Mr.
Harper: I beg to move amendment 80, in
clause 31, page 38, line 23, leave
out from ‘with’ to end of line 33 and insert
‘requiring a relevant authority
that is or may be obliged, or has decided, to provide a relevant
service to, or to arrange the provision of a relevant service for, a
disabled person (P) in prescribed circumstances to do the
following— (a) to support P to
assess his own needs; (b) to
support P to draw up a plan (his “support plan”) setting
out how he wishes those needs to be
met; (c) to support P to review
and revise his support
plan; (d) to assess the value
of any relevant services to which P is
entitled; (e) to notify P of
the value of these services (his “individual budget”) and
of his right to choose how his individual budget is
managed; (f) to comply with
P’s decision about whether he wishes to receive his individual
budget in the form
of— (i) a payment to him
(a direct payment); (ii) a
payment to any prescribed person for that person to manage on his
behalf and in accordance with his support
plan; (iii) in the form of the
provision of services by the relevant authorities which accord with his
support plan; or (iv) any
combination of (i), (ii) and
(iii).’.
The
Chairman: With this it will be convenient to discuss the
following: amendment 26, in
clause 31, page 38, line 23, after
‘person’, insert
‘, including a person with a
disability caused by mental health
problems,’. Amendment
27, in
clause 31, page 38, line 23, leave
out ‘in prescribed circumstances’.
Amendment 81,
in
clause 31, page 38, line 39, leave
out paragraph
(c). Amendment
45, in
clause 31, page 39, line 12, at
end insert— ‘(c) require a
relevant authority to co-operate with one or more relevant authorities
in connection with the provision of relevant services for disabled
people.’. Amendment
82, in
clause 32, page 39, line 21, leave
out subsection
(2).
Mr.
Harper: One or two of the amendments in the group are on
separate subjects, but amendment 80 is the one on which I want to
focus. The amendment effectively rewrites a provision of clause 31, and
I give credit to RADAR for providing the wording. This probing
amendment was tabled to enable us to have a useful discussion about the
thinking of Ministers in the Bill, as compared with in the White Paper.
The amendment would turn around the measures setting out what an
authority will provide for a disabled person so that the disabled
person would be in control and the organisations would be effectively
serving the disabled person’s needs, rather than the other way
around.
The reason
behind tabling the amendment is that the policy intention in the White
Paper was very much a system of individual budgets, based on
self-directed support, with which the disabled person would have
options for exercising greater choice and control, including, but not
limited to, the receipt of direct payments. I concur with RADAR that
clauses 31 and 32 more closely resemble a request just to get a direct
payment and do not go towards providing self-directed support. Clause
31(2)(a) states that the local authority will “carry out an
assessment” of the disabled person’s needs, which
suggests that the old model will be followed in which the professionals
will tell the disabled person what their needs are, rather than the
disabled person carrying out their own assessment and saying what they
need. The White Paper said that the intention of the right to control
was to reflect that the disabled person was the expert in their life,
so surely clause 31 should reflect that intention. The purpose of the
amendment is therefore to turn around the power so that the assumption
is that the disabled person is at the centre, that they will assess
what they need and that the authority’s job will be to help them
in doing that—that would be very much putting the disabled
person at the centre.
The White Paper also said that
disabled people would be told their resource allocation—either
the resources available to be paid to them directly, or the resources
spent on providing services to them—up front, but the measures
in the Bill simply enable the disabled person to require authorities to
provide that information. In my view, the disabled person should not
have to do anything to trigger notification, and the authority should
provide that information as a matter of course. The amendment is
important because clause 31 will be used to set out the
pilots—when we get to the pilot section of the Bill, we will see
that this framework will be used to run those pilots. If we are to
learn as much as possible from the pilots, it is important that they
should be set up as we want the system to work, and as the White Paper
said that it should, which is to put the disabled person at the heart
of the arrangement, rather than having local authorities deciding what
is going on.
