§ 2.56 p.m.
§ Baroness YOUNG rose to call attention to the development of social policy in relation to the needs of the community; and to move for Papers. The noble Baroness said: My Lords, since I first put this Motion down on the Order Paper a number of your Lordships have kindly inquired what I meant by it. Coming from Oxford, as I do, I suppose the correct reply would be: "Do you want the short answer or the long answer?" The short answer is that I have drawn the terms of reference widely in order that we may debate the philosophy of the social services and in so doing make use of the great experience of many of your Lordships. The long answer is that the House, so far as I can ascertain, has not debated the philosophy of the social services before, and I believe that the time is ripe to do so.
It is now 25 years since the inception of the modern Welfare State. Looking back to what the late Lord Beveridge had to say, I quote:
The plan for social security is designed to secure by a comprehensive scheme of social insurance that every individual, on condition of working while he can and contributing from his earnings, shall have an income to keep him above want when for any reason he cannot work and earn.
§ It is interesting to measure how far we have fulfilled this aim, for it is, too, just over 25 years since the start of the National Health Service scheme and the system of comprehensive National Insurance. Not only should we consider the results of the Beveridge policies, but look at them in relation to three major changes that I see have taken place in society in the last quarter century.
§ The first major change is one of demography. There are now 2½million more people over the age of 65 than in 1950. The number of those over 75 will rise by another 25 per cent. by 1984. These facts are coupled with a falling birthrate, from a peak of 20.4 births per 1,000 in 1947—it was even 18.8 per 1,000 in 1964—to only 12.2 births per 1,000 in 1975. These figures most profoundly affect long-term planning for health, social and educational purposes. They mean, 125 for example, that now 45 per cent. of all hospital beds are occupied by those over 65, that 65 per cent. of all social security expenditure goes on the old, 94 per cent. of all local authority accommodation for old people, and 75 per cent. of the home help services. When we add to this the estimated number of people, 920,000, who do not claim supplementary benefit but who, it is thought, are entitled to do so, one has some measure of the expenditure which will go very largely on the elderly.
§ We live, too, in an era of rising expectations, and at the same time of economic crisis. Many professionals working in the field believe that there has been too much legislation recently, introduced, quite rightly, in each case to meet public demand, but each time with too few resources to implement it. In the last eight years there have been no fewer than six major Acts of Parliament affecting social service departments. It is true, at the same time, that the amounts of money available for the social services are very large. The most recent public expenditure White Paper shows that in 1976/77 spending on education, libraries, science and the arts is expected to be about £6,000 million, on health and welfare services, including supplementary benefits, about £10,000 million. Add to this housing subsidies of £1,400 million and food subsidies of £400 million, and the total conies to £22,800 million—the equivalent of £415 per annum for every man, woman and child in the country, or approximately £1,175 a year for each family.
§ Yet with all this legislation and expenditure there is still dissatisfaction. Because the automatic response to so many difficult and different social problems has been more legislation, society has looked to the State and local government for a solution. Not unnaturally, those working in social service departments feel often that they have been given an impossible task to do, and are resentful when they are blamed whenever something goes wrong. For it is difficult for the State to catch up with the latest problem. Take youth, for example. Two years ago the great problem was drugs. Now, fortunately, that does not appear to be quite so serious, but violence among the young does. New needs are uncovered, battered babies and battered wives and the plight 126 of the one-parent family, and an ever higher standard of services is demanded. How can the machine of State alter course quickly enough to satisfy any of these demands immediately?
§ Frequently, therefore, public expectations remain unfulfilled. Not only are professionals concerned that they are blamed when things go wrong, but the public is worried about the qualifications of professionals for the difficult tasks that they are called upon to perform. It is true that great strides have been made in the training of professionals. In 1950 there were only ten qualifying courses in the country; today there are 140. Even so, only 40 per cent. of those working in the field are qualified, and, more serious still, only 4 per cent. of those in residential establishments are qualified.
§ I shall not attempt to define what is meant by that oft repeated phrase "the permissive society", but what is clear is that over the last 25 years has come a new attitude to the family and its responsibilities. Two recent examples illustrate this. The National Council of Civil Liberties' evidence to the Law Commission proposing that the age of consent should be lowered to 14 implies that at 14 a girl no longer needs the protection either of the State or her family. For the first time in at least 100 years physical maturity means adulthood. Childhood, and with it parental responsibilities, has been shortened, putting the position back to what it was at least 100 years ago. The second example is the reported remarks of the mother of a child who was said to be a prostitute while in the care of the Bedfordshire County Council. It was reported that the mother blamed the social services department for her daughter's behaviour, and appeared to consider that she herself had no responsibility at all in the matter—an attitude accepted by the media, and, I suspect, by many members of the public, as being right. Twenty-five years ago such attitudes would, I believe, have been unthinkable.
§ I have touched briefly on three bigchanges in our society. They are all big issues; each one, in itself, a subject for debate. But pointing to some of the great changes which have taken place in the last 25 years 127 is not enough, and I should like to make some tentative suggestions as to the principles we should be adopting as we look ahead. It was, I believe, Sydney and Beatrice Webb who said that the study of the social sciences would make people socialist. I would beg to differ from that view, and would suggest that the Conservative Party has a great deal to offer to the social services. One need only look at its record between 1970 and 1974 for proof of this: pensions for the over eighties; the attendance allowances for the old and the disabled; and, above all, the proposed tax credit scheme. This scheme was the most imaginative way I believe yet devised of helping those most in need, without a means test and with a guarantee of take-up of the benefits. Care for the young, the sick, the old, and the handicapped is not a prerogative of any one political Party.
§ That said, in questioning any of the accepted principles which have guided thinking for the past 25 years, I hope I shall not be accused of being someone who either has not looked at the facts or, worse still, does not care having ascertained what they are. Let us look first at some of the consequences of the Beveridge concept, with its universal benefits. I have already touched on one problem, that of finance. It is a fact that over the last 25 years expenditure on the social services has more than quadrupled, but now we have reached the point where we cannot get any more money by increasing taxes. Already we have a position where a widow of 60 with only her widow's pension, or someone on long-term supplementary benefit, has become liable for income tax. There is a growing number of families who are caught in the poverty trap, where any increase in their earnings is largely, or even completely, cancelled out by a combination of taxation and loss of entitlement to means-tested benefits. In August 1974 200,000 families would have had 75 per cent. of any increase in earnings cancelled out by a combination of taxation and loss of entitlement to means-tested benefits. As a result of a combination of the changes in the Budget and the increases in social security contributions, this figure will now be considerably higher.
§ Not only, therefore, are the very poor taxed, but so many benefits which come 128 from the taxes of the average citizen go into subsidising the average citizen. It is the fact that the standard of, and the money for, the social services depend on the private enterprise system—what I call the creative society working profitably I believe this to be not simply a matter of economics but one of morality. Without profits there can be no wealth; without wealth there can be no taxes from which to pay for the services. Too often I think those in much of society, and sometimes in the social services, look on those in industry as concerned only to make money but not to do good. You cannot do good, or at least not much practical good—and, after all, who wants just sympathy?—without money.
§ Neither industry nor the social services are doing a better or a more worthwhile job than the other. Those in real need require both. This is a philosophy—the understanding of the relationship between the profits of industry and the level of the social services—which needs to be believed by far more people in the country than at present believe it or understand it. it affects everyone, whether they are dependent on the statutory services or are in an occupational pension scheme. The understanding of this fact must remain at the centre of any argument about resources. And when resources are stretched, as at present, we should not forget that by taking too large a proportion of earnings away from individuals we force an ever-increasing number of people into dependence on the statutory services, leaving less help for each person, particularly those who have never been in a position to provide for themselves. And to me the most telling argument against inflation is that it forces into dependence on the State thousands of people who had expected to provide for themselves in their old age, but who now find themselves caught by rising costs and a fixed income.
§ There is, therefore, everything to be said for doing whatever is possible to help those who can provide for themselves, and to ensure that for people in retirement the value of their pension is maintained. It would be encouraging to hear from leading trade unionists, millions of whose members are now covered by occupational pension schemes, that they understood this as well. The tragedy of the falling pound is not simply that the price of 129 food will rise for those who can earn; it is the permanent lowering of living standards for the retired.
§ Next we should take a long, clear look at indiscriminate subsidies. One of the oft quoted examples is whether or not it is sensible to subsidise every council house tenant. We have trodden this ground many times before and I do not intend to tread over it again this afternoon, although many tenants are in occupation of their houses because they have been fortunate enough to come to the top of the council house waiting list many years ago, and not necessarily because they are most in need of help today. But this illustrates the difference between indiscriminate subsidies and other subsidies.
§ At the same time it is often found that social service departments cannot meet all their commitments, particularly to the chronically sick and disabled and mentally handicapped, because they have not the staff to do so and cannot afford to employ more. The result is selection of a kind. Those left without help are often those whose needs remain undiscovered. There is thus no rational basis upon which the choice is made, no basis on which it can be discussed, and it is simply left to chance who is helped and who is not. It is surely questionable at a time of scarcity whether indiscriminate subsidies, particularly in housing and food, should go to anybody regardless of income, and that we should find that the subsidies go to those who do not need them while many in need get nothing at all.
§ My third point is this: I believe that we should make a determined switch in policies to an increase in domiciliary services and social support of all kinds rather than increase the provision of residential accommodation. I was glad to read these recommendations in the Government's own Consultative Document. I deliberately did not choose to debate that document in itself, not because I find myself in disagreement with it but because I believe that its terms of reference are very limited, and I wish to go wider in this debate today.
§ I was glad to see these recommendations because I believe there to be thousands of 130 old people in hospital who could be in homes in the community and thousands of old people in residential local authority homes who could manage in sheltered housing on their own, given domiciliary help. Such a policy would be far better for the individuals concerned. Who, after all, does not value his independence and dignity in old age? And, of course, it would be cheaper, too. It is estimated that an old person's home might now cost as much as £400,000 to provide, with running costs of at least £50,000 a year, to provide accommodation for 40 or 50 people, whereas a local authority home help service might be able to provide help for at least 7,500 people in a week.
§ The same argument applies to children's homes. There are, of course, children who need residential care, and some must be provided, but there are many children who would be better off in foster homes if only there were the staff able to make the necessary arrangements. And it would be cheaper, too. The same is true of child minding. In one London borough it costs £1,200 a year to provide one nursery school place, whereas a child minder can look after a child for £250 a year. Who is to say that this is necessarily worse care? In any event, one of the tragedies, for me at any rate, of the present situation is that often it is the most difficult or most tragic cases which end up in "homes" where, as I have indicated, there is the least qualified staff. Such a shift in emphasis would begin to hand back to the individual, in so many cases the old, a freedom of action to be independent, an opportunity to help themselves, a support for the family; and the family needs support, for the whole of our society is still based on the family unit.
§ Lastly, we must make better use of personnel, both professional and volunteer. I have had many suggestions put to me, but I like the idea of a more specialised training course. Specialism need not be on the same lines as before, dividing specialisms by types of case, but a specialised course designed to meet today's problems; for example, a course on different ways of providing substitute care or a course on inter-departmental communication and understanding. If only those in the hospital services communicated better with those in the local authority services and vice versa, and, 131 within local authorities, if only education, housing and social service departments communicated better, tragedies such as Maria Colwell might be avoided. It is often tempting to try to legislate for good social work practice, but this is never possible and would never work; but better social work practice can undoubtedly come with better training. Not only would better training be of help but professionals would be helped by the training of auxiliary helpers. It has been estimated that only one-third of social workers' time is spent on the client. The rest is spent on administration.
§ The debate that we had in the House last June not only emphasised the value of volunteers and the voluntary organisations but indicated the many different ways in which both can help. Two arguments seemed to me to be compelling. One is that a grant to a voluntary organisation is often a better and cheaper way of giving a service than to legislate and set up a statutory department; the other is that by using volunteers one can immediately deal with an immediate need, and no better case of this was illustrated than the Question we had today about children who run away from home.
§ In the last 25 years I believe that as a country we have tried through the Welfare State to produce universal benefits for all. We have long since abandoned any idea that some kind of insurance system would pay for all the benefits, and an elaborate system of taxes and subsidies has been built up. Now we find that the whole system is creaking very badly and one reason for this, I believe, is that the State can never provide for all the varied needs of individuals. I have been asked what solution I would give to the problems I have proposed. My answer is that there is no one solution that is right; different problems call for different solutions and I have tried to point the way to some of them. By introducing this debate today we on this side of the House are trying to make a positive contribution to thinking about today's social problems because we, too, care deeply about them. My Lords, I beg to move for Papers.
§ 3.16 p.m.
§ Baroness WOOTTON of ABINGER
My Lords, in September 1974 a certain 132 Mr. Lewis—that is not his real name but the name which I propose to use—got a job at a wage of £30 a week and for that reason came off supplementary benefit on which he had previously been living. I should explain that Mr. Lewis was living with a woman to whom he was not married, but a divorce was pending. He was maintaining this woman, who, to save time, I will call his wife and the two children of her marriage, one of school age and one younger. His return to work created formidable domestic and financial problems. The first thing that happened was that the income tax man appeared on the scene and Mr. Lewis was given an emergency code which made no provision for the two children. The result was that he was reduced to a level lower than he had previously had on supplementary benefit; he must, therefore, have regretted taking the job. However, he had a friend who had some professional knowledge in this sphere and he got his friend to conduct a continuous correspondence over a month with the income tax office and as a result of this the tax inspector was allowed to make a temporary code which put Mr. Lewis back in a position above supplementary benefit and allowed for the two children. That went on for more than a year but I regret to say that a week or so ago the discretionary power of the tax inspector was withdrawn and Mr. Lewis is back again now paying £1.70 a week in income tax.
Then family income supplement, which I will call FIS, turned up. At the beginning Mr. Lewis was not eligible for FIS but after July of last year the limits of eligibility were raised and he was able to apply for FIS. So he asked his wife, who was then eight months pregnant, to get the leaflets from the post office. She went to the post office but the leaflets were not available there, so she had to go to the social security office. That office was half an hour's walk away and, having walked there, she not unreasonably came back by tube and that cost her 40p. She found the leaflets rather difficult to fill up so she again referred to the friend who had some experience and who would be able to help. Getting in touch with him, further travel and so on brought her total expenditure up to a total of 65p. She completed the form, mentioning that her baby was due the following month, and sent it in.
133 When it came back no allowance was made for the baby, which by this time was on the scene, and her husband was asked if he would like to make a new application, whereupon he said that he could not do that because it would mean sending in his FIS book, the family allowance book already being out of their possession for another reason. In fact, the family allowance book was out of their possession because as soon as the baby was born—and babies must often be born to the knowledge of the family allowance organisations—she had sent in her family allowance book in respect of the other two children. It went to Newcastle and she expected to get it back by return with the new name on it. What she got back by return was a request for her to explain why the new baby had a different surname from the other members of the family. This she was able to do without help and she sent the form back immediately. She instantly filled up the form with the new surname and sent it back by return of post, but I regret to say that it took the office in Newcastle 10 weeks to understand it and during those 10 weeks no family allowance of any kind was payable to the family. The arrears were paid in the end but that is not quite the same thing when one is living at that level.
Next they thought about free school meals. As long as Mr. Lewis had been on supplementary benefit he was eligible for free school meals automatically for the older children, but now he had to apply for them on the grounds of his smaller income. His wife went to the education office. This was in the school holidays and by now she had the new baby, so she had to trail round with the two older children and the new baby to the education office. That enterprise took her two hours and cost her 64p. The baby was less than a month old and she was herself barely that long out of hospital. She got all the details and gave them to the education office. Then there came the question of school clothing. She got a form authorising her to get the uniform from Marks and Spencer's. She went to Marks and Spencer's and got it and then went back to the education office with the form. So that one went fairly smoothly. Then came rent and rate rebates. I am sure that your Lordships will be delighted to hear that rent and 134 rate rebates were dealt with all in one. This went smoothly except that she had of course to go to the housing department rather than the education department, which was a further fare of 36p. She filled in the form, giving all the same information all over again.
Then everything was fine until she was asked for husband's last five wage slips. She said, "I can't send those because they are up in Blackpool with the FIS organisation to settle that question." I shall not take that story any further. That is as much as I can tell your Lordships in the time. The story is not finished: there were further difficulties about the maintenance of Mr. Lewis's ex-wife, but those I will spare the House. The end of the story is that this family is paying £1.70 a week in income tax and receiving £1.80 in family income supplement. It is impossible to imagine a greater absurdity.
If I may, I should like to add a second story about what happens in the country. Mr. Shaw—and, again, that is not his real name—is a sick man. He has six children, all of school age and he lives on a combination of supplementary benefit and sickness benefit. These come in two separate Giros, one on Tuesday and one on Saturday. Mr. Shaw lives 19 miles from Bury St. Edmunds. To get to Bury St. Edmunds from his village one must take a bus which goes on Wednesdays and on no other day and which costs slightly under a £1 for the return fare. Alternatively, one can telephone at one's own expense, or ring from an inquiry office in the village where there is one officer and no privacy at all. One has to give all one's personal details over the telephone for everybody else to hear.
I need hardly say that sickness benefit, being computerised, does not come very quickly. It takes three weeks and during that time the gap has to be filled by supplementary benefit—I suppose, while the computer is getting up and having its breakfast and going to work. All this is all right until something goes wrong and I am afraid that something not infrequently goes wrong. One day, Mr. Shaw sent off his medical certificate on a Monday and nothing came during the week. His wife telephoned on Thursday morning. She was told that they could not trace the 135 papers and asked to ring again in the afternoon. It is quite expensive to telephone a distance of 19 miles and when one gets through, the answer generally is, "Yes, I will find the right man," following which the right man has to find the right papers. This therefore becomes quite an expensive enterprise. In this case, Mrs. Shaw again telephoned on Thursday afternoon and they still could not find the papers. She telephoned again on Friday morning and the papers were still missing. Then she managed to mobilise somebody who knew something about these matters and who was more authoritative and he telephoned and asked to speak to the man in charge of the section. The latter was very surprised to hear that the papers had not been able to be found because they had in fact been on his desk for two days. He said that the matter had been dealt with and the money sent out.
