§ 1.59 p.m.
§ Mr. Ivor Clemitson (Luton, East)
I am grateful for the opportunity to raise what might seem to be a small matter following our debates on the great issues of the economy. I wish to draw attention to the conditions at the Industrial Rehabilitation Unit at Egham, Surrey. It is not a small matter for the people concerned; nor should it be a small matter for the people of the United Kingdom. How we treat the disadvantaged members of our society is a measure of the level of humanity and of civilisation that we have reached.
835 In the next few moments, I shall try to be the mouthpiece of one of my constituents, Mr. David North, who recently spent some weeks at the unit. He is a severely physically disabled person, he walks with great difficulty, his hands are badly crippled, and his speech is badly affected. Yet within his crippled body there is an able brain. Indeed, he is currently a student at the Open University and is making good progress in his studies.
Even more important, he is a man of the highest integrity who is intensely concerned for the welfare of his fellow human beings. I say this as background, because it is of more value to hear and consider the views and experiences of a "consumer" of the unit than those of a casual visitor to the etablishment. That is particularly true when the "consumer" is a disabled person. Much as those of us who are not disabled may sympathise with those who are, and much as we may try, by an effort of the imagination, to put ourselves in their place, we can never fully succeed in doing so.
The criticisms of the unit that follow are in no way a criticism of the staff. Mr. North emphasised that he felt enormous gratitude for the extreme kindness and helpfulness that was shown to him by every member of the staff. The criticisms are directed rather to the physical and environmental conditions prevailing at the unit, conditions which Mr. North described as appalling and the initial shock of which took him several weeks to get over.
It may be argued that his expectations were too great and that his standard of reference was unfair. Over the past three years he has spent some time at several modern university campuses and stayed in their residential accommodation, but for him to make such a comparison and to use such a standard of reference is perfectly legitimate. After all, a university and art industrial rehabilitation unit both perform educational functions. One may be academic and the other concerned with training for jobs, but both are educational in the broadest sense. Given such a wide difference in conditions and facilities between the two establishments, I have every sympathy with a disabled person who is a client 836 of the unit and who regards himself, or herself, as a second-class citizen.
The unit is a large conglomeration of army type huts covering a wide area surrounding a large Victorian mansion. The house is used exclusively for administrative purposes and as staff quarters. The unit has accommodation for 2,000 rehabilitees. To cater for those persons outside working hours there is only a welfare block which, excluding the dining rooms and kitchens, consists of three rooms—a relatively small reading room, which is supposed to be quiet but rarely is, a large television room with two billiard tables and which, therefore, offers little opportunity for watching television programmes, and a gymnasium where games such as darts and table tennis may be played.
The lack of adequate space for relaxation and study Mr. North found to be one of the most distressing aspects. It is an especially important feature because of the large number of people attending the unit who lack confidence in themselves. One way in which they might be enabled to build up confidence is through participation in small informal groups meeting in a relaxed and comfortable atmosphere. That would argue for the provision of a large number of small comfortable sitting rooms or meeting rooms.
Another disturbing aspect of the unit is that it is so ill-adapted to the needs of the most severely disabled. Not only are the walking distances involved great for such people, but certain essential facilities are lacking. Mr. North told me of one young person, confined to a wheelchair, who was unable to use the toilets in either the welfare block or the workshops. Each time he wished to use the toilet he was forced to go back to the block containing his billet. The maximum inconvenience tends to fall upon those who are in the worst position to cope with it. It is ironic that modern universities should have taken into account to a far greater extent the needs of the disabled than has a rehabilitation unit intended for their use.
There is also a fire risk. Regular fire drills are conducted, but Mr. North reported that he was not convinced that the more severely physically disabled in the central wing would stand a fair chance of getting out safely in the event 837 of a fire during the night. There is a lack of doors designed to prevent the spread of smoke, from which much danger might come. Further, there should be an emergency exit in every billet to take account of the problems of the most severely disabled.
Mr. North raised with me a further matter that at first sight might seem trivial or frivolous. Despite his experience of working on the shop floor, he was somewhat disturbed by the continous flow of "rather filthy language". He is no prude and, as a democrat, believes in the right of every individual to use whatever language he chooses, but he points out that other individuals have an equal right to escape from it, and the opportunity to do so is not available at the unit. As he says, the use of bad language is a symptom of the insecurity and lack of confidence of many people in the unit. The whole environment of the place does little to remedy the situation, and perhaps a great deal to encourage it.
To sum up, the industrial rehabilitation unit at Egham leaves much to be desired. It caters inadequately for the physical needs of the disabled and, just as important, for their psychological needs. I return to what I said at the beginning—the way in which we treat the disadvantaged members of our society is a fair measure of the level of humanity and civilisation that we have reached. The disadvantaged need a greater, not a lesser, share of our resources of all kinds, material and other, than do the rest of us. They should be at the front of the queue, not at the back.
I emphasise that these criticisms of the unit are not offered in a destructive spirit. They are intended to help to achieve the common objective of my right hon. and hon. Friends in the Department of Employment, of Mr. North and of myself, namely, the improvement of facilities for disabled people.
§ 2.10 p.m.
