Disabled Persons (Independent Living) Bill [HL]

My Lords, I am always in favour of systems of best practice. That is an excellent idea. I will look into it. If it is not in being, it clearly should be. People tell us that they want to take control of their lives and choose the way that they are supported. They want to shape their own future and make their own decisions. They know where the shoe pinches. The Government are clear that for social care, putting power in people’s own hands is the way forward. A modern system should put people in control by offering personalised services and giving them the freedom to choose the type of support they want. We are committed to driving this forward through the individual budgets initiative, the in-control programme and work on promoting and increasing the take-up of direct payments. These are not separate initiatives or fleeting experiments, but the future for social care in the next decade and beyond. We are determined to make this approach work and will bring together learning from the three programmes to tackle any barriers, share best practice and build momentum for that vision. The individual budgets pilot programme being led by the Department of Health across government is a key driver in this strategy. We have commissioned a comprehensive evaluation of the pilots to make sure that we are gathering the evidence that comes out of them. This will identify whether they can be delivered within our existing resources, whether they are delivering benefits to the people who use them, and whether there are blocks to delivery which will need to be overcome. The evaluation will also look at whether there is a particular model or models of the individual budget programme that work best for people with different needs. We do not expect to have final evidence from the pilots until spring 2008. Therefore, it would not be sensible to have a statutory requirement for the introduction of the individual budgets approach until we have seen the results from the pilot projects, and have had time to consider all the evidence. With the individual budgets initiative and services focused around the person, joint commissioning is needed to bring the services together. The evidence shows that partnership arrangements and joint commissioning are increasing significantly. Perhaps the greatest change in bringing health and local authorities together to meet individual needs will come through the White Paper on local government, with its emphasis on more robust local area agreements, which will enable services to determine jointly what people need in terms of health, housing and social care, and to plan, provide and fund in partnership joined-up thinking, as advocated by the noble Lord, Lord Skelmersdale. Each local authority will be required to have a lead member on health and well-being partnerships—the very person to knock those heads together, as advocated by the noble Lord, Lord Addington. The health service will have a duty to co-operate with local authorities through the statutory local-area agreements. I have heard noble Lords’ concerns that local authorities are raising the thresholds for access to care. It is, of course, for local authorities to ensure that they provide or commission services to meet people’s eligible needs, subject to their resources and with regard to guidance on fair access to care services. We know that local authorities have to make difficult choices. The Commission for Social Care Inspection has recently reported that most local authorities are making the threshold substantial, but that does not mean that the system is excluding those who need lower level services, although I hear the very clear statement made by my noble friend Lady Wilkins. Key to ensuring that people receive the support that they need and want is assessing their needs in the right way. I have heard and understood the frustrations that too many people have encountered when facing multiple assessments. By requiring health and local authorities to implement a single assessment process, the Department of Health intends to ensure a person-centred approach to assessment and care planning for people regardless of organisational boundaries. This will ensure that people receive appropriate and effective support. We are developing a common assessment framework for adults by building on, and extending the scope of, the single assessment process. As with the existing single assessment process, it is proposed that the common assessment framework will cover several domains in order to take a holistic view of an individual’s circumstances and to identify any risks to his or her independence, and the need for support. There is so much I could, and would like to, say about carers and the measures that the Government have implemented to support carers of disabled people. By 2008, we will have invested over £1 billion in support for carers. But we must, and will, do more. I am pleased that the work on the new deal for carers, announced in the White Paper Our Health, Our Care, Our Say is well under way. We are very anxious to take a fully inclusive approach on this project, and the project director is working closely with carers’ organisations to ensure that we do so. We are anxious to ensure proper support for young carers and the provision of short breaks for carers. I fully agree with the noble Baroness, Lady Finlay of Llandaff, that we owe a huge debt to young carers especially, and we must ensure that we consult them when we make policies. The Government are increasing the carer’s grant this year, which, as