The next disaster happened on a Saturday. On a Saturday, one cannot telephone to the DHSS office in Bury St. Edmunds because it is closed. Nor would it be any good going there when the office was closed, but it would in any case be impossible because the bus only goes on Wednesday. There was no money in the house. What was Mr. Shaw to do? He telephoned the social services emergency office in Bury, which was open. A social worker came out 19 miles at our expense to lend him £2 to get over the week-end. However, when the week-end was over and Monday came his money had still not arrived. I do not know which day it came. I was not told that, but about a week later exactly the same thing happened all over again. I do not know whether Mr. Shaw was lent money on this occasion or what happened, but I feel that I must leave him at this point.
Those are individual examples of the position we have reached. Now let me mention a general picture. Last year we passed the Child Benefit Act. This was to give the single parent the benefit for the first child which it is hoped will later on be available for all children of a family. There are about 650,000 people—mainly widows —who are responsible for one or more children as single parents. Of those, rather more than half are drawing either supplementary benefit or widowed mother's allowance. When those people are taken out, one is left with around a 136 quarter of a million or probably a few more. That means that one is left with those women who are able to go out to work and earn something.
When they do so, in comes the tax collector again and they are taxed not only on their earnings but on this new benefit of £1.50 for the first child. The tax officer insists on the assumption that this is being drawn and, as it is taxable, they are coded as drawing it. They cannot say that they would rather not draw it because they do not want to pay the extra tax. They are taxed on their earnings and lose any rebates which they may already have on school meals and other benefits such as rent or rate rebates. As a result, very few of them end up by being better off and some may end by being worse off as a result of this nice benefit of £1.50 which we gave them last year. One commentator who has gone into this has made the rather cynical suggestion that the only people who are likely to be quite sure of getting their benefit in full are single mothers under 16, who of course have no right to be mothers anyway.
This means that people do not get what they are entitled to. The noble Baroness, Lady Young, has referred to the difficulty in getting take-up of benefits and to the large number of people living below the supplementary benefit level. From official figures published only last October it appears that about 1½million people are in that position; that is to say, they have incomes below the level that is supposed to he the minimum living income in this country—an income which they are entitled to receive. It is also estimated that about one-fifth of those who are eligible for free school meals do not claim them. Claims for welfare milk were heavily advertised round about 1971 or 1972. The number then rose to about 84,000. It has since dropped to about 11,000, though whether that is a result of people being better off or of the campaign having faded away is for others to judge. It was also estimated at about the same time that there are about 875,000 people who are entitled to rent allowances but who do not claim them, and that there are at least 1 million people who do not get rate rebates but should do so.
The real trouble with this low take-up is that those who need the money most 137 are those who are probably least well informed and who do not get it. It is also true that when the Government of the Party opposite introduced the family income supplement they hoped they would get an 85 per cent. take-up. They got a 50 per cent. take-up in the first instance and we are now claiming that the take-up level is about three-quarters. It is rather difficult to believe that, when the numbers of people drawing FIS are in fact falling. This is the Welfare State, so-called. This is what it means for individuals for whose welfare it is apparently run. I believe that it is time to ask two questions. First, how did we get into this muddle and, secondly, how can we get out of it?
I was delighted to hear the noble Baroness, Lady Young, say that she intended to make some constructive suggestions. Some of her suggestions coincide with mine, but some very much do not. We got into the muddle, I think, even though we started on a fairly sound principle, even before Beveridge, in the days of the first insurance Act, the Lloyd George Act of 1911 which covered only a limited part of the population. But that part of the population which it covered, it covered without further question. They were insured, and once they were insured their benefit was automatic. There was no more fuss and they got it. We then gradually have extended it, as the noble Baroness said, to cover practically the whole population.
We have since made two new kinds of discovery. We have discovered new categories of people and we have discovered new kinds of needs. We keep on discovering them, and as the noble Baroness said we shall never get to the end of discovering all these needs. We have discovered recently low pay and tried to provide for that by FIS. We have discovered single parents and we are trying to provide for those by a special single parent allowance, if we follow the Finer Report. We have discovered, or rather rediscovered, the disabled, and we have discovered that they need rather more things than money; they need ability to get about, they need aids to mobility, and they sometimes need people to help take care of them at home. We have also discovered that people have expenses which they cannot meet. We have dis- 138 covered that they cannot pay their rates and rent, and therefore they need to have help which is earmarked for that purpose, to have these paid for them instead of having enough money to pay them. We have discovered all these things under separate rules, some local, some national. That is how we got into the complicated situation.
So, my Lords, my first plea is: could we please have some simplification? Attempts at simplification have been made. Not so long ago a body of people got together to try to make a simplified form. I have to admit that I have not seen this form, but I have seen an account about it in a professional paper which I think must be well informed. The form does not cover two of the most important things—namely, supplementary benefit and FIS—but it tries to cover other things. It is six foolscap pages long, it asks 15 questions, aiming to get 58 separate pieces of information. It is accompanied by a very helpful booklet of 10 pages, which a sardonic commentator has described as chiefly concerned in telling you when not to use it.
My Lords, we do not need a form like that. We need a place where someone can go, where there is a sitting or walking encyclopaedia and a sitting or walking computer which does not have to spend all its time getting ready for work. That place should certainly be attached to a post office. We should have the information, both national and local, concentrated in one person, or in one person aided with suitable machines. That person should be able to say what is one's entitlement, with one form, and give one the money to go on with. That is the first point. Secondly—and here I differ from the noble Baroness—I think that we must get back to the principle of universality. We started with universality in the very obvious things, like old age and sickness, and we added family alowances. It is remarkable that the child allowance —the family allowance—is the one service which has practically a 100 per cent. pick up, because there is no means test and the allowance is available straightforwardly every week at the post office. We must get back to that kind of principle. That means that we give it to everybody. Of course that sounds immensely expensive, but it is much easier to give the allowance 139 to everybody and then take it back from those who ought not to have it, using one form, which would be their income tax form, than it is to start sorting it out into many separate allowances, deciding whether A, B or C is entitled to it. There-for I very strongly urge that we go for simplification and universality.
We already pay allowances in respect of almost all children, and when we get round to including the first child, allowances will be paid for all children. We are paying nearly all children a certain sum of money, through their parents, merely for being alive. We pay nearly all old people for the same reason, merely because they are still alive, even if perhaps they ought not to be. Well do I remember in 1908 my mother—who was a very good Tory—being in a state of absolute mental disturbance because it was proposed to pay old age pensions to persons over 70 years of age who had incomes of less than £21 a year, not a week, because the pension was five shillings a week. My mother walked up and down in dismay from room to room, seeing the beginning of the end. Perhaps some of your Lordships will think that she was right. But many of your Lordships, myself included, are now walking about cheerfully, proudly taking the practically universal retirement pension for persons covered by social insurance.
These two classes—the old, not always the very old, but some of the very old, and the young—are getting their payments without a fuss and practically without any dispute. In between there are all these ranges of people going through what Mr. Lewis and Mr. Shaw were going through. There must be very few households in this country in which something is not coming in out of what are called the benefits of the Welfare State. I realise that this is looking ahead, but I plead with your Lordships that we should work more and more towards the idea that everybody is entitled to a guaranteed minimum income, and if one has not got it all one need do (whether one calls this negative income tax, or whatever) is go to my one encyclopaedic person and fill up one form—an income tax form—show that one has not got this guaranteed minimum income, and then it is made up to one. Then, if there are extra things to be dealt with, that would be a different matter. Therefore, I wish to conclude 140 by pleading with your Lordships that we should make our aims easy access to information, simplification, and universality.
§ 3.37 p.m.
§ Baroness ROBSON of KIDDINGTON
My Lords, first I wish to thank the noble Baroness, Lady Young, for giving us the opportunity to debate this most important subject. Not very long ago an Indian friend of mine visiting England said to me, "Isn't it tragic that a nation that can afford a Welfare State no longer needs it, and a nation that really need, it can't afford it at all." There is much truth in that statement, but I do not believe that it is 100 per cent. true. Yet I felt very sad when I listened to it because it made me realise how long overdue is a real assessment of priorities within our Welfare State. I feel that it is tragic that it takes economic difficulties of the present order to concentrate our minds on whether we are getting value for money and whether we are spending our money in the right way.
It is particularly tragic because when we are in a state of economic difficulties, such as we are in at the moment, it is increasingly difficult to change the pattern. As has been mentioned, since the war expenditure on social policies has been accepted as a desirable aim by all political Parties. I particularly wish to thank the noble Baroness, Lady Wootton of Abinger, for her reference to a member of my political Party, Lloyd George, for being instrumental in the introduction of the Welfare State. I was saying that since the war all political Parties have agreed about the desirability of expenditure on social policies, but cynically one could say that this has been very easy because in a growth economy, which we have lived in until quite recently, the problem of increasing social aid to members and sections of the community more or less took care of itself on the back of economic growth in general. It was merely a question of deciding how we made the best use of the money available. This decision on what use we made of the money available was often made in the competitive bidding for support at General Elections.
I am not mentioning this because I believe there is not a real, genuine feeling 141 on behalf of all members of all political Parties to create a situation where social policies are instrumental in establishing a just and fair society. What we have to ask ourselves—and this has been asked from two angles already—is whether, in the days when we were a reasonably affluent society, we achieved the ends that we hoped to achieve through our social policies; and the answer, I am sure we will all agree, is obviously, No. It has already been mentioned by both the noble Baronesses who have spoken that a number of citizens on our society are still living below the poverty line, that this number has not really been substantially reduced, and the social benefits created by the growth economy have not always gone to the people who needed them most. I believe this has happened because the money available for social needs was too easily available, without our having to assess properly the needs of society.
However, we have now come to a completely different era. We have left for the moment the growth society, particularly in this country; and we have also entered, and are suffering from, a period of unprecedented inflation. It is at this point that there is an alternative economic impact on our social policies which can become very damaging if allowed to continue. During the period of growth we may have wasted our resources, or some people may have felt that we did, because we did not concentrate on the right priorities. But that is in the past. What is worrying me now is that, in a highly inflationary economy, even maintaining the services that we have created becomes virtually impossible through increased costs—and those services were not all bad or wasteful. Secondly, the problem of maintaining those services is made more difficult in an inflationary economy because the Government themselves—and here I would say it is true of whatever Government we have—tend to use social policy in an attempt to contain inflation. This is done mostly by the introduction of general subsidies, which in themselves are, without a doubt, inflationary, because they increase Government expenditure. But I am also worried about them because they remove expenditure from the fields of real need. In other words, the nation cannot afford the two, and so we tend to neglect the 142 people who really need the help that we should be giving them.
The noble Baroness, Lady Young, has ranged widely over the whole field of social policy, whereas the noble Baroness, Lady Wootton, has concentrated mainly on social security problems within our Welfare State. There are many eminent speakers whose names are down on the list and who are experts in various fields, and I should therefore like to confine myself to the problems of the health and personal social services, in which I am personally involved. In 1974, when the health services of this country were amalgamated with the local authority health services, this went some way towards achieving what we were looking for; that is, a co-ordinated Health Service for the whole of the country. However, again, it happened at the beginning of a period of financial restraint and at a time of extreme inflation; and although for the first two years the Health Service was inflation-proofed to a certain extent, as from this year it is no longer so. I am not complaining about that. I welcome the restraint on health and social services resources because of what I said in my preamble; namely, that it helps us to concentrate our minds on what are the priorities. But we cannot change a pattern in a matter of a few months, and we shall need a very long period in order to change the priorities within the health and social services.
The other day the Department of Health issued its consultative document on priorities in health and personal social services in England, with the aims of which I agree; but I should like to ask how, in a period of financial constraint, we can achieve the aims of this document. The underlying aim is that priorities should move from expenditure on hospital and institutional services to expenditure on the domiciliary services. I am a great believer in this, and I hope that the suggestion has not come because it is assumed—and I must emphasise "assumed"—that it is economically cheaper to give people domiciliary services than to give them hospital services. I hope it has been suggested because it will provide a better and more satisfying service for the citizens of this country. But that type of change necessitates a very close co-operation 143 with local authority social services departments, which are having to work at this time under perhaps even stricter financial restraints than even the health services themselves; and even within the Health Service and that part of the local health services that was taken over in 1974 the change is difficult although it is now under one authority, because, again, the change necessitates bridging finance.
It is not very difficult to produce figures to prove that certain moves would be economically advantageous to, and probably (as I believe) more satisfying for, the persons who are having to make use of the services available. Let us assume that we have 80 per cent. of the old people who have been referred to earlier in this debate living in the community and in receipt of some form of community services or family services, and that we have 20 per cent. hospitalised, not all because of necessity but because there is no alternative service. In order to change the emphasis, it would be, to my knowledge, perfectly possible to return between 5 and 10 per cent. of those elderly people in hospitals to the community if the services existed. Let us say it was 5 per cent. That would add 5 per cent. to the cost of the community services, but it would reduce the hospital services by 25 per cent., because it would be reducing the occupation of hospital beds by those people by that amount. But we cannot close the hospital beds before we have created the services for the elderly which are necessary in order to be able to return them to the community.
So, however much one hopes and wishes to achieve a change in emphasis of the health and social services that we provide for our nation, it is a very difficult problem in a time of financial constraint and at a time when some of the regional health authorities, quite rightly—and, again, I agree with this step—have had their allocations reviewed in order to make the allocations over the whole of the nation fairer as between regional health authorities. I accept that. But we cannot at the same time take three different steps. You must make up your mind which is the one you are going to follow. I should prefer to follow the principle which reduces to the greatest possible extent the number of people having to stay in hospitals and in institutions, but I hope that 144 the nation realises that this cannot be done without bridging finance being at the disposal of the authorities in charge. I am not trying to look at difficulties, but when we are looking at priorities in the various aspects of social services that this country provides for its citizens, we must be absolutely clear what are the financial implications and how we are going to set about it.
§ 3.50 p.m.
§ The Lord BISHOP of SOUTHWELL
My Lords, in the order of speaking today I find myself as a Bishop among five Baronesses. I feel very much like a thorn in a bunch of roses. But in taking part in this debate I am conscious that my role is to stick to my last. It is the expectation of society that the Church should help the community, and the individuals who comprise it, to discover the norms and standards by which life should be lived. With this in mind, I trust that I shall be allowed to try to ask some of the questions which at this time we should be asking ourselves if we are to establish a wholesome philosophy of social action.
When we are considering the development of social policy, we need to ask ourselves not only in what way it is actually developing but also in what way it should be developing. I have no doubt that your Lordships would at points give very different answers to that question. For some, it is a question of interfering as little as possible in the lives of others, leaving them to be free from "busybodies", free to stand on their own feet and enjoy life in the way that suits them best provided they do not deprive others of a like freedom. This philosophy of social policy means providing appropriate help for those who, for one reason or another, cannot cope with life because of inadequacy or ill fortune, poverty or sickness.
For others, such a policy smacks far too much of an "I'm all right Jack" attitude. They see social policy not as interference but, certainly, as social engineering, as an attempt to mobilise all the resources of the community so that the district is a better place to live in and each individual has a chance to live a full and happy life, giving to other people as well as receiving from them. This is to be achieved by social workers and ordinary people playing their respective parts under 145 a local authority which is ready to try to provide the resources to make such an effort possible.
My Lords, I am one of those who believe that the development of social policy should not be governed by the attempt to impose a political dogma on people, not even a religious dogma for that matter; but by the attempt to let communities be themselves and develop a complex of human relationships that are unselfish and fulfilling. It is very easy for us with the best of motives to endeavour to impose our way of life on others. There is a danger that social policy can become a politicians' battleground. It is for this reason that I welcome this afternoon's debate. We cannot afford a partisan approach to the ongoing task of social development, with changes of direction as Governments with different philosophies take over.
I wonder, my Lords, if I should command assent if I were to say that the aims of our social policy should be something like this: to enable people to be human in the deepest and fullest sense of that word; to create the right social environment for that to be possible; to rescue and relieve those in distress; to curb and reorientate the anti-social and delinquent; to recast our institutions, however time-honoured, to assist in this creative process; and so to build real community life.
If, my Lords, this very imperfect attempt to define aims has any support—indeed, whatever the result of our effort to define just and wholesome objectives—we then have to ask ourselves whether our policies are the best to achieve such objectives or whether we have any personal or political axes to grind which are partisan, selfish or divisive. One thing is certain—we shall never achieve the ideal; although we must not forget the importance of ideals as objectives. We can, however, get our priorities right. Indeed, it is just such a policy which is forced upon us by the financial stringency of our times.
My Lords, I am of the opinion that this financial stringency could, in one way, be a blessing in disguise in that it will make us review the potential of voluntary agencies afresh and harness the immense potential of the community to help itself. In social 146 work we are tending to come full circle. Social work began as voluntary work which has properly been taken over by the State. Are we perhaps discovering that no State, however wealthy, can ever meet all the social needs of its citizens? Indeed, that it ought not to do so for fear of inhibiting the far greater benefits that accrue from people being responsible for helping one another. There is an amazing capacity for neighbourliness and compassion to be found in areas where there are real community ties and loyalties—often in the poor and very deprived parts of our big cities.
I hope you will allow me, my Lords, to pursue the place of voluntary work in the development of social policy. Of course, as a Christian and a Churchman I have, as it were, a vested interest in the right use of voluntary work. The Church and charitable organisations have a long and honourable history in this field. That does not mean that we therefore have a right to go on doing work of this kind in the changed circumstances of today, or that we have the right to go on doing it in the same old way. There is a proper place for the voluntary society today but it is not necessarily the same place. In some instances voluntary societies are still doing good, progressive work which is recognised by the State as being of such calibre that it can well be the agency for that particular work and no further provision needs to be made. More often, however, voluntary societies will have to recognise that the time has come to bow out gracefully because the State can make better provision. Where this is so, it does not mean that voluntary work is less necessary, merely that it must be different.
