Disabled Persons (Independent Living) Bill [HL]

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 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 reviews 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. 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, when she announced £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 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 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. That is something that we must and will address 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. The noble Baroness, Lady Masham, rightly drew our attention to many shortcomings in the National Health Service. I shall get back to her in writing on some of the issues; clearly the problems experienced by her husband were and are unacceptable. The noble Baroness is correct that some services are patchy in some areas: in some areas they are excellent and in others there is huge room for improvement. That is precisely why my noble friend Lord Darzi is undertaking his review. On palliative care, I am grateful for the examples that the noble Baroness cited. I also draw attention to a very fine ““hospice at home”” programme in my own PCT in Gloucestershire, which is being run in conjunction with Sue Ryder Care. That provides an excellent service which I hope will be replicated throughout the country. Of course we must give greater attention to tender loving care and dignity. We have, as noble Lords will know, a Dignity in Care campaign, and we have to ensure that it brings about results. The noble Baroness drew to our attention the problems of assessing people with mental health problems. We agree about the importance of assessment and treatment, but we believe that the best way forward is through measures to support and develop best practice on the ground. The Government's role is to set priorities and standards for the NHS but it is best for those assessments and the requirements for those assessments to be met on the ground. The noble Baroness, Lady Greengross, spoke about disabled people and employment. We are working with employees and employers to disseminate best practice in health and safety at work and in absence management and recruitment and retention policies. We are working with health professionals to disseminate best practice in vocational rehabilitation, providing support for employment advisers. We also have pilots ensuring that there are employment advisers in GP surgeries. The Department for Work and Pensions published a consultation on 3 September to consider options to reform disability employment programmes such as Work Step. The DWP wants to ensure that the individual's requirements are properly supported. The consultation runs until March 2008 and I urge noble Lords to respond to it should they know of any examples. On better and earlier advice on employment, we are introducing a new gateway to benefits and are transforming the current assessment process within the gateway so that it provides professional assessment of an individual’s eligibility for financial support based on their functional capacity. It identifies those who are capable of taking part in work-related activity and the support and interventions required to help them get back to work. It identifies people who are so limited by their illness or disability that it would be unreasonable to require them to undertake any form of work-related activity in the foreseeable future. The noble Lord, Lord McColl, drew our attention to the difficulties encountered by disabled people who move from one place in the country where they have a care package tailored to their needs to another where they have to go through the assessment procedure. I will come back to him on that issue. If we are not addressing it, it will have to be addressed. It is a problem that disabled people should not have to encounter. The noble Lord, Lord Best, raised many housing issues, some of which I shall return to in Committee. I regret that I cannot update him with information on building regulations. As he will know, we recently announced increases in the disabled facilities grant. We will increase it by £25 million for 2008-09, a significant 20 per cent increase. The Government have also announced plans to strengthen home improvement agencies, the locally based not-for-profit organisations which help home owners and tenants renting private housing to repair and maintain their homes. We have also announced a new three-year contract for a national co-ordinating body for HIAs which will support the delivery of the forthcoming National Strategy for Housing in an Ageing Society, providing ongoing support for HIAs and giving the sector a voice in government. On the lifetime home standard and housing for people with disability, the Government have decided to take forward lifetime homes, at least in the first instance, through a code for sustainable homes. The Government consider the code to be extremely important. Its aim is to give developers a non-regulatory means of improving the sustainability of buildings and to become the single national standard that all developers will subscribe to and consumers demand. Putting that in the code is, we believe, a faster way of getting the standard out to developers; making it part of the building regulations would take far longer. Nor does putting it in the code rule out making lifetime homes part of the regulatory base in the long run. This is an issue which government will continue to keep under close review. The noble Lord, Lord Addington, raised the very important issue of transport and the difficulties encountered by so many disabled people. Of course the London underground presents specific problems, and those problems must be addressed. However, I understand why it takes so long. Nevertheless, we have made huge improvements on bus transport, even getting rid of the much loved Routemasters in order to ensure that people with disabilities can travel on buses. I would also draw the noble Lord’s attention to the fact that, just last week, Transport for London won an independent living transport award for making London buses so accessible. I have been speaking for an awfully long time, so will come back to noble Lords on any other issues. In conclusion, I repeat that I welcome the principles underpinning the Bill and again congratulate the noble Lord, Lord Ashley, on giving the House an opportunity to discuss this very important issue. However, I also have to emphasise that the Government are not convinced of the need for legislation of this nature although of course we recognise the right of people with disabilities to be emancipated—in the words of the noble Baroness, Lady Campbell. We believe that there would be major cost implications in implementing all that is proposed, although I firmly believe that the work which the Government have set in train in publishing and responding to the challenges of the life chances White Paper, in particular the plans for a five-year strategy on independent living, means that the goals that we all desire can be delivered without recourse to legislation. I know of no person more determined than my noble friend Lord Ashley; so despite what the Government say, I am sure that one day his Bill will be enacted.