§ 2.58 p.m.
§ Baroness Masham of Ilton rose to call attention to the International Year of Disabled People (1981) and to the pressing need for educational facilities for handicapped children as outlined in the Government White Paper Special Needs in Education (Cmnd. 7996); and to move for Papers.
§ The noble Baroness said: My Lords, I beg to move the Motion standing in my name on the Order Paper. First of all, I should like to thank your Lordships' House for making it possible for us today to debate the International Year of Disabled People and also the 45 Government's White Paper, Special Needs in Education. Both are wide-ranging and important issues. I am delighted, as I am sure will he all noble Lords, that the noble Viscount, Lord Mersey, is making his maiden speech in this debate. I am also pleased that the most reverend Primate the Lord Archbishop of Canterbury is speaking and that the presidents of England and Scotland, the noble Earl, Lord Snowden, and the noble Lord, Lord Campbell of Croy, are also speaking.
§ I am sorry that the noble Lord, Lord Vaizey, is not with us, but he is still having hospital treatment. Neither is the noble Baroness, Lady Macleod of Borve, who has broken her knee. But I should like to pay a special tribute to my noble friend Lady Darcy de Knayth for being here. She came out of hospital only just before Christmas and then went down with 'flu. I thank all noble Lords and Baronesses who have put down their name to speak in this two-in-one debate.
§ My Lords, the United Nations' resolution proclaiming the "Year" gives five principal objects: helping disabled people in their physical and psychological adjustment to society; promoting all national and international efforts to provide disabled people with proper assistance, training, care and guidance; to make available opportunities for suitable work and to ensure their full integration in society; encouraging study and research projects, projects designed to facilitate the practical participation of disabled people in daily life (for example, by improving their access to public buildings and transportation schemes); educating and informing the public of the rights of disabled people to participate in and contribute to various aspects of economic, social and political life, and promoting effective measures for the prevention of disability and for the rehabilitation of disabled people.
§ The aims of the Year are to stimulate increasing awareness of the needs, abilities and aspirations of disabled people; to encourage the participation, equality and integration of disabled people; to help in the prevention of disability, and to make more positive attitudes towards disabled people. Many people ask the question: Why have a special year? The designation of a "year" by the United Nations cannot itself change attitudes, but it does provide a major opportunity for educating and informing people about disability.
§ The success of the International Year of Disabled People depends on the willingness of individuals and groups to take initiatives and participate nationally and locally. Internationally, nowhere is the need for the Year greater than in the Third World countries, where efforts to prevent disability need much more support. This 1981 International Year of Disabled People includes people who are physically handicapped, deaf, hard of hearing, blind, partially sighted, speech impaired, mentally handicapped or mentally ill. It also includes handicaps such as epilepsy and psoriasis; and disabilities linked to ageing. It also includes children who are disabled.
It must not be forgotten that every disabled person is an individual with different needs and aspirations. Many people do not understand disability because they have never come in contact with it. Some find it difficult to contend with, and others who would like help do not know how to start. Some years ago I
was involved with a camp to give severely disabled people from a hospital a holiday for a week. We used volunteer borstal boys to look after the disabled patients. When the boys had returned to borstal one of them said to me:
I used to take the mickey out of disabled people. After living with them for a week, I have learned that they are people the same as anyone else and I will never do it again".
§ I hope that this debate will be helpful to many people concerned with the varied and different aspects of disability, and also to those people who do not understand disability and fear it and need enlightening. Up and down the country organisations and clubs, both professional and lay, are taking note of the disabled persons' Year. They are holding their conferences and events in connection with the Year. I am very pleased that your Lordships' House is also discussing them.
§ It was most encouraging to hear on New Year's Day about the results of a survey carried out by Radio 4 and New Society. The majority of the public questioned had been in favour of disabled people being helped and provided for even if it meant a rate increase. It is now 10 years since the passing of the Chronically Sick and Disabled Persons Act. It is a good time to look again and to see what the needs of disabled people are at national and local level.
§ During the past 10 years much to help disabled people has been accomplished; but not all has been helpful. The abuse of the orange badge scheme by able-bodied people has been a great disappointment to disabled drivers. People who drive their cars and do not have companions with them have great difficulty when parking. The noble Lord, Lord Crawshaw, and myself, have encountered many problems, especially in central London, when staying the night and when we have to park our cars. Central London does not even recognise the orange badge.
§ I feel that it is of benefit to disabled persons to have their cars marked clearly on both the front and the back. When I have had punctures or have broken down on the motorways I have been helped, but only because I have a "disabled" sticker on my car. At our National Health hospitals, which nearly always have parking spaces for the staff, only occasionally have they places for disabled patients or visitors. I hope that the health authorities concerned will look at this necessity during 1981.
§ It has been a great worry that the clause in the 1970 Act dealing with access to public buildings has not been made mandatory. I officially opened a community hall a few years ago only to find a step at the entrance. When I inquired why the step was there, I was told, "Nobody thought it necessary to have no steps". The next time I visited the building I was pleased to to see that a ramp had been included and this was made to look as if it had always been there. I hope that 1981 will make everyone aware that access is necessary. Not only does good access make life easier for disabled people; it helps prevent further disability to able-bodied people who have to lift the disabled people up and down steps. Access has been a major priority covering most of the groups looking at 1981. It conies into integration, education, employment, housing, leisure activities, travel, prevention and independence.47
§ The public seem to take for granted that everything is suitable for disabled people if the entrance to a hotel is accessible. They do not look further. Many people have been surprised when I have told them that it is only very occasionally that one can find a bathroom in an hotel in which one can reach all the facilities. This is due to the bathroom doors which open inwards and block off the bath, basin or lavatory. If only there could be a few sliding doors put into bathrooms in each hotel this would make all the difference to a wheelchair user. I hope perhaps during this year hotels will look at this as it has been done in many hotels in the United States of America.
§ Travelling round the country as I do, I often see well-meaning evidence of people wanting to help and not going about it in the correct way. My husband and I were driving down from Scotland, and we stopped to have lunch on the way home. He went to wash his hands and found that the hotel was in the process of adapting a lavatory for the use of disabled people. But it was down six steps! I also find very often on motorways that specially adapted lavatories have been built, only to find that wheelchair users cannot use them as rails have been placed on both sides. It is so much better if the outside rail, if there is one, can be movable. Perhaps if more disabled consumers were involved in the planning of these facilities, there would be fewer mistakes made. I hope that 1981 will encourage this.
§ There are several systems in operation to help disabled people, but these will fail if the people who are to operate them are not helpful, reliable and aware of what should be done. The noble Viscount, Lord Ingleby, and myself travel up to London from Yorkshire and back very often by British Rail. Sometimes everything goes well and the system works; but on some occasions the message that we are travelling does not get passed on to the correct person and then the system fails. We either get left on the train or there is panic at the last moment.
§ British Air now have a system for regular travellers and they have information on these people. If there is to be information about disabled people, then the information should be correct, otherwise it is better to have none at all. While speaking to the doctor in charge of disabled persons' travel at London Airport, I got him to read over the telephone to me what information he had on me. His information was wrong in that it said that I could walk, when I cannot. This was the one piece of information which was vital to the airline. I had not given the information in the first place, so I was not surprised that it was wrong. Accuracy is necessary if any system is to work and the consumer should always check what information is being recorded. That, I feel, is one of the reasons IYDP is encouraging participation by disabled people.
§ I feel that in each health district there should be at least one organiser of volunteers. Many large hospitals have them and this has been found to be invaluable. I believe they are just as important in the rural areas. Volunteers can help with transporting handicapped children to assessment centres and can help to transport the elderly disabled. They can do all sorts of voluntary work which can make life easier for the people looking after the disabled. Unless this voluntary help is 48 co-ordinated and shared, much will be lost. The load often seems too big for one organisation, but if there is a central point with an organiser this will help to overcome the problem. I hope that during 1981 the Department of Health and Social Security will look into this and find out how many health districts do not have an organiser of volunteers.
§ Disability crosses into many different departments, as will be made evident by this debate. When there is a shortage of resources, as there is at this present time, it must be of benefit to have more joint funding, especially with some of the projects dealing with disability. Shared resources could help overcome some of the results of the cuts which some departments have had to make. I hope that during 1981 ways will be found to protect disabled people from becoming victims of inflation. Many essentials of life for disabled people have become very expensive, especially means of heating, food, clothes and petrol. I should like to ask the Minister whether there are going to be any safeguards for disabled people if there is to be a transfer to employers of the responsibility for payment of sickness benefit for the first eight weeks of sickness.
§ The Psoriasis Association are greatly concerned about the possible implications for sufferers from chronic skin disorders, such as psoriasis, if this transfer comes about. It is possible that employers might be reluctant to employ the disabled or those with poor health records. There is worry that there may be an increasing rejection of workers who are medically suspect by employers who will not be prepared to accept the risk in employing them, especially in small firms. The proposals might result in the imposition of additional anxiety and hardship on sufferers from chronic disorders, the partially disabled and those who have recovered from such conditions as cancer. I hope your Lordships will agree with me that, if the Government have not considered the disabled in this matter, they should do so. It would be very sad if 1981 were to become known as the year which made employment even more difficult for disabled people to obtain.
§ Research has come a very long way and some disabling diseases seem so near to a solution or finding a cure; but when another young person becomes disabled or dies it can seem so far away. I hope that 1981 will give new impetus and a new spur to brilliant minds in finding cures. One young man who has just qualified as a barrister and is a member of the Spinal Injuries Association, having broken his neck in Zambia, is giving up a year of his professional life to start an international spinal cord research fund. After months with fellow patients at Stoke Mandeville Hospital, he is convinced that the research fund he is starting this year will help to encourage doctors and research workers to find a way of mending this vital body link. Many disabled people have their rehabilitation and life interrupted by serious pressure sores. I have just heard that this year a doctor in London has managed to acquire a laser, which may be a new way of speeding up the treatment of this troublesome problem, which should not occur in the first place. I hope that 1981 will be a year of the start of all sorts of progressive and exciting projects, but we must not forget the destitute and lonely disabled people who need care. I also hope accident prevention will become a high priority throughout our society, starting with the embryo in utero 49 through the working life to old age.
During 1981 a group to consider the needs of disabled people is being formed in the European Parliament. I hope that this newly-formed committee will not only work during this year but will become a permanent fixture. The organisation Rehabilitation International has stated that there are at least 500 million people who are disabled in the world today. This organisation has prepared a charter for the 1980s, which will be presented this year to the Head of State of every country of the world. This charter states that,
the goal of all nations should be to reduce the incidence of disability and to evolve societies which will respect the rights of persons with disabilities and welcome their full participation".
§ Many countries in the third world still look to Britain for advice and help over their problems of disability. Save the Children have been running a "Stop Polio" campaign in several developing countries. They hope, with the publicity of this International Year, to be able to raise more funds to extend this programme. Polio, along with other infectious diseases, can now be prevented but it needs the energy and authority of leadership to see that the vaccine is distributed and the correct doses are taken. I hope that this country will still be able to help these developing countries to extend their clean water campaigns, their immunisation programmes and their primary health care.
§ Television, radio and the papers, so far during 1981, have been giving good coverage to the needs of disabled people. This is most helpful. Without the media, educating the public would be almost impossible. Last week I helped to interview applicants for the Winston Churchill Memorial Fellowships on the category of prevention of perinatal mortality and morbidity. Some of the awards were given to people doing the most important and necessary research work which will help in the prevention of serious handicaps in children. Some of the applicants were of a very high calibre and we wished that we could have made more awards for this much needed work. I feel it is a great worry that we do not have more channels for these vital research projects to advance. Every time I see a baby or a child with cerebral palsy, I keep thinking that the handicap might well have been prevented. We must, as a nation, strive harder for the prevention of all types of handicap.
§ When women are pregnant and are asked if they would like a boy or a girl, the answer is very often: "It does not matter as long as all is well with the baby". There can be nothing more disappointing than to find that a baby when born has a severe disability. I am sure that if parents are going to cope well and manage to bring up a handicapped child they need counselling and support from the start. This should be done by a combination of professional people, supported by the specialising voluntary associations, which can put the parents in touch with others whose children are similarly affected. If such support is not forthcoming the parents will feel isolated and fearful. It often happens that they cannot face the future and give up so that the child, unless adopted or fostered, faces a life of residential care.
§ Today gives us an opportunity to discuss the Government's White Paper Special Needs in Education. The 50 fact that Britain is caught up in the world recession and there are educational cutbacks, along with others, must not deter us from looking hopefully towards a brighter future. If this White Paper is the introduction for legislation, we must work hard to rectify some of the Government's omissions. On page 8 of the White Paper we are told of the figures of handicapped pupils identified by local education authorities in England and Wales in January 1979 as requiring special educational treatment. By far the largest groups are the maladjusted and the educationally subnormal: maladjusted, 22,402 and educationally subnormal, 119,005. This is a sorry reflection on our society. I do feel it is not an easy matter to decide on the future of educating children with such varied disabilities, but I hope this can be done with compassion and understanding of the individual needs and, wherever possible, with the full involvement of the parents. Many people welcome the proposals to replace the present system of categorising children for special educational treatment on the basis of type of handicap by individual assessment of educational needs. There is concern that certain handicaps, particularly sensory and speech defects, require very specialised services. These must on no account be lost or diminished as a result of allocating resources under a broad concept of special educational needs. When social services brought in the generic social worker, such groups as the blind found that the service deteriorated, because they lost the specialised expertise which they needed. I hope that when legislation is brought in there will still be a safeguard provided for these children who need teachers with expert skills. I also hope that the changes which are made will upgrade education, but there could be a danger that standards for some children might drop even lower than they are now. I am sure that the Minister, the noble Baroness, Lady Young, would agree with me that every child ought to have the opportunity of reaching its highest potential, wherever possible.
§ I have over the years visited many schools of different kinds. I should like to say here what admiration I have had for so many of the dedicated teachers working in them. But I have been worried at the low educational standards in some of the schools for physically handicapped children. Many of the schools do not have an O-level course and only reach CSE standard, if that. The headmaster at one school found that many of the children came from homes where the drivers who fetched them had to get the children up, as the parents were still in bed. The headmaster had to give them breakfast when they arrived, so the school day did not begin until 10 a.m. and the children started to go home at 3 p.m. The library service in many special schools is very poor. The bright children have little hope of reaching their potential.
§ It is wrong and undemocratic that a head teacher of an ordinary school should be the one person who makes the decision whether a child with a handicap comes into the school. I hope that this will now change. I have witnessed such different attitudes by head teachers over children. One child who had been at a normal primary school was not accepted at the secondary school, because she used a wheelchair and needed some help to go to the lavatory at lunchtime. The school was accessible. After endless battles between the parents and the LEA, who wanted to send the child 51 to a boarding school a long way from home, a compromise was made and the girl, after remaining in her primary school for an extra year, had to travel by taxi from Grassington to attend a school with a special unit in Bradford.
§ I think that the Government should look at the ancillary staffing in schools, as some children will have to be given help when they need it in normal schools. A very different attitude was evident at a Newcastle school when a pupil broke her neck. After leaving hospital still paralysed, she was welcomed back to her inaccessible school by the staff and children who helped her.
§ If teachers are to have responsibility for children with different handicaps in their schools and classes, then all teachers need to have a certain amount of knowledge and training in the needs of disabilities. If this becomes a routine part of training, surely it should not need to take extra resources. Much can be done by teachers using visual aids. The biggest problem is breaking down the barriers between students and teachers, who forget the children and think too much about the handicap. There is a splendid comprehensive school in Leeds, called Holt Park, which has been built with facilities and access for wheelchairs. This shows what can be done when there is a will to do it and it is made to work. As the White Paper says, it would be unrealistic for all schools to have such facilities, but having some makes all the difference.
§ This forthcoming legislation needs to be planned very carefully. Many people who are concerned with handicapped children waited for a long time for the Warnock Report. I hope that the Government will not rush through something for which they would be sorry later. Parents and children with special needs nearly always depend not only on the educational services, but on the personal social services, the health service and the employment service. Getting information can be very difficult and different professionals often give different advice. Some parents cannot cope with trying to battle through so much bureaucracy, and I think that the "named person" to act as a guide, whom parents when confused could consult, is an excellent idea. I do not think that the named person should be compulsory, but he or she should be available for anyone who needs help and advice.
§ Parents may well need advice on whether or not their children should be "recorded". I shall listen with great interest to the Minister, when I hope she will explain this part of the White Paper. There appears to be a cut-off point between "recorded" and "non-recorded" children. There remains above this cut-off point a grey area of children, who manifest specific problems at some time during their school life and whose needs are possibly not being met. I am not clear which children shall or shall not be recorded, and might this not vary in different LEAs? If families move to a different part of the country, they might find that the system is different. Is it intended that there will be a code of practice?
§ I suggest that if there are to be reports which are kept secret from parents but available to many different professional people, the law will be setting up barriers between the professionals and the parents, 52 which will destroy trust and co-operation. There is no reason why professionals cannot consult each other confidentially, but the written word should be available to the parents. If the reports involve the parents, they should have the right to comment and they may learn to be better parents.
§ I cannot understand the Government's views in rejecting the Warnock Report's recommendation that independent commercially-run schools should have properly constituted governing bodies. Some local authorities may have such difficulties in placing handicapped children in schools that, in desperation, they may result in undesirable establishments. There should, at least, be regular statutory inspections. Most good schools have governing bodies and this is why the Government should think again.
§ The White Paper has omitted to mention anything about hospital schools, which are essential for children who have to spend long periods in hospital, and about the placement of children in care who have special educational needs which should be taken into consideration. I know that the Minister, the noble Baroness, Lady Young, is interested in nursery education and knows the needs of the under-fives. Mothers of handicapped children can become very isolated and they need a break to run their homes. I should have liked to see stressed the training of health visitors in the needs of all disabilities of the under-fives. It would be a quite retrograde step if nursery education was cut.
§ Nowhere in the White Paper have I seen educational psychologists mentioned. They do so much in the assessing of children with educational problems. The biggest disappointment seems to be in the provision for the post-16s. Nobody seems to know what to do with this group. They are realising that they are going into a difficult adult world and they need help to do it. I am sure that good LEAs will try to do all they can for this insecure age group, but the White Paper has left it wide open for the bad ones who might decide to do very little.
§ I have talked to some teachers who felt that they should have had more time to make comments on this paper. It came out in the middle of August, during the school holidays, and comments had to be made by 6th October. It was difficult for colleges of education and training colleges to meet. Perhaps, now that the International Year has brought so many aspects of disability to the forefront, the Department of Education will consider more comments from interested people and those that your Lordships will be making today. I have spoken for too long and I apologise. But the scope is so wide, from the university student who had to change universities after breaking her neck in a car crash, to the little, mentally handicapped gipsy boy who was found chained by his leg. My Lords, I beg to move for Papers.
§ 3.30 p.m.
§ The Minister of State, Department of Education and Science (Baroness Young)
My Lords, I am sure that the whole House is grateful to the noble Baroness, Lady Masham, for introducing this debate today. No one can speak more effectively on disablement than she does, and it is good that your Lordships have this early opportunity to debate the International 53 Year of Disabled People. I know that the whole House will look forward to hearing the noble Viscount, Lord Mersey, when he comes to speak.
In the course of my remarks I shall be saying something of the Government's response to the Year and in particular about the legislative proposals outlined in the White Paper Special Needs in Education, but first I should like to set the Year within the Government's overall policies. The Government have expressed their full support for the International Year of Disabled People and its aims of participation and integration. We recognise that it provides an excellent opportunity to increase everyone's awareness not only of the special needs and problems of disabled people but, more importantly, of their abilities. We also hope that the Year will help disabled people themselves to participate and integrate more in every aspect of society.
However, I have no doubt that in the course of the debate the Government, and local government, will be asked to find more resources for a great many good causes, and I am equally certain that I shall have to resist these demands. As a consequence, once again the Government will be described as uncaring and willing only to pay lip-service to the International Year of Disabled People. This is far from the truth. A genuinely compassionate Government do not allow spending to increase beyond what can be afforded or what can be earned. This only builds up trouble for the future. Eventually the facts have to be faced and very unpleasant action taken. Short-term economic expedients such as we have had over the past 20 years or so, and those which have been suggested again, should be avoided. They all amount to spending more public money, which leads inevitably to increased inflation. That will neither improve our social services nor cure employment.
Indeed, if we can, and I believe we shall, succeed in getting the economy right—and there are already some hopeful signs—then we shall have the kind of social services enjoyed by other countries in Europe whose economies have grown and prospered over the last 20 years in a way that ours has not. Some other noble Lords may well say that the cuts have meant that the welfare state is being dismantled. In fact, local authorities are spending more in real terms on the personal social services, which includes the disabled, than in any of the years of the previous Administration. Figures show an increase in the provision of day nurseries, of day centres, and for mentally handicapped children. It is equally true to say that spending in real terms in the National Health Service is higher than in any year under the Labour Government. But it is not enough to say that the state or local government should provide. As a country we need new attitudes so that people increasingly think in terms of what they can do to help themselves. One of the chief concerns of the International Year of Disabled People will of course be the prevention of handicap, a point to which the noble Baroness referred.
Many handicaps occur even before birth and there is therefore a clear responsibility to take all steps possible in the antenatal period. The Government have a responsibility to provide the necessary services in such a way that they are both available and acceptable to the expectant mother, and to make sure that she 54 knows what is provided for her. The current Health Education Council "Mother and Baby" campaign is playing an important part in achieving this. For her part, the mother, too, has a major responsibility. She must take all elementary precautions, such as in matters of diet, avoiding smoking and excessive alcohol, and so on, and she must make full use of the services provided. She should go to her doctor or midwife as soon as she suspects she is pregnant and she should take care to keep all her antenatal appointments.
The whole subject of death and handicap in the perinatal period has recently been examined by the Social Services Committee, and we are indebted to Mrs. Renée Short and the members of her committee for the report they published last July. Noble Lords will know that the Government published their reply to the report just before Christmas (Cmnd. 8084). We have welcomed the committee's report and share their concern to achieve further reductions in perinatal mortality and handicap. We see considerable scope for this through a sustained campaign. We have therefore sent copies of the report and our reply to all health authorities asking them to consider the committee's recommendations that concern the National Health Service very carefully in the light of local circumstances and to give priority to implementing those which will contribute most to improving the services in their areas.
Not only do we look to people to see how they can help themselves but also how they can help the more vulnerable in our society. My right honourable friend Mr. Jenkin announced in December a scheme for the International Year of Disabled People to offer up to £1 million, spread over four years, to match, pound for pound, voluntary funds raised specifically for local projects to help mentally handicapped children out of hospital.
Indeed, as with other international years, the main response will of course come from the voluntary sector. We have therefore provided substantial financial support for the specially formed voluntary organisations committees in England, Scotland, Wales and Northern Ireland, and I am pleased to see so many distinguished members of the committees here today and taking part in the debate. The role of the voluntary organisations committees, which have a high proportion of disabled people as members, is to stimulate and co-ordinate activities at both national and local level. We are very fortunate to have His Royal Highness, the Prince of Wales, as patron of all four voluntary organisations committees.