I, personally, believe that there are still endless social work projects to be pioneered which are best done by voluntary effort. People need and enjoy the opportunity to work, for instance, in support of a Cheshire home or to run outings for the physically handicapped, or to provide musical instruments for a youth band. Social policy must surely endeavour to determine what provision is better made by the statutory bodies and what provision is better made by voluntary effort. Some help is only acceptable if it is seen as unofficial, and some good voluntary work is killed stone dead by being authorised and made official.
147 It is, surely, the whole aim and purpose of the Seebohm Report to stress that a community can and does generate its own resources if given the chance to do so, and to allow it to do so is ultimately for the health and happiness of that community. We have not yet learned how best to integrate the voluntary with the statutory. Amazing strides have been made and there is much good will; but it is understandable if at times there is a failure in communication between one or the other; a lack of understanding of each other's ideas; a failure to observe the proper boundaries of their work; an inability to trust each other's experience and expertise; an inability to give each other the authority to do the job the other must do. Statutory workers can be possessive, and voluntary workers can be unobjective. But I believe that the development of a trusted working relationship between statutory and voluntary workers is at the heart of a developing social policy that is big enough to meet the manifold needs of our society today.
As your Lordships can imagine, I give a lot of thought to the role of the Church in society today. It is changing role and, if I may, I should like to use it as an illustration of that change in attitude that must mark all relationships in social work in the future. The Church of England has had for a long time the privilege and opportunity of serving the country through its parochial system. The aim of that system is to provide a Church presence in the midst of the people always available to them in order to help them cope with the problems of living and dying. In days past its activities may well have been authoritarian, patronising and with very definite ulterior motives, but this stance is entirely inappropriate today. Today its task may still be to provide a Christian presence in the midst of the people readily available to them, to help them cope with the problems of living and dying. But today the Church is a partner, not the boss, and none the worse for that. Today it is just one of the agencies at work in the local situation.
The Church is still looked to as a source of volunteers and it is no longer necessary for it to set up organisations of its own. Its members are found taking a full and often considerable part in secular organisations. The change that has taken place is that of shifting authority from the tra- 148 ditional providers of help to the local people who, in varied and enthusiastic ways, make the locality hum with life. In my part of the world this picture is much more true of village life than it is of urban life. We have a lot of ground to make up in establishing the same pattern of community responsibility in urban areas, where it is all the more necessary because of the shift in population and the redevelopment of whole areas of our big cities, with the consequent loneliness and restlessness of so many people. Not only the Church but the social services, too, have to be ready to abdicate the authoritarian role in favour of encouraging local responsibility. The role of the expert and the specialist is that of the enabler, the one who provides the encouragement, the advice, the pump-priming finance perhaps, which may make all the difference between success and failure.
In the final analysis, my Lords, social policy depends upon the mobilisation of the total resources of the community, using the different agencies and individuals appropriately, according to their capacities and not in ways that are beyond them. I am personally often staggered at the capacity of the community to meet a wide variety of needs. I call to mind a piece of social work, sponsored by the local Council of Churches, in the London borough of Waltham Forest, where one solitary housewife with no social work training manned a telephone throughout the week to receive requests for help from any who rang up. She never failed to find someone to meet each request, whether it was a question of finding someone to take children to and from school while a mother had to take another child to hospital, to exercise a disabled person's dog, to sit by a sick old person at night, or indeed to meet far more complicated and prolonged commitments. Social workers at times throw at voluntary agencies their most troublesome and intractable cases. Because this housewife never failed to meet a request, the service became one which could be relied on. It was extensively used by social workers, who generally had too much to do themselves, and the local authority started putting money into the venture; so that what started as one housewife on a telephone became, at very moderate cost, a valued piece of ongoing, reliable voluntary work, in which people from all over the district were mobilised to help as they 149 were able in a neighbourly and uninhibited way.
Perhaps the ultimate question we have to answer is this: Does our social policy make people more responsible, more unselfish, more caring of one another, or does it make them more dependent, more demanding and more self-seeking? If we achieve the former, not only will we be establishing real and happy communities, but we shall also be preventing a lot of unsocial, destructive behaviour, and have the caring services freer to provide money and time for those who most need help because they are least able to help themselves.
§ 4.7 p.m.
§ Baroness MACLEOD of BORVE
My Lords, like other noble Lords, I am most grateful to my noble friend Lady Young for introducing this debate this afternoon. All too rarely do we have the opportunity to debate this type of issue in your Lordships' House. I want to look at the social services as they are today—not as we want them to be in the future, nor as they have been in the past, but as they are today with all the financial stringencies and problems as a whole.
Before I do so, I should like from my own knowledge to pay a tribute to those who work in the social services. They are undermanned, overworked and often underpaid. But in this country today there is so much more expected to be done than ever before yet no more money is available to recruit the necessary numbers to do the work. People are becoming more and more used to relying on the social services instead of relying on each other. Now, through financial stringencies our backs are to the wall and the people of our country will always rise to a challenge if it is put to them. We have become much too used in this "nanny" Welfare State—and it is more of a nanny than anything else—to being looked after from the cradle to the grave. Now the time is coming when we have to be prepared to look after not only each other, but ourselves.
There are three areas on which I should like from personal knowledge to touch this afternoon. The first is the hospital 150 services. I agree with the right reverend Prelate—and how nice it is to have three men among nine women taking part in a debate!—that in this area specifically we must try to get better organised voluntary services. In the hospital services there are 279 voluntary services organisers. It is their job not only to organise the voluntary services within their hospitals, but also to act as liaison officers between the social services and those hospitals. In some areas of this country this is being done very effectively indeed. What happens is that the social services get into trouble and, as has been suggested already, perhaps pass over the difficult cases to the voluntary services organiser, who contacts somebody on her or his list who is willing to do whatever service is necessary. That service is done, and done by voluntary people.
Another problem I have discovered recently is that very often geriatric patients are discharged from hospitals on Friday afternoons. As has also been mentioned, the social services obviously do not work full-time at week-ends; nor is there a full meals on wheels service, at least not generally throughout the country. Very often elderly people are left high and dry without their families knowing that they are coming out of hospital, and there are no meals on wheels or social services to help them at that time. I should like to suggest that this is one way in which volunteers could act as voluntary service organisers, either attached to the borough or to the hospital, and assist in this way.
Another area I am concerned with is the courts. As your Lordships will know, throughout the country we are trying to operate community service orders instead of using other means of bringing a citizen up short when he or she is tending to slide down the slippery slope of crime. This is one area where the community service orders are becoming very effective indeed throughout the country. However, certainly in my own area and in others I have heard of, there are not nearly enough people to man the service or oversee people in connection with community service orders. For that reason alone, the community service orders are not always able to be made when they could or should be. I have heard this morning from the probation staff of my 151 court that if only there were more voluntary people to come forward and help them in the many areas where they are trying to help not only the delinquents in our community but the wives of prisoners and so on, their workload would be very much less than it is now—and I can tell your Lordships that in any case the workloads of probation staff now are far too great.
Another area of which I have some knowledge concerns a large borough about which tribute has been paid today by the area organiser to a vast number of voluntary people who help local organisations. Among them, to name but a few, are the WRVS, Welfare and also the Mentally Handicapped Association. I could go on to name many more voluntary organisations which are assisted by voluntary helpers. I should like to say here that these organisations take great note of this help and encourage young people to come forward, more than I have found elsewhere in the country. I believe that if young people come forward to help the social services, even in a minor capacity—since, of course, they are not qualified—it does them a great deal of good. They certainly give of their time and effort to help those in need.
In spite of a long list I have from my own borough of the kind of help given to the community, much more help is needed primarily to ease the pressure on the social workers. I also suggest that it is not necessary to have educational letters after one's name to be able to help and advise others. Experience of life, gained from years of coping with one's own and other people's problems, is just as useful to anyone needing help and advice. There are many people who, despite present financial conditions which may necessitate having to work part-time—and most of us do—still have a few hours in which to give time, effort, sympathy, guidance and help to assist their neighbours and the social services. There are plenty of people around: they only have to be asked. Therefore, I am suggesting today that perhaps the noble Lord the Minister will encourage the social services to increase the numbers of voluntary people they ask for help. If we can do that, then perhaps some of the people in this country will not go without the help they need.
§ 4.16 p.m.
§ Baroness MASHAM of ILTON
My Lords, I also should like to thank the noble Baroness, Lady Young, for providing this opportunity which today's debate is giving us to discuss some aspects of social policy which I think need bringing to your Lordships' notice. Today during this very wide debate I should like to speak on some of the needs of disabled people living in the community. It is now nearly six years since the passing of the 1970 Chronically Sick and Disabled Persons Act. This has been called "the charter for the disabled". Up and down the country I hear the same thing from ail sections of people interested in the needs of the disabled, from directors of social service departments, voluntary workers and the disabled themselves; that is, that the Act must be made stronger. It is too permissive and, because of this, is ineffectual. Section 4 of the Act, concerning access to and facilities at premises open to the public, should be made mandatory, in my view. A few months ago I was asked to open officially a community centre in our local county town. This is an excellent place for all the community, and it has cost £250,000. But on arriving I found two steps, and on inquiring why there was no ramp, which would have been so easy to incorporate, I was told it had been thought unnecessary.
If planning committees go on approving buildings such as these and ignoring the 1970 Act, how is access ever to be improved? Many new councillors coming on to planning committees have never heard of the Act. The local authority officers do not tell them of its existence because nothing is laid down in law saying that they must do so. If the example set in the adaptions to your Lordships' House and another place were followed by the community in general, perhaps there would not be this need.
There has been a very disappointing response over the co-opting of disabled persons on to local authority committees. There is no doubt in my mind that, even if they never open their mouths, by their presence alone disabled persons help councillors to remember their needs. One director of social services told me she had co-opted a disabled person on to committees and he had to be carried up and 153 down stairs to every meeting he attended. As long as these things are shelved, the disabled people will not feel they are part of a community.
The Consultative Document, Priorities for Health and Social Services, states that among their priorities are the disabled. On page 46, on the hospital side, it is stated that the most important need is for the establishment of a spinal injuries unit in the South of England. I have been very pleased to see this in print. As we are discussing today the community, I mention this because of the great distances, expense and hardship both relatives and patients have to bear by travelling such long distances. This unit is so important. May I ask the Minister where it is to be? Knowing of the appalling waiting lists at Stoke Mandeville, I should like him to say that there will be one in London and one in Bristol.
As a member of the Spinal Injuries Association, I am aware of the great need of extra care attendants to make it possible for very severely disabled people to remain in the community. I should like to bring to your Lordships' notice the Crossroads scheme, which was founded by the television programme of that name and one of our members who had broken his neck. A care attendant comes into a house and gets the disabled person out of bed and allows him to go off to work, thus relieving the rest of the family and making it possible for the family unit to stay together. There is a tough selection to get the right people. This scheme is operating in Rugby, and I hope that Area Health Authorities will study it, as the benefits of keeping the severely disabled person in the community when all the people involved wish this to be done must mean that this is the correct solution. With so much short-stay surgery and out-patient operations, together with elderly sick and handicapped people in the community, the Red Cross have launched a short-course scheme this year called Nursing for the Family, which is aimed at helping people to cope with these problems. I should like to see more education of this kind as part of the school curriculum.
We are experiencing the problems of the young generic social worker. Very often she works in an aura of theory with 154 little practical experience of some of the specialised problems that will arise. One young girl told me that she was the most junior person in her social work department, but had been put in charge of aids for the handicapped. Because of this lack of knowledge and expertise many more voluntary specialised groups have been formed. I recently attended a meeting of many voluntary organisations and social workers, and their unanimous conclusion was that there should be more specialists working in social service departments, so that the basic grade social workers can get the advice they need. For someone with no experience to try to work with clients with severe defects is a waste of time causing frustrations all round.
Emerging from some specialised voluntary groups is the wish of certain members to help fellow sufferers back along the road into the community. This help can be given by advising a patient in hospital before he goes home, and by visiting in the home and supporting him and the family until they feel ready to cope. To enable these schemes to work there must be co-operation between the voluntary organisations and the professional staff. There is a great deal of good will in many people, but sometimes the statutory social worker seems jealous of the volunteer. To plan a discharge means multi-disciplinary groups working together, including the volunteer when necessary, so perhaps the Government will encourage this aim. I was delighted to hear the noble Baroness, Lady Macleod, also say this.
To pave the way for my Question on 5th May, I should like to bring to your Lordships' notice Her Majesty's Government's policy of withdrawing invalid vehicles from disabled people in category 3 on the grounds that they are no longer in employment. Is this not the most monstrous act which could be performed against rehabilitation for retirement from work? Her Majesty's Government state that to allow these very few people to have their vehicles for the rest of the time they could drive them would be unfair to the many people who, despite equal disabilities, have never qualified. But the people who have worked have not only paid their way in life, making great efforts to do so; they have saved on other services such as 155 home helps as they have been made independent, and they have not been a constant drag on their families.
A disabled man in Doncaster has had his three-wheeler taken away. He continued to work after being injured at work in 1963, but he now cannot even get to the Post Office to collect his pension. He says that he is just a prisoner in his own home, dependent on others, after years of striving. His Member of Parliament wrote to me on 13th April and said:I think it was an atrocity to take away this man's trike as soon as he finished work; after a lifetime of work he is now left to gravitate slowly towards the grave.Another desperate person wrote to me saying that she had contracted tubercolosis since the struggle over the withdrawal of her three wheeler. The numbers involved are very small, but the desperation of the individual is immense. If there is this kind of policy, without regard to the individual, I am not surprised that so many social workers leave the service. The noble Lord, Lord Wells-Pestell, knows very well some of the problems that come my way, and I should like to thank him for all the help he gives me.
I would make one more point. I find that housing is one of the greatest difficulties, as this involves the whole family. When a new house is needed, a disabled person is so often offered one outside his neighbourhood, which means that children have to be disrupted at school and wives are moved from their friends. But when an offer is turned down, which sometimes happens because of pressure from the family, the housing authority seems to lose all interest and makes no further effort to help that individual. I hope that this hard-line, impersonal attitude will die and that the social policy of the future will produce a more sympathetic, flexible and caring approach, considering the individual and the whole family.
§ 4.27 p.m.
§ Lord REDESDALE
My Lords, like other speakers, I must thank the noble Baroness, Lady Young, for giving us this opportunity to debate this big and important subject. It is indeed a big and important subject; so big, in fact, that I feel I can touch on only one small 156 aspect of it. But it is an aspect in which I have an interest which I have already declared, in that I have two foster children. Those people who have interests tend to go on a bit. so I shall try to exercise some self-discipline and not talk at too great a length on this aspect, which I should like to draw to your Lordships' attention.
We are talking about the community service, and more and more this means the care of the individual. There are some 85,000 children in care at the moment, which means that there are 85,000 individual, separate problems and they are all different. The point is that they are all individuals. When one talks about subjects of this kind, it is so easy to gloss over and generalise. I am interested in fostering which is just one aspect of care. I do not intend to generalise or to say that fostering is the only answer; I just say that it is one aspect, and I want to make that very clear at the start.
There are so many conditions which affect a child in care—his mental state, his age, his health and so on. So many have to go into community homes because they need to be assessed, or there are other problems which mean that they cannot be put out for either adoption or fostering. We have a rather low proportion of children boarded out, and that is a pity. Only about half of our children in care are boarded out. This compares with Sweden where about 80 per cent. of the children are boarded out. Massachusetts has a scheme, and there are hardly any children in homes. It is easy enough to quote these examples and say that these are wonderful situations which should come about in this country; it is just one of those generalisations which you cannot pick up. However, let us say that there is a ceiling figure which is probably close to the Swedish figure—let us hope it is, anyway.
I think it would be better for the children if we could get up to this figure of 80 per cent., but it does not stop at just being better for the children—and I sincerely mean that it is better for the children. There is a financial advantage and it is a very big and important one, especially when we are in a period of nil growth. So often when we talk about community schemes in your Lordships' Chamber we 157 say that we must put more money into something. I appreciate that one cannot always be asking for money; the money is not there to give. I am saying that fostering provides a means of releasing more money and if we can increase the number of children who are boarded out we can make savings which will mean that the service is not cut back but maintained.
This is an important point and to back it up I have with me some figures relating to a London borough. These are 1975 figures, so they will have gone up and my point becomes even more valid as inflation continues. Last year it cost this London borough £4,253 to keep a child in one of their community homes. One has to set this against a figure for a voluntary or a charity organisation of about £2,383. It is still a lot of money, but then one has to set that figure against what it costs to keep a child boarded out. That figure is only £981 and includes the social services—the visiting of the social workers and everything else. This is a big saving. As I said earlier, this can apply only to some children, but it could apply to more children than is presently the case.
When one turns to the really agonising problem of the disturbed child the cost rockets. In some cases, depending on occupancy (where, for some reason, it can be put on a low occupancy figure) the cost can get up to as high as £12,000 a year to keep a child. The Department of Health and Social Security has mentioned to local authorities the need for secure units. Many local authorities feel that this is "pie in the sky"; that is, that you cannot keep these children in secure units when the cost is becoming so high. Therefore, schemes like the Kent scheme, which I want to talk about later, are important because they could make a big contribution.
I feel that we must give credit to the social workers and other people who have so much enthusiasm and who have given so much of their time in order to develop fostering schemes. There is a multitude of these operations starting up at the moment and it is important for us and for the media to support the social workers. It is a question of morale. If the morale of the social workers goes their performance also goes, so please let us try to keep up their morale by giving them all the 158 support that we possibly can. We have to accept that at the moment many children are at risk. As we know only too well, from the Children Act and everything else, social workers cannot rush into a home and seize a child just because they think that child is either at risk or in danger. They have to wait until something happens. This is a sad state of affairs, but a very necessary one. You cannot have people seizing children from their parents.