§ The Minister of State, Department of Employment (Mr. Albert Booth)
I thank my hon. Friend the Member for Luton, East (Mr. Clemitson) for the constructive and sensitive way in which he initiated this debate on an admittedly difficult problem. I also thank him for 838 the courtesy which he has shown myself and my officials in indicating to us some of the particular aspects of the problem which he wished to raise.
First, I should like to deal with some of the specific points. The maximum number of beds in the Egham unit is 179, and not over 200. For various reasons, it is seldom that as many as 170 beds are occupied. On the check which we made, it would appear that over the past few months there has been an average number of 130 people at the unit. In the welfare block there is a small reading room and a large television room, with two billiards tables at the back and a gymnasium. The gymnasium is used for darts, table tennis, concerts organised during the winter and weekly film shows.
Additionally, in each residential block there is a large common room which is rarely used to any extent. Most rehabilitees prefer to congregate in the welfare block in their leisure hours. However, unfortunately, for the relatively few chair cases among the unit's population, these common rooms are not accessible because of steps. Clearly we could not defend that situation in any permanent arrangement for public buildings. In accordance with the spirit of the Chronically Sick and Disabled Persons Act, we in the Department regard ourselves as being under a strong liability to ensure that there are proper facilities for the use of disabled people.
There are discussion groups at the unit organised by the rotary club, and handicraft classes are set up according to demand. These are successfully held in the dressing rooms adjoining the gymnasium. Further education classes have been in demand and the dining room is used for this purpose.
Therefore, there is a range of activities open to residents which may be pursued simultaneously by making good use of such space as is available at the centre. During the summer the position is better, as the facilities and equipment for tennis, putting, cricket and archery are available. For the younger rehabilitees there is free membership of Egham Youth Club. We would not contend that these are ideal welfare facilities for the number of residents catered for by the centre, but, for reasons which I shall mention, I hope that it will be agreed that they go some 839 way towards meeting an important need of a residential centre.
It is contended in Mr. North's complaint that the unit is ill adapted for the needs of severely disabled people. Walking distances are involved in using the centre's facilities. However, it must be borne in mind that the unit's purpose is to prepare disabled people for employment and therefore we expect either a certain standard of physical fitness to he achieved or that people in wheelchairs are able to use their chairs in circumstances not drastically dissimilar from those which they will encounter on taking up employment in industry or commerce. We believe that the distances which people have to cover within the centre are not totally incompatible with that aim.
Not all the toilets in the blocks are specifically adapted for the needs of disabled people, but there is a toilet in the welfare block which has been fitted with a handrail and which may be used by people in wheel chairs. The workshop has toilets specially adapted for chair cases.
I take seriously the criticism made about bad language in the spirit in which it was raised. I appreciate that bad language can reflect a number of things, one of which may be a degree of insecurity. It may also reflect an attitude towards the environment. I recognise that this can be a problem. To the extent that by providing better facilities in industrial rehabilitation units we make a contribution to overcoming this problem, I give the assurance that we are doing something about it.
On the other hand, we recognise that people's speech habits reflect social relationships as well as relationships with more material environmental aspects. We bear in mind that when people go into industry they face problems of social relationship and immediate physical environment. Therefore, as we are trying in the rehabilitation centres to achieve what might be called a halfway house arrangement or, better still, a way of adjusting disabled people in two stages to life in an industrial environment, it would be wrong to attempt, by a rigorous régime, to stamp out the use of bad language. That might cause more problems than it solved, and it might be said that if we did that we were treating 840 people as second-class citizens in an undesirable manner, because one thing which the first-class citizen can apparently claim to have is the right to use the language he chooses.
I come to the more general problem of the Egham unit. It was the first such unit to be established by the Department of Employment. It was opened in 1943 and was located in what was then a country estate in a quiet part of Surrey. In those days, industrial rehabilitation was regarded very differently from the way in which the Department regards it today. It was then thought that it consisted largely of convalescence, moderate exercise, good food and plenty of fresh air, and the siting of the unit was accordingly considered to be ideal.
Today we want units to be sited very much closer to places at which people leaving them are likely to be employed. We want them to have an atmosphere and construction which lends to their adapting people to moving rapidly into industry. At Egham an old mansion was adapted to accommodate an administrative block and staff quarters, and residential quarters for the disabled rehabilitees were established in army-type huts adapted for the purpose.
The unit currently provides residential accommodation for 179 rehabilitees—149 men and 30 women. It caters particularly for those who live beyond daily travelling distance from centres and for more severely disabled people who require such facilities as nursing supervision who could not be looked after satisfactorily at day units or at residential hostels and lodgings. Therefore, we have a continuing problem with this type of centre because it must cater for people in residence, which is not the case with other centres, which are used, in the main, to train people who can make daily visits and can go from the centre to an industrial environment without necessarily requiring the special facilities which the more severely disabled must have.
