, I am afraid to say to my hon. Friend, who raised the issue at the beginning of his speech, has the policy of the Government changed. I hope that, for the reasons I have outlined, my hon. Friend will understand the policy issue, even if he does not agree with it, and that the Owen family will apply as soon as possible—three months in advance of Seren's birthday—for the higher mobility component of the DLA. I am sure that they will do so, given the well-documented organisation that they are clearly capable of. I am assured that the specialised vehicle fund can be called into play very quickly thereafter. We all hope that Seren and her family will then have available a vehicle that will make their lives easier.
 
20 Oct 2004 : Column 303WH
 

 
20 Oct 2004 : Column 305WH
 

---