At the same time we must accept that this is a real problem for social workers. When a tragedy occurs it is so easy for people to say, "Oh, it's the fault of the social services". It is their fault, but most of them, or nearly all of them, are doing their very best, and when a tragedy occurs it is often because a somewhat inexperienced social worker is dealing with the family. It can be said that inexperienced social workers are supervised and that it is a management responsibility because it goes up the line to the supervisor. But one must remember that it is the social worker—perhaps this inexperienced social worker—who has to see the family, make an assessment of the situation and report back. Therefore the whole problem goes up the line. It is on that information that the situation is assessed by the supervisor, and as the work load goes up and up it is very hard for them to supervise and see each individual child. The noble Baroness, Lady Young, and also the noble Baroness, Lady Macleod of Borve, spoke about the proportion of trained to untrained social workers. Unfortunately, it is only 40 per cent. qualified as against 60 per cent. unqualified. This is an area where we must try to give support—perhaps by saving money in some way along the line—and encourage the senior practitioner grades. As doctors gain experience, it becomes more important for them still to be active, to carry out operations, and so on. Therefore we must concentrate on the senior practitioner grades so that they do not become just pen pushers but remain active and so that we can use their experience, although they are fully administrative people.
The advantage of using the senior practitioner grades arises when we think about the growing need for greater specialisation, especially in the care of children—for instance, in the finding of foster homes. There are other aspects 159 where a social worker can be employed on just one particular aspect. An excellent job is being done at the moment by the Adoption Resources Exchange. It is a great pity that this scheme is not applied to fostering. There is, in fact, a great wastage of foster parents. One local authority may have a parent but not a child while another local authority may have a child but not a parent. This scheme could utilise, to a greater extent, the unfortunately relatively rare foster parent. There are, of course, different kinds of foster parents, from short stay through to long-term fostering.
Another aspect to which I should like to draw the attention of the Minister is that it would be a great help if the registration scheme were standardised across the country. If a fostering scheme could be introduced to enable parents from different boroughs to be matched, with a standardised registration scheme delays would be obviated. As I have said, the real problem is to get families. Fostering, as I know only too well, is not easy but it is very rewarding. I feel that everybody who is concerned with social welfare must try to help those schemes which are starting up now to gain parents.
For instance, the "Mums and Dads" scheme, for which I am wearing a lapel badge now, started within the last month. There are many similar schemes. One scheme which we ought to look at very carefully has been tried before and now is successful. This is the Kent scheme which is trying to board out particularly difficult adolescents. They are paying a relatively high fee—round about £32—to get them boarded out. Obviously this is much cheaper than any other scheme. They are not having to apply the same degrees of vetting that would have to be applied if they were trying to board out a baby because adolescents can vote with their feet. However, the scheme is starting to work and, like all the schemes I have mentioned, it is important that the experience gained should be collated and that there should be seminars. Seminars cost money but in the end they will save money. If we can give support to seminars so that this information can be exchanged, I feel that it will result in a higher number of boarded out children.
May I mention some of the other problems which exist. For instance, it is 160 easier, as we can see from the figures, to board out children in rural areas than in the centres of cities. It gets harder to board them out as you come into towns and there is a quite simple reason. It is a question of housing. You have more room in rural areas and less room in the centres of cities. But I hope the Kent scheme will pave the way for something to happen in this particularly difficult area of adolescents. Another scheme which has been running is the Soul Kid Scheme for coloured children, and in October of this year the National Foster Care Association are running a Foster Care Week. I note that the DHSS Consultative Document speaks of the need for fostering. I feel that perhaps greater emphasis could be given to this need and to the support that could be given, because this is a vital service. At this stage we must try to support the scheme because it will result in savings which will keep the community services in this particular area running when money is very short. I would just ask that tangible support should be given to this scheme because of what it can produce not only in financial results but also in human terms.
§ 4.41 p.m.
§ The Earl of LONGFORD
My Lords, like the noble Lord who has just spoken so movingly, I should like to congratulate the noble Baroness, Lady Young, on initiating this debate and also on the incisive and comprehensive way in which she dealt with this vast subject. I hope that perhaps in 20 years' time she will initiate another debate; some of us may have to watch it from afar, but I have a feeling that when she does so she will not be quite so depressed about the heavy burden constituted by senior citizens. At the beginning of her speech she pointed that out as one of the hardest problems confronting us; that is, that such a large proportion of the population was elderly. I suppose that would apply to this House even more than any other collection of human beings of similar mentality. But I hope that in years to come she will feel that the older citizens can also be very beneficial.
Like other speakers I must concentrate on one or two themes. I am starting from the fundamental proposition of my old master, Lord Beveridge, who is quoted 161 selectively on these occasions. People usually bring him in to suit their own purposes one way or another, but I start from his fundamental proposition that State action should provide what he called the floor, and voluntary action should build up to the ceiling. I am not going to concern myself with the precise relationship between central Government, local government and voluntary action. We all agree that that should be as harmonious as possible; and we leave out another all-important issue which has perhaps hardly raised its head, because there is today a kind of understanding—almost a ukase—that nothing must be said that is controversial in any Party sense. I believe that if I were to make a Party point somebody would move, "That the noble Lord be no longer heard", and it would be carried unanimously. On the question of the distribution, and how much of the distribution, of the nation's resources are to be given to the social services, I can only say that those of us who believe in the more equal distribution of wealth would call for a much higher allocation than those who believe in a less equal one. I will not pursue the Party point any further than the noble Baroness, who began spelling out the advantages of a Conservative approach to the social services.
My topic is different; I am concerned with the priorities within the total amount of the provision, taking that total amount as given for the purposes of the discussion. Of course there are any number of issues here. There is the very important one dealt with by the noble Baroness, and in the powerful speech of the noble Baroness, Lady Wootton of Abinger, on the question of universality. In that connection I merely say that I am entirely on the side of the noble Baroness, Lady Wootton, but I will leave it for them to sort out among themselves.
At the risk of over-simplification, my thesis is that we must set out to do for psychological needs what Beveridge and those who followed him did for physical needs. I am not saying that we do nothing for those who are psychologically disadvantaged, and it would be equally untrue to say that nothing was done before Beveridge for those in physical need. But I am saying that a much higher priority should be given within the total provision 162 for those who, for psychological reasons, do not benefit in practice from the Welfare State to the extent that on paper they are supposed to benefit.
For the purposes of illustration—and others will provide examples from their own wide experience—I will touch on three categories: The single homeless—and particularly the single homeless young; the prisoners and ex-prisoners, and the black community. I may be told that if we are talking of psychology, the mentally sick and the mentally handicapped provide the most glaring case of all. In their case, of course, the psychological factor is the essential element; it is recognised and pinpointed. To a lesser extent, that is true of the old. But in the cases just mentioned this aspect of psychological disadvantage is ignored. The collective will of our people—and I am not saying that other countries are any better—is reluctant to do more for groups such as those I have mentioned than is done already, because basically it is felt they do not deserve that more should be done for them. For example, most people would agree that the disabled deserve better treatment than they are getting, but the groups to which I am referring are not, on the whole, regarded sympathetically by the general public. The feeling is understandable but superficial, as we shall see when we look at the problem.
Take the homeless young, for example. When, some years ago, I and others started a centre in Soho for homeless, drifting young people, I assumed that those in need would be immediately anxious to take advantage of any help that was offered to them. That was, and is, far from the case. I learned then what the noble Baroness, Lady Wootton, referred to in another context, that many of those in the greatest need of help are the most reluctant to accept it.
No one who has any contact with the single homeless could say that they have what might be called a normal sense of expectation. Many years ago, in my hearing, Ernest Bevin used to quote John Burns as saying:the tragedy of the working class is the poverty, of their desires".I suppose today there are those who would say that is not true of the working class generally, and regret it. In so far 163 as it has ceased to be true, I welcome the change. However, the tragedy of large sectors of our society remains the poverty of their hopes. They simply do not believe that anybody is going to help them. To come to a concrete issue, it will not be easy to eliminate such pessimism and inner hopelessness, but one thing at least the Government can do is to establish the rights of those concerned beyond question. Last summer in this House a number of us urged the Government to lay down minimum rights for the single homeless. I am under the impression that the Government will be making some announcement fairly soon, but let us hope and pray that it will induce the local authorities to make provision for the single homeless, and to make it as a statutory duty.
So with ex-prisoners. The provision of aftercare for ex-prisoners is somewhat better than it was, say, 20 years ago—which is saying very little. At least we now have a national Probation and Aftercare Service—terribly overworked, as was said by the noble Baroness, Lady Macleod of Borve. It is far less effective than it should be, not through any fault of the Service, but simply because it is overworked. But we still spend ludicrously small amounts on penal treatment and aftercare generally, because in the last resort we as a nation consider—whoever happens to be in power, whatever the Ministers and officials may feel—that prisoners do not deserve a larger share of the national cake when many more deserving citizens are going short. We as a community seem unable to bring ourselves to understand that, whether we like or do not like them, prisoners and ex-prisoners are handicapped persons just as much as if they were suffering from physical disability. They are handicapped by their temperament, by their experience in prison, and by the way they are treated afterwards.
It is so with the black community also. I am talking of the community as a whole, without pointing a finger in any particular direction. We still cannot realise the handicap under which they labour from the beginning of life, even when born and brought up in this country. I do not mean just the colour prejudice, although that exists, but the educational handicap from which most of these people suffer, 164 the deep feeling of alienation, of being outside what they call the host community—and that expression alone is evidence of the alienation I have mentioned. The Melting Pot, a centre for young black people in Brixton, of which I am honoured to be a patron, is receiving valuable help from official sources and is truly grateful, but those concerned keep raising the question of why more black people cannot be employed in the social services. I hope the Government will be sympathetic to that aspiration at least.
My Lords, I expect some of your Lordships will have read in The Times of 13th April an impressive article by Mr. Mark Bonham-Carter, chairman of the Community Relations Commission, which arose from the argument as to whether the black people are committing more than their share of crime, and, conversely, whether the police are treating them fairly. Mr. Bonham-Carter wrote:Mutual recrimination between the police and the black community will help no one save those who want to sensationalise race relations. What is required is the means of bringing the police and the black community together, not to blame each other but to work out ways of helping both to achieve civilised relationships".We have scarcely begun to scratch the surface of the problem, in spite of a good many efforts made in this House and elsewhere. We still think we have done our duty by the black community if we tackle positive discrimination with intermittent energy. We cannot realise that here again—and this time without any fault; in the case of prisoners you can talk of fault, but you cannot talk of fault here—the black community is suffering from this built-in disadvantage which can only be redressed by positive action in their favour. I am not asking for vast sums of money, the provision of which would impede the development of our justly admired services, the great services of health, education and social security for example. I am urging that our eyes should be opened to the need for a new, additional dimension which would render our social services more humane, more civilised and more relevant at the crucial points.
In my view, we shall never arrive at this enlightenment unless we clear our minds about the place of merit or desert in our social provision. Most of us will remember the words of the Gospel—it is 165 not those who are well who need a physician, but those who are sick. That notion, admittedly, is a large factor already in our social provision, if the idea of sickness is extended to cover those who are unable to earn a living, to the old, to the unemployed, to children, for example. But the next sentence of the Gospel is less regarded:I have come not to call the just, but sinners to repentance".No one who has listened to those in authority, Ministers for instance, expressing reluctance to spend more on penal treatment, can suppose that the second part of the Gospel message, the call to sinners, has got home, and it is high time it did.
My Lords, a little while ago, a prisoner who for many years had been in an American prison—a prisoner befriended by the noble Baroness, Lady Wootton of Abinger—described the untiring efforts of those who tried to help him, and he asked what justification there could be for all this noble exertion on his behalf. There was nothing in himself, he realised, which should have drawn it forth. The only answer he could find was this, and I quote his own words:There was my great need, but that is enough for real champions".If we accept the test of real need, psycho-logical as well as physical, our sense of humanity soon directs our gaze to large numbers of men and women who are today too psychologically disadvantaged to obtain the benefits of the Welfare State, which we persuade ourselves in our well meaning way, are available to them. It is with these psychologically disadvantaged groups in mind that our social priorities should be adjusted, not only in their own interests, but in those of the British community as a whole. The well being of the respectable members of society cannot be divorced from theirs, bearing in mind that we are all members of a single family.
§ 4.55 p.m.
§ Baroness FAITHFULL
My Lords, as a former Director of Social Services, and one whose profession has been that of a social worker, I must declare an interest in this debate. I am indeed grateful to the noble Baroness, Lady Young, for initiating it. It is perhaps inevitable that 166 I should view social policy in relation to the community through the eyes of local authority social service departments, voluntary social work agencies, and as a member of the British Association of Social Workers. Perhaps even more important, I view this debate through the eyes of those who come to posts in social services or voluntary agencies with a problem in the business of living which cannot be solved by their family, by their friends or by their neighbours.
My Lords, I seek to take up the position of counsel for the defence of social workers. In your Lordships' House there is much understanding and much sympathy for the social service departments. But there has been widespread criticism arising out of certain cases during the years since 1970. Social workers—and I count myself as one of them—would be the first to admit that we have made mistakes. In fact, I would submit that growth cannot come about without mistakes. We do not wish to have excuses made for us, but we wish the circumstances to be understood. Therefore, with the permission of your Lordships, I should like to look first at the past six years, the present, and the future.
There are many people who are regretting the passing of the childrens' departments, the welfare services and the mental health departments. I speak with much diffidence because the noble Lord, Lord Seebohm, is in the House, and he will know better than I the personal findings of the Seebohm Committee Report. I remember very well sitting in my office one day as a children's officer, when a woman came in insisting that she see the children's officer because she was owed money. I saw her. Whenever one thinks the accounts are going wrong, one always sees someone. The woman said to me, "You owe me money". I asked her why. "Well", she said, "there are six of you from the town hall visiting me. That is six cups of tea and six biscuits a week; and I should be grateful for a home help to clean the place while I am looking after you all". This is bad social work. It is waste of manpower, and it is a waste of travelling time. For this reason, social workers supported the noble Lord, Lord Seebohm, in his recommendations in the report of his Committee.
167 In the last six years we in the social services, have realised that "the buck stops here". Social services are the last port of call. If anything goes wrong with any other department, or if a person has been unable to get any help, or the help has gone wrong, then it is to the social services finally that the case presents itself. May I touch on one or two things—first of all housing. The problem of housing the homeless in the last six years has been absolutely appalling. The social service departments have been inundated. When at one stage I did some statistics, I found that the staff were spending 60 per cent. of their time dealing with homeless families, and only 40 per cent. of their time dealing with work which was rightly theirs by legislation. Since February 1974 the housing of the homeless has reverted to—or at least is now—the responsibility of housing departments. Nevertheless, if there is a failure to house a homeless family, under Section 1 of the 1963 Act the case goes to social services. On neither side of your Lordships' House and on neither side in another place has a solution been found for the homeless, despite the massive building programme and the large number of empty properties in this country. I would merely say, as I said earlier, that the problem of housing the homeless has bedevilled the work of social services departments.
I then come on to building. There has already been a debate in your Lordships' House concerning the type of building, council houses and sheltered accommodation, that we are putting up. I would ask particularly that note be taken of insulation for heating; that expensive underfloor heating by electricity should not be put in. It only means that people cannot pay their bills, that ultimately either they are cold or they run up expenses they cannot meet. I speak particularly of the elderly, who if they have no proper heating suffer so badly from hypothermia.
My Lords, I turn to planning. I speak withs much diffidence, because the planners must have had great difficulty. I think it is cause for sadness and concern that we in this country have had this massive building programme and we have not planned our areas, except in a few instances. For instance, no play space for children, which has meant the adventure playground and the National Playing Fields Association 168 finding space and money to make good this loss. We have built high rise flats. Some people are happy in high rise flats, but I cannot believe that it is right for families to live in such flats. I know of many families where the children are given aspirin to keep them quiet because the parents cannot put them outside and constantly watch them. Those who cannot tolerate the problems arising out of high rise flats and high rise living ultimately come to the social services departments.
My Lords, I was going to speak on the subject of poverty. I would have spoken with diffidence, having spoken on it before. But having listened to the noble Baroness, Lady Wootton, speak so ably on this and on the whole question of benefits, I will perhaps leave that subject out. But may I make one comment. Reading the history of trade unions, one cannot but be moved by their past objective to help the poor. It is a cause for mystification and some concern that the TUC appears now to further the interests of their more vocal and better paid members, doing much less for the workforce caught in the poverty trap and on low wages.
Turning to the Supplementary Benefits Commission, I would say that the relationship and the organisation of that service has greatly improved; there is a very much better relationship as between social services and the Supplementary Benefits Commission. There again, as has already been mentioned, at the end of the day a family without money has to go to the social services, because they have a weekend and evening and night service.
May I mention the public services: gas and electricity. Whenever anything goes wrong with the gas or electricity services, such as we have experienced in the past few years, the social services have to deal with the matter—that is, not only the social services but the health visitors and the health service. I well remember, during the various strikes we have had in the public services, how devastating was the work of visiting the elderly who might not have heating.
My Lords, I should like to touch on one more point. I would ask the noble Lord, Lord Wells-Pestell, whether he is quite sure that there is the necessary cooperation and understanding and communication as between Government 169 Departments that have a common problem, dealing with the same people. In local government there has been corporate planning. It has not always been easy, but at least everyone knows what everyone else has been doing. Perhaps I had better look to the beam in my own eye. First, in the last few years the social services have carried very heavy legislation; it was legislation all of which, I am sure, was required: the Children and Young Persons Act 1969; mercifully, the Children Act of 1975 has not yet been fully implemented, and, although it is a pity it would not be possible with the present manpower. Then there is the Chronically Sick and Disabled Persons Act 1970; the Health Services and Public Health Act, Sections 12 and 13, giving a service to the elderly; the change of policy from hospital and residential to community care.