Much is already being done by and for the disabled people, but the Year presents us all with a special opportunity to look at policies that affect them, for, despite advances, there is still ample scope to increase the awareness of the general public, especially building managers and designers, of the need to provide good access—another point to which the noble Baroness, Lady Masham of Ilton, referred. We hope this will be one of the main areas in which the IYDP will make its impact. It is particularly true of existing buildings, which, with a little imagination, can often be adapted at small cost.
Hence we are looking in particular to the Committee on Restrictions against Disabled People, known as CORAD, to stimulate activity, and we unhesitatingly 55 support this committee's work. It is currently promoting several initiatives. It has recently issued a design guidance leaflet for local authorities to hand to architects and developers to remind them about access; it is running a schools' competition on access and mobility with BP oil; and is seeking ways to encourage the creation of local access groups. The committee has also been asked to investigate the whole subject of discrimination against disabled people, and its report is due to be made in 1981, the International Year of Disabled People.
Government departments, especially those most closely involved with the disabled, have proposals for the Year. For example, the Department of Transport has proposals to reduce to 16 the age at which young people in receipt of mobility allowance can apply for a provisional driving licence. The department will also be holding a conference—Transport without Handicap—in London in March, designed to bring together leading representatives from the disablement and transport fields to look at ways in which transport generally can better be made to meet the needs of disabled people. There is to be a national rally for disabled drivers at Silverstone in June. The Department of Employment and the Manpower Services Commission are continuing in their efforts to promote the "Fit for Work" campaign.
The Department of the Environment are sponsoring an awards scheme for good building design suited to the needs of the disabled. In their urban aid programme they are placing a special emphasis on the needs of the disabled. The Property Services Agency of the Department of the Environment currently has a programme to adapt at least one public building in 71 towns in Great Britain to make them accessible to disabled people. Investigations to find suitable buildings for adaptation in other towns are continuing. The Department of Health and Social Security are funding the secretariat for the English Voluntary Organisations Committee. They are also placing a special International Year of Disabled People emphasis on grants to voluntary bodies. A new edition of Help for Handicapped People, a guide to benefits and services, is to be issued. We do not want the Year to lose momentum. I see the Year as a highlight in a continuing process of increasing participation and integration of disabled people.
We also intend to introduce legislation very shortly in this Session of Parliament to reform the framework within which special education is provided, and the legislation will embody all the major changes set out in the White Paper.
To some of your Lordships the Bill may appear somewhat cold and stark at first sight. But it is inevitable that in translating the recommendations of the Warnock Committee into law we have to use the precise but dispassionate words appropriate to Acts of Parliament. The Bill will, for example, require parents to be consulted over the educational provision to be made for their handicapped child, but it cannot ensure that this is always done with as much understanding as we would like. As the Warnock Report so rightly recognised, nothing in their report would be fully effective without changes in attitudes and that cannot be achieved by 56 legislation.
Like most people who care about the handicapped, I wish more resources were available for special education, but I believe it is a policy of despair to say that nothing can be changed without extra resources. The fact is that there is scope for some re-deployment of the existing resources within a new statutory framework; the Bill will provide an opportunity for all to look again to see how the resources are used, and to see that they are used to the greatest effect. At the same time, over the next five years the total school population will fall dramatically. This demographic trend must be reflected in the number of children with special educational needs and this will case the introduction of the new measures.
The Bill will introduce a new legal framework. This will mean a new concept of special educational need embracing a wider group of children than hitherto, and will include provisions for the multi-professional assessment of the educational needs of those children with severe learning difficulties in close consultation with parents. The legislation will do everything possible to ensure that parental views are taken into account before decisions are taken on how and where a child's needs are best met. It will be a great improvement on the present law which simply requires parents to be given a form signed by a doctor certifying that their child is suffering from a disability of mind or body. I regard this as a most important aspect of the legislation and I am pleased to say that local education authorities have been paying far more attention in recent years to the views of parents, and our proposals will build on the practice of the best.
The new arrangements for parental involvement in the process of assessment and the decisions taken on placement should do much to eradicate any unnecessary conflict between local education authorities and parents on the appropriateness of a particular educational setting. However, in a very few cases we must accept that disagreement cannot be resolved and the legislation will therefore provide for parents to appeal to a local appeal committee established under the 1980 Act ultimately to the Secretary of State. This extension of local appellate procedures to embrace the parents of handicapped children, and the new arrangements for notice to be given of special school closures, will do much towards placing parents with handicapped children on the same footing as other parents—a point which was stressed in your Lordships' House during the debates on the Education Act 1980 last spring.
I should now like to say a few words on the vexed subject of integration. I wish to make it perfectly clear that the Government wish to see as many children with special educational needs as possible educated in ordinary schools and this statement of principle will be embodied in the legislation. However, there must be certain safeguards, and we spelt those out in the White Paper. Not least among these is that parental wishes should be respected wherever possible and by no means all parents with handicapped children feel that their child's interests are best served by education in an ordinary school. We have to acknowledge that special schools have a concentration of specialised equipment and expertise which will always provide the most appropriate setting for some children. The Warnock Committee recognised this fact, and I 57 would commend Chapter 7 of this report to anyone who has not read it so that they may see the differing forms of association and integration that are possible within the true meaning and spirit of those terms. Our goal should be to remove the artificial barriers between handicapped and non-handicapped children so that all children learn to work together and understand one another's problems. I am sure that we must all strive to develop a caring society where each has his contribution to make and has the right to have that contribution acknowledged for what it is.
I now turn to another area in which I know your Lordships are particularly interested; that is, parental access to professional reports. What our proposed legislation will do is to guarantee parental access to the record of their child's assessment of special educational needs, to comment on the record when in draft, and the provision considered appropriate by the local education authority. For the record to be subject to an annual review, this information will be contained in what the legislation will describe as a written statement rather than a "record", as I am anxious, because of the unhappy connotation of that word, that we should not slip into the habit of talking about "children with records".
I have already referred to the difficult economic background against which we will be introducing the new legislation. In these circumstances, I believe it to be vitally important that we maximise the use of resources through the different services available locally. One of the Government's objectives is to see improved co-ordination between education, health and social work services and between the statutory and voluntary agencies concerned with the needs of handicapped children. Close contact exists at both ministerial and official levels between my department and the Department of Health and Social Security in respect, for example, of joint policies for the co-ordination of services for the under-fives, and I have visited joint schemes for this age group and have seen how this kind of co-ordination can work on the ground to provide an effective service.
Where difficulties have arisen, I have seen them overcome by a willingness to provide a service of care and education for young children. The early identification of special educational needs and appropriate provision for the child under school age is greatly helped by the increasing facilities for the under-fives. Despite fears to the contrary, experience is demonstrating that most local education authorities which have nursery provision are anxious to keep that provision, and indeed many of them wish to increase it. The statistics for January 1980 show that while the number of children in nursery schools remained at roughly the same level as in the previous year, the number of children in nursery classes increased by 5,600. A total of 215,800 children are now receiving education in nursery schools and classes. The majority of nursery education is in areas of disadvantage, which reflects the fact that for the years between 1968 and 1974 nursery education was provided almost exclusively through urban aid funds. When the DES nursery education building programme began in 1974, it, too, gave priority to schemes providing nursery education in areas of disadvantage and for handicapped pupils.
The community itself can make a valuable contribu 58 tion to the education and care of the handicapped child. Voluntary bodies will continue to make a valuable contribution in this field. They run homes, special schools, nurseries, playgroups and a host of other activities. I am convinced that at a time when resources available to statutory authorities are stretched, support for voluntary bodies can do much to ensure that what resources are available are used cost effectively. A good example of this is the Pre-School Playgroups Association which receives from my Department £30,600 and the DHSS £272,500 annual grants of around £300,000 in total. This helps the Pre-School Playgroup Association to further its invaluable work throughout the country and represents very good value for money, because every pound spent can be said to be multiplied many times over by the voluntary activity which is generated.
I have mentioned earlier the fact that we have a school population which is declining. This decline will be reflected in the number of children with special educational needs. We are thus presented with a unique opportunity to reappraise the kind of educational provision that can be made for the handicapped child. Local education authorities are faced for the first time with declining rolls and are increasingly reviewing the nature of their special education provision at local level. I anticipate that in the next five years some special schools will be closed and that local education authorities will be looking at further ways of integrating or amalgamating this provision for children with special needs. I shall do everything in my power to ensure that any necessary rationalisation of provision at local level is in the best interests of the children concerned. I am particularly anxious that children with different handicaps are not placed together simply because it appears to offer an administratively tidy solution to the problems arising from falling rolls. I will not, for example, be prepared to agree to the inappropriate mixing of handicaps purely on the grounds of convenience. Solutions must be found to the problems created by falling rolls that are educationally sound so that every child receives his education in an appropriate setting and is given every opportunity to develop his full potential.
But education does not necessarily stop for the handicapped child at 16. Local education authorities have the same duty towards handicapped young people as towards all others over compulsory school age and under 19. This is to secure that facilities for full-time education are available in schools or in further education for all those who wish to continue their education. Depending on the nature and degree of handicap, some youngsters are able to pursue academic courses of further and higher education with great success. This kind of achievement can often be made possible by a willingness and determination on the part of colleges to do all in their power to remove obstacles to learning. A little thought in this area can go a long way to help handicapped young persons participate in the academic and social life of colleges and universities. Some institutions are able to offer special facilities for the disabled student, but more could I think be done, perhaps in college prospectuses, to make their existence more widely known.
The International Year of Disabled People provides for a unique opportunity to focus public attention on the 59 problems created by disability and how they might be overcome. I am hopeful that in the next twelve months there will be vigorous debate at all levels followed by action, both major and minor, to improve facilities for the disabled and to change public attitudes. Educationally, I have outlined what the Government propose to do, and I have no doubt that in the long term this will have far-reaching effects. But much can be done now if attitudes are changed and we can make people realise that the disabled person is a valued member of our diverse society with a contribution to make to that society. We all have much to do in this respect if this special International Year is to have the impact that I for one would like to see.
§ 3.53 p.m.
§ Lord Wells-Pestell
My Lords, by the time I sit down I think a number of your Lordships will feel that I have been rather disagreeable, but I shall seek to gain your approval by being brief, bearing in mind that there are 30 more speakers to come. The debate, as your Lordships know, has attracted a considerable number of speakers—and I cannot resist saying this—including those whom we in your Lordships' House know by the endearing term "the wheel-chair brigade". I think it is the first time in the 20 months that this Government have been in power that they have all been here on the same occasion. I exclude the noble Duke, the Duke of Buccleuch. My remarks do not refer to him at all.
My Lords, I think I am bound to say that we on this side of the House have been appalled that those who have, if I may so put it, a vested interest in the problems of the disabled have not taken this Government to task in no uncertain way. For the whole of the Session that this Government have been in office they have come under very little, if any, attack from those who never left us alone—I am talking about disablement, not education—for a single day in a matter of five years. I knew this to my cost when I was a junior Minister occupying the position now occupied by the noble Baroness, Lady Young. In view of their record, which I think is an appalling record when it comes to the question of disablement—and I will come back to that in a moment—I feel that the Government should have been subjected to more criticism and more questioning than they were by those people who I think have a responsibility to do it.
I notice that the most reverend Primate the Archbishop of Canterbury is to take part in this debate, and I am glad about that. Here again—and I speak as someone who until two years ago had 50 years' active service in the Church of England—I think we have not had from the Bishops' Bench in the last Session of Parliament all the help that this House has a right to expect. I am expressing a personal opinion. The Church of England has a fine organisation known as the Board of Social Responsibility, which is extremely competent and able. When my party were in Government there was not a single social problem discussion in which a bishop did not participate, and was asked to do so. In fact, the late Bishop of Leicester, who was then chairman of the Board of 60 Social Responsibility, I think never missed a debate or a Bill that called into question the social fabric of this country.
I concede that we have had in the last Session one or two bishops talking on unemployment. I think there were about three contributions on unemployment; there were several on education; there were two on housing, and I think there were two on immigration. I really do not think that is good enough. If I may say so with very great respect, I think this House can look to the bishops to provide a knowledge which is denied to a good many people in your Lordships' House. When we were in Government, as I say, there was a good deal of comment and criticism—and we do not mind criticism—coming from the Bishops' Bench. I mention this because I feel very strongly about it. I believe as a Christian Socialist that the Church has a voice which is of supreme importance in these matters. I think we need to know what the Church is thinking more often than we do. I hope I shall be forgiven for saying this, but I feel very keenly about it.
My Lords, I have been reading the survey on the extent of the effects of the cuts in expenditure on personal social services compiled by the Association of Directors of Social Services. I have it before me. I really cannot reconcile myself to the impression that the noble Baroness gave, that in this field which we are discussing this afternoon things are better than they have ever been before. How can they possibly be better when immediately the Government came into power in May 1979 they applied wholesale and widespread cuts in the personal social services? In 1979–80 14 authorities made cuts in residential care of the physically handicapped, 25 authorities made cuts in residential care of the mentally handicapped, 21 authorities made cuts in residential care of the mentally ill. In this present year 13 authorities have made cuts in residential care of the physically handicapped, 24 authorities have made cuts in residential care of the mentally handicapped, and 23 authorities have made cuts in residential care of the mentally ill.
It is no good trying to deny this. We all know that a large number of local authorities have made substantial cuts in aids and adaptations, in day centres for the physically handicapped and in day centres for the mentally ill. We also know that a large number of social workers and specialist social workers have been discharged. We also know that there have been serious cuts by local authorities in aid to voluntary organisations.
To sum it up, the survey shows that cuts giving savings are being made across the whole range of services, representing some significant withdrawal of services in many instances as well as increased charges and reduced growth. I do not wish to say any more on the subject because, as your Lordships know, I have been down this road many times before. While the Government continue to impose cuts on that section of the community that can least afford it we shall be ready always to attack them on this particular matter and would expect other people in the community to do precisely the same. It is no good mincing our words about this matter. The Government's record is absolutely deplorable and they cannot justify it. Of course Governments have to save money, but why 61 impose restrictions, savings and cuts on the people who can least afford them and who can least put up with them?
Some of your Lordships must know that quite recently on the programme "That's Life" one of the staff engaged in the programme got into a wheelchair and acted as a disabled person for a certain length of time. The programme showed the difficulties that he encountered. I do not want to go into the whole matter, but what appalled me was that when he arrived at Heathrow to board a plane for somewhere I cannot remember, he had great difficulty in getting down a ramp and also in getting up a ramp. Finally, when he complained about this, he was told that all would be well, "We can take you to the aeroplane a special way and you will be lifted up into it if you pay £15". The programme occurred less than a fortnight ago, and I am sure that some of your Lordships saw it for yourselves. I have made inquiries since then, because I never consciously mislead your Lordships in any way, and I have found that only one British airline is involved; all other airlines apparently do the lifting at no charge whatever. I would ask the Government quite seriously to look into the matter.
I do not expect the Government to be able to wave a magic wand overnight and repair all the things that need repairing. I am not unmindful of the financial problems. However, I say that they have got themselves into these difficulties and that they could have avoided them. But that does not solve the problems that we are discussing now. I think that we have reached a stage where we must really take note of what is happening. There is one local authority in this country which is likely to be prosecuted in the courts by a well known voluntary organisation because of the failure on the part of the authority to install a special hoist in the home of a handicapped woman. It is coming to a pretty fine pass when voluntary organisations have to consider taking a local authority to court in order to get the authority to enforce what is laid down in the Chronically Sick and Disabled Persons Act 1970. I think that we would all want to avoid that. However, that is precisely what is happening.
Before I sit down, there is only this one matter that I should like to raise with the noble Baroness, Lady Young. I wonder whether she would consider using whatever avenue is considered to be the right one to see whether the Cabinet could not be persuaded to find a certain amount of money to be given somehow to each local authority to be earmarked for one purpose and one purpose only, namely, to provide aids and adaptations in the homes of the chronically sick and disabled where such things are needed? I am not suggesting that it should meet every aid or undertake every adaptation. But there are certain adaptations and aids which are of supreme importance to disabled people, and a hoist is one. How can a local authority turn down an application like that, or postpone it for the time being, when it is of supreme importance to the person concerned to have it?
The programme "That's Life" showed how one London borough had levelled the pavement so that disabled people could cross the road. But the pavement on the other side had not been levelled, so they had to be taken back because a wheelchair could not make the gradient. Then there was illustrated a notice 62 showing toilets for disabled people at 300 yards distance. However, when they reached them they found that they had been closed for some considerable time. Such things as toilets are quite essential and it is difficult to understand why they cannot be provided. To anyone who needs, as some of us do because of some physical disability, to have fairly easy and quick access to lavatories it is vital that they should be not only open but functioning, and that people who use a chair of some kind should be able to get into them without difficulty.
I shall not say any more, but I would ask the noble Baroness whether she can do something, first, about the £15 that this particular airline is charging; and secondly, whether the Cabinet could be persuaded to release a certain amount of money for local authorities to provide a category of aids and a category of adaptations.
§ 4.7 p.m.
§ Lord Banks
My Lords, the House is greatly indebted to the noble Baroness, Lady Masham of Ilton, not only for the way in which she introduced this debate this afternoon, but for giving us so early in this International Year the opportunity to discuss it in general terms, and also to discuss the White Paper, Special Needs in Education. During the discussion we shall look forward to hearing the maiden speech of the noble Viscount, Lord Mersey.
We on these Benches would wish to express our full support for the International Year of Disabled People. We hope that it will be successful in achieving its aims, and we shall certainly do what we can to ensure that it is successful. We welcome the steps which are being taken by the Government in support of the Year and which were outlined by the noble Baroness, Lady Young, in the course of her speech.
The International Year of Disabled People Committee has outlined the priorities: to secure increasing awareness of the needs, abilities and aspirations of disabled people; the participation, equality and integration of disabled people in society; and the prevention of disability. We are to hear later in this debate from the noble Earl, Lord Snowdon, and the House is well aware of the distinguished contribution which he has made in this field, not least perhaps in chairing the working party which has produced the report, Integrating the Disabled, which has been recently published by the National Fund for Research into Crippling Diseases.
That report covers the question of integration under the following headings: education, employment, housing, community relationships, transport, public building, sport and leisure. Just to read out those headings is to indicate the scope of this debate this afternoon. The report makes the point that in order that their lives may most closely approach normality the disabled require positive support from society, positive discrimination by society which should be purveyed with tact and compassion at every level.
The noble Lord, Lord Wells-Pestell, has referred to the BBC programme "That's Life". I agree with him that it revealed the inadequacy of our provisions to ensure access for the disabled to public buildings and places. In that sphere we are not giving that degree of positive support which the report that I mentioned a minute ago says is necessary. I am glad that the 63 noble Baroness, Lady Young, was able to tell us that the Government will give attention to this particular problem during this International Year. Incidentally, the programme "That's Life" indicated that we fall well behind other countries in providing public telephones which the disabled in wheelchairs are able to use.
As the noble Lord, Lord Wells-Pestell, said, the programme also indicated how inadequately the Chronically Sick and Disabled Persons Act has so far been implemented. Public authorities should give a lead. In our discussions in this House over the past year we have seen how bad local authorities and local health authorities are at employing their quota of disabled people. When we discussed the question of local health authorities the House was told that the Secretary of State was to have discussions with local health authorities on this matter. I hope that those discussions have taken place and that they will produce a great improvement.
I turn now to a matter which was raised by the noble Baroness, Lady Masham. I wonder whether it will be possible during the International Year to institute a system whereby there is a statutory referral of children who are identified as having a disabling disease to voluntary specialist organisations which can provide the parents with information and support. In this connection I think particularly of the victims of Down's syndrome. It is regrettable that in this International Year of Disabled People the Government should be reducing the benefits and services available to those people. The introduction of the mobility allowance and of the non-contributory invalidity allowance by the previous Government were greatly to be welcomed, as was also the housewives' noncontributory invalidity allowance, although I hope that it will be possible to abolish, or at least to modify, the household duties test.
The present Government have considerably increased the mobility alowance, which is to be welcomed, but they have reduced the real value of benefits affecting the disabled. For example, in the case of invalidity benefit, first, the link with earnings was broken and then the benefit was classed with short-term benefits, and increased by 5 per cent. less than the Government's estimate of rising prices. There is concern as to how the disabled will fare under the "no-cost" reorganisation of supplementary benefit.
The cuts in expenditure on the personal social services, to which the noble Lord, Lord Wells-Pestell, referred, are, in the view of the directors of social services, likely to bear most heavily on the disabled and the elderly. These are serious matters which we have debated in this House before and which we shall certainly debate again. Those of us who do not think that the disabled should have to share in general expenditure cuts, through cuts in services and benefits directly related to their disablement, will continue to press that point of view as vigorously as we can.
I turn to the White Paper, Special Needs in Education. I welcome the new definition of "special educational need" and also the commitment to integration, though I fully understand the reservation which the noble Baroness, Lady Masham, made about possible lowering of standards. That must be guarded against. The 64 criticism has been made that the commitment to integration is somewhat half-hearted and is not the clarion call that is required. There is a fear that backward local education authorities will be able to find sufficient excuse, particularly with regard to resources, to enable them to go slow on integration. Certainly the new definition of "special educational need" will mean that many more children will be covered. The Warnock Committee, on whose recommendation the new definition is based, thought that one in six would be covered at any one time. If this wider need is to be catered for, and if it is to be catered for in ordinary schools, then it is difficult to see it being done efficiently without a fairly substantial increase in resources.
The proposal to record those with more serious disability who will not be able to be educated in an ordinary school without annual review, derives of course from the Warnock Report, but it has been criticised on the grounds that it creates two classes of handicapped child and that the recorded child will be at a disadvantage as regards integration by virtue of that label. I think that there is something in that criticism, but nevertheless I believe that recording on the basis proposed in the White Paper cannot be avoided. The White Paper expresses the hope that most recorded children will, in fact, be educated in ordinary schools. But this again underlines the need for additional resources, perhaps in some ordinary schools in each area, if not in all. In addition, special schools should be used as resource centres for ordinary schools.
I think that it also raises the question of teacher training. The White Paper recognises the need for this, but it is vague about what should actually be done in present circumstances. I should have thought that short courses should be undertaken by the majority of serving teachers over the next few years to prepare them for integration on the lines recommended by the Warnock Committee. As the noble Baroness, Lady Young, said, it is vitally important to involve parents to the fullest extent.
Although the White Paper provides that the parents should have access to the record form of a recorded child, the parents are not to see the reports of the multi-professional team which produces the assessment. There has been very widespread criticism of this—and, indeed, the noble Baroness, Lady Masham, referred to it and criticised it earlier—and I wonder whether the Government are prepared to look at this matter again. Perhaps at the very least at some time parents could meet the multi-professional team.
Then there is the question of appeals in relation to placement. The result of the appeal body is not to be binding on the local education authority, which would seem to be very unsatisfactory from the parents' point of view. With regard to independent schools for the handicapped, the White Paper rejects the Warnock recommendation that all such schools should have a hoard of governors, which would have provided an opportunity for parents and, indeed, for a representative of the local education authority—from which the bulk of the funds for the school would be coming—either to serve on the governing body or at least to attend the meetings of that body. I regret that the White Paper rejects the recommendation of the Warnock Committee that in the case of each child with special educational needs there should be a named person who can provide 65 parents with a single point of contact with the local education service and expert counsel in following their child's progress through school.
