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We must try to get this right. Every time we make a mistake, to come back to the point made by the noble Lord, Lord Best, that effectively generates on-costs. If we do not provide the right support for carers, they will be taken out of economic activity. We all know this. It is absolutely accepted by everyone. If carers become economically active, that will help to balance the nation’s economy, as will getting more disabled people into work. The world of work is changing; often it involves not physical activity but mental activity. If you enhance the position of people with disabilities, many of them will be able to work and enhance the economy. There are savings to be made if there is investment up front.

There are great bureaucratic dragons to be slain with this Bill. If the Government can show us that they are doing that anyway and that there is some form of enforcement to ensure that it is happening, we will go away happy. I will take considerable convincing, however, because usually at this stage we hear about a series of committees. Unless there is a driving force behind the committees and these new liaison groups, I am worried. Unless we tell people to do things, we will have not the old postcode lottery but a whole new one, albeit involving different and larger areas.

I look forward to hearing what the Minister says in reply to this debate. The noble Lord, Lord Ashley, has shown the one true quality that anyone needs to change anything in Parliament: perseverance.

11.12 am

Lord McColl of Dulwich: My Lords, I, too, congratulate the noble Lord, Lord Ashley, on his amazing tenacity in fighting for a better deal for disabled people all round.

My eyes were opened to the plight of disabled people when I was asked to chair a government committee of inquiry into services for disabled people some years

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ago. I found it difficult to believe that the services were in such a poor state. There was plenty of money but the management was fundamentally flawed. We made 49 recommendations to help disabled people, but the civil servants simply said, “We will bury your report”. I was astonished at their apparent lack of concern for disabled people. When we asked Prime Minister Thatcher to intervene, however, she soon straightened them out and almost all the recommendations were accepted apart from the vision for indoor/outdoor wheelchairs. That was implemented later, together with direct payments, for which we campaigned along with other noble Lords.

As the noble Lord, Lord Pearson of Rannoch, mentioned, when severely disabled people have to rely on carers who come each day at a time that suits the carer, their lives tend to be rather chaotic and disorganised. However, when disabled people themselves have direct payment, they can employ the carers and have them come at a time that is essential to them, to enable them to leave home early and go to work.

The recent announcement by the Government that they will extend direct payments and carry on their trials of individual budgets is certainly welcome. There are too many barriers preventing disabled people from accessing direct payments. The Disability Rights Commission recently emphasised that a subjective judgment made by local authority staff that a person lacks the competence to manage direct payments can preclude those payments, and there are too many restrictions on how they can be used. That is a polite way of saying that there are too many little bureaucrats sitting behind desks pontificating about subjects about which they know little.

For instance, a young lady with a severe heart condition went to her GP for a repeat prescription. The GP said to her, “Mary, you’re really quite severely disabled”. “No I’m not”, she said, “I don’t recognise disability”. The GP said, “I’m telling you, my girl, you are severely disabled. You can’t walk up a hill and you’re pretty blue. You need, and are entitled to, a car, and you will get one”. She reluctantly agreed to that, but she encountered ridicule and disbelief on three separate occasions when she was told by a clerk sitting behind a desk, “You’re not disabled. You don’t need a car”. She had not even asked for the car. She was so angry that she nearly told them exactly what they could do with it. What sort of procedures are in place to minimise that kind of discrimination?

Disabled people tend to conceal their disabilities when they can. For instance, that particular girl, Mary, used to get really quite angry when she held out her hand in a shop or to collect a paper and the other person would say, “Ooh, aren’t you blue?”. She learnt to squeeze her hand while she was waiting so that, when she held it out, it was white rather than blue. Disabled people do not like to be different from the rest of the population.

As my right honourable friend the leader of the Opposition has said, the Conservative Party welcomes the principles underlying the Bill. We are pleased that the noble Lord, Lord Ashley, has again introduced the subject, enabling us to discuss it again in detail. The Conservative Party is committed to

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introducing individual budgets so that people can take care of their own needs. Individual budgets would allow people to commission healthcare and social care services jointly for themselves, because they know better what they need.