Despite the attractive rural environment at Egham and the dedicated efforts of the staff who operate the unit as effectively as possible, the Department has recognised for some years that the site and the standards of accommodation are not entirely satisfactory. In 1966–67 the industrial rehabilitation service was reviewed in depth by an interdepartmental 841 working party which recommended that the unit at Egham should be closed and replaced by two purpose-built residential units, one in the north of the country and one in the south. It was considered that the two proposed new units would provide a more realistic industrial environment and tempo, and more suitable central residential accommodation, as well as improve the national geographical distribution of residential facilities at industrial rehabilitation units.
Unfortunately the Department has not been able to accord a high degree of priority to implementing these plans for improving its residential facilities because it has been considered desirable to concentrate available resources on improving geographical coverage provided by day industrial rehabilitation units. A planned expansion programme has increased the number of units from 17 in 1966 to 26 in 1974. I hope that in view of these numbers it will be appreciated that a considerable amount has been done, and spent, by the Department in increasing the size and number of rehabilitation units available, and that expenditure on the Egham unit has to be seen in the context of the total amount available for rehabilitation facilities.
Moreover, the Department has been faced with difficulties in finding suitable sites for the proposed two new residential units. However, a site has been obtained in the North and a new mainly residential unit with 140 beds is scheduled to be opened at Preston in 1976. This will be a modern, specially designed unit with first-class facilities and high standards of accommodation.
The Department has not yet been able to find a site for a new residential unit in the South, but a recent review of the overall demand for residential facilities has shown that, because of the better distribution of day units and the marked preference of most disabled people for day visits where available, we should be able to meet the demand with a smaller unit in the South than was originally envisaged—perhaps with about 80 or 90 beds. This has significantly improved the prospect of finding a suitable site and will, we hope, enable Egham to be closed in 1976.
Against this background, and bearing particularly in mind the considerable ex- 842 penditure over recent years on new day units and the plans to close Egham, it has been difficult to justify spending money on major projects designed to improve the standard of residential accommodation at the unit. While it is accepted that the standard of accommodation at the unit leaves much to be desired and falls short of what the Department would wish to provide, it has been necessary over recent years to strike a balance over the expenditure which could be justified.
The unit has been kept under regular review, essential improvements have been put in hand and maintenance work has been carried out where necessary. During 1969 and 1970 £20,000 was spent on improving welfare facilities, uplifting standards in the kitchen and canteen, providing single room accommodation in the residential blocks, and on workshop improvements. In 1971 the women's block was redecorated and equipped with new furnishings. As a result of an inspection in January this year it is proposed that further improvements be made in the unit's furniture and fittings at an estimated cost of £8,000.
When the new industrial rehabilitation unit opens at Preston in 1976, residential facilities for disabled people in the North) will be considerably improved. If a suitable site can be found in time to open a new residential unit in the South also in 1976, it will enable us to close the unit at Egham and the position throughout the country will then be transformed.
In the circumstances it should not be necessary to undertake more than the modest interim improvements already planned at Egham. If, however, a site in the South cannot be found reasonably quickly and it appears that it may be necessary to retain the Egham unit beyond 1976, I assure my hon. Friend that we shall fully accept the need to review the situation urgently to consider whether more extensive improvements to the residential accommodation at Egham should be put in hand.
The position will be closely watched and meanwhile we shall look carefully at some of the other specific points which my hon. Friend has raised. But I assure him, in view of the way he has raised this matter, that we shall do one of two 843 things—either create a new unit or, if we cannot fix a date to do that, look quickly at what can be done to make more significant improvements in facilities at Egham.
My hon. Friend raised other specific points, including fire risk at Egham, which I take seriously. There is an emergency exit at the end of each corridor in the unit. The Factory Inspectorate issued a certificate of fireworthiness on 19th October last year under the Offices, Shops and Railways Premises Act 1963. The local fire brigade holds an exercise at the unit about once a month in order to rehearse its arrangements, and to check fire hydrants and the adequacy of contingency plans. Fire drills are held regularly, although they are arranged so as to cause minimum inconvenience to the residents.
I must stress, however, that the average length of stay is six to eight weeks and there is, therefore, a rapid turnover of residents. The physical disabilities of many of the residents are severe and I am sure my hon. Friend will agree that it is absolutely right that precautions should be taken against the outbreak of fire and that emergency arrangements should be regularly rehearsed.
I end on a note on which I feel sure there will be general agreement, relating to the staff at the unit. I much appreciate my hon. Friend's remarks about the staff. I have looked into their work, and, since it is in the context of the debate about the problems of the rehabilitation unit, I report the results of the work at Egham.
Once a year a follow-up survey is made of all rehabilitees who have completed courses. This takes the form of a written questionnaire six months after completion of the course. Nationally about 63 per cent. of rehabilitees were in employment or undergoing training for employment six months after completion of courses. This is a considerable achievement. I particularly draw attention to the fact that from the last survey taken it was found that slightly more than the national average figure had been attained by the staff and the rehabilitees—it is a joint achievement—at Egham. About 65 per cent. of those who completed courses at Egham were 844 found six months later to be in employment, or undergoing training for employment.
I join my hon. Friend in complimenting the staff. Despite the difficult conditions at Egham, which concern both my hon. Friend and me, and about which I have given assurances, the staff have done a wonderful job, which is to their credit and to the benefit of the many rehabilitees who have gone through the centre.