Disabled Persons (Independent Living) Bill [HL]

My Lords, the temptation on an occasion like this is to recycle the speech one made last time. I shall resist that temptation. I do, though, congratulate the noble Lord, Lord Ashley, on bringing his Bill forward again. However I must warn him that what he seeks is one of those issues that seem to take a long time to bear fruit. However, as my noble friend Lady Gardner of Parkes said, perseverance pays. I know, of course, that my right honourable friend David Cameron has written to the noble Lord on the subject of independent living for disabled people, saying that my party desires it for as many people as possible, both for those who are disabled and in the social care field more widely. I hope and trust that I have never given the impression that I believe anything different. If I have, it is certainly a subject that would cause my days on this Bench to be numbered. What I do, and always have done, is base my consideration of any issue regarding disabled people on a very simple concept upon which no one anywhere has ever contradicted me: that disabled people are people first, disabled second. It follows from that that I believe that disabled people should have the same rights as able-bodied people. I believe that, on the whole, they have those rights but are unable to access them because of discrimination. So, as the noble Lord, Lord Ashley, has highlighted this afternoon, disabled people still have quite a long way to go to catch up with able-bodied people. There have, however, been great strides in this direction. My right honourable friend Mr Hague introduced his disability Act in 1994, and this Government tightened it up in their amendment Act which we discussed in the 2004-05 Session. I hope that the noble Lord, Lord Ashley, will not have to wait yet another 10 years to get a Bill like this one on to the statute book. Returning to my concept, I find that Clause 1, especially subsection (1), fleshes that out wonderfully. The problem is, though, that there are many areas of our national life where disabled people have become, or indeed always were, second-class citizens. I single out in particular transport, housing and healthcare. On transport, of course, we as a nation are getting there. More and more buses and trains are being equipped with sight and sound machines, for want of a better description, so that if you are blind or deaf you can be told that a train, for example, is now arriving at such and such a destination—something that an able-bodied person would be able to tell almost automatically. Why, oh why, though, does my London bus tell me only that it is stopping at the next stop and not what, or rather where, that stop is? Trains and modern black cabs—if you can afford to use them—now almost invariably have ramps for wheelchair users, and modern buses have low-level access. I am the first to acknowledge, though, that none of this is universal and that, as a nation, we still have quite a way to go. I wish that I could say the same of the housing and health and social services of this country. First, I shall deal with housing. In our debates on the 2005 Bill, we pressed the Government hard on the need for local authorities to have a list of properties in their area that were suitable for disabled people. The noble Baroness, Lady Wilkins, waxed lyrical on this issue. Even though the best local authorities already have such lists, the Government refuse point blank to make it a general requirement, for what I regard as a most spurious reason; namely, the need for constant revision and the fact that all dwellings would have to be surveyed originally. What nonsense. A reporting requirement is all that is necessary. There can be no downside in landlords and owners having an obligation to inform the local authority of adaptations making their properties suitable for disabled people. Nine times out of 10 they would need planning permission anyway. The Government pride themselves on joined-up government, not always realistically, as I pointed out on Wednesday, so why not joined-up local authorities? Anyway, if Liverpool can do it, why not Hounslow or wherever? I think that the real grouse of the noble Lord, Lord Ashley, is about access to health and social services, on which I am afraid an unhappy picture emerges, as we have heard. It has been the law for some time now that health services in residential homes are free. However, it just is not happening, mainly I suspect because there is no definition of health services and because, unlike in Northern Ireland and Scotland, health and social services are not run by a single authority in England and Wales. The result is that each guards its budget very carefully, to the huge detriment of those it should be spent on. If they are conjoined into the same health and social services authority, this simply does not happen, as I know from my time in Northern Ireland Where the money comes from the pot, people benefit. This joined-up thinking extends to the right of an individual, disabled or not, to refuse residential care. Why should people be shovelled into inappropriate ““boxes”” against their will? The answer surely is that it is more convenient, though by no means cheaper, for social services. The figures speak for themselves. As the noble Baroness, Lady Wilkins, said, the government-commissioned report Reviewing the Disabled Facilities Grant Programme tells us that the average cost of independently provided homecare in 2005 was £4,800 and that the cost of residential care is now £36,000 to £40,000 a year. The Government’s response was due early this year. It is now almost next year. Why the delay? Then in care homes, we know all about the problem of social service workers and the health service making the necessary investment in things like chiropody, physiotherapy, rehabilitation—perhaps after a stroke, in which I declare my usual interest—and general confidence-building. There simply is not enough joined-up thinking here, when some of the requirements must come out of the NHS budget and others from the local authority. The answer of the noble Lord, Lord Ashley, to this is to have a joint pot of money, distributed to individuals to promote their capacity for independent living and to spend as they want. This proposal causes great sucking of teeth. ““How””, the authorities ask, ““will we know that the money is being spent appropriately by the recipient?””. What no authority is prepared to answer is the question: does it matter? Does it matter, that is, as long as it keeps people out of hospital and care homes? Speaking personally, I do not think that it matters one jot. The same applies to dying in dignity. We in this Chamber are lucky enough to be able to exercise that right. Millions outside, however, are not. It is rare indeed for people to spend their last days in a hospital ward with dignity, especially in mixed wards, which have been so much in the news lately. There are occasions—far too many, I am afraid—when disabled people are expected to conduct their own affairs with officialdom. I agree that it should be automatic for someone with motor neurone disease, deafness or mental health problems and so on to be able to take an advocate with them to, say, the jobcentre, hospital or local housing authority. I am not, however, saying that the advocate should necessarily be paid for by the state, or indeed at all. I am saying that there should be no bar to access, and I shall be exploring that in connection with the Welfare Reform Bill. In the same way, why cannot one part of officialdom trust another? I ask your Lordships to envisage a situation where a person becomes disabled. He is assessed for his needs in one part of the country, lives there for a bit and then wants to go and live with, or closer to, another member of the family many miles away. Why should he then have to be reassessed, with all the trauma and extra costs to the authorities that that entails? Those costs are huge. I am told that assessment and commissioning amount to 32 per cent of the total cost for people with learning difficulties, 19 per cent for physically disabled people and 26 per cent for families with disabled children. To have to incur these costs again and again, and sometimes even again, is, to quote the late Lord Hailsham, stark staring bonkers. To sum up, the heart of the noble Lord, Lord Ashley, is, as usual, in the right place, as is shown by the ringing endorsements that he has received from both the Director-General for Social Care and the Local Government Association. I warn the Minister that the noble Lord always gets his own way in the end.