Apropos the
discussion that we have had about making sure that these things happen
and that more people use the service, the benefit of amending the
clause would be to tell the disabled person that they have the right to
decide what they need and to make their own assessment, and that the
relevant organisations have to support them. That would put pressure in
the system, from the bottom up, enabling disabled people to say,
“I can organise things better myself,” and to pull local
authorities with them. With sensible direction from the Government
above—the Minister has laid out the direction of
travel—as well as such pressure from below, the amendment would
make the Bill better able to help disabled people who want to control
services to do so, and we would move further and faster, which would be
welcome.
For
today’s purposes, amendment 80 and the two consequential
amendments are probing, so I do not intend to press them to a Division,
but I would like the Under-Secretary to think about what the White
Paper said about disabled people being at the centre. I would also like
her to think about whether the clause does that and whether the
Government should move an amendment on Report to make that
change. Amendment
26 refers specifically
to “a
person with a disability caused by mental health
problems”. I
am not going to press that amendment to a Division either, because its
purpose is to elicit from Ministers an explicit undertaking that when
we talk about disabled people, we do mean not only those with a
physical disability, but those with a mental health problem and those
with a learning disability, whom the hon. Member for Sheffield, Heeley
and others have mentioned. We should be explicit and encompass everyone
with a disability so that it is clear to disabled people themselves and
to the various authorities that we mean the measure to apply to
everybody. Interestingly, the move towards individual budgets and
direct payments was started as a result of parents of children with
learning disabilities feeling that the provision of services was not up
to scratch. I know that the hon. Member for Sheffield, Heeley has been
championing the cause of those with learning disabilities throughout
our proceedings but, in fact, it was the parents of children with
learning disabilities who kicked a lot of this off. It would therefore
be welcome if we made sure that there was an explicit commitment from
Ministers that people with learning disabilities and those with mental
health concerns were explicitly included in this
process. The
only other matter to which I wish to draw attention is the one that we
briefly touched on earlier. Amendment 45, which, if I may say, is
elegantly drafted, is better placed in this group. It would ensure that
relevant authorities and services had a duty to co-operate. I know that
the Under-Secretary of State for Work and Pensions, the hon. Member for
Chatham and Aylesford, is keen for that to take place. In the evidence
session, he said in that local authorities were at different stages. He
also set out the direction of travel and said that the Government
wanted local authorities to work together. The amendment would make it
explicit that the duty to co-operate was there. Again, I do not intend
to press the amendment to a Division, but the Under-Secretary of State
for Scotland, the hon. Member for Glasgow, North, needs to say whether
she thinks that the powers already in the Bill put sufficient pressure
on local authorities and primary care trusts, which the hon. Member for
Rochdale mentioned, to ensure that they work together to try to deliver
a seamless provision. It would be most welcome if the Minister could
reassure the Committee about that. Paul
Rowen: Again, I support the sentiments of the hon. Member
for Forest of Dean. In many respects, there is all-party agreement on
this aspect of the Bill, and we all want to see it work. I particularly
want to focus on amendment 26 because mental health and learning
disability issues are important. It is acknowledged that people
suffering from mental health problems suffer, and feel that they
suffer, discrimination, perhaps in terms of getting a job and so on.
The Bill is designed to do something to help to alleviate
that. When
developing the powers for direct payments, it is important that the
needs of that particular group and those individuals are not forgotten,
although I am sure that that will not happen. However, when we consider
the pilots, perhaps certain individuals and organisations could be
worked with to ensure that a pilot specifically targets children with
learning difficulties, or people with mental health problems, so that
we can see how the measures will work out, because their needs are
different from those of people with a physical
disability.