We have, too, and rightly, so, been beset by pressure groups—Shelter, Age Concern, Mind and the Disablement Income Group. I should also say—and I think it is fair to say it —that the social workers had great enthusiasm with the passing of the Local Authority Social Services Act in 1970. Perhaps, it may have been the case—and certainly I was guilty of this—that one attempted to attract to one's department as much work as possible, hoping that one was meeting the needs of our new departments. In Oxford, for instance, with a population of 110,000, in the first year we had 10,000 callers at the office. With the new Act, with the pressure groups, the expectations of the community were enormous and, as has been said before in this debate, it was their problem. I think that the social services are now realising that there must be a reappraisal and a reassessment and the boundaries must be set. They are fully aware of the cold climate of the cutback due to inflation. One of the things which social workers have fully appreciated is the fact that responsibility must be put back where responsibility should rightly rest; that is, with the neighbourhood.
First, may we look at the alternatives. It has been suggested by somebody—not today—that there should be a cutback in one of the services. My Lords, which one? If there were to be a cutback on the elderly the Lord Mayor of London, whose special interest is the elderly, Age Concern and Help the Aged, would 170 protest. If there were a cutback on services for the disabled then certainly the Under-Secretary of State for the Disabled would have something to say, not to speak of the Disablement Income Group.
May I say that the Minister was in Manchester a fortnight ago and congratulated the Manchester social services along with the chairman of the Spastics Society on their excellent service to the disabled. I would say that this applies elsewhere, although there may be gaps in other areas. As regards the mentally ill and the handicapped, we could not cut services here. As has been said before in this debate, it would mean either people being left in hospital or that they come out of services with a community care.
The Social Services Department is also responsible for children and their families. If time had allowed I would have wished to speak at length on service to children and their families. It is a subject basic to the wellbeing of the nation, and ought surely to be the subject of a full debate. The situation is growing critical and crucial. Statistics show that those aged under 17 years commit 25 per cent. of all serious crimes, more than 40 per cent. of burglaries, and nearly one-sixth of all violent crime. It is no wonder that the police and the Association of Magistrates call for a change in the Children and Young Persons Act 1969.
However, I would make two points. First, this law is a non-law. As directors of social services we made mistakes, though I must say that many of us never sent a child home immediately where a care order had been made. This law is a non-law because we have not had the resources. The police understandably call for secure accommodation. This should certainly not be in prison. In a community home there are ways of providing a child with the kind of life which can hold him or her. Even if the law were to be altered there would still not be the resources. The Kent scheme, already referred to, for fostering difficult children is less costly than residential care, but to be successful it needs and requires qualified social workers to get the scheme under way and to support the foster parents.
My second point is perhaps even more fundamental. I would say that I had already written this speech when I heard 171 the noble Baroness, Lady Wootton of Abinger, on the wireless the other night and I feel both proud and humble to have written, I would almost say, what she said. By the time a child, or young person, reaches court it is, as I am sure my probation officer colleagues would agree, almost too late. The damage is done. Prevention would have been better than cure. The damage was done along the years of that child's life, and I am one who believes that it was done in the early years. The damage lies in the social conditions and the family life of the child up to the appearance in court. This may sound like doom and gloom, and must be set against so much in family life in this country which is on a firm footing.
We shall continue to have problems until we have a constructive and coordinated policy fot the development of children: a policy overall, and not of one Department but of several Departments; the Department of Health and Social Security, the Department of Education and Science, the Department of Labour, and so on. The policy should offer a service in the broadest sense to children, as far as is practical and possible in the setting of their families, and, if not, in a setting which meets the needs of the individual child. This is clearly brought out in the book, Children who Wait, by Jane Rowe. The National Children's Bureau showed the effect of social policy on the development of children who are, after all, the best investment a country has, and, more important, demand our compassion.
My Lords, I am bound to say to you that some of us have tried, and are trying, to meet this need. When I was a director there was an arrangement as between our education department and our social services department whereby teachers in schools who, at an early age, found children difficult, disturbed, unhappy, perhaps not cared for, should refer them jointly to the education department and the social services. The city council, the Ministry, had approved the building of two children's homes of a new type and nature, and we were to accept the children into the children's homes; some for the week, some for the weekend. The school would give them special classes. We hoped in this way at the same time to support the parents. Thus we hoped to 172 prevent juvenile delinquency, and to prevent the lives of children from becoming unhappy. Two days before I left the Department we had a note to say that there were to be no further projects, and that these projects must be put in cold storage. Therefore, I would say that the Children and Young Persons Act 1969 is an Act we believe in, but we have not the tools to carry out that Act and to carry it out well.
Social workers are very well aware that they cannot be doing all the work that is laid at their door, and therefore they are developing neighbourhood projects. They are attempting to put work back to the neighbourhoods, and back with families. I would say that the volunteers, and voluntary workers, are of inestimable value to social services departments and they are, to my certain knowledge, being used to a very great extent. There is just one thing I would say on the question of staff, and this applies not only to social services but to education and to the hospital staff, and it has already been mentioned. There should be a two-tier promotional ladder whereby people may attain promotion and yet remain in touch with the work on the grass roots. If the good teachers remained in the classrooms, if the good nurses remained as sisters, if the good social workers remained at the grass roots, I think we would not have had many of the troubles that we have had. This is not to say that I do not approve or like or respect young social workers. They have been magnificent and have carried a burden which perhaps we should not have asked them to carry.
A great deal of self-help is growing up and so are many self-help organisations. These, I am sure, should be supported and I would mention one group, the child minders. Registered child minders care for more children than all local authority, private and factory nurseries put together. It is the major form of day care of children in their first two years. Child minders look after the children of, by and large, mothers who are unskilled; of course they are not all unskilled. Child minders do not stick to hours and they have no training. I do not think that we have harnessed, used or helped this service adequately. The subject of training has been mentioned and I hope that whatever else we may have to cut back on, it will 173 not be training; and I hope particularly that this will be borne in mind in relation to the residential staff who carry the most difficult cases in the social work world.
It is a realistic fact of life that to improve a service and change direction there must be some money. The personal social services can, and I am sure will, deploy their staff, use neighbourhood schemes and volunteers and co-operate with voluntary organisations, but society cannot have it both ways; it cannot blame and arraign the social services for doing their work inadequately and at the same time not be prepared to meet the cost. Should there be more drastic cuts, then the community will need to provide a service for itself. Social workers realise that, to be effective, a balance must be struck between the preservation of and incentive towards a life of self-reliance and independence on the part of all members of the community, while at the same time adopting towards those realistically in need a policy of support given in such a way that the person in need and the social worker together seek to resolve the problem, maintaining and preserving the dignity of the individual.
§ 5.23 p.m.
My Lords, the noble Baroness, Lady Young, has drawn the terms of her Motion so widely that I, like others, find it difficult to decide at what point in this wide social spectrum to fix my thoughts. Unlike others she has mentioned, I did not get in touch with her about the Motion to try to find out exactly what she meant in case I might be discouraged from taking the line which I hope to take, the more so because it has to do with a subject which was debated in this House only recently and in which she played a notable part. I am, therefore, risking riding a hobby-horse on the premise that almost every speaker has managed to alight on a different subject without being, so to speak, redundant.
Having missed the debate to which I am referring — it was about juvenile delinquency—I wish to take this opportunity to deal with two aspects of the treatment of young people who are in trouble with the law. I have of course studied the Hansard of that debate and in particular the speech made by the noble 174 Baroness, Lady Young. Since then there has been a debate in the other place on the Report of the Expenditure Committee on the working of the Children and Young Persons Act and I understand that a White Paper is now awaited. First, policy; I shall be touching briefly on policy and on provision. In both the debates I have mentioned there was a good deal of discussion about the principles underlying the Act and whether the very alarming increase in juvenile crime was due to some faulty thinking behind the Act or a failure to supply adequate resources to make its provisions workable. As we know, there are a number of factors, and the noble Baroness, Lady Faithfull, mentioned one, the high rise flats situation.
Not all the factors which have a bearing on this worrying situation are fully understood, but I think that one principle in the Act, apart from the matter of resources, has something to do with this problem, and that is the principle of selecting a date in the life of a young person and saying, in effect, on the one hand that under the age of 17 he or she should be treated differently by a different service for committing an offence, even perhaps a very serious offence, with the court exercising no control after making an order committing that person to the care of the social services and the local authority, while on the other that same offence above that age and after that date becomes overnight a matter for a quite different approach being dealt with by a different service which is answerable to a court of law.
In my view this situation is unrealistic, unnecessary and therefore wrong. For one thing, it is generally too old an upper limit. Many, perhaps most—I do not have the statistics—young people in trouble with the law have been for up to a year away from school or college by their 17th birthday. They think of themselves as adults; they think of themselves and behave as though they are entirely free of parental control. They need to be treated for failures in responsible behaviour exactly on that footing. I also think that the lower age limit, 13, needs to be looked at afresh. Juveniles are committing serious offences at a younger age year by year. It may be true, as the noble Lord, Lord Harris of Greenwich, said in the debate in January, that 175 the incidence of juvenile crime among the under 14s has been steady for the last four years, but I believe—I am subject to correction—that it is growing younger. I am not sure that it is right for some of these precocious, highly anti-social 12-yearold hooligans to be treated as not having responsibility for their misdeeds, or how realistic it is to place the whole of the onus of blame on the parents.
The wrongness of that upper limit was implicit in a statement made by Mr. Alex Lyon, speaking then as Minister at the Home Office, in the recent debate in the other place on the Expenditure Committee's Report, when he said that it was "not possible to phase out the use of the Probation Service in children's cases"—which the Act requires and which the Expenditure Committee had recommended should be hastened—and it will continue to be wrong as long as it is deemed right to retain two separate services, the Probation Service and the social services, to meet distinctively different kinds of social need. I hasten to add that, for my part, I find it right that this distinction should continue. To blend those two services into one comprehensive service would produce the worst of both worlds and would therefore be a false economy. I believe that this has been shown to be the case in Scotland. Certainly it seemed that it did not provide for the adequate supervision of the more serious offenders in the community on parole while I was chairman of the Parole Board for England and Wales. The plain fact is that the Probation Service, backed by the courts, has the expertise to deal with certain youthful perpetrators of crime—I shall not call them criminals—through what one might call a "no nonsense" approach which I believe, by and large and with no disrespect to them, the social services lack.
The noble Baroness, Lady Young, and other speakers have touched on training. One of my worries, which is shared by a number of other people, is the Government's policy of training both services through the same system—what is called the "generic" approach—in the Central Council for the Education and Training of Social Workers. I believe that this is a mistaken policy and another false economy. Penal treatment is an area for specialists, not general practitioners. Indeed—and this is the important point—a condition of 176 making progress in treating more offenders, both adult and juvenile, in the community (because we must remember that progress in that direction depends on public confidence), is to have a service which masters the difficult skill of combining discipline with a caring relationship with its clients.
To sum up on this first point of policy, I suggest that either the age divide should be fixed at a younger upper limit—perhaps it might be the school-leaving age of 16—or that there should be an intermediate period of transition, perhaps between the 15th and 16th birthdays, instead of an arbitrary age divide during which a decision as to which service should have the supervision of the young offender should be at the discretion of the courts considering each case on its merits. That system would be my strong preference. It postulates a very close relationship and liaison between the magistrates, the Probation Service, the social services and the police. I am well aware that in some other forum than this that latter proposition might be shouted down and that I might be thrown out, but, in my opinion, there is far too much suspicion, arising in no small degree from lack of understanding about the attitudes and real roles of the various bodies concerned, between the three public services and as between the social services and the Probation Service, on the one hand, and the courts, on the other hand. There is too much playing of the one against the other.
Young people, in particular, are not slow to exploit a situation of that kind. I have no doubt at all that police liaison officers working with young people are doing excellent work and it would quite often be the more effective for being carried out in less enforced isolation from the other services. I should like to see more of the small integrated team approach to social problems involving young people which could include the education service as well on a neighbourhood basis. There is a lot of room for closer co-operation at ground level.
Secondly, and finally, I turn to resources. Even in times of financial stringency but really at all times it is no economy in the area of crime and delinquency to restrict the provision of the most important resource of all—men and women, professionals and volunteers, working together. As regards the professional side, I must voice my concern lest the Home Office's 177 manpower target for the Probation Service in 1979 may not be met. It is not simply a matter of numbers but of the balance within the service in respect of age and experience—what one might call the age structure of the service. It would seem that neither the requisite numbers nor the equally necessary matter of balance between mature entrants and the younger ones coming straight from college or school will be realised if, as I understand, the Central Council for Education and Training in Social Work has no plans to develop Phase 2 of its training programme. Older people with some solid experience of life beyond college to put into the service when they come in are invaluable. It is not just a question of strength; it is invaluable to the whole tone of the service.
A number of speakers have mentioned volunteers and I shall not dwell on that point beyond saying that more voluntary associates than we have succeeded in bringing in so far are highly desirable in the penal aspects of social work. We are far behind some Continental countries—for instance, Sweden and Holland—in this respect. For example, I understand that, in Sweden, there are something like 12,500 volunteers as against a small professional body of 300 people who are the equivalent of probation officers. Comparable figures here are, I believe, about 5,000 professionals to 5,000 volunteers. That is a very big contrast. Of course, at any rate so far as the Probation Service is concerned, it is not a matter of substituting the volunteer for the professional; it is a question of making the work of the professional more effective by increasing the contacts with his clients by introducing the invaluable factor of a non-professional relationship. In times when economy is the order of the day, it is worth noting that in one probation area where I made inquiries the estimated annual cost of a probation voluntary associate has worked out at under £6.
§ 5.38 p.m.
My Lords, I am very pleased to have the opportunity of following the noble Lord, Lord Hunt, and of thanking the noble Baroness, Lady Young, for having initiated this very interesting debate. I should like to say that I agree entirely with what the noble Lord, Lord Hunt, said about ex-prisoners, 178 as I did with the noble Earl, Lord Longford. While I was in Plymouth I used very often to go to meet those who had come out of Dartmoor. Some had been there for such a long time that it took them several months to reorientate and they had difficulty in knowing what money meant, and so on. I learnt a great deal from them.
Being the first speaker in this debate who has been in the other House, I must pay tribute to my many constituents who in those days taught me practically all I know now and who helped me to bring in four Bills dealing with the social services. I was particularly interested in what the noble Baroness, Lady Wootton, said about benefits. I should like to add two more points. A married woman living with her husband is not allowed to claim supplementary benefit. Her husband must claim for the family and any resources that he claims for the wife must be treated as his. Secondly, to be eligible for family income supplement, the head of the family must be in full-time work. That might be a woman or a man, but it must be the head of the family. If a married woman is supporting her husband who is out of work and she has children, she is not entitled to family income supplement. These seem to me to be two points which should be looked into. It would be very helpful to many people if this were done.
I was particularly interested in what the noble Baroness, Lady Robson, said because she clearly has great knowledge of the subject. Also, I am sorry that the right reverend Prelate the Bishop of Southwell is not here at the moment because I should have liked to argue with him as regards his remarks about communications. I am not professing to be a Christian but I am professing to be a churchwoman—there is rather a difference between the two—and it is the Church which has failed to communicate. It is one of the sad things about the Church of England that it has failed to communicate. That is why the churches are so empty. When the right reverend Prelate mentioned the woman who was telephoning he eventually said that she got a grant from the local authority. Surely, if it was Church work, the Church should have supported it. I was very disappointed that the right reverend Prelate should have made that remark.
I shall certainly support the noble Baroness, Lady Masham of Ilton, in her 179 request regarding invalid tricycles, and I give the noble Lord, Lord Wells-Pestell, warning of this. The noble Lord, Lord Redesdale, is not here at the moment, but with regard to foster children he may be glad to know that a woman in Plymouth fostered over a thousand children and was awarded an honour by Her Majesty the Queen. I enjoyed every word spoken by the noble Baroness, Lady Faithfull, who is, I suppose, one of the greatest experts on this subject.
First, I wish to draw attention to voluntary work, particularly that undertaken by the Women's Royal Voluntary Service, which has just published its report. We seem to have been talking at some length about what the Government could do, but it is interesting to see what a voluntary organisation such as the WRVS can do. The WRVS stated in its recent report that it provided over 14 million meals-on-wheels, 1½ million items of clothing, and 3¼ million meals at luncheon clubs. It received 36,000 emergency calls for medical aid, and undertook extra work in hospitals, canteens, prisons, clubs for the elderly, and provided books-on-wheels. Furthermore, 29,000 helpers have been to hospitals and over 2,000 welfare workers have dealt with the disabled. Those are a few major items which I have picked out of the report.
I want to stress that most of the women involved in this work are not the youngest women in our society. They are doing great work, and I believe that at this time of stringency we should make as much use as possible of the older women, particularly those who have been trained and who could perhaps take up part-time work. Play groups are springing up, as are toy libraries for the handicapped. The Red Cross does a considerable amount of work, and there are the Cheshire Homes and the Sue Ryder Foundation. All these organisations are contributing tremendously to work undertaken for those in need.
I wish to mention as an example a small organisation, Plymouth Age Concern, which has recently been set up. It undertakes night care for people who are very ill, and 36 attendants have undertaken 279 night care assignments. Day care assignments have totalled almost 800, with 86 attendants, and over 1,215 welfare projects have been undertaken. Use is made of school pupils to do jobs and 180 almost 1,000 jobs were done in the past year. I believe that this is really advantageous, particularly following the raising of the school-leaving age. Quite recently a rehabilitation centre was set up for those who had suffered minor strokes. I have visited the centre myself and it is interesting to note that a number of the people are now fully able to look after themselves, and two are quite rehabilitated and able to live on their own.