Another very important matter is the co-ordination of the work of meeting special educational need in this sphere of the educational, health and social welfare services. There seems to be a lack of constructive suggestions about this in the White Paper. Would it not be sensible to support each local education authority with a standing committee on special educational need, comprising representatives from all the relevant departments and voluntary organisations? Incidentally, is it proposed to have a social worker on the multi-professional team? The assessment must presumably take into account the family and other social circumstances likely to affect the progress of the child.
There are many other aspects of the White Paper on which I have not touched, but I have no doubt they will covered in the course of the debate. Perhaps I have said enough to make clear that I welcome the new system of classification and the commitment to the principle of integration. While feeling that there are some weaknesses and omissions in the White Paper, the most basic being the apparent lack of provision of extra resources necessary for successful integration, I hope than in 1981 we shall make greatly improved provision for special educational needs a notable feature of the International Year of Disabled People.
§ 4.21 p.m.
§ The Lord Archbishop of Canterbury
My Lords, I wish to express from these Benches our gratitude to the noble Baroness, Lady Masham of Eton, for tabling this Motion and for drawing attention to the beginning of the International Year of Disabled People. I will not elaborate on what the noble Baroness said so well about the importance of this year and the present needs of the disabled. Nor will I take up the time of the House to answer some of the charges laid by the noble Lord, Lord Wells-Pestell, against the contribution of the Bench of Bishops in critical and constructive concern with social issues. I do not believe there is any imbalance between our contribution under the last Administration and our contribution under this. But since I take as seriously as he does that such a contribution should be made, I hope there will be some other occasion when we may have a more creative exchange about it all.
The Motion refers in part to the educational needs of handicapped children, and it is on that subject that I wish to make a few points, and I ask for the indulgence of the House for the fact that I shall have to leave the debate early in order to fulfil another engagement. We should not give the impression that little has been achieved in the past 20 years. Attitudes have changed considerably and there has been an increase in concern and provision from both Government and local authorities. An example of this has been the transfer of responsibility for the education of severely sub-normal children from the Department of Health and Social Security to the Department of Education and Science. These children often now attend schools rather than training centres and this has enabled a raising of expectations and an important enlargement 66 of the educational provision for these children to take place.
Education is no longer confined to learning to cope with a handicap, however great. All the richness of educational opportunity should be available to the disabled as to all other children. The chance to acquire numeracy and literacy, to develop logical thought, the appreciation of beauty, moral values and spiritual awareness, is as much the need and right of the disabled as of any other child. Education for the child with a disability should start as early as possible and long before the age of five. It should involve the parents from the outset so that they are not inhibited from playing their part in the child's education by fear or ignorance of his handicap. It has been said that inhibition often results from a handicapped child being regarded as either a potential monster or saint. What is primarily needed is a sense of his or her particular capacities.
At the other end of the spectrum, if he is to cope with his hardship and make the best use of general education, the disabled child needs extra time in which to do it. When the general school leaving age was 15, it was 16 for the handicapped child. It is still 16 today. The Warnock Committee noted that the opportunities were limited for further education for handicapped young people and considered it as one of their top priorities. The White Paper acknowledged the need and admitted that the present legal position was unclear but proposed leaving the issue until a general review of all continuing and further education could be undertaken. Meanwhile, various voluntary bodies and some local education authorities continue to experiment with imaginative schemes of further education. For example, I have personal knowledge of the Church of England Children's Society Centre for the Education and Training of Handicapped Young People from 16 to 21 in North London. However, it is still a matter of some concern that young people who have the most need for an extended period of education do not yet have an unequivocal right to it.
We are trying to act at a time of financial stringency. This is not a time when statutory authorities find it easy to be experimental, and this places a special responsibility on the volunteer element in our society, particularly on the churches. It is my hope that before they start preaching to others, we will have a look at our own attitudes, facilities, use of buildings and resources. It is for this purpose that I recently addressed a letter to all our congregations and encouraged them to see what can be done, and it might be a salutary question for each of them to consider the number of disabled people in their company, both as leaders and members. The disabled are a special care of the churches, because Christians cannot regard them as on the edge of society or objects of pity but as those who are at the centre of the discovery of depth in trust, love and sharing. I know a block of rather soulless flats in which lives a crippled man who cannot move from his room. The door is always open, and it is with the so-called handicapped person that the desperate and lonely housewives or the unloved children can find attention and unselfish interest. The care of the handicapped always draws out unsuspected qualities from those engaged in it, and when you minister to others they minister to you.
67 The churches have historically been pioneers in education and perhaps we now have an opportunity for a fresh recovery of that spirit. There is a difficulty here for us in that the Education Act 1944 did not envisage that voluntary bodies would be involved in the establishment of special or nursery education. Voluntary schools in the maintained sector are either primary or secondary schools. The Church can, of course, provide special facilities for disabled children within their own schools, and to some extent it does so; there is a purpose-built unit for deaf children at a school in Dorset, and most of the Church comprehensive schools are providing remedial facilities for the slower-learning child. Under the White Paper proposals there may be scope for further work of this kind, but I should like to think that where it is impracticable to integrate those with severe handicaps into the life of ordinary schools, there could be a possibility of voluntary bodies establishing special schools within the maintained system and sharing this task with the LEAs. Some of the money which has become available through the closure and sale of schools in rural areas—a topic on which some years ago I spoke in a lively debate in this House—might, for example, be able to be diverted to these causes, but that may require a change of legislation.
Of course the provision of special schools or units in schools is only part of a strategy. Parents coping with handicapped children need support. All experience suggests that the best place for a disabled child to grow up is, as with other children, in the warm, consistent, loving relationships of the family. The parents of such families need the possibility of taking a holiday away from their children. They need advice on finding their way through the tangled thicket of social security provision. They need educating themselves on how to help their children and not to smother them with over-protection; and they need security as they think of the child's future when they are gone.
Again, a time of financial stringency makes it unlikely that there will be an expansion in the number of social service officers who deal with these problems, and this places a special responsibility on the voluntary organisations encouraging action in the various forms of physical and mental handicap. A parent of a mentally handicapped child who belongs to a voluntary society is often the very best person to help and explain the possibilities to a young couple who have just had their first mongol baby. The disabled members of the St. Raphael Clubs are often the best people to help unsentimentally and to save other disabled people from crippling self-pity in a way that the able-bodied ought not to dare to do.
I believe that we must be prepared to look again at the burden that VAT is imposing on the work of the voluntary societies. It is known that service charities are losing a very large amount of money each year on unrecoverable VAT; this is estimated at, for example, £450,000 for Dr. Barnardo's. If there is to be increased partnership between Government and voluntary societies, as we all urge, there really does seem to be a strong case for the present rules to be changed. There is another provision in the statutory services which I believe is called for, and which has already been mentioned to your Lordships more than once this 68 afternoon. The Warnock Committee recommended that there should be available to the families of all handicapped children a named individual officer who would be able to co-ordinate advice on facilities for the benefit of families. This person would be able to direct parents to the proper source of assessment and education for their child. Such a named individual can be very helpful to the efficient administration of education, medical, and social services, for there is often a great gulf fixed between families and the services provided for them.
The White Paper does not consider it appropriate to prescribe such a relationship by law, but it looks to local authorities,to consider ways in which parents can obtain access to information and advice in the most effective way possible".I think that that is too vague. This serious communication problem might not even call for a person to be professionally qualified. It could well be an area of voluntary service undertaken with professional guidance. I know a doctor who spent last year undertaking a major research project into the need for short-term residential care facilities for mentally handicapped children. One of the most striking results of the research was the discovery that parents of severely mentally handicapped children who are qualified to receive the attendance allowance and mobility allowance were unaware of the existence of these allowances or of their right to receive them. There was no one available at personal level to inform those parents of this important form of relief, which would have eased, at least to some extent, the heavy burdens that they had to bear.
That was for me a striking illustration of the need to tackle more precisely the communication problems which could reduce the isolation of the families of mentally handicapped children. It should, I believe, be a principle of government that available resources should go first to the weakest and the most vulnerable. That means that even in a time of stringency we must try to ensure that those who begin life with mental or physical handicaps do not suffer further because of what we fail to do and inevitably end up at the bottom of a heap. It also means that resources must be used in the most effective ways.
The National Health Service, responsible for large hospitals for the mentally handicapped, and local authority social services departments, which provide hostels, training centres, and community care, should work together to reduce the number of people unnecessarily in hospital and relocate them in hostels and group homes in the community. Research projects have shown that with the existing amount of resources being devoted to the mentally handicapped they can have fuller lives if the resources are deployed in ways which provide greater care within the community. Central Government's major contribution to the Year of the Disabled could well be to ensure that such a shift becomes a reality.
My Lords, I believe that the International Year of Disabled People offers an opportunity for us to display two examples of growth in partnership within our society: first, a partnership between the professional services and the strength and vigour of voluntary action; and, secondly, a partnership between disabled people and the rest of us which recognises how much we have 69 to receive from them. In days when confrontation, polarisation, and protest increase, I suggest that such robust partnerships may remind those at the centre of government that while they struggle to solve our economic problems, there is also a moral imperative without which we shall never achieve the recreation of a real community life for our people.
§ 4.37 p.m.
§ The Duke of Buccleuch and Queensberry
My Lords, I deem it a great privilege to be allowed to follow the most reverend Primate. Many a time have I listened to a sermon from a pulpit and longed for the opportunity for a riposte. Now that I have that very opportunity, I feel that after that sound, wise, and inspiring address the most suitable word is "Amen"; but I feel that I cannot let the matter remain just there as easily as that.
First, may I warmly applaud the noble Baroness for her initiative in giving us this debate and for her characteristic charm and skill with which she introduced it. Since this is the first disablement debate in which I have been able to take part I imagine that it is appropriate that I should declare a personal interest. Compared with hundreds of thousands of people far more severely disabled than I am—some suffering from a deteriorating condition, some lacking financial resources, some with no loving wife or family to help them, some as breadwinners with a family dependent upon them—I count myself exceedingly fortunate. Being paralysed merely from the chest down, I enjoy a full use of my arms, and that gives me considerable independence, including the ability to do such things as drive a car. Indeed, attending this debate today involves me in driving myself more than 700 miles, but I feel that every mile is worth it to hear the words of great wisdom and experience from noble Lords and noble Baronesses. I am also grateful for the opportunity to make a modest contribution at the start of this very significant year.
Because so many noble Lords are so very knowledgeable in these matters, it is with great diffidence that I offer a few thoughts of my own plus a few points from RADAR, of which I have the honour to be chairman. Perhaps I should quickly explain that RADAR is the Royal Association for Disability and Rehabilitation; not RADA, the Royal Amateur Dramatic Association. RADAR resulted from the merger of two of the main umbrella organisations in the field of disability, BCRD and the Central Council for the Disabled, of which I was chairman, some three years ago. With about 500 disablement charities and organisations as affiliate members, we are doing in this field roughly what the CBI does in industry and commerce; that is to say, co-ordinating policies and action, acting as a clearing house for information and as a link between organisations and the Government.
I will say more in a moment, if I may, about RADAR in relation to the White Paper, Special Needs in Education, but may I first submit a few personal thoughts on IYDP? International years can, I believe, be a mixed blessing. They can do more harm than good unless we are extremely careful to ensure that the year is used as a special occasion for launching thoughts and projects that carry on into the future, and do not 70 treat it as a 365-day wonder, at the end of which, next New Year's Eve, we shall hear people saying, "Thank heaven that's the end of IYDP; now we can forget about those ruddy disabled".
I only make this point following upon what happened to one of the leading children's charities the very year after the Year of the Child. Its finances plunged deep into the red, and I think this is a very real warning to all of us involved in this and other international years. One of course hopes that there will be a major effort to improve access to public places, with ramps, hoists, wider doors, lifts and so on. Such physical development will, of course, be of lasting benefit, and it is heartening to know of definite schemes as diverse as access into Canterbury Cathedral and the loo at Pisa Airport, both important in their own ways and both in response to IYDP.
One also hopes that the year will lead to a new era of deeper understanding and appreciation of the needs and problems of disabled people. There are signs that this is improving all the time, but I still find some people who assume that because one is in a wheelchair one must be deaf. One of the hazards of IYDP is that in our enthusiasm to make a success of it we may cause the general public to suffer from "disablement indigestion"; we might even actively alienate their sympathy. I would therefore urge the 500 disablement charities affiliated to RADAR to tread warily and, if possible, avoid the sort of demonstrations than can be so counter-productive. I am quite sure there is an immense amount of dormant goodwill provided it can be gently tapped.
Next, as a disabled person, I would make a plea to politicians not to use us as political footballs, to be kicked through the opposite goal every time there is a convenient political point to be scored. No one political party can honestly claim to have a monopoly of virtue in the field of compassion, though it is true that some claim it louder than others. At the same time, I would urge the Government to avoid leaving their goal wide open by giving a positive lead in IYDP by generally honouring the hallowed principle of a safety net for the more vulnerable sections of the community in the best traditions of Conservative Governments and philosophy.
I accept that printing money so as to spend what is not there must be the best guarantee there is of inflation. I accept that things would be even worse today than they are but for the Government's strenuous efforts, much criticised by all and sundry, to control public spending. But I find it difficult to accept some of the priorities one sees around the country for spending what little money is available. This applies to central and local government. There is also the matter of false economies. For instance, the saving on a home help can lead an invalid into hospital or an institution costing 20 times as much as when living at home in dignity and contentment. This year is surely a time for the Government to give a clear lead in these matters, together with exhortations to local authorities to follow that lead.
My Lords, I turn to the problems of the White Paper. Because RADAR is composed of an executive committee and specialist sub-committees, consisting of highly-experienced and intelligent individuals, chaired by two outstanding experts, Mr. Philip Bolshaw 71 and Mr. Peter Large, with an immensely capable director and staff, we believe we are able to offer valuable guidance to those who influence policy decisions in government. On the specific question of additional facilities for handicapped children, RADAR will be circulating its considered response to the White Paper to those concerned with the matter, both in this House and elsewhere, so I need not do more than stress three specific points that it considers most important; but first a general reaction to the White Paper. This does not lead us to think that the Government regard the education of disabled children as a high priority area of activity. I hope I can be told that I am wrong. And it does not suggest any allocation of additional resources for disabled people. Yet it is increasingly obvious that children whose physical handicaps debar them from manual employment opportunities must vitally depend upon the fullest development of their intellectual abilities.
The three specific points are, first, the identification of children with special educational needs. We think that the method suggested in the White Paper is rather a haphazard way of identifying children, and we suggest that health authorities should have a duty to inform the LEA of any child who is disabled and may be unknown to the LEA. Accurate and early identification is essential if a child's educational needs are to be adequately catered for.
The second is the training of teachers. Paragraphs 25 to 29 of the White Paper encourage LEAs to ensure that teachers receive appropriate training to teach children with special educational needs. We believe that such training should be compulsory. If integration of disabled children into ordinary schools is to be encouraged—and I was so delighted to hear the noble Baroness confirming that this is so in her speech earlier this afternoon—we need to ensure that teachers in those schools obtain the appropriate in-service training for teaching children with special educational needs. Teachers working in special schools receive a higher salary than those in ordinary schools, and in order to encourage them to transfer to ordinary schools we believe that all teachers trained to teach children with special educational needs should receive the same salary, regardless of whether they work in a special or an ordinary school.
The third point concerns the post-16s. The Royal Association's preparatory training bureau enrols disabled people onto correspondence courses. Although many LEAs reimburse it for the cost of its courses, some do not. We should like LEAs to be obliged to finance correspondence courses or home tuition for disabled people who are unable to use conventional educational facilities. During the last decade or so universities and polytechnics have considerably improved their facilities for disabled students. Unfortunately, however, many are still inaccessible, and although it is sometimes possible to adapt a building for use by disabled people, we think that establishments of higher education should produce and publicise a policy on the admission of students with disabilities, and that they should make arrangements for their welfare and other needs. We believe that central Government should release funds to adapt educational establishments so that they can be used by disabled 72 students. This, of course, may be wishful thinking at a time of severe economic crisis, but I hope that the Government can at least indicate acceptance of this in principle.
My Lords, in conclusion, and at the risk of appearing to be making a commercial plug, may I mention an especially important date in the disablement calendar. It is the annual conference and NAIDEX exhibition of equipment of every kind for disabled people, sponsored by RADAR, as usual, which this year will be bigger than ever. It is to be held at the National Agricultural Centre in Warwickshire and will run from October 21st to 24th. I hope that we shall be able to welcome many noble Lords to it.
§ 4.50 p.m.
§ Viscount Mersey
My Lords, I must begin by simply reinforcing the points made by the noble Duke, the Duke of Buccleuch and Queensberry. I do not believe it is good enough for 1981 simply to be the Year of the Disabled and then for everything to be forgotten. Rather, I hope that it will be the start of a permanent change of attitude towards disability. I should like to concentrate on the international aspect of this Year and, in particular, on the biggest single cause of disability in the Third World; that is, the disease of leprosy.
I am a documentary film-maker by profession and I have acquired various, quite isolated, areas of special knowledge over the past 23 years. One of them is leprosy. It is a subject that moves me quite deeply. It is the biggest single cause of disability in the Third World—and that includes damage from the motor-car; it is greater even than that. There is 40 per cent. disability normally among untreated leprosy patients and four out of five patients never get treated—perhaps 20 million people. Yet, ironically, the disability can be avoided and the disease can be cured. So why the huge number? I think that again one must return to this problem of the label. The man with leprosy is not a man, he is a leper. The word "leper" is swamped in emotion. People may regard it with loathing, with hatred, with fear, or, if one is lucky, with compassion and pity. But I would suggest that feelings are not the best tools with which to fight the disease. I should have thought that a better tool would be a cool, clinical approach; and even today this is still somewhat lacking.
Built into this swamp of emotion are several misconceptions about the disease which I believe are quite important. I should like quickly to mention three of them. The first is simply that leprosy is unclean. This is not so. It is in no way associated with filth, squalor or promiscuity. It is caused by a bacillus, mycobacterium leprae, which is similar to that which causes tuberculosis. It is true that poor people are more prone to catch it. This, in the Third World, is, I am afraid, just a reflection on their living conditions; they are so crowded together that cross-infection is more likely. The second misconception is this business of leprosy being highly contagious: that if you shake hands with a leper, you have got the disease. That is not so. It is in the Guiness Book of Records as being the least communicable of all communicable diseases; and rightly so. Recently, leprologists have discovered 73 that the main route of infection is not by touch at all; it is simply droplet infection, by coughing and sneezing, the same as with the common cold.
The third misconception is this business of fingers and toes dropping off in this disease. They do not; but leprosy causes anasthesia and that is serious. It causes a numbness in the hands and the feet; and numb hands and feet are easily damaged by hundreds of daily tasks. Cooking, for instance. The first sign that a sufferer will have that he has burnt his hand will be the smell of burning flesh. If he does nothing about that burn—and he might well not—it will become septic, it will ulcerate and, if he continues to cook week after week, year after year, year in, year out, he will get a mass of infection on his hand, so bad that the hand will disintegrate. Feet (with which, at least, you do not cook) are a worse problem because many people in the Third World cannot afford shoes. Those with numb feet can walk over the sharpest, possibly toxic, surfaces and do not feel anything. I have even heard some of them regard this as an advantage. One Indian leprologist said that the chief pain of leprosy is the lack of it.
So the disability could be avoided by basic education. I do not feel that that is a solution. There are very expensive ramifications to this simple policy. For a start, there would be the cost of making 20 million pairs of surgical boots for the sufferers—a big cost. But much greater than that is the cost of keeping the sufferers themselves. You see, my Lords, they cannot cook, they cannot plough or dig, they can do no heavy manual work; and I am afraid that they are simply not contributing to the forward march of their emergent country in any way. They are a burden on their country. Most developing countries, one could say, are marching forward, as it were, with one leg shackled to a ball and chain—and that chain is leprosy.
Of course, it is much better to treat the disease before all this anasthesia sets in. Leprosy is curable. The first effective drug, which was DDS, came into use just after the Second World War. It was hailed as a miracle, though rather a slow one. It took some three years on average to cure the patients. Lately—and this is rather less good news—the bacillus has become resistent to the drug. But there are new drugs, Rifampicin and Lamprine, to name two of them. These can reduce the treatment period to three months. That is still a long time, but it is an improvement.
I am happy to say that a British leprosy control project in Southern Malawi has worked to a huge extent. Of the 14,500 original sufferers, 12,000 have now been discharged free of leprosy. The remaining 2,500 are still on a small maintenance dose. This is an out-patients' scheme based on Land Rovers visiting every infected village every week. Badly disfigured people are taken to hospital and not to a leper colony. That is a thing of the past. The vast majority of patients take their pills from the Land Rovers and carry on working, carry on leading their normal lives. This British project, which is presided over by the noble Viscount, Lord Boyd, has now moved to the north of that country. Leprosy now in Southern Malawi is such a small problem that the local Ministry of Health have been able to assimilate it into their overall health programme. I would say that Dr. Hastings Banda has been commendably realistic about his 74 country's leprosy problem. He let the experts in; and the problem is well on the way to being solved. Southern Malawi has lost its ball and chain.
However, I do not believe that the Malawi method is relevant to, say, the Indian sub-continent. I calculate that at least 3,000 Land Rovers would be needed in India for the weekly visits. What is needed to fight leprosy on a world-wide scale is a drug so powerful that it will cure the disease with one shot or perhaps two and, of course, a vaccine. It has been difficult to make a vaccine. Doctors have found it hard to cultivate the particular bacillus outside the human body. Lately, there has been a breakthrough: first, in the footpads of mice and then in the nine-banded armadillo. Today, we have 300 armadillos with leprosy. There are some at Carville and Atlanta in America and some at Porton in this country. These armadillos are regularly sacrificed and their tissue, riddled with bacilli, is sent to research institutions in Hyderabad, Malaysia, Hawaii—all over the world. From the armadillo, doctors in England have made a vaccine and have tried it on mice. It seems to work—although I must add the words "so far", because leprosy has such a long incubation period.
I am afraid that that is not quite the end of the problem. Even if it works it will be far too expensive to use world-wide. In order to vaccinate hundreds of millions of people it stands to reason that we would have to breed millions upon millions of armadillos and then infect them with leprosy. That might be ethically unacceptable to many. Apart from anything else, it would be appallingly expensive and just not possible.
Another breakthrough is needed: the ability to cultivate this bacillus in a test tube—in a broth as it is termed. Then it will be possible to mass produce vaccine cheaply. With regard to that breakthrough, I can only say that I detect a note of guarded optimism emanating from the Medical Research Institute at Mill Hill. I can only hope that in the next 10 years this will be done. When it is, then surely the world leprosy problem will start to be solved by vaccination. Then and only then will this colossal and largely unnecessary cause of third world disability be removed and the source of the stigma will go, too. That is in the future. For the present, I can do no more than wish every doctor working on this disease in every part of the world every success.