Prime Minister Thatcher was always very supportive of respite care, emphasising what a great contribution carers made and how we should do much more to support them. We are exploring means to give more support to carers, including through the tax and benefit system. Noble Lords may not be aware that it was Mrs Thatcher who emphasised the importance of disabled people by splitting the old Department of Health and Social Security into its two present component parts. She also changed the title “Minister for the Disabled”—disabled people do not like being called “the disabled”—to “Minister for Disabled People”. She said, however, “They’ll want to change the notepaper”, and they were allowed to use up the existing notepaper first.

The provision of services for disabled people is uneven across the country, as the noble Baronesses, Lady Masham and Lady Campbell, mentioned. How do the Government plan to deal with that? There seems to be no system in place at the moment to cover a disabled person who moves to a different part of the country. They often have to start from scratch to renegotiate a new care package from a variety of different sources. The Bill is designed to ensure that they have a right to this to avoid the present confusion and frustration.

How will the Bill improve the provision of accessible information and advice and ensure that the comprehensive assessment of a disabled person’s needs will be effective across all local authorities and NHS bodies equally? The new concordat, which was published this week, is certainly welcome, but it seems to contain no means to ensure that individual disabled people can challenge local service provision if it is inadequate. Does the Minister have any estimate of the cost of the provisions in the Bill?

I have always been very impressed by how much so many disabled people contribute to society. They enrich it and are an inspiration to us all. A severely disabled girl with liver disease, rickets and kidney failure could not find a job when she left school. A secretarial job was created for her at Guy’s Hospital, and she soon proved to be one of the best secretaries that we had. Moreover, she insisted on being dialysed three times a week at night, so she took no time off work. The effect on the rest of the department was very impressive, because, suddenly, no one else took any time off work—how could they? She later started to go downhill, but was given a kidney and liver transplant, which was a great success. She took on a new lease of life. She went into the church; when she gets up to preach, everyone listens to what she has to say, because she knows what she is talking about. A few years later, she got married. What an amazing transformation. What courage.

We have friends who adopted a Chinese boy of 10, who was born without eyes and thrown on the rubbish tip soon after birth. He was rescued and taken to an orphanage, but was neglected there for

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years. However, after adoption, he was surrounded by love and attention and, within two years, this almost uncontrollable boy had improved so much that he was able to go skiing.

There are many examples in this House of amazing, cheerful triumphs over adversity. What an inspiration and a great investment are so many disabled people. However, if altruism is not enough to encourage us to strive to improve the life of disabled people, a touch of realism might do, because half of us will be disabled to a greater or lesser extent before we die. We need to declare an interest in more senses than one.

11.24 am

Baroness Royall of Blaisdon: My Lords, I once again pay tribute to my extraordinary noble friend Lord Ashley and celebrate his unceasing efforts over many years in furthering the interests of disabled people and his many achievements in the field. I am proud that this amazing, tenacious person really is my noble friend. He is a shining example of someone who has used the democratic system to bring about profound social change and increase social justice. Last week, I was speaking on the Human Fertilisation and Embryology Bill. I assured all noble Lords present that the Government are firmly against cloning in every shape or form but, when it comes to my noble friend Lord Ashley, I think that I would make an exception.

In laying this Bill, my noble friend has provided another excellent opportunity for your Lordships’ House to debate the crucial issues around what independent living means for disabled people and how we can ensure that we enable them to have full choice, control and empowerment over their lives. I welcome this further opportunity to set out the progress that this Government have made in addressing these fundamental issues. To the noble Lord, Lord Addington, I say that, yes, we have achieved much, but he was right that it is the duty of every Government to achieve more.

The debate around independent living rightly continues to be one of the liveliest and most informed in the disability community. As my noble friend Lord Ashley has argued, this debate is not simply about services that disabled people access; it is about the kind of society we believe that we ought to have in this country. It is about changing the thrust of the debate from the historic stance of providing a one-size-fits-all solution to one of enabling disabled people to live autonomous lives, enjoying the same choices, freedoms, dignity and control over their lives that the rest of society takes as given.

When I spoke a few months ago, I emphasised that the Government supported the principles underpinning my noble friend’s Bill, but that we did not believe that a legislative solution to delivering equality and inclusion for disabled people was necessary or desirable. Our position has not changed.

