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5 Mar 2009 : Column 354WH—continued
The Government also pledged, in their first response to the Committee, to address the issue in the NHS operating framework. I hope that the Minister will
outline how that has been done. I note that it is a new, popular Government response—the same has happened with dementia—because it places the burden on local hospitals and primary care trusts without mentioning the funding, especially any funding that might be attached to it, passported or carried through. In making sure that we are holding the Government to account on their responses, it is vital that we understand that, when they place a burden on others to deliver on the general point, they have also addressed where the funding will come from, rather than simply expecting budgets at local level to be adjusted, prioritised and squeezed ever further because what is spent in one area means that spending has to give in another.
I was pleased to see that the Government agree with the Committee’s position on parents with a learning disability and on the need for support, so that their children can live and grow in that situation. However, in their response the Government did not mention the resources that will no doubt underpin this agreement. Again, I hope that they will take this opportunity to clarify what they are going to bring forward by way of resources to deliver on that agreement.
I see that the Minister will have a long time to answer all these questions and that will be helpful, as he will be able to cover all the points that have been raised.
As mentioned by the hon. Member for Edinburgh, West (John Barrett), who speaks for the Liberal Democrats, two pieces of legislation that are pertinent to this debate are being considered: the United Nations convention on the rights of persons with disabilities, and the equality Bill. There was some expectation that the equality Bill might arrive this week. I hope that we will have some indication of when that will appear.
On the United Nations convention on the rights of persons with disabilities, we in the Official Opposition broadly welcome it and are pleased that the UK was one of the first states to add its signature, on 30 March last year. However, despite the previous Minister for disabled people indicating that the convention would be ratified by the end of last year, the new Minister has admitted that this date has slipped to spring this year. Spring technically finishes on the summer solstice on 21 June, but, as with the Green Paper that we are so eagerly awaiting from the Minister, we are all desperately hoping that he means before Easter, which, in parliamentary time, means before 2 April. I hope that he will confirm that. The delay in ratification has seriously damaged the opportunity for the UK to be represented on the UN committee. The Government have already stated that they do not see a gap between our current legislation and the convention, so it is difficult to understand why there has been such a delay in ratification.
The hon. Member for Edinburgh, West also mentioned the signing of the optional protocol. Having resisted it, the Government have now signed it. But it is worth those who have been pushing for this move considering what force it will have after the Government have applied their reservations to the protocol, particularly in the areas of defence, education and immigration. The Disability Charities Consortium is arguing forcefully that these reservations should not be applied. It will be telling to see where the Government go with that debate. The Minister has the knowledge—I would like to say comfort—that the Official Opposition understand the need for
some of the reservations and opt-outs, not least in relation to the armed forces, as the Liberal Democrat spokesman also mentioned.
I have no doubt that when the Minister gets to his feet in the next few seconds, the main thrust of his response will be that the Government are about to publish a Green Paper, and he will mention the other things that are about to come. I said at the outset of my remarks in this important debate, which we all care deeply about, that in respect of many of the issues we have spoken of today, the nub of it is the implementation and funding that goes along with the rhetoric, the aspiration and the agreed set of principles, on which there is more or less a uniform view throughout the House.
I am anxious that, given the growing cracks in the system in this area—any Government who have been in office for 11 years must account for the system—the Government have been serially deferring reports that lead to action, and one report has been begetting another and so on. Sadly, there is no indication as yet that the Green Paper will break this cycle. I fervently hope that the Minister will dispel my concerns. But if he does not, I hope that he will at least set out the options for a new system, with the funding implications, so that we can have a full and informed public debate and ensure that the debate fostered by this important report shows how we can link social care services with the funding, and with the people with need. We clearly have to do that for society; it is a moral and philosophical demand upon all of us.
4.35 pm
The Minister of State, Department of Health (Phil Hope): May I start by thanking my hon. Friend the Member for Hendon (Mr. Dismore) both for chairing the Joint Committee on Human Rights so effectively and for leading the debate this afternoon with his usual commitment and intelligence? I thank him for his kind words—he said that the hearts of Ministers and their policies are in the right place—and for warmly thanking us for our commitment. He also talked about the need for a cultural change if we are to progress this agenda. I will say more about that in a moment. I will endeavour to answer all his questions, but if I fail to do so I will ensure that we write to him on any of the specifics on which he was asking for clarification.
This has been a good, thoughtful, provoking debate across Government, with all parties involved. I know that the hon. Member for Rochford and Southend, East (James Duddridge) has had to leave the Chamber, but none of us can sit here and listen to the cases of abuse that he and my hon. Friend the Member for Hendon described without feeling tremendous revulsion at what has happened. I am unable to comment on individual cases that are still the subject of investigation, but we understand, and expect the report that was mentioned to be published shortly. Certainly, preventable deaths of people with learning disabilities are unacceptable. If anything positive comes from tragic cases of neglect uncovered in “Death by Indifference”, it must be a reminder of the need for constant vigilance across local services.