§ 5.2 p.m.
§ Lord Rhodes
My Lords, may I congratulate the noble Baroness, Lady Masham of Ilton, on being able to introduce this subject today. She has fought a valiant fight for the disabled over many years. I am certain that the House is indebted to her for all that she has done. We say to the noble Viscount, Lord Mersey, who has made a maiden speech this afternoon: Thank you for what you have said in the contribution that you have made to the debate. The noble Viscount's father was a greatly respected member of this House. His courtesy was well known to everybody and his mastery of the procedures of this House as Chairman of Committees was appreciated and known by everybody. It is nice to come into this House after such a father, but I am sure that his father would have 75 been very pleased to have heard him this afternoon making a special plea for the disabled.
My Lords, I ask for forgiveness this afternoon for speaking on this subject in the way that I am going to speak. I have not made a public speech on disablement that I can remember. If it had not been for the persuasion of the members of the society that I helped to found when I was Member for Ashton-under-Lyne 25 years ago, I doubt whether I should have spoken now.
I was wounded in the 1914–18 war, just before the Armistice. I was in hospital for two and a half years after the war was over and was discharged with an open would which I still have—and I have to have it dressed every day—following a long series of operations The reason why I have not spoken of it, and do not want to speak of it, is that all my life I have been determined not to be recognised as a disabled person. A person setting out in life with a disablement does not have a cat in hell's chance if seen to be disabled.
I am looking at two people in wheel chairs who cannot disguise their disablement and who in consequence have an enormous amount of experience about public attitude towards it. I do not think it is possible for anybody to understand what it is like to be disabled unless you live with it or have it yourself. However, I agree with the most reverend Primate the Archbishop of Canterbury that there has been a good deal of improvement in the attitude of people over the years. Nevertheless, a great deal more needs to be done. Such a long experience since 1918 has its pitfalls, as I once remember to my cost. Sitting in front of the fire one winter's afternoon, one of my grandsons started "twanging" the spring on my right leg. He said, "What is this?" I replied, "This keeps my foot from dropping". He said, "How did you get it?" I said, "I was shot". He said, "What with—a bow and arrow?".
The attitude of society towards the disabled is often mean and offensive and is one of the reasons why the International Year of Disabled People has been brought about. I have my leg dressed every morning by the district nurse. What a blessing it is for the disabled that we have them! Word should go out to them applauding them for what they are doing and the sacrifices they are making. I said to two of them in turn: "You are part of the general public; you are in daily contact with the disabled; you are ministering to them at all hours of the day and night and you are housewives with families. How do you assess the attitude of the general public towards the disabled?" The first one said: "Negative; the general public does not want to know". The second one gave an answer which was rather different: "A tiny majority of intelligent and compassionate people do know, but the vast majority are afraid of the disabled and turn away".
The Government have agreed to make available £89,000 for pamphlets and other expenses incurred in the course of the year. But the Government have already made their attitude towards the disabled known. In the past 12 months, supplementary benefits for the disabled have been hard hit and the real value of the invalidity benefit has been reduced. Local authorities have been urged to cut social services and these cuts have made a nonsense of the Chronically Sick and 76 Disabled Persons Act. Everybody should make themselves aware as to what has happened during the past 12 months. If only public opinion could be roused sufficiently to wipe out what has been done in this past 12 months, it would be a blessing. Even the quota employment system is under review.
What has happened regarding the pensions of servicemen? Do your Lordships realise the enormous problem that is arising at the moment by the awards which are given in the civil courts for disability in comparison with the awards which are given by the Ministry of Defence? The awards which are given by the Ministry of Defence are derisory. Does the House realise, also, that there are three levels of compensation for widows? They are pre-1952, post-1952 and post-1973. I have not the time to go into that this afternoon, but I would ask your Lordships to look up the awards.
The cynics are drawing our attention to the Year of the Child and what has happened since we embarked upon that International Year. We cannot allow the cynics to divert us from making the best of the opportunities of this Year. The real strength behind the International Year of Disabled People is vested in the voluntary associations. There are 5,000 of them in this country and, if we can back them, so much the better.
No one can quarrel with the aims of the central committee who are running this Year: increasing awareness of the needs, the abilities and aspirations of disabled people, promoting their participation, equality, integration and positive attitudes towards them, and preventing disability. The big question is: How do you put this sort of rhetoric into practice? It is no use unless it is backed up by funds. You will make no real impact on the problem of the disabled in this country until every disabled person is able to live a normal life with a normal standard of living. We owe it to them as a nation.
Another aim is employment. Twice as many of the disabled are unemployed. As to attitudes, we cannot dictate them; they have to grow. There are plans for access for wheelchairs; and so it goes on. Until we have sufficient funds so that the disabled in this country can be enabled to live a normal life, we shall not get the response from the public that we need.
I should like to put three practical points. My first is a simple one on which action can be taken at once and it will not cost any money. I would call on all local authorities to check all entitled to "disabled" car-stickers. Do your Lordships realise that there is a grave misuse here and that the smart alecs of both sexes are moving in on it? This is happening to such an extent that police authorities are prosecuting holders of valid permits. I heard of one case this week.
My next point concerns the mentally disabled, particularly the young. The most reverend Primate the Archbishop of Canterbury was a little wrong when he was talking about the age at which the responsibilities for mentally handicapped children are removed from the education system; because in one or two special schools—we have one in our area connected with the society that I helped to found—we have the responsibility, along with the social services, of looking after children when they leave school at 18.
Most people may not have realised the effects of 77 drugs and the ability of drugs to keep people alive. We are now at the time when some of the drugs are affecting some of our mentally disabled who are in their late 20s and early 30s. It is a fact that more mentally deficient children are born to women over 40 than in any other age group. These children are being looked after by ageing and aged people, and here is an urgent problem which needs attention. I draw attention to it because I know what the circumstances are, and I should like to know what is happening about it.
I will make one more point and then I have finished. Here is another one which will not cost any money, either. Let the word go out to the boards which are assessing the disabilities of war veterans. It so happened that last year I was one of those applicants in this category, so I know what I am talking about. I was hoping that I would be given advice as to what I would need to do in the event of its being necessary to amputate my leg and whether there was any up-to-date information about modern methods of stemming deterioration in the condition of the bone. I wanted to know what could be done by diet or behaviour to help myself. They were not interested. All I got was the question: "Can you walk 100 yards"? Later I received an impersonal stereotyped letter from a junior. It will not do. We have got to tell these people that they must behave with some compassion, and if they are in the favourable position of having index-linked pensions, let them behave decently to some of those who have not.
In conclusion, I hope that the House will pay tribute, as did the most reverend Primate, in a most statesmanlike speech, to those voluntary organisations throughout the country which are the salt of the earth. We have to think of the time that some of those people are putting in and the generous way in which they are spending themselves for the disabled of this country, badly backed by money from the central authority. We are indeed fortunate in having 5,000 such societies and I hope that during the year we shall make closer contacts with those societies and be able to channel more money towards them, because in the main they are our bulwark for the disabled.
§ 5.18 p.m.
The Earl of Snowdon
My Lords, after the eloquent and caring speeches already made by noble Lords and by the noble Baroness, Lady Masham—a very sympathetic and beautifully made speech which initiated the whole debate—there can be nobody in this House who is unaware that 1981 has been designated by the United Nations as the Year of Disabled People. But I would rather describe it as the first 12 months of a new era of understanding of, and action to benefit, the 500 million disabled people who exist in the world today.
The difficulties of integrating the physically and mentally handicapped into human society, to their benefit and to society's own benefit, are not only financial and psychological; they are technical too. Thus it is vital that we plug into the worldwide technological revolution with all the determination we can, so that the new machines which are dynamising life across the earth shall not fail to be applied to the needs of disabled people as well. We must have the advantage of the latest improvements, innovations and 78 technical miracles that feed on one another, generating new invention, until things are done for and by disabled people which were inconceivable only a few years ago.
Still, the standards of design—and, of course, I mean both functional and aesthetic—of aids for handicapped people are appallingly low in every field, often in the style of Heath Robinson. This country has, possibly, the greatest history for inventiveness, but, too often, getting inventions into production has been our failure. Manufacturers frequently reject ideas, with the excuse that the tooling-up costs would be too great for a relatively small demand. This applies especially to creative ideas and designs to aid any kind of handicap, but which are only partially developed and need the experience of industrialisation and mass production techniques, so that the projects are too frequently disbanded to the detriment of disabled people. It is therefore obvious that action on an international scale for a wide market brings new possibilities of commercial production and profitable runs, which until now have eluded us.
Now, if I may, I want to make one appeal to the Government. It is in respect of my continuing concern for the mobility of disabled people. It is still no good being given or possessing the means of getting about if you cannot afford to use it. I understand that the national cost would be miniscule to make the changes that are needed. For that reason, after the encouraging decision to remove VAT from cars bought under the motability scheme, could not the Government also remove it from the cost of car adaptations? And could a fund be set up to finance individual adaptations? And could the Treasury examine how all disabled people might be allowed to buy a set amount of petrol—perhaps related to their work needs—every month free of duty? And might they look into the possibility, while they are about it, of partial or total remission of road fund tax for their vehicles, while that tax continues to be imposed as at present?
The field of disability is so broad. I should like, if I may, to concentrate on two areas of it which deserve special consideration in this coming year. The first, the prevention of disability, has a world application. The point is that disability can come, and frequently does, at any time to any one of us and with age is likely to come to everyone. So it is about time that the dated and misguided thinking of "them and us" was dispelled. Disabilities that come from disease, from polio to multiple sclerosis, from leprosy to German measles, may eventually become preventable. May I emphasise, then, that those societies and researchers that are concerned with the prevention of pre-natal problems, the causes of blindness, of deafness, of geriatric suffering or the prevention of accidents, both at home or at work, have as large and vital a part to play in reducing the needless sum of human disability as have the vigorous and energetic teams of vaccinators and inoculators who are ridding the entire world of the scourges of the past, as was so aptly and expertly described by the noble Viscount, Lord Mersey.
To anyone inclined to cynicism about the practice of devoting particular years to particular concerns, I would say that I naturally agree with the noble Duke the Duke of Buccleuch, that a national or international programme of prevention obviously makes no sense 79 whatever, unless it is carried on and carried through. But if 1981 becomes a year for launching new plans for prevention and medical research, they could not conceivably be dropped again come next New Year's day, neither here nor in the third world.
The second area which I should like to mention costs nothing; that is, nothing in money terms. Integration of disabled people means far more than ramps for wheelchairs and making access easier in public places. That should be taken for granted. If we wanted it this Year could—and, I hope, must—see the final breakdown of all the social barriers of fear, ignorance and prejudice against disabled people throughout the world. It could spell the end of economic and architectural excuses for the failure to smooth their paths. If we want it, it could be the year when there begins the general acceptance of all disabled people and the end of exceptions made only for those in high positions, whose complaints are listened to—a time to appreciate and applaud the abilities of disabled people, rather than to look at their disabilities.
This could be the year when they can be made to feel welcome, wanted and needed, not only at work, places of entertainment and on public transport, but into our lives and our hearts: and that means into our schools, our private societies and clubs, our theatres, cinemas, exhibition halls and galleries, as we would take anybody else; not condescendingly, not as a well-meaning duty, but as of right and as of nature.
What does that imply in practice? No one, I am sure, discriminates on purpose. Discrimination comes at one level through lack of planning, lack of design research, sometimes lack of money, of course, sometimes through rigid, dated safety regulations and, most important, through the problems of employment for, as the noble Lord, Lord Rhodes, said, it is twice as hard for a disabled person to get a job compared with his able-bodied counterpart.
So the people who can bring the most pressure to change attitudes are those in the corridors of power, from Government officials to trade union leaders, from managing directors to entrepreneurs, from local councillors to town and country planners and, certainly not least, Members of Parliament on both sides of the House, for this must be above party politics.
Some of the barriers that exist come from thoughtlessness or embarrassment stemming from lack of contact, from lack of imagination, from lack of know ledge, from lack of appreciation of the needs, psychological and physical, of disabled people and from the inability of too many of us to treat those who are disabled as they would wish to be treated. I call, therefore, not so much for charity as for understanding and action, not for pity but for encouragement with enthusiasm and compassion; not just for money, but for determination to make social integration real for everyone and anyone to have equal opportunities on every level, wherever feasibly possible.
Disabled people are not rejects. They are not manufacturers' seconds to be treated cheaply. Their rights and opportunities must be the same as the rest, for they are as much part of humanity as the rest. A humanity that carries on without them, that ignores them, that leaves them lying, that tramples over them, 80 that condescends to them—that kind of humanity deceives itself and utterly denies itself, because it is merely trampling over itself.
§ 5.30 p.m.
Lord Campbell of Croy
My Lords, I am very glad to be following the noble Earl, Lord Snowdon, who has just made a most constructive and compassionate speech. In the early 1970s he was the chairman of a national committee and did distinguished work then. His interest in the subject has been continuous. I congratulate the noble Viscount, Lord Mersey, on his maiden speech. He has made a notable contribution to the cause of leprosy. The whole House will look forward to hearing him speak on other occasions, on both this subject and others.
We congratulate the noble Baroness, Lady Masham of Ilton, on initiating this debate and introducing it with such a speech, which we all enjoyed and in which she told us about the International Year of Disabled People and what is being aimed at. As she said, I am the chairman in Scotland for the IYDP. This has meant that since early last year I have been much engaged in the preparations. Early last week I carried out the inaugural rites at a very representative gathering in Edinburgh. I can report to the House that the International Year of Disabled People is well and truly launched in Scotland.
I shall try to be brief. I should like to draw attention to three guiding principles not only during the year but, as other speakers have said, for long after it. These are access, awareness and adaptation—the three "As". These three principles can help both able-bodied and disabled to contribute towards helping seriously handicapped people to circulate in the community and to live lives as normal as possible.
I have one particular purpose in speaking in the debate. It is to suggest a practical project for sponsored volunteers. I hope it will be widely considered and taken up. It is a way in which volunteers and potential sponsors can provide extra and most useful help, for there is still no complete record in this country of severely disabled people. The appropriate tiers of local authorities have the power to compile lists, following Section 1 of the 1970 Act, as changed by later legislation, but over the country the results have been patchy. There have been other priorities for manpower and resources. For the disabled who are not war-disabled or handicapped by industrial injuries the system is still haphazard.
What I am suggesting therefore is that volunteers, after enrolling for suitability checks and briefing, could be sponsored to help with the doorstep and administrative work necessary to complete a national register. Instead of being sponsored to walk or run, say, 20 miles—a tough and praiseworthy undertaking—volunteers would use their energies on something useful to the cause of the disabled. For example, they would be sponsored to check a defined area: to visit every address in named streets or in particular blocks of flats or tenements. Instead of being sponsored to push a wheelbarrow up Ben Nevis, for example, the colourful kind of enterprise which is now something indulged in for sponsorship, a volunteer would be enlisted to go up and down the stairs of tenements in cities such as Glasgow or Birmingham. That would 81 be doing something really useful for the disabled. The project would not only bring in the sponsorship money; it would also use the energy and effort expended. While in no way reflecting upon the remarkable and unusual activities which volunteers undertake to attract sponsorship, my suggestion would use the sponsored effort itself for a task in the field of the disabled which all concerned agree still needs to be completed.
I must give the background to your Lordships. It was in the mid-1960s that anxiety first arose and spread that there was no full register of the severely disabled in the country. There was a register of the war-disabled, and on the whole they have been well looked after. There was a general impression that the others were all known and catered for under the national insurance system and the National Health Service. But the national insurance system was directed to employment, or the lack of it. It applied to individuals in work, or who had worked, or who were available for work. Everybody capable of normal kinds of work had a national insurance number. That was not a national register or, indeed, a register of adults in the country. Nor were the relevant benefits available to those who had not contributed. The position has changed since then. Non-contributory pensions have been available since the early 1970s, in particular the attendance and invalidity allowances. However, people who had been severely disabled from birth or from youth and who were too incapacitated to be able to do normal work were not in the system. They were not registered. They had no national insurance number. There was no record of them. And the numbers were not even known.
As regards the National Health Service, treatment and beds were of course available when necessary but it was not a source of any financial help. The National Health Service card system is not one from which a register can be compiled. It is not universal. The card system was intended for part of the population when it was needed. Therefore nobody knew how many severely disabled people, too helpless for normal work, were being looked after, somehow, either at home or in and out of hospital. Indeed, no realistic estimate of the numbers could even be made until 1971.
The events leading up to that first official estimate were these. The Government of the day announced on 23rd October 1967 that the Government Social Survey would undertake an inquiry. It took nearly four years. The results were announced by the Office of Population Censuses and Surveys, as estimates, in May 1971. The method used was sampling. None the less, it was regarded as the first reliable estimate there had ever been.
Other events that took place while the survey was in progress were debates in another place as a result of Private Members' good luck in ballots. There was a day's debate on 15th March 1968 in which the Government and everybody else agreed that there was this enormous gap in our knowledge about the severely disabled. I had been lucky in coming first in the ballot for Private Members' debates for that day.
In November 1969 the Chronically Sick and Disabled Persons Bill was introduced as a Private Member's Bill when the right honourable Gentleman, Mr. Alf Morris, came first in the annual ballot for Private 82 Members' Bills and chose that subject. Under Section 1 of that Bill, which became an Act in 1970, local authorities had a duty to inform themselves of the numbers of disabled in their areas. They did not have to make up a register. This was understandable. In the case of a Private Member's Bill the Government were trying to help, but neither they nor the local authorities were prepared to go further than to try to find out the numbers.
Since then it has been left to the discretion of local authorities to do as much as they themselves feel able to do. That is why the results have been piecemeal and patchy. It is difficult to carry out the equivalent of a full census of the population without extra money or manpower. A national census is now the only system in existence for compiling a register of all persons in the country. There is to be a census in this year, 1981. The questions have to be few and simple. I have made inquiries and there is to be one question to inquire about unemployment arising from disability, but that cannot—and it does not seek to—provide the information which is needed for a full register of seriously disabled persons. I understand that it has proved too difficult to include a separate question on disablement in the national census—a question which would provide the information needed for a register.
So this can only be done by a separate census which would be much easier because it would only need three or four questions and it would cover those areas which have not already been dealt with by local authorities under Section 1 of the 1970 Act. I suspect that there is a very large number of areas which have not yet been dealt with under Section 1. This could be called the disablement volunteer survey—DVS. No doubt those taking part would be called "doves" before long, or "sponsored cloves". I suggest that the Government and local authorities should consider this together and be ready to receive applications from volunteers and sponsoring firms and to harness the willingness and the energy being offered. The machinery would be simple—simpler than a national census, which is to be carried out in any event. We see from the press that the Government are offering jobs to unemployed people to come in and help with the national census. This disablement census would be carried out by volunteers and with sponsors.
The same basic rules would need to be followed, and in particular no politics and no commercial selling on the doorsteps. That could easily be policed and the procedures for dealing administratively and by paper with those who are not at home or do not answer can be done in the same way as the national census is done.
The war-disabled are registered and on the whole are adequately cared for. This I know and I have an interest, being classified in the category of 80 per cent. war-disabled because the bullet which went through my middle affected both legs, among other things. If its course had been about half an inch different, I should have been a paraplegic. In fact, I am lucky, because I can walk, not very far and, as noble Lords know, somewhat unsteadily, but I have experienced immobility and handicap, with months spent flat on my back and periods in a wheel chair, and on crutches. Indeed, I have passed through both Heathrow and Gatwick in periods when I have been in wheelchairs, 83 but not recently, and I was interested in what the noble Lord, Lord Wells-Pestell, had to say.
Being war-disabled but not much handicapped, I have been especially concerned about the seriously handicapped civilian disabled, many of whom, if not industrial injury cases, still receive little or not enough of the right kind of assistance. For example, children and housewives. There have been recognition and allowances since 1970 but this has been haphazard. I emphasise that this is not simply a matter of money: imagination and determination are needed more. For example, it is cheaper for the Exchequer and the taxpayers for a severely disabled person to be living in the community with an attendance allowance and other assistance, including equipment, rather than occupying a hospital bed. More imaginative use of funds can make the money go further. Moreover, to be as independent as possible is what most severely disabled people want. It is probably the best therapy for them. As the most reverend Primate pointed out in his speech, this is true of the mentally handicapped as well as the physically handicapped.
It is astonishing what can be achieved by people who are almost totally disabled. Triumphs of will and application are to be seen where opportunities, care and equipment are available. Very seriously handicapped people can live extremely worthwhile lives provided they are not forgotten, dumped unnecessarily as permanent hospital cases, or left to try to manage by themselves in impossible conditions.
§ 5.46 p.m.
§ Baroness Darcy de Knayth
My Lords, I should like first to thank my noble friend for giving us the opportunity to discuss the International Year of Disabled People and also the opportunity to hear the maiden speech of the noble Viscount, Lord Mersey. For me, he has given an added poignancy to the song of Flanders and Swann on the armadillo, but also it was a fascinating and informative speech and I hope we shall hear him again very often.
I share the hopes expressed by my noble friend Lady Masham that the Year will make positive steps to further the integration of the handicapped in all aspects of life—in education, employment, sport and leisure. Her example of the borstal boy at the holiday camp effectively demonstrated that the best way to change public attitude is by contact with disabled people themselves. To ensure this contact, access is vital and, as other speakers have said, I think it is important to have stronger legislation in this respect. So I am delighted to learn that there is to be a Private Member's Bill introduced in another place to strengthen the access sections of the Chronically Sick and Disabled Persons Act, which I think is very necessary.
Our first opportunity to do something concrete towards achieving integration will be in the educational field, so today, I shall concentrate on the White Paper. The ensuing legislation is likely to affect handicapped children over the next few decades, so it is vitally important that we get it right. Here I really must take issue briefly with the noble Lord, Lord Wells-Pestell—he is not here, but perhaps he will read my remarks later—that we have not taken to task the present 84 Government. First, it is something more like ten years than 20 months since we were all gathered together as a mobile Bench. Incidentally I very much regret that we cannot actually all sit here together today, but we were not allowed to take a Cross Bench out. Normally, there are only one or two of us on a social security Bill, whatever Government is in power, but this is a Bill which is somewhat comparable to the Chronically Sick and Disabled Persons Act, in that the whole Bill deals with the disabled and not just one or two clauses in it. The noble Lord said that this was not education, but it does not matter whether we were talking of education or health or anything else because, as the noble Baroness, Lady Serota, said ten years ago, the needs of the disabled are as broad as life itself. Fond as I am of the noble Lord, I really cannot let him get away with the implication that we are known as the "mobile Bench" because we change our tactics with the change of Government.
Many of your Lordships will have received comments on the White Paper from the Association of Disabled Professionals, the Advisory Centre for Education, from RADAR, as the noble Duke said, from the Association of Directors of Social Services, and others. There is widespread dismay at the repeated references to lack of resources, to fears that recording may create two classes of handicapped children, and concern that the White Paper lacks an unequivocal commitment to integrated education as a right.
