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22 July 2008 : Column 201WHcontinued
On aids and adaptations, I very much welcome the good number of changes that were made earlier this year, which I am sure my hon. Friend the Minister will set out. They should ensure that more money is provided for the substantial adaptations that are sometimes needed by families with disabled children, and that those adaptations should not be subject to means-testing. The increase in funding is also welcome, although I add the reminder that it should be provided for people in private sector housing, which involves different funding streams, and not just used to upgrade social housing. It is
important that access to the garden is included in the adaptation regime, as that is important for disabled children as well as other children.
However, there still seem to be logjams, especially in getting assessments from occupational therapists and recognition of the details of the adaptations that families need.
Mr. Andrew Smith (Oxford, East) (Lab): I congratulate my hon. Friend on securing this important debate. She is making a powerful contribution. Does she agree that one real difficulty is peoples ability to access the information that they need so that they know what they are entitled to? It was striking to read in the Joseph Rowntree Foundations research:
Most families had already moved at least once in response to their childs needs or their needs as carers. The vast majority had made those moves without any professional advice or assistance.
Is there not still too much of a maze for those who need help?
Ms Keeble: I agree completely. As I shall explain later, it is important that there is more joined-up working between those who deal with disabled children and those who deal with childrens policy, so that childrens policy and housing policy are co-ordinated. Members such as me who represent constituencies with two-tier local government know of the difficulties of two local authorities trying to work together, sometimes across different cultures. There is not always enough thought about the housing component of childrens needs.
Every Disabled Child Matters recognised housing, and homelessness in particular, as the No. 1 risk factor for children. However, that was not carried forward into tough recommendations on housing policy. Disabled children probably get the worst end of the bargain. I agree completely with my right hon. Friends point. Getting different agencies to work together to provide different aids and adaptations gives families profound difficulty. Perhaps there is a cultural gap between families thinking about how they want to live and bureaucracys attempts to fit that into its procedures.
One family in my constituency was living in quite a small three-bedroomed house. There were three children, one of whom was disabled and who, as he grew older, needed a wheelchair. As he grew larger, it was increasingly difficult to get him up the stairs to the only bathroom. The family also needed an extension to his sitting room to cope with the extra space needed in living areas for a child with a wheelchair, which is different from children sitting on a sofa. It was distressing for the parents, because of their difficulties in getting their son upstairs for a bath, as well as for the other children, who loved their brother dearly, cared for him and were wonderful to him but had difficulty playing with him in such restricted space.
In another case, a woman whose child had mobility problems came to see me. She lived in a second-floor flat without a lift, and had managed to carry the child up and down the stairs until the child got heavier when it became more difficult. The final straw was when the child was placed in extensive plaster casts for a long period, which made it impossible for the mother to get the child up and down the stairs.
In looking for a way forward, I point to the recommendations in Every Disabled Child Matters. I shall pick out a few of them for my hon. Friend the Minister to respond to. The report recommended that the Department for Children, Schools and Families and the Department for Communities and Local Government should issue guidance that adaptations for children should facilitate inclusion in family lifethat might sound obvious, but it does not necessarily work that wayso that it is not possible to argue, for example, that the familys dining space should be used for the space needed for adaptation. Families with disabled children should not have to choose between space for the disability or family life; they must be able to have both. That might mean sometimes considering home extensions rather than just using one of the downstairs living rooms for space for an adaptation.
Annette Brooke (Mid-Dorset and North Poole) (LD): I congratulate the hon. Lady on securing this important debate, and I concur with her about the difficulties with two-tier authorities. Does she agree that some problems are made worse by the fact that housing is not pooled within strategic partnerships? During the passage of the Children Act 2004, it was presumed that local authorities would cover housing, but that is not the case with housing trust arms length housing. In my experience, it is more difficult to come up with innovative ideas such as extensions, and it is only when there is a catalyst, such as an MP, that things can be moved along.
Ms Keeble: I agree completely. There may also be a perception that families with disabled children can get by, which means that the right standards are not set for the quality of the space and accommodation that they should have. The hon. Lady is right: trying to chase things through arms length arrangements and joint working is exceptionally difficult.
Mr. Philip Hollobone (Kettering) (Con): Does the hon. Lady agree that one of the main problems is that there are not enough bungalows, whether in the public or private sector? If there were more bungalows, it would help a lot of disabled children as well as a lot of elderly people.
Ms Keeble: Yes. I do not know how many bungalows or one-storey houses there are. We need to ensure that housing is built so as to allow the installation of technology that enables people to get about. The hon. Gentlemans constituency is close to mine. We have some good local examples of housing built to a high standard that meets peoples needs through making good use of new technology.
