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Public bodies must tackle these inequalities in a concerted and sustained way. That is what this duty will require. They will need to think strategically about what more they can do to address socio-economic disadvantage individually and with their partner organisations when they decide their key priorities, set their targets and plan and commission their services. That goes directly to the heart of the matter.
There was much debate in Committee about whether the Government should be tackling the outcomes or causes of socio-economic disadvantage. To be clear, we are trying to break the cycle of deprivation, where the effects-the outcomes of past disadvantage such as childhood poverty, poor educational achievement, poor housing and health et cetera-become the causes of future disadvantage and inequality. This duty will help us to break that cycle. We have made clear in the wording of the duty that we want to see real change with tangible, measurable outcomes.
The Scottish and Welsh Governments want this too. Clause 2 will enable the duty to be extended to cover public bodies in Wales and Scotland. It is noticeable that the Scottish Government, having been initially sceptical about the duty, held a public consultation that overwhelmingly backed it and then asked to be included.
Clause 3 is necessary to ensure that the duty has its intended effect, influencing the key strategic decisions that public bodies make without giving rise to private rights which would divert resources away from benefitting the public as a whole. The noble Baroness, Lady Warsi, again made reference to the comment of my right honourable friend Vera Baird that there is no harm in this. As I made clear in Committee, the noble Baroness quotes the Solicitor-General selectively. She also said it is a strong measure and that,
The duty is an essential part of the Bill. It underpins all the excellent work that we and others in the public sector are doing to tackle inequality and disadvantage. It will have a significant positive effect on the way that public services are planned and delivered. With minimum bureaucracy and maximum flexibility, the duty will make clear that tackling all inequalities-whether they arise from characteristics such as age, ethnicity or disability or are due to poverty more generally-is a core function of public services. It is the right thing to do. It is extremely important that we all demonstrate our commitment to tackling poverty and disadvantage. I ask the noble Baroness to withdraw her amendment.
Lord Avebury: My Lords, before the noble Baroness sits down, does she agree that the noble Baroness, Lady Warsi, should have been influenced by all the discussion that has taken place outside this House? As well as the Scottish and Welsh Governments, as the Minister said, the Equality and Human Rights Commission have forthrightly supported the original purpose of these clauses. My noble friend Lord Lester has wisely altered his opinion. It is a pity that Oppositions do not sometimes do that, as Governments do.
Baroness Royall of Blaisdon: My Lords, I agree that there has been much debate from many organisations, such as the CABs, around these clauses. They are right to urge us to change our minds. I am glad that, when people listen to the arguments, from time to time they change their minds.
Baroness Warsi: My Lords, I was interested to hear the comments from the Liberal Democrat Front Bench. The noble Lord, Lord Avebury, referred to the Equality and Human Rights Commission and outside bodies urging us to rethink and change our minds. I take on board those comments, but the noble Lord will also be aware that the noble Lord, Lord Lester, gave an explanation for his change of mind. If I recall, that change came from his having dinner over Christmas with some Irish, left-wing-leaning friends-not the Equality and Human Rights Commission. Clearly he is listening to other bodies and friends to change his mind.
The central point in this matter is that socio-economic disadvantage is a severe issue. There is no doubt about that. I take issue with the Minister on socio-economic disadvantage. It has got worse under this Government. The gap between the richest and poorest has got wider. Social mobility has got worse. I quoted the statistics earlier.
I am extremely familiar with the Hugo Young lecture to which the Minister referred. The lecture, given by my right honourable friend the leader of the Opposition, was extremely good and I am grateful that she referred to it. It effectively pointed out that socio-economic inequalities are dealt with by following a certain policy direction and above all by having political will, which I would say the current Government do not appear to have. When you have policies and a benefit system that effectively keep families apart, of course you are going to have worse socio-economic disadvantage in those communities, but you cannot deal with socio-economic inequality by legislating it away in the 13th year at the end of a tired Government.
