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Baroness Ashton of Upholland: The only figure of which I am certain is that of the number of people we would classify as having issues around lack of capacity, about 20 per cent of whom are unbefriended. So we know that that would be a clear group. As the noble Lord will appreciate, the difficulty with any other group is how we define it. So those who have relatives in theory but not in practice would be one group; and perhaps elderly people where there are issues about how to support them effectively could be another. I am sure that there are organisations which could probably give us a ballpark figure, but it would be an art, not a science.

I appreciate what the noble Lord is saying but one of the reasons for the consultation is to try to identify how we can develop the service to support these groups most effectively.

Lord Alton of Liverpool: It is the scale and scope that we are trying to put our fingers on. If the Minister cannot answer now perhaps she will do so in correspondence later, but can she give a figure of how many people that 20 per cent represents?

Baroness Ashton of Upholland: Sadly, no. My briefing gives 20 per cent but not a figure. I shall of course write to the noble Lord and copy the letter to other noble Lords.

Lord Pearson of Rannoch: Perhaps I can help with the mathematics.

Baroness Ashton of Upholland: Please do.

Lord Pearson of Rannoch: I am advised that there are some 160,000 people with severe and profound learning disabilities in the country at the moment. If the Minister is right—and I have no reason to doubt it—and 20 per cent of them are unbefriended, then in the category I am speaking about alone it comes to some 32,000 people. I do not query the noble Baroness's percentage, but it seems quite high to me that one in five should be unbefriended. If that is so, it gives one the nature and the scale of the tragedy.

Baroness Ashton of Upholland: I am not sure whether this will enlighten the Committee completely but I hope it will help a little. The assumption is that there will be about 17,000 decisions each year in England and Wales, of which 6,000 will be about serious medical treatment and nearly 11,000 about care moves. That is the assumption built on within the Bill.
 
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However, I should like to set this out in a letter to the noble Lord, Lord Alton, copied to noble Lords, so that it is clear. The noble Lord, Lord Pearson of Rannoch, also has figures about particular groups that we might try to pull together.

Lord Pearson of Rannoch: Those figures could fit together. The noble Baroness mentioned decisions, and I was talking about people. Not every person has to have a decision made every year.

Lord Rix: I say to the noble Lord, Lord Pearson of Rannoch, that this is not a precise science. Many of the people with a profound intellectual multiple disability, who number about a quarter of a million in this country, have parents struggling at home to give them care 24 hours a day. Those people could do with independent advocacy to support them through all the vicissitudes of benefits, and so on.

There are many people outside that range with an intellectual impairment or a learning disability who live virtually—sometimes totally—on their own. They, too, may well need independent advocacy, even though their family lives two blocks away. They may still need independent advocacy to see them through the vicissitudes of life. I honestly believe that it is like asking how long is a piece of string. If you add to that number all the other people with disabilities who have a mental impairment—an incapacity—you are trying to judge figures which I am not certain will ever add up.

Baroness Barker: Before the noble Lord, Lord Rix, replies on behalf of the whole group, I should like to take the Minister back to Amendment No. 186. I was a little disappointed that she said we could not add a group of people to a list. We already have a list. Perhaps she will write to me explaining why independent advocates cannot be on it. Will she also explain what would be the effect of enabling independent advocates to go through the kind of processes that we have talked about, such as making applications to the court, if they do not have the same force as the people covered by the Bill?

Baroness Ashton of Upholland: Rather than take the time of the Committee now, I shall write to the noble Baroness about those matters. It is a question of ensuring that we position this correctly, but I am certain we shall find ourselves in the same place.

Baroness Greengross: I am sorry if this is out of place, but I should like to make one brief point. If there is a lot of publicity about the advocacy service when it is introduced and it is a local service known by the CAB, Age Concern and Mencap, people do not have to use the service although it is introduced by social services and the voluntary sector and is available to them. I am as worried as the noble Lord, Lord Pearson, about what will happen to people who have intellectual impairment when their parents die—not people who have made wonderful plans but those who have not been able to do so. The service needs to be
 
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there, with some spare capacity, so that people can have access to it if they feel they need it. They can be helped by the bodies that are now in existence to have access to it so that it is not a frightening service but a welcome one.

Baroness Ashton of Upholland: The position described by the noble Baroness, Lady Greengross, is where we all want to find ourselves eventually, but we are not there yet by any means. It is important to remember that we are talking about a particular service and particular decisions. That is where we think some of our most vulnerable people need to be supported. I can see where the noble Baroness is going and were the magic wand available, we might all get there faster.

Lord Rix: The noble Earl, Lord Howe, said that we would get a sympathetic reaction to our amendments. I am sure that the aura of sympathy and understanding which arose from the Dispatch Box percolated to every corner of your Lordships' House. There is no doubt that the Minister fully understands our concerns, and I am sure that she will take them away and come back on Report with amendments that may assuage our problems—not our guilt, but our worries.

These amendments were moved originally by my noble friend Lord Adebowale. I think that he and the Making Decisions Alliance, which he consulted on these amendments, will want to read what is said in Hansard. I am certain that we shall return to some of these amendments—although I hope that the Government will shoot our fox well in advance—on Report. I beg leave to withdraw the amendment.

Amendment, by leave, withdrawn.

[Amendments Nos. 131 to 141 not moved.]

Clause 34 agreed to.

[Amendment No. 142 not moved.]

Clause 35 [Duty to seek advice in connection with serious medical treatment]:

Lord Rix moved Amendment No. 143:

The noble Lord said: In moving Amendment No. 143 I wish to speak also to Amendments Nos. 146, 155 and 156 with which it is grouped and which stand in the name of my noble friend Lord Adebowale.

Amendments Nos. 143, 146 and 155 seek to broaden the range of circumstances when independent advocates should be available to include befriended people as well as unbefriended people, or perhaps we should say non-supported people. This would be done by removing the restriction in Clauses 35, 36 and 37 that the duty on local authorities and NHS bodies should apply only to "unbefriended" or non-supported people.

Amendment No. 156 seeks to clarify that a vulnerable person, who may be ineligible for support from public funds for their accommodation, would still be able to claim the support of an independent advocate. I believe that such people should still be able to benefit from the independent advocacy service in
 
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exactly the same way as others in the same position but with fewer savings. I hope that the Minister will recognise the gap we are trying to close. Talking of gaps, I once again point out that the Bournewood gap would not be closed by this amendment but the appointment of an independent advocate would certainly help to promote swift access to the courts or tribunals for decisions to be made. I beg to move.

Lord Pearson of Rannoch: If I understood the noble Lord, Lord Rix, correctly, I would, of course, not agree with extending compulsorily the independent advocate service to those who are not unbefriended.


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