Will my hon. Friend the Minister consider removing completely the cap on the disabled facilities grant for children? That would mean removing even the £30,000 for mandatory grants, bearing in mind the fact that adaptations for children are often made for a whole lifetime in order to avoid the need for families with disabled children to move house, as my right hon. Friend the Member for Oxford, East (Mr. Smith) mentioned.
On inter-council working, there should be a named officer in local authorities to deal with disabled childrens housing, including access to advice and information for
parents of disabled children, transparency in housing allocations and adapting processes and participation for families in current and future housing decisions. In addition, all agencies should ensure that staff have basic housing training so that families have access to the help and advice they need.
The housing situation of families with disabled children should be included in the remit of relevant inspection bodies, such as the Audit Commission, the Planning Inspectorate and Ofsted, and the disabled childrens indicator should apply to housing as well as to other services. That is a problem sometimes. The fact that services for children must carry into housing services as well is not always thought through.
To those recommendations, which come from the Every Disabled Child Matters report, I add the following. First, the housing needs assessments and strategies of housing authorities should consider specifically the needs of families with disabled children and factor them into their procurement of social housing. That should not be difficult, as information on children with disabilities should be held by local educational and health services and well known to local authorities.
As for the point made by the hon. Member for Kettering (Mr. Hollobone), local authorities should ensure that more housing is provided to mobility standards of the type used by some specialist housing associations such as John Grooms. I have seen such houses in Northampton. The building standards that make them suitable for families with disabled children also make them much better for all families. The space in the corridors and stairwells gives the houses a completely different atmosphere and feel. Such houses are lifetime houses: a family moves into one, and the house can adapt to the familys changing circumstances. Children with disabilities become teenagers with disabilities, and parents might find that they themselves need lifts, hoists, walk-in showers and other features.
Following that recommendation would also mean that we considered carefully decisions to allow the construction of three or four-storey blocks of flats without lifts. Such buildings can be extraordinarily difficult for a family on a second or third floor with a child who acquires a physical disability or a learning or behavioural difficulty.
Secondly, the overcrowding rules should consider the spatial requirements of families with children who have physical disabilities. That has been a thorny and vexed problem for many years. I started campaigning on it as a local government councillor in 1986, and in many respects we are not much further forward than we were then. We still use standards that were originally produced in 1935, which do not meet the needs of any families, least of all families with children. Every Disabled Child Matters has asked that the bedroom standard be amended to reflect the need for all disabled children to have separate bedrooms from other children in the household and for all social housing providers to reflect that in their vettings policy.
Extra space needs to be considered for children with autism and behavioural difficulties, such as attention deficit hyperactivity disorder, which puts pressure on both living space and space for other children. The requirement must be to assess such needs in housing allocations and to take them into account once the new overcrowding standards are drawn up, which we hope
will happen in the not-too-distant futuregiven that 22 years have gone by. I understand that some of those things might be difficult owing to problems with defining some of the behavioural difficulties, which often put more pressure on other children in the family than almost anything else. If a child has to share a bedroom with a seriously disruptive sibling, and there is no proper living space eithersometimes because the parents have to sleep in the living roomthe life chances of all children concerned are profoundly affected.
On aids and adaptations, what has happened with the monitoring and assessment of the implementation of the changes made so far? As I am sure the Minister knows, just because guidance is issued does not necessarily mean that it is followed. I am sure that some local authorities follow exceptionally good practice and can be held up as beacons to those that have not quite worked out how to do it. In particular, what has happened about dealing with logjams in assessments by occupational therapists and the need for more co-ordination between the childrens and housing services managing the disabled facilities grant? A number of colleagues brought up that point. My hon. Friend should look back at the Every Disabled Child Matters report, which rightly gave very high priority to housing as a risk factor for children. However, having identified it as a risk factor, the document did not carry through into policies that would ensure that childrens housing was properly provided.
In conclusion, problems remain with the provision of the housing standards that families and children in 21st century Britain expect. In many ways, the problems may seem very challenging, and certainly some of them, such as the overcrowding, will be expensive to solve, but if we are to ensure that all families have access to proper housing, we must ensure that housing standards meet the needs of the most vulnerable children in our communities. I hope that while we all enjoy our summer holidays some careful work can be done to ensure that the thoughts on this matter of both the voluntary sector and other colleagues can be carried forward.
Mr. Hollobone: On a point of order, the hon. Lady made an excellent speech, but in the background was the near constant, inane, amplified chanting from protestors on Parliament square. Mr. Bayley, would you be kind enough to draw that to the attention of the Serjeant at Arms and the Speaker? If our parliamentary democracy is to function properly, that sort of protest should not be allowed to intrude on the proceedings of the House.
Hugh Bayley (in the Chair): I shall make a note of that. I know that the Clerk will draw it to the attention of the appropriate people.