We wholeheartedly agree that we no longer want to see public policy or services developed centrally and imposed on disabled people on a take-it-or-leave-it basis. We want disabled people to have choice

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and control over their lives and the support that they need. We want to see local strategies to commission services in response to locally assessed needs and desires. We want to see disabled people involved in the design of policy and commissioning of services. One of the major themes of today’s debate was bureaucracy, the amount of which encountered by disabled people is quite appalling. We must do something about that, as the noble Lord, Lord McColl, said. To me, addressing bureaucracy seems to be quite a simple problem. Clearly, it is not—I am sure that I shall have a ton of bricks down on my head—and we need to address it. Some of it seems to be due to managerial problems.

I welcome the opportunity today to outline how the Government are tackling the inequalities that disabled people face in their everyday lives and the work that is being taken forward to enable disabled people to have the opportunity to live independently. Perhaps I may begin by outlining the progress that has been made with the Government’s independent living review. Your Lordships will remember that we set this cross-government review in train in early autumn last year in response to the recommendations of the strategy document, Improving the Life Chances of Disabled People. This review, led by the Office for Disability Issues, has benefited enormously from the invaluable contribution of the noble Baroness, Lady Campbell of Surbiton, whose record in furthering the rights of disabled people speaks for itself. We are extremely fortunate that she is a Member of your Lordships’ House and that she is also now chair of the disability committee of the Equality and Human Rights Commission.

I feel rather nervous about discussing the review in the noble Baroness’s presence, given that she as chair of the review panel of external experts is far more immersed in the detail than I can ever hope to be. I hope that she will forgive me if I represent the work of the review rather less well than she already has done.

The review, which we see as a model for future working in partnership with service users, was rooted in the premise that independent living is about disabled people having choice and control over the support that they need to go about their daily lives. The review takes a life-course approach, from young people in transition to adulthood, and takes a step beyond the original Improving the Life Chances of Disabled People strategy in explicitly including the needs and wishes of older disabled people. When the review is published, as the noble Baroness rightly said, in January, it will set out a five-year strategy to improve opportunities for disabled people to live independently, including much needed new investment in housing.

The strategy will clearly outline how the Government will achieve their policy commitments, identifying what difference those policies are intended to make, and how they will be measured and monitored. The new strategy for independent living will help deliver better joined-up delivery across government, and will promote a greater understanding of the principles of independent living.

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I must pay credit to the noble Baroness and the rest of the external advisory panel for their efforts in contributing to this review. While independent living is one of the most interesting social policy debates, it is also one of the most complex, and the panel played a vital role in challenging officials leading the review to pull out all the stops. As you would expect, the review generated a lively debate and many ideas. In fact, one real strength of the review is the way in which it has been conducted. The review has been based not just on discussion between a few government departments and local authorities, but on the principle of co-production, involving disabled people at every stage and bringing the views, thinking and experience of independent living experts into the heart of government.

These principles of control, choice and empowerment are also fundamental to the Department of Health’s White Paper, Our Health, Our Care, Our Say. I have had the opportunity before of outlining the work that the Department of Health is taking forward to deliver greater choice and control and personalisation of care, not least through piloting individual budgets. I take the opportunity to highlight the recent Comprehensive Spending Review announcement that local authority funding would increase by £2.6 billion by 2010-11. In addition, direct funding from the department for social care for older people and support services for carers will increase by £190 million to £1.5 billion by 2010. This additional funding will support the delivery of the vision set out in Our Health, Our Care,Our Say through personalised budgets; provision of advocacy and information services; increased focus on preventive services to support people to live independently; and support for 3,000 people with learning difficulties to leave NHS campus accommodation and be supported to live independently within the community. I think that that answers some of the points made by the noble Lord, Lord Pearson of Rannoch.

I am sure that noble Lords welcome Putting People First: A Shared Vision and Commitment to the Transformation of Adult Social Care, which we announced earlier this week. This really is about transforming services and people’s lives. The noble Lord, Lord McColl, asked what would happen in the context of that new policy about challenges to the amount of money that people were awarded. I imagine that the situation will not change from the present situation, but I shall come back to the noble Lord in writing.

