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Danny Alexander: I agree very much with what the hon. Lady is saying about the importance of individual budgets. Does she agree that, for those budgets to be truly effective, the full range of services has to be available at a local level, so that the budgets can be used to obtain the services needed? A number of Members have referred today to the inadequacy of services in certain areas; unless they are adequate, the individual budgets cannot be fully effective.
Mrs. Humble: The hon. Gentleman makes an interesting point. We need to think outside the box, instead of simply focusing on the services currently provided, and to enable providers to come in with new services and to be responsive to the requests of individuals. In fact, that has already been happening in some parts of the country. For example, Lancashire's vibrant and enthusiastic private sector has responded to changes in legislation and in service provision over the years. There are difficulties, however. Funding often comes from the local authority, so in trying to be innovative, the private sector has to rely on traditional local authority purchasing patterns. However, as individuals start purchasing their own services, there will be opportunities for outside providers to be responsive. I am an optimistI am looking forward to these changes.
Perhaps I can help my hon. Friend on this point. It is perfectly possible to buy a bath board for £12.99 from Argos, which suggests that many disabled people do not need a bespoke service. Sometimes, only very simple things are needed that can be bought on the open market. Having their own funding stream would
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enable disabled people to go out and buy such things, thereby giving them the advantage that I already enjoy, as someone in work with a reasonable salary. We need to provide the flexibility to enable those on benefit to have the same level of choice that everyone in this Chamber takes for granted.
Mrs. Humble: My hon. Friend is absolutely right; indeed, an increasing number of organisations sell community care products in their catalogues. Giving money to the individual will open up great new possibilities for them. As I said earlier, I am looking forward to the results of the pilots and the subsequent roll-out to other parts of the country.
I come now to three issues: children, learning disabilities and advocacy services. I endorse many of the remarks that colleagues made about the particular needs of children with disability, but we should consider an issue that has not been touched on thus far: the new Childcare Bill. For the first time, the Government have produced a strategic document for child care provision, but it also recognises the very special needs of families with children with disability, and their difficulties in accessing suitable child care.
The Childcare Bill focuses on providing child care to enable parents to go out to work, but in some instances child care is an end in itself for the childthey learn to socialise, for example. If we are to educate the community about the needs of disabled people, we should start with children and ensure that disabled children mix with other children from the very earliest age, and that their parents get used to such contact. I look forward to the Bill providing more child care for disabled children and support for their families.
The question of quality has come up in the debate on the Childcare Bill. We must ensure that the services provided are of the highest possible quality, which means that staff providing child care are trained to the highest level so that they understand the special needs of children with disability.
I also pay tribute to the Government for abolishing the means test for families with a disabled child who apply for the disabled facilities grant. Families have told me that they are thrilled about that, although often they have worked through the old system and are pleased that others will not have to go through what they went through. People have also asked about the cap on capital expenditure and, given that some alterations on houses are major, that needs to be looked at again.
Other problems arise as children grow up. Thankfully, more children who are born with profound disabilities now live longer, but that can cause difficulties in the family home. Altering the house once is not always the end of the matter, as other alterations may need to be made as the young person grows older.
I am sure that the whole debate could be devoted to disabled children, so I shall merely say to my hon. Friend the Minister that more respite care and specialist equipment should be made available, and that parents need to have access to more support and advice. Above all, we should listen to the voice of the child. Usually, that is the most instructive approach: children know what they want, but sometimes their voices are not heard.
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I move on now to people with learning disabilities. Recently, I had the pleasure of speaking at a conference for learning disabled representatives on the learning disabilities partnership boards. The representatives came from across the whole of Lancashire, and they were very pleased at last to be part of the policy-making process determining the services available for them. However, they told me about some of their concerns, and emphasised that they need support if they are to enhance their life chances.
Too often, the eligibility criteria applied by social services departments are so tight that people with moderate learning disabilities find it very difficult to access services. I spoke to one man at the conference who had moderate learning disabilities. He was a member of the partnership board, but he told me that he could not get the help with transport that would allow him to get to meetings. If we are to involve people with disability in the decision-making process, we must help them and look at whether they are being excluded by the eligibility criteria set by local authorities.
I used to be a county councillor, so I fully understand the pressure on local government budgets. A line has to be drawn somewhere, but people with learning disabilities can sometimes feel disadvantaged and we need to listen to what they have to say.
Another matter to come up at that conference was that, sadly, people too often still see the disability rather than the individual. I am sure that all hon. Members are aware of that, but I was surprised to hear how often it happens across a range of services, including health and education. I am pleased to say that it is less common in social services, as I hope that people with disabilities would be seen as individuals at least by those who work in social care. Educating people to see the individual and not the disability is a major task, especially when it comes to people with learning disabilities.