Speaking in another place, the Secretary of State for Education has already said that the proposed Bill will be the Government's main contribution to the International Year of Disabled People and, since paragraph 16 of the White Paper acknowledges that more and more people believe in integrated education, we could indeed expect a really rousing call towards integration from a document heralding legislation for many years to come.
Let us first consider the United States of America's 1975 Act covering the education of all handicapped children. That was enacted six years ago and it states that handicapped and non-handicapped people will be educated together to the maximum extent possible and the handicapped only placed in special or separate classes where the nature or severity of the handicap is such that, even if they are provided with supplementary aids or services, education in regular classes cannot be achieved satisfactorily. Compare that with the Government's statement of principle (paragraph 41):The Government proposes that a child with special educational needs who is not a recorded child should normally be educated in an ordinary school, and that a recorded child shall also, wherever this is reasonable and practicable, be so educated. Accordingly the proposed legislation will provide that a child with special educational needs shall be educated with children without such needs, provided that the arrangements are capable of meeting his needs, are compatible with the efficient education of children with whom he is to be educated and with the efficient use of public resources, and take proper account of the wishes of his parents".My Lords, it is rather less of a bang than a whimper.
The noble Baroness said that a compassionate Government does not make wild promises that it cannot keep, but I really feel that a Government that cared should surely aim a little higher than this when legislating for future decades. This provision (paragraph 85 41) is possibly even less likely to speed progress away from segregated education than the never-enforced Section 10 of the 1976 Education Act which it replaces. It gives, as the noble Lord, Lord Banks, said, backward LEAs undiminished scope to justify continuing segregation and little encouragement to progressive LEAs attempting to end segregation, and I believe that this is particularly true in the case of recorded children.
I agree with my noble friend Lady Masham that it is a good thing to have the abolition of categories of handicap in legislation but that there is considerable anxiety that the needs of the more severely handicapped children with physical or sensory disabilities may be overlooked. I do urge the Government to ensure that this will not happen. I am very glad that the noble Baroness the Minister said in her opening speech that there will be no inappropriate mixing of handicaps for administrative convenience.
I fear that the label "recorded" is likely to be far more damaging and indelible than any now tied to handicapped children. I fear that it will make it that much more difficult for a parent to argue successfully against an LEA that his child should be educated in an ordinary school. The recording system has many worrying aspects. I have done my best to summarise them. I hope I am not overlapping on what Lord Banks said, and I hope the Minister will be able to enlighten us on some points which I do not think she quite covered in her opening speech. Recording depends on whether a child's special educational needs can be met at an LEA ordinary school without the need for systematic annual review by the LEA. in the case of a wheelchair-bound child if there is no accessible ordinary school in the area in all probability that child will be recorded. This is one very important reason for strengthening the access clauses in the Chronically Sick and Disabled Persons Act. I withdrew an amendment to the 1976 Education Act on assurances that regulations governing school premises would be amended, and since then I find that it cannot be done.
Paragraph 60 states that the record will be passed to the child's new LEA if he moves. It there is an accessible school in this new area will there be a system by which that child can be derecorded? And what happens to the record once a child leaves school and moves on to higher education or into employment. Is it going to follow him through the rest of his life?
Recording establishes two classes of handicapped children and two classes of parent. Parents of recorded children will have fewer rights and more obligations because they will be obliged to submit their children to the multi-disciplinary assessment. They will not have access to the professional reports lying behind the record, and, as my noble friend Lady Masham said it is vital that they should, because only thus can possible errors be corrected; professionals are not infallible, as many parents of handicapped children know to their cost. It is interesting that the United States Education of All Handicapped Children Act gives American parents the right to examine all relevant records and reports.
There appears to he no procedure for appeals against a decision to record a child (paragraph 57), only against his subsequent placement. Can the Minister clarify this point, because I do not think she 86 said anything about this in her speech? Moreover, if the parents appeal over a placement and the appeals committee decides in favour of the parents and against the LEA, the Committee's findings will not be binding on the LEA but only "in the nature of a recommendation to it" (paragraph 58). Admittedly they can appeal to the Secretary of State, but I feel that few parents will have the conviction and determination to pursue a complaint this far.
I shall touch only very briefly on the extremely important areas of further and higher education and teacher training. I think the noble Lord, Lord Renton, is going to be dealing with this, and the noble Duke has already mentioned it. I very much hope the reference in paragraph 34 to concentration and rationalisation of facilities will not lead to segregation, nor to a limitation of the handicapped person's choice of courses and universities. They, like every other student, should be allowed to base their choice of university on the nature of the courses offered.
If paragraph 52 means that the Government intend legislating to make it a duty to provide for the needs of handicapped students in further education, that is something I warmly welcome. I regret that the Government do not accept Warnock's recommendation to introduce a special educational element into adult training and day centres. I think that is something which would be very valuable to mentally handicapped young people.
I do hope the Government will encourage the training of disabled people as teachers, because it is very helpful for able-bodied children to come to understand handicap. And also it makes handicapped children realise that they can grow up and lead useful lives when they are adults. I am sorry that the Government do not make a reference to the Warnock Committee's recommendation to encourage special schools to act as resource centres to local ordinary schools, because that is something which would not cost anything and would improve integration, and I think it would give very important boost to the special schools and their staffs, because at this time many of them are uncertain and anxious about what their future role will be.
There are some extremely good special schools with excellent teachers and a high standard of education, and very many of my friends have been educated at them. There are, unfortunately, many which are not so good, which are insufficiently demanding educationally and are socially isolating. This problem was very vividly illustrated in an article in The Times last year by the mother of a severely handicapped boy of 10. At four his IQ has been judged slightly above average by educational psychologists, who recommended that he went to a normal school. The LEA insisted that he went to a special school, but the mother was assured that the educational standards were exactly the same as in an ordinary school. She has since discovered that the school day is shorter, no child takes anything higher than CSE, no science is taught, and children remain in the same class for several years because there are not enough staff. The atmosphere, admittedly, is extremely happy and she and her son are very fond of the teachers. But—and I quote—Recently I was summoned by an ILEA educational psychologist and told that my son's IQ is now below average and that 87 I must expect it to drop further as he continues through the ILEA system. He told me solemnly that it had been 'artificially high' before because my son came from an 'advantaged' home. The advantage of my son's home is that he has an educated mother and sisters. There is also the disadvantage that his father is dead and that he has an overworked mother".The writer adds that her son's biggest disadvantage, apart from his handicap, is that he has become socially isolated by his special school, and his IQ failure lay apparently not in reading or maths but in "social knowledge."
In an article in The Times Educational Supplement last September, Professor David Kirp of the University of California, Berkeley, ended his assessment of the White Paper with the words (this is talking of the Government proposals):They will encourage the petrification of the very worst of present tendencies in present practice, notably the distinction between regular and special education itself".If that is so, we shall have made a mockery of IYDP and its aim to further the participation and equality and integration of disabled people. I am sure no one, least of all the Minister, wants this to happen. We shall be legislating for the future, so we really must get it right. I hope that when the Bill on special needs in education comes before this House, you will bear in mind both the spirit of the United States Education of All Handicapped Children Act 1976 and also the cry of the mother of that 10 year-old boy, who asks: "Who is to say whether his IQ at four was 'artificially high', or whether it is now 'artificially low'"?
§ 6 p.m.
§ Baroness Phillips
My Lords, I shall not intervene at any length because I know that so many of the speakers have covered a marvellous amount of ground and, indeed, those to follow me will also do so. However, I should like to congratulate the noble Baroness not only on the quality of her speech, which we have come to expect, but on her cleverness at getting this debate at the beginning of the launching of more caring for the disabled.
I was on an Any Questions panel in the Cheshire Homes, and some of my friends from there are here this afternoon. Rather ironically they cannot all come in at once because we have not the facilities. Therefore, they have to come in in turn. Perhaps some more benches should have been taken out to add to the Cross Benches. During the course of the questions that were raised, one of the distinguished panellists, who shall be nameless, said that he did not believe in the year of anything. I am afraid that I totally contradict him: I do believe in the year of any subject that we like to bring forward as a launching pad for what is to happen.
People do forget, but equally campaigns do succeed. There are more people who do not smoke today than there were 11 years ago. Indeed, there were not as many people drinking and driving this Christmas as previously. None of that kind of thing would come about unless notice was brought constantly before the general public. That is how I see the Year of the Disabled: it is a start for what is to come later. What we hope to get from something of this kind, from its aims and objectives, is information, education and, 88 most of all, action.
I remember the excitement when the Chronically Sick and Disabled Act was passed in this House in the dying days of the Labour Government. It was introduced into this House under the very imaginative sponsorship of my noble friend Lord Longford. It was an exciting Act, because it enabled local authorities to do certain things that they had not been charged to do previously. Sadly, because we wanted to get the Bill through, many of the clauses that should have been mandatory were not, and that is why I think we are now seeing that so much of it has not been implemented. So perhaps the Year will bring at least something as regards that Act and we shall now see certain clauses being implemented. The noble Baroness who has just spoken has drawn attention very ably to certain matters in that connection as well as others.
Another reason for my intervention is that I had the privilege and pleasure of being a member of the working party under the noble Earl, Lord Showdon—whose work again has been so imaginative, remarkable and sustained—and from which came a remarkable report. May I ask that in this Year of the Disabled most of the suggestions in the report be implemented? Some of them will not cost any money at all, and that is a very important point.
As I have said before in this House, my husband had a right-sided stroke and certain adaptations had to be made in the house, none of which inconvenienced the ablebodied people who subsequently lived in the house. So the adaptations that are made are often very simple and certainly not costly. In my view, whatever the form of the disablement—and we are obviously talking about all kinds—I suspect that what these folk want most of all is to be accepted as people in the community; in other words, integration. Integration is made of very simple things. Human dignity is made up of very simple things. My mother died last year at the age of 97. I recall that she was active to the last in every way. She kept everybody in order and perhaps that is why the Almighty did not call her before! I recall that on one occasion she was having a chat with her great grandchild. Her great grandchild said to me afterwards: "She kept her dignity to the last, she was always able to go to the bathroom". That is what mobility is made up of—very small things which make all the difference as regards independence and having a dignified and sensible life.
After my broadcast I had, as I am sure most of your Lordships have had, a host of marvellous letters from people with various disabilities asking if they could be helped. I could have read a very large number to your Lordships, but I shall not do so. However, I will select one, because I think it highlights the kind of problems that arise.
The letter is from a young man who said that he had requested help only once and that was to alter two difficult outside steps. He went on to say that after months of telephoning the office, and great assistance from the Citizens Advice Bureau, he received some visits as follows: first, from a field worker; then a visit from a field worker and an administrative staff; then a visit from three administrative staff; then a visit from one administrative staff and one workman, at which point he said he thought that he was getting on. Then there was a visit from a workman who did not bring 89 any tools. There followed a visit from two workmen who disappeared for three weeks; then a visit from one workman plus a driver who delivered some sand and cement; and then a visit from two joiners. It is rather like the 12 days of Christmas! Then he had a visit from two joiners plus a builder. That was followed by a visit from a builder's forman; and then a visit from a woman to inspect the work. Four months later, after three months of telephone calls, another administrative staff arrived. Then two men arrived with a small rail which they did not fix. The remainder of the bannister rail still remains not erected and the final inspection has to be completed. The time taken was eight months and the estimated cost to date is £1,000.
Can your Lordships wonder that somebody with a disability does not ask again? I use that as a classic case because I would like to feel that it is unusual, but it is not. Even the noble Lord, Lord Rhodes, has told us of the kind of treatment which he received. Mind you, there are moments when I could regale the House with that kind of story of what happens to any one of us if we ask for something. However, the alteration would make all the difference to this particular person.
One of the aims and objects which the noble Baroness outlined was the promotion of all national and international efforts. We have heard about all the different societies for those who have disabilities. I should like to mention the societies which are doing something for the disabled. My own Keep Fit Association is forming classes for the disabled. They will not end at the end of the Year, they will go on. The Association has raised £37,000 from sponsored swims which it presented last year because it said that it wanted to be ahead of the Year for the Disabled so that the disabled could have it in the Year. The money was given to the Riding for the Disabled. I would say, in the old theatrical parlance, that there was not a dry eye in the Albert Hall when I presented the cheque and the surgeon described the little girl of seven years old who had never spoken. Nobody really knew what was wrong with her, but she had received all kinds of treatment. They took her out and put her on a horse, and for the first time in the whole of her life she spoke to the horse. From that point on he said that they were able to cope with the nature of her disability. It was a wonderful story and showed very clearly how the most unlikely thing can bring about not only cures, but actually bring people back into the main stream.
What about industry? I find that industry is reacting in a marvellous way. The piano industry is actually offering to do all sorts of things with the disabled In fact, there is to be a marvellous invention of an electronic keyboard which people can actually use lying flat on their back. It is typical of this very warm-hearted industry—and it is not often mentioned, I think—that one of the most able teachers in this country is willing to go around and set up volunteer groups of teachers who will then go into the homes of the disabled in order to teach them the joy of music-making, which I think we all know.
There is also my own livery company; I have just become a member of the Worshipful Company of Glovers which has discovered that, of course, disabled 90 people—and I am bound to say to my shame that I did not realise this myself until it was brought to my attention—if in a wheelchair, propel it with their hands. In other words, their hands become their feet. That means that normal gloves are worn out at a great rate or the disabled have to use their hands which eventually become very bruised. They have invented a little pack which is specially for those people who need this kind of glove. This is their contribution to the Year of the Disabled, and I hope that it will be picked up.
I could go on in great detail about what is happening. It is exciting. People feel that they have a responsibility to a particular group in the community, which cannot be anything other than good. I am sure that the Minister will be relieved to know that I shall make only one comment on the Warnock Report. It is on behalf of the National Association for the Welfare of Children in Hospital, with which I have been concerned for some time. They are very disappointed that apparently the recommendation of the Warnock Committee concerning the education of children in hospital has not been picked up in the White Paper. As many handicapped children have to be in and out of hospital for long periods, they enter a plea that at least when we come to look at the legislation this very important point will be considered.
The other day I saw a small article in, rather unbelievably, I think, the Daily Mail. I particularly liked the quotation which began:Human values are quite simply the value that people put on other people".The writer went on to say:We are the most caring nation in the world—the only one in which more man hours are expended on unpaid social service than paid; the one which invented nursing and the one which put the capital letter in 'Care' itself. Our great nation must no longer rest on its laurels".
§ 6.12 p.m.
§ Baroness Elliot of Harwood
My Lords, it is with great pleasure that I take part in what I think is a very remarkable debate. Nearly half the speakers on the list have spoken; every speech has raised a matter of the greatest interest, and each speaker has made his or her contribution in a most original manner. This is a matter of tremendous interest to everyone and this International Year of Disabled People is of great importance.
Of course, I know that there are difficulties about concentrating the world's interest on a particular subject for one year. In 1960–61 I had the experience of leading the World Refugee Year appeal in this country. It is quite true that during that period we concentrated entirely on raising money for the World Refugee Year. On the other hand, all the organisations that took part in it benefited, because far more money was raised in that way than was ever raised individually, and it left behind a tremendous interest in this particular subject throughout the whole country and the world. I very much hope that the Year of the Disabled, which is every bit as important, will also provide additional finances through voluntary sources of all kinds, but also that it will concentrate the world on this vital subject, which has been so brilliantly outlined by every speaker, and that it will not only last for one year but will be the beginning of a great 91 many years during which people will take the very keenest interest in this subject.
All of us who are speaking today have had the opportunity of taking an interest and we know how vital it is. But there are millions of people for whom, to some extent, this passes by. I hope that this concentration on the Year of the Disabled will continue from one year to another and will mean that those organisations which are participating and the people who are participating will benefit tremendously as time goes on.
If I may, I should like to talk about my experiences as chairman for a number of years of local authority committees dealing with social services, which included all the handicapped and education. I should like to outline—very swiftly I hope—some of the most successful developments. I entirely endorse all those who have spoken about the importance of co-operation with voluntary organisations. I was on the local authority side, although I have been associated with a great many voluntary organisations. However, I am quite sure that a far better combination of community service comes from co-operation between the great voluntary societies, which are all represented here, and the local authorities than by saying that this is the job of the local authority only.
As chairman of the committees, I certainly found that it was immensely helpful to receive so much help from the voluntary organisations. I should also very strongly like to endorse what has been said on the educational side about integration, so that as many handicapped children and handicapped adults as possible can work with the non-handicapped. Obviously, it is not possible for all handicapped children to go to ordinary schools, but in so far as it is possible for children who are to some extent handicapped to be educated in normal schools, I think it is extremely important.
I should like to pick up one of the points made either in the White Paper or in one of the reports about the importance of having a certain number of people in ordinary schools who are trained to deal with the slightly handicapped—those who are able to be educated in ordinary schools. Also, in the ordinary schools simple aids for the handicapped should be available so that they can take part in the ordinary classroom, possibly with some small adaptations, which would be no handicap to ordinary children but which would help the handicapped child to work and carry on his education in the ordinary school.
If we must have—and we know we must have—special classes for the handicapped, it is extremely important that those special classes should be situated either in the schools or on the campuses of the ordinary schools. We should not have the problem, with which I was faced on one occasion, of a special class for handicapped children being held in a different part of the town, away from the ordinary school. When a change had to be made, it meant that the child had to travel quite a long way—perhaps a mile or a mile and a half—to another school. Fortunately, when the school was rebuilt I insisted that all special classes should be sited within the school that was to be rebuilt, so that we did not have this division. If one had, perhaps, been too optimistic and taken a child from a special 92 class and placed him in an ordinary school and had then found that that child could not keep up, that child could slip back into the special class which possibly was just on the other side of the road, the corridor or on a floor above. That passed, as it were, unnoticed. It is extremely important to try to keep special classes within the ordinary school, so that this transition can easily be made.
I also very strongly agree with the recommendation that parents should be consulted throughout the education of their children. This also has the excellent effect of the parents learning far more about the handicap of the child. It is not only the children who require education; very often the parents are longing to obtain more information and more help. I think that the teacher, or whoever is dealing with the child, should keep in the closest touch with the parents at all times. Obviously, it is the social work departments that start to look after children who are under school age and who are handicapped, and they continue that task during those children's lives. However, it is extremely important that social workers and the education departments of county councils or town councils should work very closely together. I have quite often found a division; the children moved into the educational orbit and the social work department then tended to say, "They are now outside our jurisdiction". That may have been the case during the day, during the educational period, but not for the rest of the day. Close co-operation between the local education authority and social work department is extremely important.
An encouraging feature of the last five to ten years has been the amount of pre-school work being done in many areas. Pre-school playgroups have been enormously successful all over the country, certainly in the areas of which I am aware, and it is clear that the whole pre-school movement is being successful. This is particularly important because parents as well as children are brought into the activity. That should be encouraged greatly, bearing in mind especially that it does not cost much because on the whole, the people concerned are working voluntarily. Nursery schools are important, but generally speaking they are difficult to organise. They are costly and are not always able to be established. Where it is possible to have nursery schools that is excellent, but playgroups and nursery classes are proving very successful.
The suggestion is made in a report I have read—this was mentioned by the noble Baroness, Lady Darcy de Knayth—of using special schools as resource centres. This could be valuable because while, obviously, one can have special schools or classes on a limited basis, the advice coming from such a point could provide a resource centre. For those over the age of 16 who are hoping to go on to further education, university or technical college, it is most important that as much help as possible is given. There is an organisation which specialises in helping handicapped people to go to further education and university. It is the National Bureau for Handicapped Students, an organisation with tremendous experience in this field. They have produced a paper giving a marvellous account of what they have been able to achieve without an enormous sum of money. Obviously some money must be expended, but it is very well invested because if an adolescent or youngster of up to perhaps 21 years 93 of age can benefit from further education at university, technical college and so on, the cost involved is slight compared with the cost of keeping that person for the rest of his or her life. Indeed, this is not spending money but investing money, and it is a different proposition from any other way of expending money. I strongly urge the Government to look at this type of financing as a real investment in the future which will pay hands down, for it will mean the handicapped who receive this training not having to be kept for the rest of their lives.
A couple of other points I have found extremely useful. One is the establishment of boys' and girls' clubs for both the physically handicapped and the non-handicapped, places where both can be brought together in their leisure time. One organisation helping to bring adolescents together in this way in their leisure time is called FAB. They have some wonderful achievements to their credit and, again, this is a wonderful form of investment.
I was responsible, with the help of the noble Lord, Lord Wells-Pestell, when he was at the Ministry of Health, in starting a college called Prospect Hall in Birmingham for the training together of handicapped and non-handicapped adolescents and adults. Originally we were hopeful that it would be run by volunteers, but the organisation was found too expensive. It has now been taken over by Birmingham's department of social work and is being run extremely well by a person of real genius who is doing a wonderful job by providing that sort of integration. Not only that; the people at Prospect Hall College are being so provided with equipment that they can be trained to live outside and to look after themselves.
Birmingham has been very imaginative in this respect. They have provided equipment in this college which enables severely handicapped persons to learn to live by themselves and thus be independent. If it is found that such a person can live independently, a flat or house will be equipped in Birmingham and, having received such training at the college, the person can become independent. Authorities are criticised for not doing enough, but I cannot praise sufficiently highly the imaginative way in which the social work department of Birmingham has operated this scheme and for the money invested so that people can, having learned the various techniques, live on their own, when in the past they would have thought they could never live independently. This idea of special flats might be taken up by other local authorities, particularly the London boroughs and big towns. I hope that noble Lords present today from other areas will encourage this type of development, so helping the handicapped to be independent.
I also hope the Government will consider the need to have a sufficient number of teachers and therapists to enable young people to be trained. Indeed, this applies to training at all ages, because we need to ensure that the teaching is done at the time when those concerned are prepared to learn. It is vital that people are taught in the educational years of their lives, as it were; it is no good putting it off simply because one does not have the right therapists or teachers in the special type of teaching that is required in particular cases. If it is put off, the chances are that the age of learning will have passed and that that type of 94 education will no longer be possible. I am told that in Scotland a number of occupational and speech therapists are being made redundant. If so, and if we are in need of therapists elsewhere for the handicapped—for the autistic, the spastics and others—it would be better to invest money to teach those children now rather than put it off. If this educational opportunity, in the years when they are ready to learn, is missed, that learning period will have been lost for ever in their lives.
I do not speak without a realisation of the Government's many problems, but I hope that they will be very selective in the way in which they decide to stop doing one thing and do another instead. I believe that in this particular category of work it is important to select the really vital matters at a certain time in a child's life and possibly not give them so much when they are a little older. This must be done on a very selective basis. I hope that the Government will do this; I am sure that they will, because obviously they are well aware of the problems. It is extremely important that we concentrate on the timing schedule and on the way in which people can be trained at a certain period. If that period is missed, it will not be possible to make it up later.
I should like again to stress what I think has been mentioned by others—namely, the great importance of day centres for very severely handicapped people and for old people, too. Families can be helped where it is possible for people to spend a period of time in a day centre. This provides some relief in the home. It is an extremely successful arrangement and is well worth pursuing. I should much rather see day centres and sheltered housing than large establishments, with people all living together, never getting away from one another. It is far better that people should remain in their own homes or be independent in some other way, rather than go into old people's homes or other residential establishments. I realise that some people have to live in residential centres, some of which are marvellous. But I believe in the principle of independence, whether it is for the old or the handicapped. That is of enormous importance.