Mrs. Joan Humble (Blackpool, North and Fleetwood) (Lab): I am sorely tempted just to say that my hon. Friend the Member for Northampton, North (Ms Keeble) made a brilliant speech and that there is no need for anyone to say anything else. Given that we are here, however, it is important that we support her comments and reinforce some of her pointsand that is what I intend to do.
My hon. Friend mentioned that I and our right hon. Friend the Member for Coatbridge, Chryston and Bellshill (Mr. Clarke) held a series of parliamentary hearings
looking into the pressures on families with children with disabilities. Interestingly, housing did not feature very large in that debate. Part of the fault lay with us and the questions that we asked in order to focus the debate. However, it was equally important that many of the families whom we met and who came to give evidence to parliamentarians put health and social care needs to the fore. I think that they did that because they thought that we could do something about those things, whereas with housing they seemed to have so many insurmountable problems that they often gave up.
From my dealings with the local authorities in my constituency and with housing associations, I get the impression that all too often they give up as well and do not know what to do. It is about time that we decided that something can and should be done, and that we got on and did it, which is why I agree with my hon. Friend about the excellent report from the Every Disabled Child Matters campaign, which focuses our attention on housing and the way that it really can make the difference between a family staying together and falling apart. A family with more than one disabled childor just more than one childmight be receiving support from the health service, the education service and social services, but if they are in cramped and inadequate accommodation, everything will go wrong. It is our responsibility therefore to look at housing and to push it up the agenda.
Like my hon. Friend, I congratulate the Government on what they have done so far. We campaigned long and hard for the removal of means-testing for families with a child with disabilities applying for the disabled facilities grant, which made a huge difference. The Government also raised the limit from £25,000 to £30,000. However, it remains inadequate for many families, which is why I too would like the Government to re-examine the problem. We do not want families to have to move to find better accommodationin some instances, in so doing, families have had to repay some of the money paid to them. We need to get this right at the beginning.
The parliamentary hearings highlighted the fact that many families with a disabled child do not understand why different agencies do not talk to each other about their needs. In our debates we get tied up in all sorts of questions about data sharing and limiting the amount of data shared to protect information held on individuals by different Departments. However, the people whom we are trying to help just assume that data are shared, and then do not understand when they find out that the health service does not tell social services that a disabled child has been born who will need social care help, or tell the education service that, In X number of years you will have X number of children with this disability. Plan for it! If they cannot even plan across health, social care and education, what about housing? It is a very poor relative in all this, and there does not seem to be any planning whatsoever.
I would like the Minister to take away a simple message: endorse the comments being made about agencies working together and planning the needs of their local community. There have been many changes in the way that local government operates, such as local area agreements and the setting up of childrens trusts, that should facilitate that. There are opportunities for the housing needs of children with disabilities to be incorporated into strategic planning.
Mr. Andrew Smith: My hon. Friend is making some good points. Does she agree with the point that our hon. Friend the Member for Northampton, North (Ms Keeble) made about accessing information and advicethat it would be helpful to have a named lead officer in each local authority with responsibility for housing advice and leading the way on assessment and assistance for disabled children? Such officers would link social services and whoever else is involved, so that we got a coherent response.
Mrs. Humble: I absolutely agree. Information, advice and guidance are key to everything that we do for families with disabled children. They need that advice and guidance on education, health, social care and housing.
There are concerns about areas with two-tier authorities. I see the difference between the two halves of my constituency. The half in Blackpool has a unitary authority that has co-ordinated services, which means that I can get such advice from one person, who should therefore be able to give similar advice to residents. The other half has Lancashire county council, the third-tier authority, providing childrens and social services, and Wyre borough council as a housing authority. Those authorities need to liaise with each other, particularly because the housing authority is planning future housing development. I speak as a former Lancashire county councillor, so I know that the situation is not new. The difficulty of getting information and co-ordination across two-tier authorities has always been complex, but there are now ways of doing things that did not exist before, and we can get that co-ordination.
I want to discuss some of the recommendations in the Every Disabled Child Matters report. One recommendation was that Government offices should
ensure that all English regions are considering the housing needs of families with disabled children in their housing strategies.
Of course, to underpin that, we need a clear idea of who those children are, how many there are and the nature of their disabilities, but such analysis often does not exist. One reason why is that clinicians sometimes make inaccurate prognoses about childrens future outcomes. When a baby is born with profound disabilities, it is difficult for a clinician to say exactly what is wrong with the child and how they might progress as they grow older. I have had constituency cases in which the family had been told that a childs disability would have certain consequences, but five or six years later the situation was entirely different. It is therefore important, if agencies are to work together, that clinicians make as clear a diagnosis as possible about the child and their life chances.
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