Baroness Royall of Blaisdon: If I might say so, I think that the noble Baroness's memory about what has been happening over the past 12 or 13 years is somewhat selective. We have made significant progress over the past 12 years in addressing inequalities and there have been notable reductions in child poverty and pensioner poverty, and significant improvements for poor children in school achievement. Yes, I recognise, like the noble Baroness, that there is a lot more to be done. That is why we have included these clauses in the Bill, because we believe that this is one of the ways forward.
Baroness Warsi: My Lords, I do not doubt the sincerity of the Minister in her commitment to this cause, but we on these Benches do not feel that this is the right way to deal with it. At this stage, I would like to test the opinion of the House.
"( ) Without prejudice to the operation of sub-paragraph (2), the mental impairment consisting of or resulting from depression that has ceased to have a substantial adverse effect on a person's ability to carry out normal day to day activities, shall always be treated as if that effect is likely to recur if the person has had within the last 5 years a previous episode of such impairment which has had a substantial adverse effect on the person's ability to carry out normal day to day activities for a period of 6 months or more."
"If an impairment ceases to have a substantial ... effect on a person's ability to carry out normal day-to-day activities, it is to be treated as continuing to have that effect if that effect is likely to recur".
Our concern is that many fluctuating and recurring conditions are very hard to diagnose, and this situation may be exacerbated by considerable debate in the medical profession. The end result, of which we are afraid, is that some people may not be covered by the protective provisions in the Bill purely because it is too difficult to forecast accurately whether the condition is likely to recur.
In her response, the noble Baroness, Lady Thornton, stated that this amendment would create a risk that those with depression are treated more favourably than others and that it could blur the line between those who have suffered a single period of depression and those who have a clear illness. Although I take those points on board, the noble Baroness did not address the key issue, which is that it is very difficult to draw the line between what might be a single period, or even several discrete episodes, of an illness such as depression, and an underlying long-term condition. Evidence shows that at least 50 per cent of people will have a recurrence following their first episode and that at least 70 per cent of people will have one following their second. However, this can often be confirmed only retrospectively.
I fear that legal wrangles will arise from this part of the Bill whereby the courts will have to make the final decision. That is far from ideal. Moreover, diagnostic manuals drawn from the National Institute for Health and Clinical Excellence guidelines say that moderate or severe depression is a time-limited disorder which will typically last up to six months. That is why we have included the period of six months. Therefore, it is not an arbitrary figure but comes from those guidelines. It often cannot be confirmed that specific periods will last for up to 12 months. If it also cannot necessarily be determined whether the depression should be classed as discrete episodes rather than as a long-term condition, it is likely that those with depression could be left out of the Bill's provisions.
The noble Baroness, Lady Thornton, was nervous that this amendment could afford greater protection to those with depression than to those who have other impairments. However, that is already the case for some other conditions which are rightly deemed to be covered by the protection of the provisions although the facts of those cases might not quite fit the definition given in the Bill; patients with cancer, HIV or multiple sclerosis, for example, are all deemed to come under the definition of disability. Is it therefore correct to say that the amendment could not be accepted because it would treat depression more favourably? Surely the Government have already accepted that this is necessary in some cases. They have already said that the position is difficult as there could be two periods of depression that were not connected and, therefore, did not represent an underlying problem. That might be true, but the situation illustrates the difficulty of diagnosis. Sometimes it could represent distinct episodes, but at others it could represent an underlying condition. A different trigger is not necessarily conclusive proof that they are distinct episodes.
The main difficulty is clarifying exactly when an underlying condition starts. We are looking to achieve certainty and clarity in the Bill and to ensure that protection is there for all who should have it. I am not at all sure that the provisions in this area achieve that.