I was very pleased that the Mental Capacity Act 2005 enshrined in law the fact that we are all able to make decisions, and that it must never be assumed that someone is incapable of doing so. Whether or not a person is capable of making a particular decision must be tested. I meet people with learning disabilities and they are often capable of making a whole series of decisions. There may be a complex financial matter that they cannot deal with, but many people without learning disabilities have difficulties with complex financial matters.
All too often when I visit a home in the community for a group of people with learning disabilities, the care staffI am sure with the best of intentionsmake decisions on their behalf instead of asking them what they think, what the care staff can get for them and what they want out of something. Staff will require a lot of training on the Mental Health Act so that they understand that they can no longer do that. They have to carry out functional tests and respect the decisions of people with learning difficulties.
People fail to listen to those with disabilities, so it is important that there are independent advocacy services to speak on their behalf. I have the grand title of president of the Blackpool advocacy. It is an excellent organisation that provides information, support and representation to enable individuals to access services. Advocates accompany people to meetings and,
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importantly, explain the procedures and processes to them and what they will find. Sometimes they make sure that there is appropriate access to the meeting. Sadly, it still sometimes happens when people with a disability are invited to a meeting that either they cannot get in or, if they are hearing impaired, there is not a loop system, or, if they are visually impaired, there is not the necessary equipment for them to read documents. An advocacy service can help them throughout all that, ensure that information is presented in the right manner and that the setting takes into account the particular disability of the individual.
Recently, the community learning disability nurse made a presentation to the Blackpool advocacy. She highlighted some of the barriers for people with learning disabilities to access services. They can forget appointments, are often afraid to go to the doctor, dentist or nurse and can have transport problems or communication problems. In those circumstances, sometimes they do not attend the appointments or meetings that they should, or cannot communicate their concerns. In those cases, an advocacy service is essential. Certainly in Blackpool, the advocacy service also provides support to children. Children's advocacy is important for some of the reasons that I outlined earlier. Sometimes the wishes of a disabled child are not the same as those of the parent or those of the professional. Again, it is important that the voice of the child is listened to. An advocacy service can provide support and ensure that that happens.
The Children's Society runs a disability advocacy project in London. It, too, gets positive feedback from the young people who use its services. Of course there are no guarantees of good advocacy services around the country. When I describe to colleagues what happens in Blackpool, they say that that does not happen in their locality. I urge the Minister to consider establishing a national framework for advocacy services. There is a national organisation for advocacy services, but the services have been set up individually around the country, have different funding mechanisms and provide different services.
The Mental Capacity Act 2005 offered an opportunity to promote advocacy services and I argued the case for them during its passage. The Government have acknowledged the need for legislation on advocacy services for people who lack capacity and have no family or friends. I want advocacy services to be provided much more widely, although I welcome the Government's consultation in relation to the Act.
National standards are being considered, under the legislation, to improve the life chances of people with learning disabilities in a broader setting. I urge the Government to put independent advocacy services on a much more secure financial footing, and to give them a statutory base. Sadly, the chief executive of Blackpool Advocacy, like many chief executives of charities, spends most of her time chasing funding instead of delivering vital services.
Direct payments have been implemented. Individual budgets have been developed. The health and social care White Paper has made proposals to improve preventive services. The Equality Bill will set up a new commission and we already have the Human Rights Act 1998, the Mental Capacity Act and the improving life chances strategy. Together, all those measures provide an
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excellent framework in which to develop and improve services for people with disability, to enhance their future life chances.
The Care Standards Act 2000 has not been mentioned so far. It set a framework for service quality and introduced three important bodies that can help us in our campaign to improve life chances. The Commission for Social Care Inspection not only supervises and inspects services, but produces interesting discussion papers on their improvement. Recently, it issued a document on brokerage schemes, which help people with learning disabilities access individual budgets. The Social Care Institute for Excellence has amassed much excellent information and data about services, about what is available and what should be available, which is useful for Members of Parliament and service users. It provides excellent support for the all-party group on social care. Its research can be used to enhance services and to help people work out what should be provided in their area.
The third organisation is the General Social Care Council. Earlier, I drew attention to the role of social care staff who support people with disability. They are an important group and we should acknowledge the special role of social workers. We are all asking for improvements in the process for assessing children, carers and adults with disability, but the social workers who undertake that vital work need support and recognition of their position. Their job is often difficult; they tread the mine field of the competingsometimes conflictinginterests of the disabled person, their family, their friends and other people who offer them advice and support.
Many care workers provide care in individuals' homes or residential settings. Sadly, all too often they are not very well paid. People who are trying to recruit high quality care workers are competing with supermarkets, which pay more. There is an issue about raising the profile of the social care work force and making such employment a real choice for individuals. At the end of the day, such people can do so much good in supporting people with disability and providing them with the right level of care.
"Where, after all, do universal human rights begin? In small places, close to homeso close and so small that they cannot be seen on any map of the world. Yet they are the world of the individual person".
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