I very much look forward to the Government Bill which is based on all the various recommendations and on the Warnock Report. I am full of hope. I believe that excellent things have been done in the last few years. The reports that have been issued have been vital and most important. I know that the Government want to do all that they possibly can, and in the noble Baroness, Lady Young, we have an experienced person, one who really understands the subject. I believe this debate to be most important and I hope that from it, and from the Year of the Disabled, there will arise a real concentration on all these problems, the solving of which is so vital to the whole world.
§ 6.33 p.m.
The Countess of Loudoun
My Lords, I, too, welcome this International Year of Disabled People and join with other noble Lords in hoping that the efforts made during this year may help, no matter in how small a way, to change the attitude of many members of the public today towards the disabled—both the physically disabled and the mentally handicapped. I hope that 95 the latter group, the mentally handicapped, who cannot speak for themselves, will not be forgotten.
The International Year of Disabled People offers the whole community a chance to reshape its attitude towards the handicapped who belong to it. It is an opportunity to counter the isolation of the disabled by acceptance of their weaknesses and strengths. It is a time to work with the disabled rather than for them. Many healthy people are nervous of the handicapped. They are reluctant to mix with them and often would secretly prefer to forget all about them. In ignorance of the unknown, and sometimes in fear, the positive contribution which the disabled can make to our society is mostly overlooked.
In the past handicapped people have been segregated from society, closed away in large institutions. This is now recognised as not being the best way of fulfilling their needs. Education in its broadest sense is vital if mentally handicapped people are to gain any freedom and self-reliance for themselves. All children have the right to receive education, and more and more people now believe that those with handicaps should receive an integrated education with those who are not handicapped, though it is my opinion that there will always be some who, because of the degree of their disability, will need to be educated in a special school. But the onus surely should be on the providing authority to prove that integrated education would not be in the interests of the individual student, when it has been requested by the parents.
That brings me to the important role of parents in deciding their children's educational needs. This was stressed in the Warnock Report, and I feel that consultation with parents should be compulsory. But to enable parents to make an informed choice, access to information is of vital importance—information on facilities, services, physical lay out, et cetera—though I appreciate that some information may have to remain confidential.
At the moment parents have no rights in terms of whether or not their child is to be "recorded". They can express their preferences about schools, but the final decision on all this is left to the local education authority. The wishes of the parents are of the utmost importance in the education of their children. Parents need guidance and advice, and are often confused by the variable nature of services. It is essential for the mentally handicapped to have a key figure who could give them this guidance and advice, and it is unfortunate that the White Paper has rejected the idea of the institution of the "named person". That would have increased significantly the parental involvement.
A family with a mentally handicapped member has the same needs for general services as have all other families; but these families also need additional special help, and this varies from family to family. However, this additional help must be given within the community where the family belongs and should not be provided in specialist hospitals remote from the areas they serve. Official statistics show that the total number of people resident in mental handicap hospitals has diminished somewhat in recent years, but I have been given the figure for 1977 of approximately 4,000 children still in these hospitals. To those of us concerned with the welfare of mentally handicapped 96 children it seems quite wrong that there should be anything like that number who are living permanently in long-stay mental handicap hospitals, though short periods of treatment there might from time to time be necessary for them. Will the Minister please confirm for me the figure of approximately 4,000?
To conclude, the present situation is confused, with thousands of mentally handicapped people in hospital but not needing to be there, and others living at home or elsewhere in the community, but not receiving the help and support that they need, and who may be more severely mentally handicapped than many people in hospitals. It should be noted that Professor Peter Townsend of the Disability Alliance has estimated that 97 per cent. of all additional resources for mental handicap in the past 10 years have gone into the hospital services and only 3 per cent. into community services, despite a growing commitment to the concept of community care. This International Year of Disabled People will, I hope, give us the impetus to take a bold step forward, despite all our problems, in the provision of care for our handicapped, and I wish it well.
§ 6.40 p.m.
§ The Earl of Radnor
My Lords, like other noble Lords I, too, should like to congratulate the noble Baroness, Lady Masham of Ilton, on bringing this subject to our notice and on making such a thorough speech. I should also very much like to congratulate the noble Viscount, Lord Mersey, on his first speech in your Lordships' House. He showed great eloquence and a wide range of knowledge, and I hope, as I am sure all your Lordships do, that he will join us often and speak on a number of subjects.
My Lords, the subject of education and learning disability is obviously of tremendous importance to our society, dealing, on the whole, as it does, with the young; and it has recently been reviewed extremely thoroughly by the Warnock Committee. If I were to criticise this debate so far at all, I would criticise it for not enough acknowledgment being given to those who worked on the Warnock Committee, which produced that enormous book and that quantity of recommendations. A tremendous amount of work must have gone into it. The Government are now to follow some of those recommendations, and legislation is apparently on its way. Furthermore, of course, as many of your Lordships have mentioned and as is in the Motion, this is the Year of Disabled People.
My Lords, we have had Years for this and that—none of them, perhaps, quite as important as this one—and they sometimes pass by and are soon forgotten. But, like many of your Lordships, if not all of us, I suppose, I hope that this concern for disabled people will in fact endure well beyond the confines of 1981 and will in fact, as many people have said, be a kind of launching pad rather than an entity in itself. I also hope that when the law on special education is finally enacted, it, too, will be thoroughly effective and will persist and be useful for at least a decade or two. It is of vast importance to the future wellbeing of the country that we should all take great care, now that we have had this review and report, to get it absolutely right, or as right as we possibly can.
My Lords, I was going to concentrate (and I still will, if I may) on the White Paper on Special Needs in 97 Education, but having listened to Lord Wells-Pestell talking about the slope on one side of the road and the precipice on the other—and, of course, walking-stick people like myself always think that it must be the same on the other side, so we fall flat on our faces—there is one point that I have noticed that I should like to bring up in your Lordships' Chamber, and it is not a facetious one. Over the last few years there has grown up in our traffic system traffic lights on which, when you press a button, a sign says either "Wait" or "Walk". I have become more and more convinced that what it should say to people who are not quite hale and hearty, and possibly to the elderly, is "Wait" or "Run like mad", because it always turns back in favour of the motor-cars before you have quite reached the other side. I think it would probably cause no trouble at all to adjust a little screw, perhaps, throughout the country, so that while by all means giving the cars longer turns as well, it might be possible to give us a longer turn also.
As I said, what I really wish to talk about—and I shall not be very long about it—is certain aspects of the question of learning disabilities, and I should like to touch particularly on the question of dyslexia, which, I am very sorry to say, has been to a very large extent left out of the whole pattern of special education in this country in the way that it has been directed by local education authorities. In talking of dyslexia, I must declare an interest in that I am president of the Dyslexia Institute, which is a charitable body which teaches people suffering from this disability; and the mere fact that that charitable body has to exist to teach these people, and to train teachers in the special, multi-sensitive ways that they have to be taught is a commentary on the situation I have described.
Before I go further, I should like to say that I feel that the White Paper points the way to an improvement in the existing law dealing with special education—I think "points the way" is the operative phrase there—but I have a number of reservations which I should like to make, and possibly one or two suggestions. My main fear regarding the White Paper is that, although it sounds all very good and extremely sensible, and although it embodies what I would call the Warnock Committee's new approach to children who have difficulty with their education, it does not seem to be stringent enough to ensure that local education authorities carry out in practice the spirit that is within the White Paper itself. I think the most reverend Primate used the word "vague", and I see that I have written down "woolly" and have crossed it out again. I think it is important also that we should keep in front of us the backdrop against which this White Paper is written. I do not mean this in any party way because it goes back ages, but it is not a great success story because I believe that 10 per cent. of our school-leavers leave having a reading age of nine years or under, which, although it is a reading age, is a very poor performance.
I must admit that I am pleased that the categorisation of children is to be abolished and replaced by this new approach of the Warnock Committee. The categorisation was insufficient, anyway, to cover all the needs that could arise, and often did arise, and I believe it was essentially the wrong approach. However, I am now worried that since there is to be no categorisation at all, an excuse might well be furnished for local 98 education authorities to ignore certain disabilities which perhaps they do not have the skilled staff, the funds or—and I do not say this in an unpleasant way—the inclination (the belief would perhaps be a better word) to deal with. I should like to feel that the children are dealt with as individual cases exactly as described in the White Paper, but would it not be possible perhaps in the form of a schedule or an appendix, or some vehicle of that sort, to keep the categories and to add dyslexia or other categories to them, because I think that with consultation the others should be there. I have a feeling, arising from the Chronically Sick and Disabled Act 1970, that even though dyslexia was noted there in a rather strange manner it had no effect on the situation of the children suffering from that disability. I feel that if it is not even mentioned then, really, this situation where nothing is happening at all will continue, one sometimes feels ad infinitum, despite all the work done by the British Dyslexia Association and other agencies.
My Lords, I realise that this is what might be called a belt and braces approach, keeping the best, perhaps, of the old, or part of it, and putting it at the back of the book, and taking the best of the new, but I think it is immensely important that local education authorities be really obliged to deal with all children and all disabilities. I think there are other areas where local education authorities might also find it a little easy not to follow the spirit of the White Paper. I appreciate that we are dealing with a White Paper and not with a Bill, but when the Bill does come along I think it will be very important to look at the whole question of the availability to parents themselves of professional documents relating to the assessment of children, and indeed to any facet of their educational life. For myself, I can see nothing but trouble, and even mistrust, arising from the suggestion that certain professional assessments of the child should not be available to the child's parents. Surely, if parents had a child that was sick they would want to know everything about it, and I see an exact parallel in an educational disability. I personally can see absolutely no reason at all why there should be any secrecy in the matter whatsoever, even if it be delicate, embarrassing or whatever you like.
I hope that when the Bill comes forward we might be able to look at this area. I have spoken longer than I meant, so I will not dwell too much on the next point. I am very sorry—and I have heard this so often—that the named person concept is not going to be entertained at the moment. One hears of people worried about their children, their future and their disability going to talk first to one person and then to another and never getting satisfaction. It is a matter of trust. If there was a named person it would reflect well on the local authority because it would save them an immense amount of probably unnecessary and unfair criticism and bother. I think that, so far, these suggestions would not cost any money; but I believe that they would all bear looking at closely and might enhance the situation as it exists now and as exists in the White Paper.
I should like to return to the question of dyslexia. This disability was mentioned in the famous, or infamous, Section 27 of the Chronically Sick and Disabled Persons Bill, where the local authorities were 99 exhorted to do something about this condition. It was not mandatory. I made my maiden speech partly on that subject and got the point out—I am sure badly. In fact, experience has shown—my experience has shown; and it has been reasonably wide as I was for five years chairman of the British Dyslexia Association—that to all intents and purposes nothing at all has been done about this block of children. It is quite a large block of, I think, some 24,000 school-leavers a year and it is worth taking a little trouble over. I do not quite understand how, if nothing has happened so far, anything will happen to these children if a very strong obligation is not put upon the local authorities.
There is another matter concerning them. There has been a lot of talk about funding and that sort of thing. I think that all of us (and I, certainly) appreciate that there is not likely to be a great deal of money going around to spread here and there. What I do not understand (and I think I can declare my interest as president of the Dyslexia Institute) is that the institute, which has been visited by the Department of Education and Science a long time ago, now has centres in quite a lot of important towns—Birmingham, Leeds, Sheffield, Harrogate, Staines and so on. We train teachers in the skills necessary for these particular children. We are available there as a service to the local education authorities. They would have to pay a fee like anyone else to take a child from their school and send it to us for so many days; but they do not—or, at least, they do so only in very rare cases—take advantage of this facility. I should have thought that in times when money was short and where there was this terrible lack of education this would at least be a small way in which local authorities could start dealing with this problem which, in my opinion, they have misinterpreted very often and for a long time. I think that they have misinterpreted it in all the ways that many of us know, in assessing the children perhaps wrongly and getting them in the wrong category—which is a double waste, a waste of child and a waste of money as well.
I have spoken for long enough. I should like to end by reiterating that I think it is certain that, however the law is framed, there must be some way in which these children are dealt with. To get back to the money question, I do not believe it would be very expensive to deal with these 24,000 school-leavers a year. It would take a little time; it is a new element; it has not been dealt with before so, presumably, it would take some money. But the connection between illiteracy, delinquency and crime is well known and earlier today at Question Time we heard a little about the expense of the prisons and so on. I should like to suggest to the noble Baroness that a little money spent in the short term would come back tenfold in the medium term by saving all the social troubles that stem from children who are frustrated and not taught properly.
§ 6.56 p.m.
The Earl of Halsbury
My Lords, my interest in this subject, for the debate on which we are all grateful to the noble Baroness, Lady Masham of Ilton, has been progressive with the years and has marched in parallel with the progressive disablement of my wife. She has wisely followed the example—may I call it the 100 shining example—of the noble Baroness, Lady Masham of Ilton, in identifying herself with her fellow handicapped and doing what she can to help them specifically by being chairman of our local branch of Arthritis Care. I represent the back-up facility that she draws upon for the necessary access and transport to the meetings of her fellow arthritics, with the result that I regularly sit in, as a sort of fly on the wall, on meetings of arthritics who are trying to help one another and I am acutely aware of the problems they face and how new problems can swim into their ken. For example, to draw on something which I think the noble Baroness herself said recently, the modern practice of having self-service petrol stations is a very severe barrier to handicapped persons in getting supplies of petrol. Does it occur to any petrol station that is going in the direction of self-service to put up a notice saying, "The nearest non-self-service garage will be found at so-and-so"? Can anyone imagine one shop sending a customer to another shop? It is not in human nature to do it. It is astonishing how little co-operation people give to this sort of problem. They do not even recognise it.
In selecting a particular topic to speak about, one which much concerns me and which hinges naturally on to the speech made by the noble Earl who preceded me, I have in mind a dictum of the late Lord Marples when I was serving on his National Transport Advisory Council. He said to me that the only important problems and the only difficult problems have this in common: they are always interdepartmental. The educational problem of children who are handicapped with respect to the quality that renders them educable is of a different order of difficulty from the problems of access and transport which are usually the keys to most problems that need solving in the case of the handicapped.
I am going to refer only to those problems arising from language difficulties and in particular those requiring the services of speech therapists. How many children at school have been told at some time that they must concentrate, that they must try harder, that they must work away at the problems of learning to read and write; how many of them have been told that they are lazy because they do not learn to read and write, when all the time they are suffering from a clinical condition known as cross-lateralism which is preventing them from recognising the difference between a letter and its mirror image? That is rather a mouthful; but just as most of us are right-handed and have a master hand in the context of manipulation, so we have a master eye. If the master hand and master eye are co-operating, you learn to read and write easily. But if they are not, you learn to read and write only with difficulty. Those difficulties can be just as discouraging for the dyslectic as it would be for a colour-blind learner-driver to be failed time after time because he could not do the right things at the traffic lights. The speech therapists cuts across the departmental boundaries of education and health, and speech therapy is just as much relevant to dyslectic children in an educational context as it is to brain damage and therapy, be it from a stroke, traffic accident or whatever it may be.
May I first ask the noble Baroness whether, as a contribution to the International Year, she will add 101 the weight of her Ministry to that of the Department of Health and Social Security in seeing that the importance of speech therapy does not fall between two stools? Secondly, will she remember that this International Year coincides with a reorganisation in the Health Service and that in any such reorganisation it is always the inter-departmental activities that tend to get paralysed at the interfaces? Will she tell us what positive steps she will take to see that this does not happen during the present year? Watching it needs to be made someone's special responsibility.
I first came across the importance of speech therapists six years ago when the then Secretary of State at the DHSS, who was then Mrs. Castle, asked me to take the chair over a series of inquiries into the pay of nurses, midwives, the para-medical professions and the speech therapists who were out on a limb by themselves. I found the speech therapists a small, isolated profession, whose members needed the capacity for abstract thought characteristic of an honours degree coupled with the patience of a child educator, coupled with the compassion of a nurse. In contrast with the paramedical professions, they did not work under the supervision of a doctor; they were responsible for their own diagnosis, for their own therapy, from beginning to end. I found them at that time under-paid and under-recognised. They reached the point of no return where they could earn through their native wit more outside their profession than within it. They were leaving it in very large numbers.
They no more lent themselves to the kind of hierarchical structure where one's pay depends upon the number of subordinates that one has than a barrister or a consultant surgeon. They practise as individuals. The whole pay structure failed to recognise their problems. I left them properly paid and properly recognised, but I left the Secretary of State with a warning that they would go back unless the situation was watched. It was not watched, and they have gone backwards towards the situation in which I found them five or six years ago. They have lost ground from the pay point of view; and so far as recognition by the Clegg Report is concerned, all I can say is that it was not helpful.
In raising this matter of the speech therapists, which is highly relevant to what has been said this afternoon, I should not like it to be thought that I have forgotten the problems of other protégés of past years, the nurses and the midwives on the one hand and the para-medicals on the other. I have for nearly 60 years suffered from a slipped disc attributable originally to a football accident, but to many other incidents since. I know what it is to make straight for the nearest physiotherapist if I want to continue to lead an active life following the local slippage of the day, whatever it may be, and without physiotherapists I am quite certain that there would have been many occasions when I would not have been here with your Lordships.
§ The Earl of Longford
My Lords, when the noble Earl first acquired that 60 years ago it was not called a slipped disc. It was probably called lumbago. Does the noble Lord think that the slipped disc is just a new-fangled invention?
The Earl of Halsbury
My Lords, there was a field game at Eton called the under-14½. If the noble Lord is ignorant of that I will tell him about it after the debate, but I should not think that the rest of your Lordships would be interested in the precise technical details in which—as I was told in after years—I had slipped my disc. It was just called a bad back in those days and, later on, lumbago.
My Lords, currently I have promised such help as I can to the fund-raising activities of a body called the Invalid Children's Aid Association. They need to raise £1 million for their purposes. What are their purposes? They are multifold, but they are heavily concentrated on what I have been talking about. One might almost say they are nucleated around the problems of speech therapy to which speech therapists contribute so significantly. I mention this because it would be so easy if an organisation calling itself the Invalid Children's Aid Association came to the attention of the noble Baroness. She might so easily think that it meant measles, mumps, chicken pox and whooping cough, whereas in fact it is largely speech therapy, dyslexia, and so on. I think that is the point at which I should conclude what I have to say.
§ 7.6 p.m.
§ Lord Renton
My Lords, the noble Baroness, Lady Masham of Ilton, deserves our praise and thanks indeed for having initiated this debate. Not only that, she does so for all that she does for the disabled, including the mentally handicapped. I know this because I happen to be chairman of the National Society for the Mentally Handicapped—MENCAP for short. May I say that I am delighted that on the Opposition Front Bench the debate is to be wound up by the noble Earl, Lord Longford, who was the first chairman that MENCAP ever had, and that my predecessor, the noble Lord, Lord Segal, will be speaking a little later in this debate. Incidentally, I was delighted that one of our patrons, the most reverend primate the Archbishop of Canterbury, made such a helpful speech from our point of view.
I am sure that the noble Earl, Lord Longford, will take it from me, for I became chairman of MENCAP nearly three years ago, that the present Government have been at least as helpful and encouraging to us as the previous Government were. I am glad to say that we have had good relations with Ministers from both sides of the House. I am grateful to the noble Baroness, Lady Masham, for drawing attention in the Motion before the House to the pressing need for educational facilities for handicapped children. I should like to join with my noble friend Lord Radnor in praising Mary Warnock and her colleagues. They have produced a report so far unique in this century—an exceedingly valuable report.
As the noble Baroness, Lady Masham, pointed out, in paragraph 20 of this report we find some figures which your Lordships may consider surprising; namely that nearly two-thirds of handicapped pupils in England and Wales—certainly in January 1979—had the disablement of mental handicap. That is sometimes a factor which is overlooked. We think so much of the other handicaps, and it is right that we should do so; but two-thirds of the handicaps suffered by children and young people are mental handicaps; and of course 103 some of those, like our own daughter, have physical handicaps as well.
Most mentally handicapped pupils can be taught enough to lead more or less independent lives, as my noble friend Lady Elliot of Harwood was saying. But they need to have a start made in their education and training when they are very young, well before school age of five years, and it needs to be carried right on certainly until they are 21. Some of them can even be trained to earn their own living by that age, and we in our national society are pressing on with our "Pathway" schemes, which we are finding increasingly enable young people to enter employment. We have had good co-operation from many employers in this respect and from the Department of Employment. It is surely an advantage not only to the mentally handicapped themselves and their families, but also to the Treasury and the taxpayer, that these young people should be educated and trained to be as independent as possible. Money spent on that is money well spent. Indeed, as my noble friend Lady Elliot pointed out, it is money invested for the future; and so failure to spend it is, as my noble friend the Duke of Buccleuch said, false economy.
It is with those principles in mind that I should like to refer to some of the serious omissions from the otherwise positive proposals in the Government White Paper on Warnock. May I say that we welcome the proposals so far as they go, apart from some reservations of detail, referred to, for example, by the noble Baroness, Lady Darcy de Knayth. Unfortunately, those omissions relate to matters which Warnock described as "three areas of first priority". Although they have been referred to, I think it is helpful to refer to page 336 of the Warnock Report, where they are set out and summarised. First, there isProvision for children under five with special educational needs",and in particular they refer to—A substantial extension of nursery education for all children".The second provision concerns young people under 16 with special needs. Here is a case which needs clarifying under the present law, and perhaps my noble friend the Minister of State will be so good as to deal with this if she has time. I understand from a recent report in The Times, that the present law obliges local education authorities to provide further education for all young people between the ages of 16 and 19, whether or not they are mentally handicapped. If that is so, this is already an obligation, and one which should be by law fulfilled though admittedly the cost will fall upon local education authorities. The third area of special priority is teacher training, and especially—the inclusion of a special education element in all courses of initial teacher training".These matters are fundamental, because nearly all the other proposals in the report—proposals which the Government accept—depend upon those three objectives being achieved. If they are not achieved, we shall to some extent, when the Bill comes before us and passes into law, be enacting a dead letter—and that is something we should try to avoid.
104 The Government say that resources are not available. Like others who have spoken, I support the Government's appeal for reducing public expenditure; but let us get a sense of proportion about this, for in this financial year we shall be spending altogether on education and science, health and social security, £38,000 million. I say to the noble Lord, Lord Wells-Pestell, that that is not a niggardly provision. It is about £700 for every man, woman and child in this country. But the question is: Is all that vast sum of money well enough spent? Have we, as my noble friend the Duke of Buccleuch asked, got the priorities right?
We have to consider this. There must be scope for finding the relatively minor sums required to enable the three areas of priority under Warnock to be achieved. Let us hope, therefore, that the Government will have second thoughts about those three matters. But in any event, whether or not they find themselves able to do so, I say that the money will have to be found sooner or later. Therefore, to the extent that legislation is necessary to implement those three areas of first priority, I trust that my noble friend will see to it that the necessary power is included in the Bill. It may not be totally necessary, but to the extent that it is so it should be included—because it would create the most awful frustration in a few years' time if we then had to press a Government of whatever complexion (and perhaps take several Sessions to do so) to introduce a much shorter Bill than the one we shall have before us. We do not want two bites at this vital cherry. We want to do it all at one go.