My theme today is that people come first. Social policy should be concerned with the wellbeing of people, with the way that we and our families live, and want to live, our every day lives, keeping families together. I believe that we have lost a great deal by splitting up what used to be known as the extended family system. Good housing must be priority number one, with improved social security, better pensions (when the time comes) and help for the elderly and handicapped. We are always being asked in Opposition what we would do about extra expenses, and I want to suggest one or two ways in which I believe we could cut public expenditure. Let us take, for example, school building and extensions. As has been mentioned by the noble Baroness, the population is falling at present. We should also consider the question of the extension of hospitals. We have been discussing bringing people out of hospitals into homes. Consideration could also be given to cutting expenditure on some minor roads. Similarly, spending on local museums and galleries should be considered. Many people may not like this particular suggestion, but in some ways these museums and galleries are a luxury.
We should concentrate on the training of good teachers, nurses and doctors. We have seen that many teachers who have to teach in old buildings can teach equally well and can keep up good standards in these circumstances if they are well trained themselves. They know that in this age of quick technical change they must train the future generations. There has recently been a very interesting report from Lancaster University which shows that we need to concentrate on the real teaching as was done in previous generations in the older schools, although now of course with more modern methods.
Another way to save money would be, for example, in delaying the operation of the Community Land Act which I 181 gather will cost £400 million a year. I should very much like to see that delayed, and there are many other expensive Acts which could be delayed until the right time, because to my mind people come first, and that is why I suggest that we might take this action. For example, since 1950, the European Community has achieved a sustained rate of economic growth unparalleled in the history of Europe. In 1972 the EEC issued a communiqué at the Paris Summit meeting. Part of the communiqué stated:Economic expansion is not an end in itself. Its firm aim should be to enable disparities in living conditions to be reduced"—I do not think that any of us would argue with that.
It must take place with the participation of all social partners. It should result in an improvement of the quality of life as well as in standards of living.We are now a Member of the EEC and I hope that we will try to live up to what was said in that communiqué.
I wish to return to the question of housing because I consider, though I may be entirely wrong, that inadequate housing is the root of most of the evils of our present society. There is, for instance, overcrowding. There are still many slums, and while in some cases the houses may not be actual slums there are too many people living in them. There has been an increase in the battering of babies. I made a study of this and brought forward a report to the Council of Europe, which was accepted. There is also the bashing of wives. I believe that it is scandalous nowadays to have to set up centres—I believe that there are 40 in all—in our main cities where wives can go when they are battered. The other day, apparently, a husband actually drove his car in an attempt to push in the front door to get at his wife.
Consider, also, vandalism. Why is there so much vandalism? The noble Lord, Lord Hunt, knows a great deal about this subject. But I believe that many of these young people cannot stay in their overcrowded homes, so they go out into the streets and get into trouble. Perhaps they meet up with a gang and this leads them to further trouble in the future. Young boys and girls are leaving home. This is a matter which the noble 182 Earl, Lord Longford, touched upon. I am a member of a committee which has set up, and is setting up, hostels for the centre of London. These hostels are for young boys and girls—14 in each hostel, as we like to keep them small—who have run away from home. They have run away because they cannot get on with their parents or because they may have had a bad love affair. They may think that the London streets are paved with gold, or they may come to a hostel simply because they cannot tolerate sleeping, say, six or seven in a room.
We must also consider divorce. Many people are now getting divorced and I think that much of this is due to overcrowding. For example, I recently took the chair at a conference on housing, arranged by the Exeter diocese. The conference was held in Plymouth and we were provided with a very good document. Research had been carried out into overcrowding in the Plymouth area. One couple with two children, aged three years and 14 months, said that they could not get any help from the housing department or the social services. All that the social services would say—probably the services had no alternative—was that the children must be taken into care. The couple did not want to be separated from their family so they went squatting. Another family with three children, aged 10, 4, and 18 months, eventually went to their church and they have since been sleeping in the church hall. Those are only two cases; the document referred to many others.
I think that housing should take priority and soft loans, or easy loans, should be given to people to build their own homes, as has been done in some areas. Any money available should be given for this purpose. In North America and Europe there are family budget standards drawn up by the State. These involve expert views on needs relating to food, clothes, fuels, rent and rates. Budget standards are an essential foundation for decisions by the local and national Governments if allowances, tax reliefs and local benefits are to have a rational basis. I think that in North America and Europe this system has worked very well, and I think it is very regrettable that we do not have the family budget standards in this country.
183 I should also like to draw attention to the question of the thousands of workers who are entitled to the statutory minimum wage of either £23 or £35 a week and who, illegally, are being under-paid. This has gone on—I have the figures for the last five years—to the extent that £8½ million has been saved in this way. The wages inspectorate have recently recovered nearly £400,000. I think this position should be rectified, that nobody should be paid under the statutory minimum wage, in which case those concerned would not need the extra social security grants. It does not encourage anybody to work when it is known that if people do not work, and if they have, say, two or three children, they can get more than this for doing no job at all.
Then there are the home workers. Recently I made a radio broadcast in regard to this because I was very worried about the conditions. To my amazement, not only did people write in and tell me their difficulties, of course, but quite a number wrote in begging me to put them in touch with firms so that they could earn this meagre amount. Of course, they are exploited. In one case, a woman gets £1.60 a week—she is disabled—for painting 500 miniature footballers. These sell, at their retail price, at 11 for 50p. I think it is really outrageous that she should be paid so very little, and that such a great profit should be made. Another woman covers games boards for £2.50 per thousand boards; and when you are wearing your little cap at Christmas, having pulled your cracker, you can think of a woman who has to make nearly 4,000 caps and who, for that, earns £1.80 a week after working for 36 hours. I should like to suggest to your Lordships that the sort of example that I have given today should be looked into in the future. My Lords, in the few words that I have said today I hope I have conveyed the view that, whatever else comes out of this debate today, we should see that people come first; and then, perhaps, we may have a happier society.
§ 5.53 p.m.
The COUNTESS of LOUDOUN
My Lords, one of the major hindrances to the growth of community-based mental health services has been the continual lack of adequate funds going into the social services. The balance of expenditure on 184 the mentally ill has been heavily weighted in favour of the health services. In 1973/74, £300 million was spent on hospital services, compared with £15 million on personal social services for the mentally ill, of which only £6½ million was spent on residential and day-care facilities. Now, economic pressures and restrictions on the public expenditure programme mean that establishing priorities is an important exercise at the present time, and I understand that the Department of Health and Social Security will be issuing policy and planning guidelines to health and local authorities in the spring of 1977.
In the consultative document issued recently by Mind, the National Association for Mental Health, it is suggested that the four following criteria should be borne in mind when selecting priorities: first, changes in demand by client groups; secondly, areas of past neglect; thirdly, best returns on available resources; and, fourthly, the use of joint planning and jointly-funded projects. They see the mentally ill as a priority area for expenditure over the next four years, but, recognising the economic situation, there must be an emphasis on low-cost solutions. An increased programme of local authority services has been suggested, with £4 million annually providing 1,200 day-centre places and £3 million annually providing 350 residential places. However, even to meet present needs (for 30,000 day places and 12,000 residential places), at this rate of growth we shall achieve what is needed now in something over 20 years; and this estimate of present need does not even cover some of those people still in hospital who could be successfully rehabilitated with help from the hospital and local authority.
There is a big campaign, "Home from Hospital", being launched tomorrow by Mind. I expect some of your Lordships may have seen the World in Action programme on Monday evening, dealing with the housing needs of the mentally ill and the mentally handicapped and appealing for specific offers of accommodation and other voluntary community help. I am pleased to say that the response to date has been very encouraging, with many concrete offers of help. But for the achievement of real community care the active concern, tolerance and understanding of the public is vital. I think, 185 too, that both central and local government have too often hidden behind the cloak of apathetic or hostile public attitudes as an excuse for not getting on with the job of providing homes, hostels and social support outside the hospitals.
There also seems to be a lack of coordination between the hospital and the local authority, and insufficient concern for the quality of life people will lead outside hospital, which has led to the "dumping" of groups of patients in seaside boarding houses and poor lodgings in areas with overloaded social services departments. Yet there are still only 4,500 places in homes and hostels in England and Wales, 30 per cent. of which are provided by voluntary organisations. Much more day-care is needed, where people can socialise, share problems, learn to look after themselves again and acquire new occupational skills. Surely more use could be made of less capital-intensive methods, such as using adapted premises rather than expensive, purpose-built ones; sharing premises for day centres with a youth club, for example.
During a recent visit to America I managed to visit two sheltered workshops where patients from local subnormality hospitals were taken daily. One class was doing pottery, bicentennial mugs and plaques, and they had more orders than they could supply. The work was first-class, but, naturally, they were a little slower than is normal. Another class was counting and packeting birth announcement cards and envelopes. Here, the work of some groups had to be checked, but others were working quite independently. The boost to their morale and sense of independence which this gave them was remarkable.
The Government propose to introduce a mechanism for jointly-funded projects, where the initial cost will be shared between the health authority and the local authority, with the local authority taking over full responsibility after a number of years. This I welcome. It will enable more homes, hostels and day centres to be provided. Let us make a determined effort now to get our priorities right and take a real step forward in our care of the mentally ill and the mentally handicapped, thus enabling them to look with greater hope to the future.
§ 6 p.m.
§ Baroness ELLIOT of HARWOOD
My Lords, as the last Back-Bench speaker in this debate, I do not propose to delay your Lordships for very long but on this occasion mine is the only voice to speak for Scotland. Very often there are a number of Scottish speakers, but on this occasion I am the only one. The noble Baroness, Lady Faithfull, described most eloquently and interestingly her experience as director of social work at Oxford. I may say that I spent some 20 years or more first as chairman of the chidren's committee and then the education committee, and then, when the Seebohm Committee reported and we all turned ourselves into social work committees, I remained chairman of that committee too; so that I have had a good deal of experience in this field. As in other fields, the more experience one has, the more one realises, how little one knows how to deal with each situation. However, one can just have the experience and, for what it is worth, I should like to make my contribution to the debate today.
I think it most interesting that while in this debate we have had some 14 or 15 speakers, nobody has said the same thing on this subject, because there are so many varied facets of social work all of which I think are of vital importance to the community. I should like to support every word of the noble Countess, Lady Loudoun, about the question of help for the mentally handicapped. This is certainly desperately important, and she knows a great deal about it. My feeling at the moment is that what has been said, and rightly said, about the importance of concentrating on doing work in the community, with the community, as near to the people as possible, is absolutely the right principle. As the noble Baroness, Lady Vickers, has said, the people come first; and when the noble Baroness, Lady Wootton, described the appalling experiences and enormous difficulties of the two people who were trying to get help from services which are there to help them, I felt this to be a form of red tape and form-filling which we should really insist upon being altered because it completely defeats the object for which all this legislation has been passed.
It is by no means easy to talk about social work as one of the great services. Some 187 people criticise it because it is not a cure. Certainly, it is not a cure. Some people criticise it because it does not prevent enough disaster. It does what it can; but it cannot do everything. Some people feel that only the failures get into the Press. This, in my opinion, is probably true. Social work can only be effective when it is concerned with individuals, when it is concerned with the families, with the places where they live, where things are done and where people are cared for; and not by filling in forms, not by writing letters, but by being in close contact with people.
When, under the Seebohm Committee Report, we reorganised the social services, we had various different specialists. We had the person who was very good with children, the person very good with geriatrics and the person who was very good with the mentally handicapped and so on. They all had to be welded into a team. It was not easy, but I am sure it was the right thing to do. It was the team of social workers that made the work very much more effective, certainly in my experience. It is impossible for one person to be an expert on everything; it is impossible for one person to take the responsibility for everything that comes up in a social work case; but it is quite possible to have a team in which you have two or three people each of whose expertise can be pooled to make a policy for that case. That is what happened when the Seebohm Report was put into effect.
As their chairman, I have always said to the social workers with whom I have had the honour to work: "Whatever happens, spend most of your time out in the district, in the towns and in the country and the minimum of time in the office". If we have not got all the records absolutely perfect, it does not matter if the cases are perfect and we do not get the battered babies and deserted wives and the tragedies like Maria Colwell and so on. That, I am bound to say, was successful and so far as my area was concerned in all the 29 years I was there, we never had a case that appeared in the Press. They were always being dealt with by the social workers. That principle, I think, is vitally important.
I agree entirely with all the people who said: "Do not take people away from their own homes. Use all the domiciliary services you can." It is most unfortunate 188 that in some of the economies that have been made in local government services recently, some local authorities have taken things like the home help service, the domiciliary services or the meals on wheels and tried to economise on those. I think that those are the last things we should economise on. There are many others we could economise on; but those services to the people in their own homes, and keeping them in their own homes, are absolutely vital.
We did one thing which has not been mentioned in this debate and which was extremely successful. We established day centres for old people to go to and also a day centre for mental care. Both of these centres were tremendously useful and they have been enormously successful. If we could duplicate them now we would do so, but there is not the money. Those centres to which people living in their own homes come for the day have proved tremendously successful. I should think that that was something which was both economical, because you are not troubled with the housing problem, and effective in that it does care for people. One of the things that have happened several times and it has horrified me is the tragic case of old people who have died in their homes and this has not been discovered until the old person has been dead perhaps for some days or a week. That seems to be a terrible criticism both of the community and, to some extent, of the social work department, although they may not have been in touch with the social workers. I am sure that if we could have more community services for the old, something disastrous like this could not happen without people realising that the old person had not been seen for a day and, somehow or other, getting into the house. This point, I am sure, is vital.
I agree with those who spoke about family life being the centre of our activities. Even when family life goes wrong, which it can, it still remains vital that in some way part of the family should be kept together if it is a fact that the husband and wife have parted. Still, I think it is possible in many cases to keep the family together. On the other hand, we have had cases where the ill treatment or bad management of a foster home has not been spotted quickly enough by either the social worker or the health visitor who have 189 sometimes not had the courage to report it sufficiently strongly. In Scotland the other day, a child died because it had been starved by its foster parents. That is a terrible thing. While I think it is rare, I think the social worker must have great courage to take a decision, perhaps, in consultation with the rest of the team, to remove a child if they think it is in the child's interest and not wait until it is too late. There are a lot of people who can pull wool over the eyes of even some of the most experienced people. It is necessary at times to be rather drastic and take action in a very courageous manner.
It is not easy to choose the right foster parents; in fact it is jolly difficult at times. Removing a child to safety is also not easy. It is always difficult to take away a child, but sometimes it must be done. Having standards which differentiate clearly between what we believe to be right and wrong and sticking to them, however difficult that may be, is something which we should all do, and we should encourage our social workers to do this, too.
The noble Baroness, Lady Faithfull, spoke about one of the troubles that we are faced with in problem families. It is that we do not have enough supporting services. We do not have the back-up services for many of the Acts of Parliament which are passed and then, when we want to implement them, particularly in regard to delinquency, which the noble Earl, Lord Longford, was talking about, we do not have the equipment, the places, and so on. Certainly in Scotland we have nothing like enough schools for mentally handicapped and disturbed children—List D schools as they are called. There are not enough methods for treating delinquency. Often all that happens is that the child is put back into its home under supervision, and the home may well be one of the reasons why the child is a delinquent. We do not have the services, and that is very unfortunate indeed. A variety of treatments is seriously needed, and the lack of places is very serious indeed.
The noble Baroness, Lady Masham of Ilton, referred to the disabled persons' Act which we all supported with tremendous enthusiasm. I back up what she said: many local authorities are not sufficiently conscious of it. I do not say that they have not done certain things, but I had a 190 similar experience to the noble Baroness when a new technical college was built in my area and I wanted to send a handicapped boy there for training after he had left ordinary school, which he had been able to attend. He could not go to the college because there were no facilities for his wheelchair and the college doors were not wide enough. The child had to be sent to Edinburgh for training because he could not attend the local technical college which had just been built. I was furious hut, not being on the committee, I did not know that this had happened.
There is another point about housing which I should like to mention. It may be that this does not happen in other places, but far too often houses are built too elaborately; they are built as all-electric houses. I had a tremendous battle with our local authority because they built a new housing estate which was all-electric. The bills were not being properly paid. The Electricity Board complained and there was a frightful row. I asked why they did not put in alternative heating. They said: "We cannot have an open fire". I said: "There is no reason why you cannot have one so that people can get fuel, and so on". In country districts fuel can be picked up cheaply. The local authority were horrified; they thought this was a retrograde step. Finally, I persuaded them to have alternative gas heating, because we had North Sea gas. Mistakes of that kind are costly and should not occur in this day and generation.
I also support what the noble Baroness, Lady Masham of Ilion, said about the physically handicapped being kept in the community. It is absolutely vital that today physically handicapped people should be treated, in so far as it is possible, as ordinary, normal people. Facilities should be provided in order for this to be so. I hope that this matter will be pressed very strongly; I am sure it will be, as the noble Lord, Lord Wells-Pestell, probably agrees with every word I say. I know from the Government document that many of these things have been noted.
I am sure the Government will receive this debate and what we are saying with great enthusiasm, knowing that we shall back them up in every way we can to get these services provided through the local 191 authorities. It is not easy today. Noble Lords on this side as well as on the other side of the House know the financial situation. Nevertheless, so far as we can, we must all help to provide community services locally and to encourage every local voluntary organisation to take an active role in helping social services. During the war years we had activities to enable the ordinary life of people to go on under very difficult circumstances. We managed to do that then, and so, with the help of the voluntary organisations and with this feeling of urgency which we have in this matter, I am sure that we can overcome some of the difficulties, even though, naturally, we should like much more money for buildings and so on. All of us in this debate have shown how keen we are that the social services should be improved and, above all, should belong to the community and be in the community, and we hope that this keenness may have some effect.
§ 6.17 p.m.