the noble Baroness, Lady Darcy de Knayth, pointed out, will assist women. The Bill includes several proposals on housing and accommodation for disabled people. The Government fully recognise that it is extremely important that disabled people with access needs are housed appropriately and are given the correct priority for housing. That is precisely why we have amended the legislation governing the way in which housing authorities allocate social housing. The changes that we introduced under the Housing Act 2004 were intended to meet precisely the sort of concerns the noble Lord’s Bill has identified. The term ““medical grounds”” was being interpreted too narrowly by some local authorities, and disabled people were being disadvantaged as a result. The Government also want to see social landlords making the best use of housing stock, including accommodation that is accessible to, or has been adapted for use by, disabled people. We recognise that accessible housing registers can be useful, and the current statutory guidance to local authorities on the allocation of accommodation encourages their use. The noble Baroness, Lady Gardner of Parkes, mentioned stair-lifts. These are usually provided under disability facilities grants, which have been doubled to £120 million since 1997, and the Government are looking for new ways to simplify and improve the delivery of the service to make it more flexible and accessible. The Department for Communities and Local Government will issue consultation options early in the new year for revising those grants. In answer to my noble friend Lady Wilkins, the Government will take forward lifetime homes in the first instance through the code of sustainable homes, which will get the standard out to builders more quickly than through regulation. We will keep it under review. A huge issue for many disabled people is to secure the support of their peers to help them to take the choice and control of their lives that we are aiming to deliver. The noble Baroness, Lady Verma, who has great experience in this area, mentioned user-led organisations, which are a key element in providing this peer support. A strong support network is essential. This is often best provided by bodies led by people who have themselves experienced the barriers that so many disabled people face in achieving equality and independent living. Working closely with the ODI, the Department of Health is taking forward an ambitious programme to deliver the life chances report recommendation that by 2010 there should be a user-led organisation, modelled on centres for independent living, in every local authority area. Working in partnership with disabled people and key organisations, including the National Centre for Independent Living, the aim is to map the current position, identify barriers to the establishment and continuation of user-led organisations, and develop proposals to increase capacity. Early in the new year, the Department of Health will lead a series of regional and national conversations with disabled people, their families and representative organisations on how to deliver this key recommendation. Only this week my honourable friend the Parliamentary Under-Secretary of State for Health, Ivan Lewis, discussed with Dame Jane Campbell further options to make this goal a reality. In answer to the noble Lord, Lord Addington, the Government have not costed the Bill, although work is in hand to establish the cost-benefit case for independent living. On whether anything in the Bill is not covered by evidence at the moment, some issues are not covered—for example, a register of disabled people, the duty to enhance the capacity of service providers and discounted disability benefits. The Government are committed to working to deliver equality for disabled people, but that will take time, as will the improvement in public services which are necessary for disabled people. That is precisely why we have set out a 20-year strategy. I am grateful to my noble friend Lord Ashley for enabling us to have such a high-profile debate on these very important issues. However, the Government are not convinced of the need for all aspects of this legislation at this time. There are parts of the Bill with which we might disagree or that we believe are already achieved through existing provisions. There would also be major cost implications if all that is proposed were implemented at the pace implied in the Bill. We should not forget that the substantial programme of work which the Government have set in train in publishing and responding to the challenges of the life chances White Paper, in delivering the Disability Discrimination Act 2005, in programmes to implement the White Paper Our Health, Our Care, Our Say and the local government White Paper will mean delivery of our shared goals without imposing new legislation. But debate on the detailed clauses of the Bill is for a later stage. At this point, I am very happy to welcome the principles underpinning the Bill, and to congratulate again the noble Lord on enabling the House to address this issue, which is of importance to all of society, but is central to the lives of people with disabilities. I hope I have demonstrated that this issue is close to the Government’s heart and one on which we have already achieved much, but on which there are still many more challenges to be overcome. I am confident that this Bill will act as a catalyst for government and wider society to ensure that the transformation in the lives of disabled people from frustration to fulfilment is as swift as possible.