The Mencap report, together with the Joint Committee’s report, “A Life Like Any Other?”, provided us with an urgent call for action to apply better safeguards across the system, to improve the skills and sensitivities of
professionals and, above all, to ensure that a person’s human rights are sacrosanct, both in public services and in the way that wider society responds to people with learning disabilities. We listened to those concerns and responded decisively.
My right hon. Friend the Member for Leicester, West (Ms Hewitt) promptly commissioned Sir Jonathan Michael to chair an independent inquiry. I am pleased to say that Sir Jonathan himself acknowledged our progress since then. He said that the steps taken in “Valuing People Now”
“will significantly reduce the risk of untreated ill health and avoidable death that my inquiry found.”
I will come back to “Valuing People Now” in a moment, but first I want to make a broader point about the clear commitment across Government—I speak as a Health Minister—to developing policies in line with the Joint Committee on Human Rights’ recommendations.
On health, last year’s NHS review is a case in point, with its focus on patient quality and patient experience as the driving force for reforms. That philosophy is now codified for future generations in the new NHS constitution. In social care, “Putting People First” provided the same call for local services to become more responsive and more sensitive to the individual needs of service users and their carers. That general philosophy, which I hope is shared by all parties—the hon. Member for Eddisbury (Mr. O'Brien) mentioned the personalisation of services—provides the bedrock for more specific reforms that we have introduced. They include the first national dementia strategy that we published last month; the carers strategy—hon. Members referred to carers’ important role for adults with learning difficulties—and the independent living strategy that we published last year; our ongoing work to promote dignity and respect throughout all health and social care settings; and the development of the social care Green Paper, which is due this spring. All those policies have come just from the Department of Health in Richmond house, but the same commitment stretches throughout Whitehall in a whole host of wider commitments.
The work of the social exclusion taskforce is ongoing, and when I was a Minister in the Cabinet Office, I had responsibility for its work. That and this year’s new opportunities White Paper have put a spotlight on improving social mobility among the most excluded groups. Our cross-Government public service agreement 16 will increase the number of adults with learning disabilities in paid work—that was raised during our debate—and in settled accommodation over the next three years. The hon. Member for Edinburgh, West (John Barrett), who speaks for the Liberal Democrats on the subject, mentioned our new strategy on employment for people with learning disabilities, which is due this spring and will present a specific action plan to support people in finding and remaining in work.
All those measures within the Department and across Government are underscored by our commitment to ratify the UN convention on disability rights. As hon. Members have said, the Command Paper and explanatory memorandum were laid before Parliament on 3 March. Our ambition is to achieve that ratification in the spring, and I confirm that we signed the optional protocol on 26 February.
Mention has been made of the Commission’s support for a positive human rights duty, and I want to put on the record that section 6 of the Human Rights Act 1998 makes it explicit that it is unlawful for a public authority to act in a way that is incompatible with a convention right. In addition, section 9(1)(d) tasks the Equality and Human Rights Commission to
“encourage public authorities to comply with section 6 of the Human Rights Act 1998”,
so we are not persuaded that additional legislation is needed.
In “Valuing People Now”, we are bringing together all the work that I outlined.
Mr. Stephen O'Brien: That is an important statement, and I am grateful to the Minister for what he has just said. Having concluded that the Government do not believe that there is justification for further legislative measures, will he explain, in addition to having explained the Commission’s role to urge the Government to comply, who will have the teeth to seek redress for non-compliance if there is a failure?
Phil Hope: We are not here to debate the Bill or the convention, so I will not address the specifics of that question, but the hon. Gentleman will have an opportunity to make his points during the passage of the Equality and Diversity (Reform) Bill. He asked me earlier when that will be, and the answer is soon. I think the House will congratulate the Labour Government on introducing a comprehensive equalities Bill that will introduce measures that will make a huge and, hopefully, irreversible difference to the equality and treatment of many more people in our society.
Mr. Dismore: On the same issue, but at a slight tangent, the Minister referred to section 6 of the Human Rights Act 1998, and a key issue is what we mean by “public authority”. My hon. Friend will be aware of the continuing debate about that, which will result in a one-off measure for old people’s homes, but the issue will remain at large for the wider privatised/contracted-out public services, particularly social services, in which there has been increasing private provision. One concern that my Committee has raised on several other occasions and which will be addressed in my private Member’s Bill is that we must ensure that those who provide public services through private means or systems are covered by the 1998 Act to enable that direct enforceability for any breach of the Act.
Phil Hope: I will certainly draw attention to the point that my hon. Friend raised. He will know far better than me how his private Member’s Bill will get on, and the procedures that may or may not be used to ensure its successful conclusion.