§ Lord SANDYS
My Lords, first, I should like to thank my noble friend Lady Young for introducing this very interesting debate. We have had 13 speeches so far, all of which I have listened to with the greatest of interest. I am sure that noble Lords who have not taken part in the debate have noted, as I have, the immense expertise which resides in this House on every aspect of social policy. It has been noted several times already this afternoon that different aspects of the total subject have been touched upon. I should like to congratulate my noble friend in drafting the terms of her Motion so widely as to enable this to happen. Perhaps it would be impossible to draw the threads together, but in attempting to concentrate a number of matters into one acceptable form, I have had the greatest difficulty in seeing a total view of the situation that we are in. I think the noble Lord, Lord Wells-Pestell, who is to reply, will agree that one of the central issues is the economic one. It has arisen from the situation in which we find ourselves. From the late 1940s, the 1950s, the 1960s and up to today, the middle 1970s, economic growth, on the comparatively modest scale in which it has taken place in this country, has been enough to make the escalator of the social services grow at the same time and in a manner in 192 which it meets to some extent, but not totally, the rising expectation of people in this country.
We have had many useful suggestions this afternoon on how the policies of the present Government could be greatly improved by the establishment of a change of view and the alteration of course to a number of low-cost policies. I think the noble Lord will agree that there have been a number of constructive proposals which may be laid before Her Majesty's Government, and we hope they will be acted upon. Let us look at some of the causes, my Lords. One of the fundamental causes for the present situation is housing. This has been touched upon by several of your Lordships. I am particularly glad to have heard the speech of my noble friend Lady Vickers on this subject. She knows a great deal about this, both from the constituency point of view and from wider aspects. It is interesting to note that so many of the speakers in this debate spoke also on the Unstarred Question on homelessness, as I did myself, last summer. This is really the point at which so many of the social policies fail to co-ordinate at the present moment.
We heard mentioned this afternoon planning aspects and the question of high rise flats and their unsatisfactory nature for families. The question of pollution has also been mentioned. There is no doubt about it, my Lords, that we are asking, through Her Majesty's Government, for the assistance of specialists in the field of planning, building and construction in looking at a subject that we believe they have got wrong. Perhaps it is unfair to single out one profession, but I think it should be mentioned that we do not believe the architects have got the sum right. In the post-war years a number of errors have been made in the public housing programme which are all too easy to see. If they cannot be corrected, at least we should not repeat the errors in the late '70s and '80s. Let us learn from our mistakes. If we cannot adapt the buildings, can we not at least recognise the fact that if high rise flats are to perform a useful function as part of the housing stock, it is far better that young families should not have their homes there? There are other groups which could find them, if not satisfactory, at least reasonable.
193 The subject is a very wide one, but in looking at so much of it I feel that prevention is better than cure, and I would congratulate the Government on a document they brought out comparatively recently called Prevention and Health: Everybody's Business. As a re-assessment of public and personal health, surely this should be a matter of very great concern and the fact that it has been published in the spring of this year should surely call our attention to the need for a personal solution.
I should like to dwell at a little length on the question of sickness rather than health—the other side of the coin—and the question of hospital admissions. From the publication I have mentioned it is quite evident that the hospital admissions currently taking place could be greatly reduced. We learn from the Consultative Document Priorities for Health and Personal Social Services that in 1972 hospital admissions numbered no fewer than 4.6 million, and during that year there were half a million in Scotland. Perhaps my noble friend Lady Elliot may be able to tell us more about that on another occasion. These figures represent globally about 8 per cent. of the population. How can they be reduced? Surely in the accident field there is an opportunity for reduction, particularly in road accidents where the tragedy is quite enormous—no fewer than approximately 12,000 deaths each year. There are also industrial injuries and accidents in the home. In all those fields the work of safety committees and the working of the Health and Safety at Work Act will surely be beneficial.
With regard to preventable disease, there is a case for at least some degree of congratulation. It has been possible in the past century to achieve a remarkable degree of immunisation. Even in the past 20 or 30 years diseases which were once very widespread, such as diphtheria, have been almost eliminated. I think I am right in saying that in the last 12 months there were only seven or eight cases of this killing disease which took such a very heavy toll of life among children as late as the early 1940s.
In the field of mental health there is another opportunity for improvement. Your Lordships will be aware that in England alone no fewer than 5 million 194 people consult their general practitioner about questions of mental health. At the lower level, this may involve purely cases of depression; but is this not a matter in which, again, all of us should be involved? The curing of mental illness is obviously a specialist field, but nevertheless the question of depression, of which many of us may have had personal experience, is surely one field for investigation and concern.
I should now like to turn your Lordships' attention to the Resource Allocation Working Party, because many speakers today have mentioned the use of resources. I was delighted to listen to the speech of the noble Baroness, Lady Robson, about this. She asked a number of pertinent questions and particularly: is money being wasted? I think this is really the centre of my speech because I, with others, believe that money is being wasted. My noble friend Lord Redesdale suggested that foster parents were being wasted. The noble Baroness, Lady Faithfull, suggested that travelling time and resources were being wasted, and that electricity was being wasted because of unsatisfactory design in under-floor heating. The noble Baroness, Lady Vickers, mentioned the mis-allocation of resources, not necessarily within the social services, but within the global national Budget. I strongly support what she said—that the Government, in our opinion, have their priorities wrong in, for instance, allocating £400 million to the Community Land Act and its implementation, when so clearly there are a very large number of urgent priorities which need to be fulfilled, many of which would cost far less than that figure.
I should like to refer to the Consultative Document itself. I read it twice; the first time in order to get the picture of the whole, and the second time to underline particular aspects of it. I sympathise most strongly with those who had to draft the document, because in seeking priorities very nearly everything in the end turned out to be a key element. The phrase "key element" recurs over and over again all the way through this document, and in it the priorities are laid before us. How difficult—almost impossible—it is to choose between priorities! In a democracy we all accept that to govern is to choose; and the 195 Government, in our opinion, seem to be making a number of incorrect choices at the present moment. If by means of this debate we can persuade them to change the course of their actions, the debate will have fulfilled a useful function. In this regard, I would suggest that perhaps it might be beneficial to seek the assistance of the noble Lord, Lord Wells-Pestell, and ask that copies of this very interesting debate be furnished to the members of the Resource Allocation Working Party. I also feel there are a number of aspects which no doubt the noble Lord will be bringing to the attention of his right honourable friend, the newly-appointed Secretary of State. From this side of the House, I should like to accord congratulations to him on his appointment, and an assurance that those policies he is adopting and which have our support will be most strongly supported, and those which do not will be criticised in full.
There are a number of aspects in cognate fields of the environmental sphere to which I should like to draw your Lordships' attention, and emphasise what has already been said. It is so clear that an interdepartmental approach to many aspects of the health and social services field should be adopted; and the question arises here: to what extent at the present moment is there interdepartmental consultation? We are unaware of the degree to which the Secretaries of State for the Environment and Social Services are jointly consulting, and it may be possible for the House to be informed at a later stage.
Specific aspects of planning have been mentioned and should be emphasised here. My noble friend Lady Faithfull mentioned the lack of play space for children. This is surely one aspect of planning which arises. All too frequently the lack of playing fields has a quite detrimental effect, and I should like to emphasise once again that this is one of many important aspects. The question of legislation has been raised by a number of noble Lords on this side of the House, and the Children and Young Persons Act 1969 has been mentioned in this regard. In addition to that, I should like to mention the Children Act 1975 and associate the same problem, because the lack of resources will almost certainly have a detrimental effect upon its implementation. If that is not so, perhaps the noble Lord, Lord Wells-Pestell, will say so.
§ Lord SANDYS
My Lords, I said 1975, but your Lordships must judge. In regard to the question of voluntary workers, virtually every speech, with I think the exception of that of the noble Baroness, Lady Wootton, mentioned the value of voluntary workers. Perhaps the most significant fact emerged from the speech of the noble Lord, Lord Hunt, and I must say that I was staggered to hear that the cost of servicing a volunteer in the Probation Service is as little as £6. This question of assisting the Probation Service should surely receive the attention of Her Majesty's Government as a matter of urgent priority.
Having spoken for 16 minutes, I feel that that is very nearly long enough, but I should like to emphasise one point in regard to the mobility of labour, which has been brought out by a number of your Lordships. This is a subject which is as important as any, and perhaps it is one about which we should have a special debate when it is possible to fit one in. Around this subject revolve so many of the most important problems of all—of employment, of housing, of the location of the education and social services and, especially, the social costs arising from mobility of labour. These have been mentioned in some detail this afternoon. I believe it was the right reverend Prelate who mentioned the fragmentation of the family, and this point was also referred to by the noble Baroness, Lady Vickers, and a number of other speakers.
In her opening speech, my noble friend Lady Young made a point of saying that the whole of the social services should be based upon the family. Inevitably, in seeking mobility of labour, fragmentation of the family is almost certainly the direct result leading to isolation of the older members—the grandparents and, in later years, the parents—and the migration of the children. The question therefore arises: is the benefit to be derived from a policy of mobility of labour such as to be truly advantageous? I think it must be an open question. Inevitably, the social costs are high and in drawing up a balance sheet, as we are attempting to do in the course of this debate, we 197 must list those as some of the most serious.
§ 6.35 p.m.
§ Lord WELLS-PESTELL
My Lords, I was quite certain that the noble Baroness, Lady Young, who holds her political views as strongly and as deeply as I hold mine, would have begun this afternoon by giving us some indication of (shall I say?) Conservative philosophy behind social policy. I was so certain of that that I spent a disproportionate amount of time at Easter thinking out the philosophy behind the social policy of my own Party, getting it down in writing and revising it, and I came here this afternoon prepared to tell your Lordships all about it. On reflection, I decided that it would be rather embarrassing if too many of your Lordships crossed the Floor, and as the noble Baroness decided not to do so, and because of the time factor and there being so much that I want to say, I shall not bother to deliver it myself.
It would be a truism to say that the debate has ranged widely, and there have been—and I do not say this lightly—many stimulating ideas on social problems and social policies. This is the first debate that I can remember in your Lordships' House where everyone who took part has remained to the end. I never recall that happening before. When we have, as we do now, both social change and limitations on public expenditure, it is all the more important to re-examine priorities, policies and practices to ensure that the best possible advantage is taken of the resources which are available.
It is the tendency—and we have to face the fact—of all Governments to legislate for the social conscience of the community, which is often ahead of public opinion and frequently in advance of the resources—financial and suitable personnel—which are needed to carry the intentions of the legislation to a successful conclusion. In some fields public expectations demand action, but this does not always mean that the community is willing to face up to the cost involved. This is apparent in trying to deal with unpopular client groups, as my noble friend Lord Longford said—drug addicts, alcoholics and offenders. Much has to be left to voluntary enterprise and voluntary organisation, and this is 198 a suitable time to say, as we all believe, that we owe not only a great debt of gratitude to voluntary organisations, but a debt which cannot be expressed in the cold lines of a few words. They are making a supreme contribution and it pleases me, as a member of the Ministerial team in the Department of Health and Social Security, to have discovered since I have been there that we spend a vast sum every year in grant-aiding voluntary organisations—in the current year £3 million. The importance of the contribution of voluntary organisations was touched upon by both the noble Baroness, Lady Young, and the right reverend Prelate the Bishop of Southwell.
The community is evolving in ways which are difficult to predict and, when we talk about what can be done, we have to look at the problem to see how much we know about it. While I say that the community is evolving in ways which are difficult to predict, and for reasons which it is often hard to perceive, the relationships between an individual's behaviour and his or her family's social, environmental and economic surroundings and educational opportunities are complex, but they have to be taken into account when policies for the various social programmes are being developed and when the services themselves are trying to provide the right kind of help for individuals. In the last analysis we have to deal not so much with groups. Social work all the time means dealing with individuals and, as the noble Baroness, Lady Faithfull, will agree, no two individuals are alike. So much is happening about which we have, not little knowledge but no knowledge at all. We really do not know the cause of violence. We all have our own ideas but I do not think that many of us know the cause of baby bashing, wife bashing, increasing delinquency and all other kinds of anti-social behaviour. Some of us will put it all in one basket while others will put it all in another, but I do not think that we really know. We know the effects but not the underlying causes, and without such knowledge we have to face the fact that it is necessary to be careful and undogmatic in developing the relevant social policies concerned.
Some types of problem are especially familiar. The increasing number of old 199 people without families who are willing or able to support them places particular responsibilities on the health and personal social services and also has implications for housing policies. There has also been an alarming growth in delinquency, to which the noble Lord, Lord Hunt, drew our attention. Whatever the appropriate remedies in individual cases, whether through the family, in schools, in law enforcement or in the social service care and treatment of young offenders, there can be no doubt of the need for effective action to combat this growing problem. Other changes in social behaviour have led to the rapid increase in the number of one-parent families, again a problem which has been touched upon. If there is to be an effective response, and, let us face it, immediate help is necessary in so many cases, it has implications again for social security, for child care and for housing—in fact for the whole community.
In some localities, integrated communities in which care has been provided spontaneously for vulnerable members—the old, the young, the lonely—have been broken up, as we know only too well, by environmental factors: new industries, roads and housing schemes. For years—and I am talking about a succession of Governments and am not on this occasion going to apportion blame—we have been like a vast army locked in battle trying to defeat the enemy and not having time to disengage to see whether we are really fighting on the right front. Regardless of what has been said today, this is going to be the pattern, unfortunately, for some time to come.
Other problems clearly arise from the present level of unemployment, a level which is quite unacceptable to every one of us here. It is intolerably high, and everybody in your Lordships' House knows not only the evil of, but the evils which stem from, continuous unemployment. While we are endeavouring to tackle the economic problems which lie at the root of unemployment we must cope with the social problems, the majority of which are depressing and distressing, that it causes.
There has also been a fundamental change in what is regarded as the best form of treatment and care for the mentally 200 ill and the mentally handicapped. The trend is away from old-fashioned institutional care towards a more selective approach, with greater emphasis on community care. This is precisely what we want. We talk so glibly, though, about "community care" which today means little or no personal involvement for most individuals. It should not mean just leaving it to an already overworked body of local authority social workers. In my submission. in every locality there are enough people to act the role of the "good neighbour" in their immediate neighbourhood. I believe that the mentally and the physically handicapped, the aged and the infirm could more appropriately be watched and helped by their neighbours. In the war we had street wardens. We should now have "good neighbour wardens" who would be responsible for half a dozen, or eight or ten houses. Then there would be somebody on the spot the whole time.
In saying this, I am not unmindful of the tremendous help which is given in our society today by a vast army of individuals working independently, many of them through social organisations; but I still feel that the efforts made by a good many social workers who are visiting cases who must be visited could be made just as well by mature people who are going to offer care and compassion although not expertise. The social worker could then become the specialist. I believe that we could deploy our social workers better than we are doing at present. I like the approach of the right reverend Prelate the Bishop of Southwell to this—the creation of what I call a "good neighbour brigade".
In the past few years there has been a growing recognition of the need for a general change in the approach to social care. The Seebohm reorganisation, if the noble Lord does not mind me putting it like that, of the social services stemmed in part from this. The legislation—the Local Authority Social Services Act, the Children and Young Persons Act and more recently the Children Act and the Chronically Sick and Disabled Persons' Act—reflects the general recognition that Government, both local and central, have increasingly large responsibilities. This does not mean that 201 voluntary organisations have a lesser role to play. Indeed, they have been among the foremost in urging the Government to respond to recognised needs. As I think was said in this Chamber today, a very good job can be done, perhaps less expensively, by using voluntary organisations and I hope that in some way this can be done.
The noble Baroness, Lady Young, raised the question of taxation. The Government are well aware of the delicate balance which needs to be kept between public expenditure and the public services they provide, between the need for industrial investment and personal consumption. In the survey of public expenditure up to 1979–80 that the Government published in February of this year we acknowledged that point. It reads:Popular expectations for improved public services and welfare programmes have not been matched by growth in output or by willingness to forgo improvements in private living standards in favour of these programmes. The public expenditure strategy is to stabilise the total level of spending on the expenditure programmes for the time being so that enough resources are available for increased exports and investments. This should in turn improve the economy so that there will be more resources available to finance the essential social programmes. In the meantime all the expenditure programmes will have to forgo some development.I think this is what I would say to the noble Baroness, Lady Young, at this point. Planning and improving the services against this background of pressure and change is, I think we would all appreciate, going to be very difficult and it is bound to be made harder by the country's economic difficulties.
The recent public expenditure White Paper sets out plans for broadly stabilising the level of resources taken by the expenditure programmes for 1976 and 1977. Within total expenditure a higher priority will be given to expenditure which is designed to maintain or improve our industrial capability, and to give us a better chance of success as the economy picks up. In spite of that, the Government have managed to allocate some resources for growth in revenue expenditure in the health and personal social services.
Those of your Lordships who are familiar with the document will know that the revenue expenditure on the National 202 Health Service will be raised by 1.8 per cent. a year between 1976–77 and 1979–80, and the personal social service is projected to increase by 2 per cent. This is not as much as those of us involved in the health and personal social services would like to be able to spend, but the growth that has been allowed for is sufficient to keep pace with demographic changes and to maintain standards. In the circumstances this growth represents a substantial priority, but it is lower than past levels of growth. It is now more than ever important to direct resources towards the greatest needs. This means thinking hard about priorities not only within particular policy areas and services, but between them. I hope nobody will feel that the notion of priorities is incompatible with a concern for justice and equality. It is not. Especially in the present economic climate, it is obviously impossible to tackle every problem at once.
§ Viscount AMORY
My Lords, I wonder whether the noble Lord would make it clear, with regard to the figures he has just quoted concerning the growth of expenditure, whether he was speaking in money terms or constant prices?
§ Viscount AMORY
My Lords, I am sorry. It was a minute or two ago when the noble Lord quoted the increase of 1.8 per cent.