I should be grateful also if my noble friend could tell us what the Government propose to do about two other important Warnock recommendations. They are to be found on page 179. The first is this:that there should be a specifically educational element in every adult training centre and that the education service should be responsible for its provision".There is a very patchy performance throughout the country over this particular matter. In some training centres, which of course are run by the social services, the local authorities are being very helpful and good. Others say, "We can't afford it". We want to know what will be the Government's attitude and advice to local authorities on that recommendation.
On the same page, it is recommended—that local educational authorities should provide programmes of continuing education to meet the individual needs of young people who require long-term hospital care".It would be a tragedy if, just because a child or young person has a very long illness or a physical disability requiring long attendance at the hospital, their education should be neglected, because they may recover one day—as we hope that they would—and then it would be important for them to have been educated to the extent possible in each case, to enable them to lead an independent life. So may we have the Government's comments on those two proposals?
In conclusion, may I say this—because reference has been made to what voluntary bodies can do—that MENCAP, like RADAR and other voluntary bodies, are celebrating this Year of Disabled People in various ways. Our main concern in MENCAP is to see more small and medium-sized residential accommodation provided, so that mentally handicapped people can live within the community instead of in large institutions. 105 We shall hope to play our part. May I say that we welcome the Government's offer of a pound for every pound that we subscribe, up to a million pounds a year. It will not take us as far as we should like to go, but it will be of some help over the next three years. Naturally, we shall respond as rapidly as possible and, if we do respond well, I hope that the Government in their turn may respond further.
§ 7.18 p.m.
§ Baroness Fisher of Rednal
My Lords, I, too, should like to thank the noble Baroness, Lady Masham, for giving us the opportunity of taking part in this debate today. As previous speakers have said, what a variety of matters has been raised in this debate! Practically all aspects of disablement have been brought forward. I was particularly interested in what the noble Lord, Lord Renton, said, because my three main points on the White Paper are exactly the same as those which he has just raised.
But before going on to discuss those points, I should like to follow on what the most reverend Primate the Archbishop of Canterbury said about those children who are in hospitals for the mentally handicapped. I agree that since the passing of the 1971 Act, there has been a substantial degree of progress in providing school facilities in those hospitals. But I want to draw the attention of this House once again to the fact that inside hospitals for the mentally handicapped there is a great need for advisory teaching services to be made available for the visually handicapped.
Today, most handicapped children do not have just one handicap. They are born with one, two or even three handicaps, and many visually handicapped children are likely to have more than one handicap which is affecting their development; very often, it will be mental backwardness. So what is required in hospitals for the mentally handicapped is expert assistance and assessment by people working as a team, which should include specialists of all types who are capable of measuring a child's assets and defects, in order to enable the child to achieve its true potential, which in many cases will be very limited.
While acknowledging the progress that has been made, there are a considerable number of children in mental handicap hospitals who are not receiving education. So my question to the Minister is: Will the Minister closely examine the reason why some local authorities are not providing in mental handicap hospitals something to which the child is legally entitled under Act of Parliament? To follow that up, why are so many local authorities using the current economic crisis to take education away at the 16th birthday in mental handicap hospital schools? A deadline is being drawn in this field by many local authorities, even though the teachers and the professional staff in those hospitals, as well as the parents themselves, feel that the children are benefiting.
So, in the same way as the Government, through the DoE, are compelling local authorities to do some things, they should also be asking questions of this kind, so that we know the authorities concerned. For many years—not just with this Government, but with all Governments—parents of severely mentally subnormal children have been forced to accept a very inferior 106 service. This year they must acquaint themselves with the rights to which their children are entitled, so that the children will benefit.
To come back to the White Paper, and to follow up some of the lines which the noble Lord, Lord Renton, spoke about, we find that the Government, while accepting the value of nursery education and agreeing with Warnock that an extension of nursery education is desirable, give economic reasons against any large-scale expansion. Do the Government feel justified in asking handicapped toddlers under five years of age to help to pay towards the economic recovery of the country? It is asking too much of these small children that they should contribute, when they have to bear a great burden in the future.
The Vernon Report on the education of the visually handicapped stressed that nursery education is of greater importance for the visually handicapped than for sighted children. It also emphasised the flexibility of hours that is necessary for the visually handicapped, and the early admission at two years. I think it was the noble Lord, Lord Renton, who went on to quote from Warnock, and said that it was important that young children with special needs should be able to be absorbed into ordinary nursery classes. Arising from that, there has been a great spread throughout the length and breadth of not only England, but of Scotland also, of the development of the policy of integration of handicapped children in ordinary units at nursery school level.
Very often, this has meant that local authorities have had to give extra support services, and to provide additional staff, because of the difficulties which some handicapped children face in attending to their physical needs. Unfortunately—and I am not speaking off the top of my head when I say this—research from colleges of education is showing that further development of the policy of integration at the very earliest age is now being thwarted because of the economic crisis, and this has prevented any expansion of nursery education places.
Paragraph 31 of the White Paper has to do with the under-fives and with LEAs taking advantage of Section 26 of the Education Act. It says that the Government hope. Can the Government not be more positive than just to hope? It is rather important to tell local authorities something more than that the Government hope—
§ Lord Davies of Leek
My Lords, my noble friend did not quote the next sentence, which states:But the present economic situation precludes any large-scale expansion".In other words, the whole thing is thwarted.
§ Baroness Fisher of Rednal
My Lords, my noble friend is amplifying what I am saying. Instead of the Government hoping, could they desire or request? I should like them to instruct. We on these Benches sat for many hours in discussing the Housing Bill and the Local Government, Planning and Land Bill, and there is one Minister in this Government who will demand that local authorities do a lot of things. I should like to see the Department of Education doing a little more than hoping.
107 We have many times debated the problem of the unemployed school-leaver and the need for a handicapped child to have full-time education in a special school. Handicapped school-leavers are at a great disadvantage in the employment market. I think the noble Lord, Lord Renton, explained the position in great detail and more than adequately. The termination of education at 16 years of age can be very frightening and worrying, not only for the pupils themselves but for their parents. If the 10 years of education and training which has gone into helping handicapped persons and which is beginning to show benefits at the age of 16 is cut off, it will be drastic, dramatic and exceedingly damaging. As the noble Baroness, Lady Elliot of Harwood, has said, it will also be a waste of money. If education is lost at that stage, the adolescent will deteriorate and in many cases will need some kind of institutional care.
I did not understand exactly the point which the noble Baroness, Lady Young, made about further education, but I will read tomorrow what she said in Hansard. If one looks at the White Paper, it seems that the handicapped are not going to do very well at the nursery school stage, that children might be able to be integrated in the middle years but that when it comes to further education there will have to be more legislation. For handicapped young people the White Paper is a very dismal piece of reading.
Many young handicapped people, especially the dual- and multi-handicapped, who are in the majority today, would not benefit substantially from academic courses at university or college. They will be able to earn their livelihoods only in sheltered workshops, and perhaps not even there. They require what is commonly called training for life in social skills. The noble Baroness, Lady Elliot of Harwood, used Birmingham as an example. She said that if we can train the handicapped to look after themselves in small flatlets—to cook their own breakfast and to cater for their personal needs—in the long run we shall save money. The institutions which house thousands of these people at the moment will not be necessary if we provide them with basic living skills.
But there is a problem over this form of education. Initially you have to provide hostel accommodation for adolescents. They cannot take lodgings in people's homes on account of their physical or mental difficulties. Therefore the opportunities for this type of education are very limited. Lee College of Further Education in Wigan is willing to provide courses of this nature and to take in people from all over the country. They want a 40-bed hostel, and eight of the beds will be for the blind. The problem, however, is that money for this type of education is not provided by the Department of Education or the Department of Health and Social Security; therefore it does not get off the ground. But some money ought to be provided for this type of education.
As a result of my involvement with the Queen Alexandra College in Birmingham, which is the assessment centre for the Royal National Institute for the Blind, I know that they want to provide courses of this kind. When a blind person goes to Queen Alexandra College after being in a school for the blind or the partially sighted, he is assessed as to his suitability 108 for open industry. Training workshops in engineering and other skills are provided there. Many of these people may not be able to enter open industry; some will have to find employment in closed, sheltered workshops. Then they are left with the other cateogry, and it is these people to whom they want to teach living skills. Unfortunately, there is no hostel accommodation for these people. I echo the words used by the noble Lord, Lord Rhodes: society's attitude to its less fortunate members is not very easy to understand. As the noble Lord said, more often than not it is a negative attitude.
The International Year of Disabled People gives us an opportunity to understand better the needs of the handicapped. Our debate has highlighted those great needs. Would it be possible for central and local government to clarify that understanding by making sure that balancing the books does not mean increased hardship, deprivation and lost opportunities for handicapped young people, whether suffering from sensory handicaps, physical disabilities or mental disabilities? If I may follow what was said by the noble Lord, Lord Wells-Pestell, during 1981 we must make some impact, and at the end of the year be able to say that we—the Government, local authorities, the people who are in a position to accomplish things—have committed ourselves to a tangible improvement of the lives of disabled children and young people. If there is no such commitment, I believe it will be clear that the Government consider the proper care and education of the handicapped to be a very low priority.
§ 7.38 p.m.
§ Viscount Ingleby
My Lords, I regret that I do not have the expertise to follow the noble Baroness, Lady Fisher, with her deep knowledge of the educational needs of handicapped children. May I begin by saying a very real "Thank you" to Lady Renton for a project known as "Demand"? She is asking for money to set up a scholarship for furniture specifically adapted for disabled people, to be designed at the London College of Furniture.
One of the objectives of the International Year of Disabled People is to improve access to public buildings and also to create better transportation schemes. I should like to speak on access and mobility. Indeed, it was on these subjects that I made my maiden speech in 1970, under the fatherly eye of Lord Longford.
A lot of progress on access has been made. The other day I went round the Tate Gallery. That was very easy. There are a number of dropped kerbs which make crossing much easier; I found some even in San Antonio, Texas. But there is still a great deal to be done. On Radio 4 last week, for example, a new bank was mentioned which has not provided facilities for access to disabled people. When asked about it, they said that they knew nothing about it; nobody had asked them to provide facilities for disabled people; they said that they would have done so if they had been asked. Obviously, therefore, there is still a lot to be done.
I should like to quote from this excellent booklet, Can Disabled People Go Where You Go? produced by the Silver Jubilee Committee on Improving Access for Disabled People. I am very glad to see its chairman, Mr. Peter Large, supported by his indomitable 109 wife, sitting behind us below Bar. Peter is much more severely disabled than any of us taking part in the debate today, yet it is he who provides us with much of the information which we use. The Committee's recommendation comes in paragraph 11.11:We recommend that legislation be introduced to make the access sections of the Chronically Sick and Disabled Persons Act 1970 mandatory. Further, we recommend that the law be amended to place on developers the burden of proof that to make a new building accessible would be unreasonable and impracticable.Surely it must be right that if somebody is intending to put up a new building, to which the public are going to have access the onus should be on him either to make it accessible to disabled people or else to show good reason why it should not be so. I should like to ask the Minister who is going to reply for the Government, are the Government prepared to make these access clauses mandatory? It would only need a very short Bill, it would cost the Government nothing and it would cost the developers very little if incorporated at the design stage.
Another recommendation of the Committee, at paragraph 11.7, is:We recommend that, until the law is changed, all local authority planning departments issue guidance on the requirements of sections 4–8A of the Chronically Sick and Disabled Persons Act 1970 to anyone intending to put up a public building of facility.In her speech, the noble Baroness, Lady Young, referred to this excellent pamphlet, Access for Disabled People to Buildings, produced by CORAD, also under the chairmanship of Mr. Peter Large. I should like to ask the Government this question: as CORAD's funds are limited and they can produce only a limited number of these pamphlets, will the Government provide enough money to ensure that everybody intending to put up a building, to which the public have access, can be given one of these pamphlets?
The third recommendation of this committee concerned the designation of an access officer. One of the difficulties, when people want to find out more about access, is that they do not know who to go to, and the recommendation of the committee is:We recommend that every local authority, at district level, should designate one of their officers, preferably based in the planning department, as an access officer who would act as a liaison officer and co-ordinator on questions involving access for disabled people".I should like to ask the Government whether all local authorities have designated someone as their local access liaison officer. If the answer is no, if I table a Question for Written Answer, will the Government say which authorities have not appointed an access liaison officer?
So much for access. Perhaps I may turn for a moment to the second of my topics, mobility. I regard myself, and perhaps the noble Baroness, Lady Masham, regards herself too, as a kind of partially publicly funded guinea pig for testing out the services provided by British Rail, and airports, and ferries and public bodies of that nature. Sometimes it is a pleasant experience, but at other times it is not quite so pleasant. It seems to me that a lot of progress has been made. The staff of British Rail on the whole are very helpful indeed. The whole of British Rail try very hard to help disabled people, and I am particularly 110 grateful to Mr. Ernie Marshall at York, who copes very well with a lot of disabled people, including these two sitting side by side here.
The system of sending messages ahead to ask for help at the other end works very well on the whole, although occasionally, on account of some human failing, a message does not get through. The other day I was travelling from Wolverhampton back to York, changing at Birmingham, and I told them at Wolverhampton the day before that I was going, but when I got to Birmingham they did not know anything at all about my arrival! There was no ramp available. Three good strong members of British Rail hauled me up into the guard's van, only to tell me that I was on the wrong train and that I had better get off it as quickly as I could!
§ The Earl of Longford
My Lords, if I may intervene for a moment, does the noble Viscount feel that these facilities are equally available to the ordinary citizen who is not so widely known and respected as he is, or as the noble Baroness, Lady Masham, is?
§ Viscount Ingleby
My Lords, I think that would certainly be so at York, which is the place of which I have most personal experience. I am sure that there the service is equally available to all travellers. As I say, there are a few occasions when the messages do not get through, and the cross-channel ferries do not seem very used to handling wheelchairs. There is a little room for improvement there. The French railways are the most frightening thing I have ever seen. They have three enormous steps up and a not particularly wide door at the top, and had it not been for three minute Frenchmen who, with great courage, manhandled me up into the train, I do not know what I should have done. The language difficulty did not help very much there, either. I think there is room for a little more international co-operation in this field.
At Heathrow I get looked after very well indeed. I have only one complaint there, about what I call "jellyfish wheelchairs". That is a wheelchair which has had the rims on the wheels taken off so that you cannot propel yourself about in it, and, like a jellyfish, you are left behind when the tide goes out because, when your very nice attendant has taken you through all the things that you have to go through, he then leaves you. There may be a considerable delay and you may want to get a cup of coffee or buy yourself a newspaper or go to the lavatory. But if you are in a jellyfish wheelchair you cannot do so. You are just stuck there until some kind person comes along and helps you. When I asked them at Heathrow why it was necessary to take the rims off the wheelchairs they said, "It is so that we know exactly where you are"!
The last point I want to mention is that of VAT on charities. It seems to be wrong that a large slice of what people give to charities should end up in the Chancellor's coffers, where it cannot make very much difference, whereas if it remained with the charities it would enable them to provide a much better service for disabled people.
§ 7.48 p.m.
My Lords, I am glad to have the 111 opportunity of joining in this debate, and I should like to offer my congratulations to the noble Baroness, Lady Masham, and also to the noble Baroness, Lady Darcy de Knayth, for the marvellous work that they do. They have tremendous courage, because they work day in and day out, helping so many people by their personal example. On one occasion I went to Brussels with the noble Baroness, Lady Masham, and there were innumberable difficulties in travelling but she overcame them very calmly and quietly. I should also like to mention Stoke Mandeville. The noble Baroness, Lady Darcy de Knayth, convinced the authorities that there was need to keep this hospital open. We are intensely grateful to her for that.
I should also like to say a word to the noble Viscount, Lord Mersey, because I was particularly interested in what he said about lepers, having worked in Malaysia, where the fear of leprosy was overcome by that wonderful man Tunku Abdul Rahman, the Prime Minister, who adopted two children of leprous parents which made a tremendous difference to the whole attitude to lepers in that country. I have also been to India where the progress in this work is tremendous.
Today I want to talk about deaf children in particular. In this White Paper it is very interesting to note that there are more deaf and partially hearing children now than there are blind children. Blindness seemed to be the biggest problem with children, but now it its deafness. There are 11,371 either deaf or partially deaf and only 3,987 blind.
Some noble Lords may have read in the Daily Telegraph of 9th January this year a very interesting paragraph, which said:Computerised genius gives a chance to babies who might never communicate.This genius is working at Hillingdon Hospital. His name is Dr. Sam Tucker and he has for 18 months been using a machine specially to test the ears of tiny babies. He has tested over 2,000 and they find that one in every thousand babies is born deaf. This will be an enormous help; it is a real advance, because most children get their tests only when they are about three years of age. The causes he has also discovered are hereditary, severe jaundice, drugs taken by the mother in labour, premature babies, rubella and lack of oxygen during delivery.
Unfortunately, deafness is considered the Cinderella of handicaps. It arouses very little sympathy because all the people who are deaf look completely normal; you can tell a blind person or you can recognise any other handicap. Perhaps it would be interesting to mention that last night in Plymouth I attended the 31st Annual Dinner of handicapped persons, in a first-class hotel, together with the Lord Mayor. We had people with all types of disability; blind people with dogs; several people had to be fed because they could not feed themselves; there were also people who have fits, and one had a small fit during dinner. Nobody took any notice; the speaker was making remarks of thanks and he continued. This shows that there is integration. There were all ages present and they were brought to this dinner by volunteers in cars. I hope that perhaps we may have the pleasure of asking Lady Masham to come one year when she has a free moment.
Most deaf children have little sympathy given to 112 them and they enter school at five years of age with an estimated vocabulary of only five to 10 words. Of 360 deaf school leavers aged 16 years who received special education in England and Wales in 1976, one in ten had speech that was intelligible, only six were literate and few could lip read. Research last year showed that profoundly deaf children receive only 2.3 per cent. of information which people try to communicate through hearing alone, 44 per cent. through lip reading and hearing, and 95.8 per cent. through cued speech and understanding when this is used in addition.
In 1970 the Royal National Institute for the Deaf estimated that 15,000 children were registered as wearing a deaf aid. This meant that 6 to 7 per 10,000 children have a hearing defect which makes special education necessary. On leaving school, deaf school-leavers have a special problem, as only 10 per cent. have speech which their teachers consider to be fairly easy to understand or wholly intelligible. I want to suggest that we might consider the new cued speech, and I should tell noble Lords that I am the chairman of the Committee. This helps not only children born deaf but those whose deafness results from illness such as meningitis. Cued speech is an American concept and it is of equally great help to the profoundly deaf as braille is to the blind. This proves that it is a real adjunct to their hearing.
In the Deafness Report (HMSO 1973) Dr. Annette Rawson stated that the need to supplement oral teaching by additional clues such as cued speech or some other form of manual indication must be looked at again. Cued speech has been used in America since 1966, and it makes a great deal of difference to the deaf and to the people teaching them. It can be learned, I understand, in 12 to 20 hours according to the aptitude of the person. In this country there have been 800 applications to learn this method, so already great interest has been shown in this method. We recently opened a centre at Putney; it was opened by the Member of Parliament for that area. It is growing very quickly and it is run by voluntary people and voluntary contributions.
At the present time cued speech is being used in four schools for deaf, in five schools for partially deaf, in some hospital clinics in Avon, Devon, Somerset, Hertfordshire and Essex, and in one ILEA school. At present, 88 parents and teachers, speech therapists and deaf class assistants hold a certificate of proficiency in cued speech. I hope this certificate will be looked upon with favour by the Department of Education. Recently, the Minister for Health, Dr. Gerard Vaughan, attended a forum and made presentations to various organisations working for deaf children. I am glad to say that the first prize of £1,000 was awarded to a voluntary organisation in Bristol who have made cued speech available to parents, through television and demonstrations and so on.
In Command Paper 7996 (page 11, paragraphs 29 and 30) the Government agree with the necessity for nursery education for the under fives. I want to suggest that we need more play groups. When I was in Plymouth I was able to get a classroom which was not being used in which I set up a nursery school; we paid the teachers by voluntary contributions. I hope that consideration will be given by the various local education authorities to giving any classrooms 113 they can to these children. We can get a good many volunteers to teach them. I think it would be very advantageous, because it is very difficult to get adequate funds and the allocation of a disused classroom would be of enormous help.
Many deaf young people under five years of age may have their whole lives affected if they cannot get this early teaching and may never be able to catch up in later years. In this House today, I am sure we would be very frustrated if we could not hear what people were saying in this debate. Think of these young people who have no hearing at all; it is a most frustrating thing for any individual not to be able to express themselves in any way unless they have the opportunity of getting early teaching.
I see that on page 25 there is mentioned the report of the Advisory Council on Education of the Handicapped Pupil, 1955, and since then there have been seven other Command Papers dealing with this subject. I should like to suggest that unless we implement them this will be a waste of money, particularly as I am sure that the Warnock Committee must have cost a great deal, too. I want to make a plea that as much action as possible is taken in regard to interesting suggestions. I hope that there will be recognition given to this new method of teaching because it has proved very successful so far and would be advantageous to young people particularly those under five years of age.
§ 8 p.m.
§ Lord Tanlaw
My Lords, I have not spoken on this subject before in your Lordships' House, but I have been forced to do so on the basis that I have two interests to declare in support of the International Year of Disabled People. My first interest is a commercial one, and my second interest is a personal one and covers really more the aspect which the noble Viscount, Lord Mersey, implied in his very sensitive maiden speech—namely, the stigma of disablement.
However, my first interest is a straight commercial one, as I am chairman of a company which manufactures and designs electric road vehicles for disabled people. To take up one point made by the noble Earl, Lord Snowdon, who said that there should be a discount of road tax for such vehicles, I should like to point out that there is no road tax for electric vehicles. I think that the only other fact worth mentioning in this connection is that technology in this field is more than adequate to suit the individual demands of disabled customers. However, to take up yet a further point of the noble Earl, Lord Snowdon, it is impossible to make a production run of vehicles because each customer has an individual requirement connected with his own personal disability, although I believe that there are areas where one could in fact standardise in this direction. I think that the one thing that manufacturers can do in this International Year of Disabled People is to listen more closely than ever to the suggestions, complaints and, indeed, designs put forward by disabled people for vehicles of the kind that I am describing.
I had not intended originally to mention that interest because the main reason for my intervention in this debate is a personal one. I am doing so on behalf of my stepson, who cannot and will not ever be able to speak on this subject for himself because of his physical 114 and mental disabilities. It is also worth mentioning that it is very difficult for natural parents of mentally disabled children to declare this interest with the ease with which I have just done so. I think that it should be recognised in this House and in another place that those noble Lords and honourable gentlemen who make this declaration do so with some difficulty. I believe that there are a large number of people working in business organisations or whatever in the outside world, who have a fear or an apprehension of mentioning, either to their neighbours or to their workmates or, indeed, to their employer, that they have a mentally disabled child or children, because in some way they feel that it may affect their job prospects. In my view that is a very sad reflection on the way in which people think and treat in attitude the problems of mentally disabled children or, indeed, adults.