Ann
McKechin: I welcome the debate, which raises important
issues about how we think that the provisions on right to control will
operate. First,
I will deal with amendments 80 to 82, which would substantially
restructure the aspect of clause 31 dealing with the powers to give
greater choice and control and remove particular powers relating to
direct payments. The amended version of the clauses would actually set
out a more rigid structure for the right to control than that in the
Bill. Amendment 80 would make clause 31 less flexible. The amendment
assumes that the disabled person, in all cases, could be proactive,
whereas clause 31 allows for other
circumstances. It
has always been our intention that a disabled person accessing the
right will be at the centre of the process and that they will have a
range of options for how support is delivered. We recognise that
disabled people are experts in their own needs and how they are best
met. Self-assessment and self-directed support are therefore essential
to the right of control. We believe that we need to take a bottom-up
approach, and to work closely with disabled people, public authorities
and other stakeholders to achieve that. We certainly do not see this as
a top-down
process. 1.45
pm The
amendments do not capture some of the vital aspects of right to
control. They would not allow the outcomes of the service to be agreed,
in partnership, between the authority and the individual. That
partnership is important, because it means that the individual has
choice and control over support, but that resources are available to
meet a set of agreed outcomes. The local authority remains ultimately
responsible for the statutory outcome and can provide further
assistance or security if required. We certainly do not see local
authorities making the primary direction—this is about them
working with disabled people.
We believe
that the amendments would remove many of the powers that make the
framework for direct payments. Without clause 32(2), we would have no
express power to specify in regulations how and when direct payments
should be made. We would also not have an express power to make
regulations about when a request for a direct payment should be
complied with. I think that it is important to be up front about the
fact that circumstances will be
prescribed. Although
we would normally expect a request for a direct payment to be granted,
there might be certain exceptional circumstances in which a providing
authority could reasonably challenge that expectation. We have
committed to consulting on what the circumstances will be, but they
might include cases where a person has deliberately misused a previous
cash payment. Without the express power to make regulations or to issue
guidance, we would risk creating confusion about what was intended by
the direct payments
legislation. The
framework of the right to control is deliberately broad. It is designed
to encourage innovation and to reflect our commitment to co-production.
We want the right people to design how this will work: disabled people
themselves, voluntary organisations, agencies, and authorities that
deal with these services every day. I know that the vast majority want
to ensure that the system works better for disabled people. Being too
prescriptive at this stage would mean that we would fail our commitment
to co-production and
consultation. While
I do not support the amendments for the reasons I have stated, I am
certainly interested to hear suggestions about how the initiative could
be taken forward and how the regulation-making powers in the Bill might
be put to
use. I
now turn to amendments 26, 27 and 45, which would have three key
effects, although it is worth pointing out that if amendment 80 were
agreed to, amendments 26 and 27 would be redundant. First, the
amendments explicitly state that individuals who have a disability
caused by a mental health problem would be covered by the right to
control. Secondly, they would introduce an explicit power to require
authorities to co-operate on delivering the right to control. Finally,
they would remove an important clarification that the right to control
will be available only in the circumstances prescribed in regulations.
I shall briefly address each of those effects in
turn. On
mental health, I can confirm that all disabled people who are eligible
for the services brought within right to control will be able to
exercise the right. We see it as important that people with learning
difficulties are included in the trailblazer project. The evidence
presented to us by RADAR and others highlighted the transforming
difference that choice and control over services can have for people
with mental health problems or learning disabilities. We are committed
to enabling those people to have the right to control and to ensuring
that the right is as widely accessible as
possible. However,
the right to control will apply to disabled people who receive
specified services, rather than to particular groups of disabled
people. The framework of the Bill is therefore inclusive, and I would
not wish to single out a particular group of disabled people within the
broad framework.
The evidence
that we heard from Paul Davies of Oldham borough council emphasised the
need for different public authorities to co-operate in providing
disabled people with greater choice and control. It is vital that
people understand all the different ways in which they can choose to
receive support. We certainly expect authorities to provide such
information, and we can issue guidance requiring them to make it clear
to disabled people what choices they have and the different ways in
which they can receive
support. During
the trailblazer projects, we will expect public authorities to work
closely with each other, as well as with individuals and service
providers, to manage the delivery of the right, and we will carefully
monitor the effectiveness of the working
arrangements. On
amendment 45, we already have mechanisms in the Bill and elsewhere to
ensure that authorities work together on specific matters. Local
authorities in England and their partners are already under a duty to
co-operate in developing and acting on local area agreements that
respond to a local area’s priorities. Hon. Members will
appreciate that different legislation applies to local authorities in
Wales and
Scotland.
| 