§ Lord WELLS-PESTELL
My Lords, I think it is in money prices, but if I am wrong about that I will let the noble Viscount know.
In the present economic climate it is obviously impossible to tackle every problem at once. We must decide which social problems we think are most important. In our view planning priorities should not be left only to small groups of experts and professional planners, occasionally making concessions to the most vocal minorities—which so often happens. Rather it means, in our view, taking positive steps to involve as wide a range of people as possible in deciding priorities so that we may understand better the concerns of the community and, equally important, gain from the ideas and the enthusiasms which exist in the community at the present time.
203 To encourage the discussion of priorities in my own Department's sphere of health and personal social services we have published a consultative document which aims to turn planning into a co-operative enterprise. Copies were placed in the Printed Paper Office, and I know that a number of your Lordships have read it—the noble Baroness, Lady Summerskill, and I had some interesting exchanges at Question Time the other day about its proposals for maternity services. It is not intended as a detailed blueprint, but to help people realise where the greatest needs are and what might best be done within the available resources. One of the purposes of the document is to show how the future development of the services can be achieved within the resources available.
What I am going to say now I think will give heart to ex-directors of social services as well as directors and deputy directors of social services. We in the Department are very conscious of the criticisms levelled against us and of our own failures. We know that we have been criticised very severely in the past, and still are being criticised, for advocating priorities without proper regard to their expenditure implications and without showing which services should be held back to accommodate them. The consultative document is in part designed to respond to this criticism. Local priorities will naturally be affected by a whole range of factors —demographic, social and practical—particular to individual areas, and it is accepted that local plans will often not correspond to the order of national priorities proposed here. What the document sets out are suggested priorities on which those with actual experience of applying policies in local circumstances are being asked to express their views. We have made clear that we will be ready to modify these strategic plans in the light of these views before issuing policy and planning guidelines to health and local authorities in the spring of next year. In this way we, the DHSS, feel that we are taking the initiative. As I have said, we invite comment and observation.
The document is a comprehensive review of the services, but some general themes are given particular emphasis. One is the very great importance of the field and 204 community services, both in the personal social services and in the Health Service. We suggest a particular expansion in the home nursing and health visiting services, financed, in effect, from the restrained growth elsewhere in the National Health Service, and in the primary health care services as a whole. The special needs of the elderly, children, the mentally ill and the mentally handicapped are also recognised, as is the special importance of social work training.
Another major theme is the importance of joint planning of the health and personal social services. Many social problems are complicated, as your Lordships know, by ill health; and many people who go to their doctors or to hospitals have problems that can be greatly helped with better social care. It can be done much better—and I think this is the point made by the noble Baroness, Lady Robson of Kiddington—in the community. It is a question of getting round to it. We are introducing new arrangements for joint planning between the health and personal social services. I should like to emphasise that this is not just another piece of bureaucratic machinery; we are backing this initiative with cash, through a new method of joint financing. I hope that this document, and the consultation and planning activities that will follow it, will lead to a wide and more informed discussion of the future development of the health and personal social services.
Of course, social policy goes beyond the personal social services and the Health Service. As I have already said, it includes housing, education (including training), aspects of employment policy and aspects of environmental policy. Indeed, there is no clear distinction between social and economic policy—at least I do not think there is. A suitable and successful economic policy is essential to the achievement of social aims. However, there can never be a grand, single strategy for social policy in the same way as this Government has an economic strategy; the services are too wide and varied for an overall blueprint. But we are determined that all the social services should be viewed together so that there can be a better co-ordinated approach to the most pressing and important social and community problems.
That is why the Government asked the Central Policy Review Staff to do a study 205 leading to proposals for a joint framework for social policies. Because we thought that the issues deserve wider debate, we took the relatively unusual step of publishing last summer what is an internal study. The study is not intended to make specific proposals for particular areas of social policy. Its purpose was for the first time to give the Government the means of looking at the social programmes overall. We are carrying through a work programme which includes the general development of better presentation and analysis of information needed for informed decisions on social policies. There are also several studies in progress including work on the relationship between housing and other social policies; the working arrangements between central Government and individual local authorities in so far as they affect the handling of the problems at local authority levels; some aspects of financial policy and related policies; further development of current work on the disabled already being done under the auspices of my colleague the Minister for the Disabled, and the longer-term implications of changes of population structure and distribution.
Particularly in the present difficult economic situation, improvements are bound to come less fast than any of us would wish, but an essential ingredient in all progress in the social sphere is wide and informed public debate. Herein lies the importance of the debate we are having today. The Government have taken important initiatives to encourage this, and many of your Lordships, even though not on this side of the House, have been generous enough to acknowledge this. As well as those I have dwelt upon, I might have mentioned my Department's consultative document on prevention which, in fact, was mentioned by the noble Lord, Lord Sandys, and also the consultative document on transport policy of the Department of the Environment. This document also has important social implications.
I should like to try to answer some of the points your Lordships have put. I do not presume to say that I can answer them all, but I do not think I have missed ally. If I have, perhaps those involved will draw my attention to it afterwards and I will endeavour to see what can be done. The noble Baroness, Lady Young, raised the 206 question of the National Council for Civil Liberties wanting to reduce the age of consent. All I want to say on that is that the overall question is being considered by the Policy Advisory Committee on Sexual Offences, the chairman of which is the noble and learned Lord, Lord Edmund-Davies. The Government at present have no plans for any legislation on the subject. I think that is all I want to say at this stage.
The noble Baroness, Lady Young, and also the noble Baroness, Lady Robson of Kiddington, raised the question of domiciliary care. I am glad to be able to tell both noble Baronesses that we are glad that they agree with our emphasis on the domiciliary services. As they said, within the resources available we are planning for an expansion of the health visiting and home nursing services, of home helps and meals-on-wheels. All these services help people to remain in their own homes. Of course, there will be people who need residential care because they are too infirm to manage in their own homes, however much help could be given in other ways, but I am glad that there is general agreement on the general direction of policy.
The noble Baroness, Lady Young, and the noble Lord, Lord Redesdale, raised the question of specialist training. The statutory responsibility for promoting social work training rests with the Central Council for Education and Training in Social Work, which was represented on a Working Party set up by the Department of Health and Social Security in the autumn of 1974. The Working Party has reported, and its report should be published in the summer. The Working Party placed great importance on the development and promotion of specialist training, and among other things recommended further training for staff with a basic qualification to develop special expertise in their chosen field. The recommendations of the Working Party will be the subject of discussions between the Department and the local authority associations in the near future.
Again I want to emphasise that, while I myself am very much wedded to the need not only for training but for selection, I think the two things must go together. They are of supreme importance. We must remember that we cannot train a 207 person to be compassionate; we cannot train a person to be caring, as is understood by the professonal social worker. I was reading an article quite recently which dealt with the Central Council for Education and Training of Social Workers, and the writer of the article took the initials and said, "Can Colleges Educate and Train Social Workers?".
My noble friend Baroness Wootton of Abinger and again the noble Baroness, Lady Robson of Kiddington, raised the question of universality and selectivity. I should like to read what has been said but I doubt whether it would be possible to devise any system that would satisfy the points which have been put forward. I am informed that selectivity tends to make the system more complicated, and that is obviously unsatisfactory in itself. The noble Baroness, Lady Robson, mentioned food and housing subsidies. Food subsidies, which are not, of course, likely to be a permanent feature of the economy, are much more important to the lower income groups, as the noble Baroness will appreciate. As a proportion of income, the benefits are three to four times as great for the low income groups as for the higher income groups, and rent and rate rebates are directed especially at those who are badly off.
The only other comment I want to make as far as my noble friend Lady Wootton of Abinger is concerned is that I do wish that our attention had been drawn to the particular cases—it could have been done in confidence—of difficulties that certain people were having, because we like to follow up difficulties of this kind.
§ Baroness WOOTTON of ABINGER
My Lords, if my noble friend will forgive me for interrupting, may I say that the cases which I quoted were by no means rare ones that I had come across by searching. They were drawn from a very large file, and I can add to them from my own immediate neighbourhood. My noble friend would have been overwhelmed had I brought them all to his attention.
§ Lord WELLS-PESTELL
My Lords, I was not suggesting that I should receive them all. If one has a number of specific cases one can then take up the matter, and very often that is much more effective than issuing a directive. It gets round very quickly.
208 The noble Baroness, Lady Robson, referred to the transfer of services from hospitals to local authorities. We are glad that the noble Baroness has raised the important question of the shift from institutional care to the care of the community for many groups, particularly, of course, the elderly. I am glad also that the noble Baroness has given such a positive response to my Department's Consultative Document on priorities. Many of the proposals outlined in that document in a sense reflect her own views for improved levels of community care. We have made these proposals not because they are often cheaper as an alternative, but because care in the community for many people provides a more suitable and more humane type of care than institutional treatment. I mentioned earlier the new arrangements for joint financing. The money is intended really for social service projects, directed at groups in the community who without them would need an expanded health service. This is an important new development designed to help overcome the problem which the noble Baroness raised.
I found myself in some considerable sympathy and agreement with what the noble Baroness, Lady Macleod of Borve, said, because I know her own contribution is born out of a good deal of personal experience. The noble Baroness, Lady Masham of Ilton, raised the whole question of the Chronically Sick and Disabled Act and said that in her view it should be made stronger and, in certain respects, mandatory. This is not a matter with which we are not dealing. It is not an easy matter to deal with, as she knows only too well. There is the question of the cost. But this is a matter—and I ask her to accept what I say on this—that we are looking at very often. With regard to the withdrawal of vehicles, I hope she will excuse me if I do not deal with that today. She has a Question down, and I am sure we shall do battle on that on the appropriate day. I am grateful for her expression of thanks for what help I am able to give her. I now recognise her writing before I open the letters, and I know what is in store for me two or three times a week.
The noble Lord, Lord Redesdale, raised the question of the boarding out of children. It has long been my Department's policy to encourage the boarding out with foster parents of children in 209 the care of local authorities. We have taken active steps to try to effect a far better response. As he knows far better than I do, the main difficulty is the recruitment of foster parents. From time to time national advertising campaigns are mounted to facilitate the recruitment of foster parents. I believe the most recent, as he will remember, was last year. My Department is familiar with many of the initiatives undertaken by local authorities and other bodies and welcomes them. A close eye is being kept on the matter, and we shall continue to do what we can to draw the attention of the public to what is a particularly important piece, not so much of community work but, let us say, of family environmental work.
My noble friend Lord Longford raised the question of homeless young people. Following the screening of the television programme "Johnny Come Home", a Working Group was established to consider the problem of homeless young people, with particular reference to the problems of unaccompanied young people arriving in London and other large cities without arrangements for their accommodation and maintenance. The Working Group, which should be in a position soon to report—and I answered a Question on this at Question Time today—consists of representatives of a number of Government Departments, the Home Office, my own Department, the Department of the Environment, the Department of Education and Science, local authorities and voluntary organisations. The Government fully realise that action must be taken to help and protect homeless children, and I can say that we are quite determined to do everything we can to promote such action.
§ The EARL of LONGFORD
My Lords, the noble Lord does realise that that deals with only one small part of the total problem even of the young homeless?
§ Lord WELLS-PESTELL
Yes, my Lords, and I am well aware that my noble friend raised other matters. I listened with considerable interest to the noble Baroness, Lady Faithfull. I remember when she was ennobled it was said that there will be at least one highly trained and competent professional social worker 210 in your Lordships' House. She was at some pains, and I thought it was very generous of her, to point out to the Press that it would mean that there would be two, but modesty prevents me from telling your Lordships who the other person is.
The noble Baroness referred to cooperation between Government Departments. I can assure her that everything is done to maintain and improve co-operation between Government Departments on services which are the responsibility of different Departments. I know that this is going on, I was going to say at the present moment, when they have an interest in a particular group of people in need. For example, there has been close co-operation between my own Department and the Department of Energy over the problem of old peoples' heating bills. This interdepartmental committee has also been dealing with problems of homeless children. So this is not something which has gone by default; it is something which is being practised at the present moment.
I do not think I ought to enter on the comments made by the noble Lord, Lord Hunt, on the question of the ages of responsibility and the line of demarcation between juvenile and adult. I walk a number of thorny paths, and this is one I do not want to walk at this particular stage, other than to say that he is President of the National Association of Probation Officers, and I am Vice-President, so perhaps we can talk about it privately.
The noble Baroness, Lady Vickers, raised a number of matters which exercise my mind, and spoke about the possibilities of cutting back in other directions in order to release more money for the social services. I only hope that she will appreciate at this stage that I cannot commit the Government in any of these fields, but I personally would like to read Hansard when it is printed so that I may draw the attention of the appropriate people to it. The eligibility of married women for supplementary benefit and family income supplement was another matter which the noble Baroness raised. The position, to put it very broadly, is that these benefits are payable to the head of the family unit. If the wife is on her own she is entitled to these benefits. If 211 the husband is with the family, then, as she quite rightly says, he is clearly regarded as the eligible partner. It would be difficult to administer benefits, I believe, on any other basis. But if the noble Baroness was expressing concern about some particular aspect of the scheme, or has some individual person's problems in mind, I wonder whether she would care to write to me. We will leave it like that, and she can rest assured that I will certainly do all I can in the matter.
I do not think that the noble Countess, Lady Loudoun, is here. I have in fact already covered some of the matters she raised. I so often find myself in complete agreement with the noble Baroness, Lady Elliot of Harwood. It was my privilege for a long time to work very closely with her on a particular project, and I do not suppose there is anybody in your Lordships' House who knows how hard she works in the social welfare field, particularly for the disabled—and who will go on foot. I am told that there are many people who will go miles for a free glass of sherry, but she will walk miles in order to get £100, and has done so to my knowledge, and has raised that in six figures before now.
The only other comment I want to make is on the use of untrained and poorly trained social workers. We ought to bear in mind that there has been a very great increase in the number of social workers since the passage of the Local Authority Social Services Act 1970 which has resulted in a good many junior social workers. But the position is not so bad as is sometimes made out. I think that more and more local authorities are getting accustomed to the idea of doing something by way of in-service training.
§ Baroness FAITHFULL
My Lords, may I ask the noble Lord what position the Ministry holds with the National Joint Council and the Whitley Council for persuading them to implement a two-tier promotional ladder so that experienced people remain in the field?
§ Lord WELLS-PESTELL
My Lords, the noble Baroness has taken me off training. I do not mind leaving it one little bit. The need for a career structure for social workers who elect to stay in the field was considered by a Working Party 212 on Manpower and Training for the Social Services whose report is expected in the summer. The Working Party considered that without a separate career structure, senior social workers would be drawn into administration, and most of the work with clients would continue to be undertaken by junior and, in some cases, unqualified staff. As a result, the standards of practice would have little chance of improvement. I think I know what is in the noble Baroness's mind with regard to a two-tier structure, perhaps going parallel, and this is in the mind of the Working Party, but they will not be reporting yet awhile but their report should be available in the summer.
I apologise to your Lordships. I did not realise that I had been talking for so long. You have been very generous in permitting me to do so. I am rather ashamed at having spoken for so long, but this is a measure of the importance of the debate which the noble Baroness has raised. I think it has been valuable. I think it has been an interesting debate in which a number of matters have been discussed, and it has given us in the Department something to look at and something to consider. I am grateful to the noble Baroness, and to all those who have taken part, for staying, because it again indicates the importance that your Lordships attach to this matter.
§ 7.24 p.m.
§ Baroness YOUNG
My Lords, I should first like to extend my great thanks to the many people who advised me in the preparation of my speech. I am particularly grateful to the many social workers who did so in the midst of their busy lives. I hope that when they come to read Hansard they will at least be able to say, as a sort of report on my efforts, that "she tried hard". I should also like to thank all those who have taken part in this debate. Those of us who are interested in the subject know how attractive it is, first, to be doing something practical and, secondly, to be discussing it. Like myself, I expect some people find it much more difficult to put pen to paper and put their thoughts on view for other people to read later. I am very grateful for the trouble that has been taken, and for people staying so long. I hope that the noble Earl, Lord Longford, will not feel in any sense that I was being critical of the House of 213 Lords in my observations about old people, because surely there could be no better examples than some of the Members of the House of Lords who may be wise in years but young in heart.
I am particularly grateful to the noble Lord, Lord Wells-Pestell, for the trouble he has taken in answering this debate. I hope he will feel that the many practical suggestions that have been made are worth following up. I am glad that he touched on the point which I believe to be the centre of the whole debate; that is, the need to understand the relationship between a healthy economy and the standard of social services. I have read the Government's own published White Paper. But I believe it is more than just a statement of intent that is needed; it is a fundamental understanding in society as a whole that you cannot have good social services unless you are rich enough to pay for them. This means that one must understand about profits and the way industry works.
The debate has ranged over the questions of universality of social services and particular points, and I should like to reply in detail but time does not allow. I would only say on this general question that if benefits are universal and equal it is true that those who do not need them can have the money taken away by taxation. This appears to be simple. But for those who are completely dependent upon benefits, it is very unlikely that the money will ever be enough to allow them to live at a reasonable standard. Therefore, one finds oneself in a world of increasing complexity of supplementary benefits in their widest meaning, and one ends up with all the problems that the 214 noble Baroness, Lady Wootton of Abinger, described so well. As we know, if benefits are all to be universal and equal, it makes it very difficult to know how all the many particular hard cases that have been named are to be helped. That is why I think there is a point about universality and selectivity that needs to be thought about, and thought about very carefully indeed.
I have not come here this afternoon to conduct a political dispute; what I hope I have done is to advance political thinking on the matter, and in so doing I hope that not only has the House found it a useful debate and an opportunity to consider matters of great importance to the community as a whole, but that it has been an opportunity for those of us who care very much about these services to think about them and to talk about them, and, I hope, to make some constructive suggestions about them. My Lords, I beg leave to withdraw my Motion for Papers.
Motion for Papers, by leave, withdrawn.