The noble Baroness, Lady Greengross, spoke of the need for greater investment in low-level social care to prevent more expensive care later. I hope that this will be dealt with in the context of the new policy, but as she will know we also have a Green Paper coming out next year on the funding of social care.

I draw noble Lords’ attention to an announcement, made by my noble friend Lady Andrews earlier this week, of £4.9 billion funding for the Supporting People programme over the next three years. This funding will help more than 1 million vulnerable people each year, including victims of domestic violence, teenage parents, older people and those with mental health problems, enabling them to live

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independently in their accommodation. Of course, I hope that it will also improve the lives of disabled people.

We should always start with the people who need support. One of the greatest changes in social care in recent years is recognising and acknowledging that people who use services can help shape those services. In Control has led the way for many. Expectations are high, and we need to make sure that the right support is available. Empowering people to manage their own care can be beneficial, not only for the individual but also for government through cost-effectiveness. The work on user-led organisations, direct payments, individual budgets, along with In Control, is showing that people can be both creative and empowered to arrange support that is right for them, as the noble Lord, Lord McColl, pointed out. The Office for Disability Issues and the Department of Health are not alone in driving forward action to support disabled people to live independent lives.

As a Government, we have taken forward a comprehensive civil rights framework to lay the foundation for equality for disabled people. Over the past 10 years, we have significantly improved and extended rights for disabled people under the Disability Discrimination Act. These improvements have ensured that a further 1 million employers and 7 million more jobs are now covered by the Act. In addition, through the Disability Discrimination Act 2005, we met our commitment to introducing a comprehensive set of enforceable civil rights for disabled people. The disability equality duty requires all public bodies to anticipate the needs of disabled service users, employees and potential employees. The duty will make sure that it is no longer acceptable, if it ever was, to wait until a disabled person complains before taking action.

The noble Baroness, Lady Campbell, asked about a single integrated complaints procedure across health and social care. We have recently completed the consultation Making Experiences Count, which fulfils the commitment for a single complaints system across health and social care. It will go much further and propose a new approach that will make the experience of making a complaint easier, more user-friendly, co-operative and much more responsive to people’s needs, involving independents where required. A vital element is that health and social care services should learn routinely from the complaints feeding into service improvement.

Like my noble friend Lord Ashley, I am under no illusion that we still have a fair way to go before all disabled people are empowered to participate fully in society. The Government are not complacent, and we are determined to deliver real change not just in the lives of disabled people themselves, but in the way in which society reacts to disability. I have set out a brief description of what we are doing, but I shall highlight key steps along the path to delivering that change.

We clearly set out our commitment to delivering equality for disabled people almost three years ago in our White Paper, Improving the Life Chances of Disabled People. As a key step in driving action to make that commitment a reality, we launched the

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Office for Disability Issues two years ago. Just over a year ago we launched Equality 2025, an independent advisory group of disabled people, to advise Ministers and government departments on disability equality aspects of policy development. At the earliest opportunity the Minister for Disabled People signed for the UK the new UN Convention on the rights of disabled people. I am assured by my honourable friend the Minister that we will ratify that convention by the end of 2008.

Many questions were posed and noble Lords must forgive me if I miss any out. I shall come back to noble Lords in writing and we shall of course have an opportunity to explore many more of the issues in Committee. Many noble Lords raised the issue of carers. This Government have done a very fine job in improving the lives of many carers, who are of course central to the lives of many people with disabilities in this country. We could not function as a society without carers. We have announced the national carers strategy review, a new review of carers, which focuses in part on the issue of young carers. The current situation is of course absolutely abhorrent and, while it is not possible to prevent children or young people from wanting to help and support their disabled relative, services and support should be in place to prevent them being depended on inappropriately. We must and will address that in the new carers strategy.

My noble friend rightly said that we must begin discussions on all the issues encapsulated in his Bill. I hope that one discussion will be in the very near future with my noble friend the Leader of the House, who will lead in the House on the new equalities Bill. I know that she would certainly value his advice on disability issues in that very important new Bill.

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