In line with the Joint Committee’s recommendations, the whole of the “Valuing People Now” strategy was written entirely from a human rights perspective, and I was interested to note that my hon. Friend the Member for South Thanet (Dr. Ladyman), although welcoming that approach, thoughtfully teased out a number of complexities that arise when we take a human rights approach. That is exactly the sort of thinking and debate that we must continually address. We must start with a human rights-based approach, and I hope that that is agreed throughout the House.
The “Valuing People Now” remit was broad. We want to ensure that we deliver change everywhere for everyone, and in response to the progress that the original “Valuing People” report made, the “Valuing People Now” strategy focuses particularly on people with complex needs, people with autism, and people from black and ethnic minority groups. I had a meeting with Victoria Willson and her mum, Jean, and the Learning Disability Coalition only yesterday, and I was profoundly struck by the fact that someone with such complex needs was living an independent life, and had been doing so for the past 20 years. People may say that that cannot be done, but clearly it can and is being done. There may be debate about resources, but the fact that it can be done tells us that such examples should be not the exception, but the norm.
The scope of “Valuing People Now” is ambitious, because we want to transform the way that people with learning disabilities view the world, and the way that the world views them. That central vision, leadership and commitment is in line with the Joint Committee’s recommendations. As has been said repeatedly this afternoon, I know that it wanted strong words to be translated into hard action. That is exactly what is happening, and our efforts are yielding real results on the ground.
People with learning disabilities now have more choice and more control over their lives. For example, 2,000 people now receive direct payments, which they can use to pay for the care or services that they want. Many are now progressing from direct payments to individual budgets. During a visit to Chelmsford, I saw how those budgets are transforming people’s lives. I met a young man with learning disabilities whose life was completely different. He was working, had a girlfriend, and was living an independent life. It was not only his life that had been transformed; the life of his family had been transformed because of what he was able to do with his independence.
All that is part of a much wider drive to grapple with the issue of how to give people with learning disabilities more freedom and independence. It is right that more people with learning disabilities are living in their own homes, and enjoying a richer and more varied social life. I am particularly pleased that improved advocacy, to which my hon. Friend the Member for Hendon referred, and better information and advice mean that more people with learning disabilities can shape their own future, and are being treated as equal citizens in our society.
My hon. Friend also referred to funding. Average spend on advocacy services has leapt by more than 40 per cent. since 2004. I dare say that he would like to see more, but I want to put on the record how much difference that has made to the lives of adults with learning disabilities.
The hon. Member for Eddisbury spoke about support for people with learning disabilities who want to make complaints about how they are treated. The Department will be developing materials to help such people and their families to understand their rights of redress and how to complain, because that is an essential part of what advocacy can do.
Sir Nicholas Winterton:
One reason why I have come to the debate and sat through certainly three quarters of it so far—I was a moment or two late—is that I was
approached by East Cheshire Advocacy. It is extremely active in my constituency and the adjoining areas, but it needs help and funding to be able to continue to provide that very worthwhile advocacy, and not least, as the Minister rightly said, to complain, because that is often what people are unable, or feel themselves unable, to do. Is the Minister understanding of the modest sums that that charity needs to provide the excellent services that it does, and not only in east Cheshire? I have quite close contact with it and meet many of those who go to its weekly meetings. Does the Minister appreciate that it cannot operate on thin air?
Phil Hope: Of course. Quite rightly, many third sector organisations—user-led organisations in particular—not only support and help in the development of policy, but campaign, either for an individual or for a group of people whom they represent, to improve services in their area. That is a core part of what charities should be about. Some Opposition Members thoroughly disagree with the idea that charities should campaign for issues in support of their beneficiaries. However, Government Members see that as a core part of what the third sector exists to do and has done for many years, and we want it to be strengthened. That does mean that sometimes such organisations bite the hand that feeds them, if I can put it that way. Good. That is right. Local authorities and central Government, when we fund third-sector organisations directly, should expect a partnership to include criticism as well as support and engagement. That applies not least to advocacy organisations.
We are developing a funding programme for user-led organisations because we want to see them in every local authority area. There will be more announcements about that in due course, but if local authorities, no matter what their political colour, believe in personalisation and developing services and tailoring them to meet the needs of individuals, then enabling those organisations and the individuals who represent them to be funded to do that work and to promote the needs of the individual is a critical part of the commissioning process overall when services are being developed.
I therefore urge the hon. Member for Macclesfield (Sir Nicholas Winterton) to go back to the local authorities to which he was referring. I am not sure of the political colour of the council in his constituency, but if it is of a similar colour, perhaps he, as a member of the same party, will be able to persuade it of the point, rather than relying just on the exhortations of a Labour Minister.
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