Paragraph 1 of Schedule 1 gives a regulation-making power. Is this something that the Government would consider using to include a condition such as depression? Will the Minister give a commitment to investigate
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I turn to Amendment 14. As I said in Committee, the Bill should be about achieving real change. The noble Lord, Lord Low, made a compelling case that access to information for disabled people remains an area where inequality is still rife and that real change is needed. Fifteen years after this party took the original Disability Discrimination Act through Parliament, we support this amendment to help disabled people share in the information age. However, we must not assume that improvement will necessarily follow. This seems to be an opportunity for the Equality and Human Rights Commission to distinguish itself. These Benches certainly want to know what plans it has to take advantage of this new provision to drive real changes for disabled people. In Committee, we tabled amendments similar to Amendments 20A and 44A to probe the Minister on the extent and cost of reasonable adjustments. I look forward to the Minister's response.
I look forward to the Minister's response to these amendments and to Amendment 60 in the name of the noble Lord, Lord Low. I have some sympathy with it but will wait to hear whether the Minister thinks that it is necessary. I beg to move.
The Parliamentary Under-Secretary of State, Department of Health (Baroness Thornton): My Lords, I shall speak briefly to Amendment 14 in the name of my noble friend Lady Royall. This amendment makes it explicit that to satisfy the first and third requirements of the reasonable adjustment duty, covering changes to provisions, criteria and practices and the provision of auxiliary aids, those bound by the duty must take reasonable steps to provide information in an accessible format where disabled people would otherwise be at a substantial disadvantage in the way that information is being disseminated.
When the noble Lord, Lord Low, spoke in Committee on 13 January, he told us that removing the barriers created by providing inaccessible information is as important to the inclusion of those with print disabilities as the removal of the barriers created by physical features is to those with physical disabilities. We were left in no doubt about the prevailing strength of feeling on this issue during the very good debate that followed. I agreed that we would take the matter away and return to it on Report.
We share the same objectives as the noble Lord, Lord Low, here. We want a duty that is set out in clear and unmistakable terms so that both those with rights and those with responsibilities understand what they are. We want to see a significant increase in the reported levels of compliance with the duty where it concerns the provision of information in accessible formats. It is important that all kinds of organisations consider the information they provide to their audiences and what steps they may need to take to bring themselves into line with the duty. As we said in Committee, we consider that the duty as drafted works. That said, however, and on further reflection, we have decided to act to move the matter beyond doubt.
This amendment reinforces what already appears in the Bill and provides greater transparency. It should enable the Equality and Human Rights Commission to exemplify with authority in its statutory codes and guidance how the duty should be delivered for those disabled people who experience information disadvantage. These debates may well cause the EHRC to consider whether an inquiry into the provision of accessible information would be a timely and worthwhile intervention for it to make.
We are proud of this amendment. We believe that if it is properly built on, it could be a turning point for people with information disabilities. I therefore commend it to the House. I am also very grateful to the noble Baroness for her support. At the end of this debate, I shall give the Government's view on the other amendments in this group, including that of the noble Baroness.
Lord Low of Dalston: I see some difficulty with Amendment 4 as drafted. One has to wonder why depression is singled out. There is also a difficulty with assuming that depression is likely to recur. However, the definition of disability is something which presents the greatest obstacle for disabled people wishing to make claims of discrimination. A particular difficulty surrounds the application of the term "long-term". Although we may not be able to achieve a final solution this afternoon, this is an issue to which Parliament will need to return at some stage.
I want to speak mainly to government Amendment 14, which has just been spoken to by the noble Baroness, Lady Thornton, and also to Amendments 20A, 44A and 60, which are in my name. Before I do, however, let me make two general points. First, those representing disabled people are very appreciative of the extent to which the Government have taken their concerns on board during the passage of the Bill, particularly as it has passed through your Lordships' House. They are also particularly appreciative of the efforts of the Bill team and departmental lawyers to find solutions to sometimes quite intractable problems and to incorporate them in the Bill. This testifies to the good outcome that can be achieved when you have a listening Government and a House of Lords which knows its onions subjecting legislation to careful scrutiny.
Secondly, I hope it will be seen as a helpful move in expediting Report stage to have grouped together all these amendments which relate to disability. This entails some sacrifices in terms of presentation and getting things on the record, but I hope that it will nevertheless be win-win and that we will all be net gainers.
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