I use the phrase "mental disability" because it seems to me—and I come fairly new to this world—that that terminology is, in a way, a form of discrimination that the public make in its attitude towards those who are mentally disabled and those who are physically disabled. I personally believe that it would be an immense step forward if, by the end of this Year of Disabled People, those who are mentally disabled were judged by society and by the state in the same way as those who are physically disabled. I say that because the term "mentally handicapped" has, I suspect, grown up as a result of society trying to gloss over or make light of this appalling disability. From my experience I see no such distinction as there is more often than not a physical cause behind these disabilities.
Mental disability is not a handicap: it is a catastrophe, and a catastrophe not only for the child or person concerned but, more especially perhaps, for the person or persons on whom he or she is dependent for the rest of his or her life. Statistics have clearly shown that, unlike physical disability, mental disability in children has caused a higher percentage than average of marriage breakdowns as well as psychological problems in the parents. I think that those are brought about by many of the factors that have already been expressed in this very wide-ranging debate, such as the extra high costs involved of clothing; the job problems during the holidays—the permanent air of crisis that always exists around children in a disorganised way in a small house with possibly both parents at work. There are the worries and strains of how to do the shopping and so on. They all add to the strain of actual living. There is also the added strain that when there are also normal children there is greater attention given to the mentally disabled one. Those are all well known facts and the experts who have spoken in this debate know how to approach the matter and how to approach the Government.
However, the worry that I have is that all parents have one dread, as far as I can see, and that is that if for one reason or another of the kind that I have given they are eventually unable to cope with this situation, there is always the long-stay hospital. That is talked about with a sense of dread because it means that they themselves have been forced to give up with their children, or indeed that society has been forced to give up giving their children a life for the future.
115 Before I deal with that matter in more detail I should like to emphasise two points that the Government should perhaps consider during this year. The first is that more day centres are required to relieve some of these worries. Indeed, they are provided by some councils, but not by others. Secondly, we need more of what I think are called "gateway" clubs for entertainment in the evening, which give parents a chance to put their children somewhere safe so that they can have time together.
Transport has come out very highly in this debate, and there have been compliments, to which I shall add mine, to British Rail. The staff of British Rail are extremely understanding and have always been extermely helpful to my wife and I when we have travelled with my stepson. I am happy to say that the bridge at Carlisle Station—some of your Lordships may know it—now has a proper ramp from one side to the other. It has taken I cannot remember how many years to be completed.
There is one point that the noble Baroness in her reply for the Government might consider. Students, old age pensioners and various other categories seem to have some special cheap day tickets, and I wonder whether British Rail can offer cheaper tickets for maybe two trips a year for those looking after disabled children.
I wish to say a few words about the long-stay hospitals. There is one question that arises in the minds of parents of mentally disabled children. I am not sure of the answer, but it concerns the way in which society treats those children or adults who have to go into these long-stay hospitals. They are kept, as many noble Lords know, under partial sedation and they live a sort of half-life for the rest of their lives. On the other hand, the convicted psychopathic killer enjoys better conditions with a long-term jail sentence, which is not for life anyway as he is released eventually back into society. I shall perhaps leave this question in the air. I first feel that there is something wrong in the balance of the quality of life in those two institutions, and that is something that we should perhaps look at more closely during this International Year of Disabled People.
Finally, I should like to make one point about the integration of schools. What has been said so far has been very technical and I am not familiar with the Bills that are coming before the House. However, I ask for one matter to be considered, which is the question that is asked of parents, especially by those people whom they do not know very well. One discovers that someone has children and one says, "How interesting". The next question that one asks is, "What school do they go to?" That often is one of the more frightening questions for those parents who have mentally handicapped children, because they cannot say that they go to the local school called "so-and-so" or to "St. So-and-so". They have to mention a special school and therefore they have to admit publicly to some people who are often partial strangers that their children or child is going to a special school, which perhaps is known in the district to be for the mentally handicapped.
As I understand it, one factor that integration will overcome is that at least parents will be able to say that 116 their children go to the same school as everyone else's children. I am not sure about the ins and outs academically, but I am sure that it is a good thing for education. I am equally sure that a great number of parents will look forward to the day when they can say that their child goes to the same school as other children, and they will not be scared of one of the most basic questions that people ask them in the course of their daily lives.
Therefore, I hope that all the things that have been asked for so far in this debate—and I sure that there are more to come—will come to pass. The one thing that I, personally, would hope for this year more than any other, is that the physically disabled and the mentally disabled are judged as one by the public, by society and by the Government.
§ 8.11 p.m.
§ Lord Milverton
My Lords, it is with great pleasure that I rise to support the noble Baroness, Lady Masham of Ilton, in respect of her Motion:To call attention to the International Year of Disabled People (1981) and to the pressing need for educational facilities for handicapped children".I missed the maiden speech of the noble Viscount, Lord Mersey, as I went out for a quick cup of tea, but from the glowing accounts which have been given of his speech, I shall look forward to hearing him in future.
I hope that Her Majesty's Government will pay proper and full attention to those organisations and research officers who are seeing that the disabled are having a chance, through educational opportunities and facilities, to use any abilities that they have for the good of society as well as for themselves. This is what the disabled desire. They wish to be seen as people who can give and not just receive.
There are three aspects of the White Paper which I wish to mention: integration, the place of governors of non-maintained schools, and the question of adult disabled seeing their own reports and parents being able to see their children's reports so that they can know their progress. I mention these on behalf of the All Party Disablement Group and the Advisory Centre for Education. At the same time, I speak for all the organisations working for the disabled.
The first point is integration. As we fully realise, this is not easy because of the unease that there may be between the disabled and others. Yet this must be bridged, as those with disabilities are people with whom we can share and receive so much, many of whose hopes and fears are akin to our own. The disabled need understanding and help from all people, for they wish to live a life which is worth while to society. If we give understanding and support to them, they will give it to us. In our 20th century we must not make some people feel that they are outside society.
Therefore, where it is possible to integrate, integration should be encouraged so that the disabled and others can have a better appreciation of one another. One acknowledges the fact that some will need special facilities of their own, with qualified teachers for certain disabilities, and that building facilities will need to be adapted for integration to be possible. The fact that the disabled can contribute to society has to be an element in our thinking, while accepting the fact that the energy and speed that they are able to muster 117 may not always be as adequate as would be wished. We hope that Her Majesty's Government will take the help and advice of the ACE, the All Party Disablement Group and others in these matters.
My second point is about the place of governors of non-maintained schools. I hope that the Government will take note of the All Party Disablement Group's brief on the White Paper, section 5, paragraph 5.1, and that the discussion will end with Her Majesty's Government agreeing with the group; also, the group's fears expressed in section 5, paragraph 5.2, recording paragraph 4.3 of the White Paper, and that they will reconsider this question. The point in paragraphs 5.1 and 5.2 concerns the place of governors. These people, who are genuinely concerned and interested, can play an important part by intelligent learning of the situations and listening to those with the knowledge.
I should like to quote one sentence from the All Party Disablement Group's brief at section 5, paragraph 5.2:We are disturbed at the statement made in paragraph 4.3 that 'it would be neither fair nor practical' for the new category of independent schools approved as suitable for recorded children to have governing bodies because they are 'commercial enterprises'. The disturbing implication of this is that the interests of handicapped children may conflict with the commercial interests of the school.Her Majesty's Government could note at the same time section 7, paragraphs 7.1 and 7.2. These express an important aspect that cannot be cut; that is, teacher training specialisation.
The third point I mentioned was the question of the availability of the reports of the person concerned. Here the All Party Disablement Group and the ACE are surely quite correct in suggesting quite firmly that parents should have some knowledge of the records and reports of their children. They should be given some idea of the progress of their child and of the development of the child's abilities. There should be consultation between officials and parents, rather than parents being kept in the dark. The parents have a responsibility as well as those who are teaching and helping the children. Both need to work together. In the same way, the adult handicapped should have access to their records and reports if they are to benefit from the help given to them. I am sure that the Minister will try to meet the concerns and fears of the All Party Disablement Group, of ACE and others in respect of their priorities and objections to the Government White Paper.
I would mention in passing the point made by the noble Earl, Lord Radnor, about traffic lights. Very little time is given for the disabled, let alone those of us who are taken to be fit and able, to dash across the road, and perhaps the Government will look into that matter. I apologise in advance lest I am not here at the conclusion of the debate; I must leave to catch a train because a certain amount of my ministry and desk work is done in the mornings before coming to your Lordships' House.
§ 8.21 p.m.
§ Lady Kinloss
My Lords, in this debate on the Year of Disabled People and Special Needs in Education, so ably opened by the noble Baroness, Lady Masham of Ilton, there are so many aspects that could or should 118 be discussed that one can only hope to select a few. I should like to congratulate the noble Baroness on having remained in your Lordships' Chamber throughout this interesting debate without moving. One of the most important aspects is for the disabled to feel at home as part of ordinary society and to be able to play their part in it as much as they can. This, of course, depends not only on psychological circumstances but on physical ones. I am told on impeccable authority that a northern city, which has a good reputation for caring for its disabled citizens, held an inaugural meeting for the Year of Disabled People on New Year's Day this year, on the first floor of a civic building, at the top of a steep flight of stairs and with no lift. One wonders what their minds were on when they organised that meeting. Certainly they were not on some of those for whom they were holding the meeting, it would seem. Perhaps that is one of the ordinary things this debate is about—ordinary, but nevertheless it is essential to provide the most needed simple devices that the disabled, certainly those who use wheelchairs, need; for instance, wide doorways.
During last year in North Yorkshire, York and the surrounding districts, an appeal led by the then Lord High Sheriff of North Yorkshire, Lord Martin Fitzalan Howard, raised £385,000 to provide a body scanner for the York District Hospital, and I understand the machine has now been installed there. It was a great local effort and I hope his name will always be remembered for it. I wonder whether, given the present financial climate for the Government, much more could not be done simply by encouraging local voluntary effort. Every county has its disabled and every county could make an effort. Perhaps special appeals for specific objects could be more effective than general requests for funds, such as from increased rates. One case I have in mind is a guide to existing benefits and services, which are rather a jungle at present, for the disabled. It is the Disablement Income Group's "ABC", and it is a guide to existing benefits and services for disabled people. Their only regret is that owing to lack of funds they are unable to publish sufficient copies to circulate to more than the directors of social services and a few others. They would like to see them in all public libraries, and perhaps this is a specific object for which funds could be raised by voluntary effort.
One voluntary effort which is particularly to be praised is the Access Guide to York for the Disabled. It was researched by pupils of Fulford Comprehensive School, York, with Mrs. C. Kellett as teacher-in-charge. The headmaster and other members of the staff are also to be congratulated. It was the outcome of a project set up by the National Westminster Bank called "Respond". Other sponsors of the guide were the Queen's Silver Jubilee Appeal Fund and the York Common Good Trust. It was published in 1980. Enormous sums are spent from time to time on adapting existing public buildings to the needs of the disabled. I suggest that all new public buildings should not be given planning permission without a certificate stating that every part of the building will be accessible to the disabled.
I now turn to the educational needs of disabled children. This covers an enormous range of disability, physical and mental. I have spoken before in 119 your Lordships' House to the effect that, where possible, every child should be integrated into the normal system of education, and I am glad the White Paper says this once again. Recent research has shown that a very large proportion of pupils require special attention at some time or other during their school careers. Children do not grow or develop at an even rate but by unpredictable fits and starts. Many teachers are held in the greatest esteem by parents because of their capacity for understanding and the help they give to the disabled child, and able-bodied children show great understanding too for their disabled comrades. However, it is obvious that for the future successful integration of disabled pupils into ordinary schools, teachers need specialised instruction during their training to help them understand the needs and problems of their disabled pupils, and to encourage teachers to notice those special needs and respond to them.
The Warnock Report in Chapter 5 reports the need for disabled children under five to have special educational attention during their early formative years. Where other children will copy others, the disabled child may have to be taught the same thing elaborately. The report also remarks:In the earliest years, parents rather than teachers should be regarded wherever possible as the main educators of their children".Parents will themselves usually need skilled help and guidance in looking after their disabled children and they should be given all the encouragement possible.
In Chapter 9, Warnock sees the need for parents as partners in the education of their children. The Parliamentary All-Party Disablement Group, of which I am a member, would like consultation with parents to be made compulsory and thinks parents should have full access to information and reports on their children. I believe that if schools could publish information about their facilities and access, it would help parents, with professional help, to make a choice for their child.
Warnock recommends in Chapter 10.27 that continued education should be provided beyond the age of 16. Not very much at present is available to the mentally handicapped beyond school-leaving age. Many disabled young people get behind with formal education because of stays in hospital and other reasons, and it would therefore help if they could stay at school until 18, instead of leaving at 16 as they sometimes do now. Where there are suitable places provided for the disabled student and the students are able to do so, they should be encouraged to take them up; the physically handicapped young person should especially be encouraged to go on to further education. For the severely physically handicapped who are able only to use their intellectual ability, it is increasingly important to have this further education in the microchip age.
I am sure everyone would agree that it is essential to start educating a disabled child as early as possible, but it is surely equally important to continue the process to the extent of their capabilities. The Northallerton health district, one of four in North Yorkshire, is hoping to educate the public to the needs of the handicapped person, emphasising that it 120 is the year of, and not for, the disabled, thus showing how best to aid the disabled, at the same time as helping them to greater independence. The North Yorkshire Social Services are to open the Yearsley Bridge Adult Training Centre for the mentally handicapped in York in April of this year. Also this year they will have a mobile training centre with permanent parking points in villages in the Dales and various other parts of North Yorkshire. They are also to open a day centre in Scarborough. They are to be congratulated and I wish them every possible success.
On Radio 4 on Sunday evening there was a programme called "Does He Take Sugar?" Mr. Jack Ashley spoke, and one remark of his particularly struck me. The gist of it was that we should be careful not to add to the burdens of the disabled as they already have burdens that are not borne by others. I hope, my Lords, that the end of 1981 will not see the end of the momentum that has been given to this Year, but that it will continue in the years to come.
§ 8.30 p.m.
My Lords, 23 gone and 10 to come! I congratulate the noble Baroness, Lady Masham of Ilton, upon enlisting so many speakers in this extraordinarily interesting debate. I also wish to congratulate the noble Viscount, Lord Mersey, on his maiden speech. In the context of the debate, the noble Viscount's speech was unique because, with the exception of comments made by the noble Baroness, Lady Vickers, it was the only speech that covered children of the Third World. The noble Viscount has probably heard of children of the Fourth World. This term refers to ill and poor children, in particular those in the Third World, though not only those children. There is to be an exhibition relating to these children in, I think, Westminster Abbey in the near future. I wish to say to the noble Viscount that I, too, was in Malawi and I was greatly impressed by what was being done in that country. I am sure we all hope that we shall hear from the noble Viscount again.
I wish to pay tribute to the Warnock Committee, as I think has already been done by my colleague here. I am sure we all agree that the committee produced a wise, well-written report which heralds a better future for handicapped children.
I also wish to pay tribute to Her Majesty's Government. In this House noble Lords on every side are on good terms with one another, and therefore it is with much sadness that I say that I very much regret the comments made by the noble Lord, Lord Wells-Pestell. Of course the noble Lord is quite entitled to say what he thinks, but I believe that his speech at the beginning of the debate contained comments of slight discord. Perhaps it is only fair to point out that the Warnock Committee was set up by the Prime Minister when she was Secretary of State for the Department of Education and Science and, secondly, that the present Government have been in office only since May 1979; and, whether we like it or not, they have produced the White Paper on the Warnock Committee Report—
§ Lord Wells-Pestell
My Lords, will the noble Baroness give way? I am very sorry about this, but I made no reference to the Warnock Report—none whatever.
§ Baroness Faithfull
I quite agree, my Lords. But my point was that there was perhaps a feeling that the present Government were not giving adequate attention to the needs of the disabled and to the social services; and that I would contend is not so. Of course the White Paper does not go as far as many of us would wish. Nevertheless, I make a plea to the Minister for very careful planning of the implementation of the recommendations of the Warnock Report. Members of your Lordships' House will remember the Children and Young Persons Act, 1963. In my view that was a good Act but to a very great extent it has failed due to lack of planning and lack of training.
The philosophy of the Warnock Report appears on page 14. I do not propose to read it at this point, but for a few moments I wish to speak on the integration of handicapped children into normal family life. Seventeen years ago the department for which I worked in Oxford placed as a foster child a severely handicapped thalidomide child. That child has lived in the community for the past 17 years despite the fact that she has no arms and no legs. She went to the normal village school. The other day we received a letter from her in which she said she was studying the history of music. Thus I have experience of placing handicapped children and keeping them in normal schools.
However, I should like to sound a note of warning here. Each case is different. Some families with severely handicapped children are able to tolerate and look after the children while other families with less handicapped children cannot tolerate the day-to-day task of looking after them. As was mentioned by the noble Lord speaking from the Liberal Benches, there are some families where the parents give so much attention to the handicapped child that the rest of the children in the family are deprived. Therefore, while integration should be supported, the pendulum should not swing so far the other way that we do not meet the needs of each individual child in each family. Here I agree with other noble Lords—a handicapped child must not be seen in isolation; he must be seen only as a part of the family. I speak with very great feeling as a member of the council of Dr. Barnardo's and I think it would be fair to say that there are some profoundly handicapped children who need residential care, bearing in mind the equipment they require and the minute-by-minute care that they must be given.
I wish to support other noble Lords who have spoken about the training of teachers. If handicapped children are to be integrated into normal schools, the teachers will be faced with a very difficult task. Already in other spheres we are pleading for delinquent children to be helped in the community and not be placed in custodial care. There is, sadly, a rising number of disruptive pupils and now we are asking teachers to integrate handicapped children into their schools. That is surely right, but the teachers need skill, they need knowledge, they need patience. For the integration to be successful, there must be time in which to plan the training that teachers should have, and I would make the plea made by other noble Lords that voluntary organisations and local authorities who run very good special schools should be used as resource centres for helping teachers in normal schools to acquire the necessary skills and knowledge.
All members of your Lordships' House have received 122 briefs from a number of organisations and local authorities. I have been particularly grateful for the help that I have received from Dr. Barnardo's and like the noble Earl, Lord Halsbury, from the Invalid Children's Aid Association. In the spirit of planning for the future, I would ask the Minister for consideration to be given to various questions put to me by those local service departments and voluntary organisations. Is the Minister satisfied thst the many "unrecorded" children who have an impairment but who attend normal schools will in fact receive the individual care which they need? If they are moved from one school to another will they be recorded, and if they are unrecorded cases how will they be helped when they move into the world of work? I think that this point was raised by the noble Lord, Lord Banks. Will parents be central to the education and well-being of their children? Other noble Lords have asked whether parents will serve as governors of schools which their children will attend.
My Lords, on the question of social workers, I have learned that if one is working with the families of handicapped children—supplying them with information; supplying them with that difficult commodity, time; and supplying them with skill—one must have qualified, experienced and understanding social workers. I would bring to the notice of the Barclay Committee that social workers should be skilled and trained in this particular aspect, and that local authorities should give very careful thought to their social work service, so that social workers are able to give this counselling service which the parents of handicapped children so badly need.
I have also been asked, as have many other noble Lords, about nurseries. I would say that I have travelled up and down the country, and the nursery schools service for handicapped children is very patchy and very different in various parts of the country. Unless there is a good nursery service, either through the pre-school playgroup movement or through nursery schools, or in day nurseries, it is going to be very difficult to help the handicapped child when it goes to school at five years old.
I should like to ask the Minister what multi-disciplinary structure there is going to be for assessing the handicapped child, for following it up and for caring for the child.
I would also just make a comment on the various self-help groups that I think we ought to assist. I mention particularly a group called Contact, where handicapped parents are put in touch with other handicapped parents and form groups for the discussion of their problems. There is one question that has not been touched on in this debate, and that concerns the terrible problem of parents who care for their children and who then, as they get older and older, see themselves finally leaving this world and wonder what is going to happen to their handicapped child. For such handicapped persons there are, of course, the organisation CARE and Campsfield; and one would hope and press in this International Year of the Disabled that there should be a bridge between the child being cared for in the home and the place to which that child (probably by then an adult) will be going when its parents have gone.
Lastly, I should like to support the noble Baroness, 123 Lady Elliot, on the question of the National Bureau for Handicapped Students. It is surely the right of all handicapped persons, if they wish, to have further education. Here again, the colleges of further education have not the staff who understand and who have the knowledge to help and deal with the handicapped; and, secondly, even if they have, I would make the plea to the Minister that discretionary grants should be given to handicapped students wishing to go on to further education. My Lords, I wish the noble Baroness, Lady Masham, and all her colleagues well in this International Year of Disabled People.
§ 8.44 p.m.
§ Lord Gainford
My Lords, first I must add my congratulations to the noble Baroness, Lady Masham, for this magnificent debate, which, so far as I can remember, was already creating interest before your Lordships' House rose for the Christmas Recess. It is also my great pleasure to add my congratulations to the noble Viscount, Lord Mersey, for his outstanding maiden speech and for an interest that he mentioned—Malawi, a country close to my heart. When it was Nyasaland in 1951 I was working there as a land surveyor. I look forward to having talks with the noble Viscount about that country, and I hope that that will be quite soon because obviously he is going to receive every possible encouragement to come to your Lordships' House and to speak often.
I also have to thank the noble Earl, Lord Halsbury, for what he has said, because I can now make my speech more brief than it might have been. I have sympathy with the noble Earl concerning the field game, which he has tried to explain. It was a particular football game peculiar to the educational establishment that we attended. It was something between soccer and rugger, but even the goalkeeper was not allowed to use his hands. The noble Earl spoke about the Invalid Children's Aid Association. This began about 90 years ago, taking care of children when their illnesses became very prominent as a result of the great swing in this country from rural to industrial life.
I have been honoured by the ICAA in being asked to be chairman of one of its appeals committees in connection with a school I have just visited, the Pilgrims' School at Seaford in Sussex. This is a small school which provides a public school education for boys of 12 years of age and upwards who have the medical handicap of a respiratory disorder—asthma, and the like. The boys receive considerable medical attention, and in due course are able, as well as being encouraged, to take part in many sports and athletic activities. Many of the boys look quite normal, and very healthy indeed. I did see one boy, a new boy who had been there a week, who did not look quite as healthy as the others.
These boys are of an age when they know what ICAA stands for. The initials sound fine, but they resent the fact that the "I" stands for "Invalid". They do not deny that they have problems, but they do not want to be labelled as invalids, and they do all that they can to show that they are not. In that respect, I think that the organisation has been a great success. If an invalid trys to show that he or she is not an invalid, they deserve every possible credit.
124 I am also grateful for what the noble Earl, Lord Halsbury, said in reference to speech defects and speech therapy, which has been mentioned several times in this debate. Here, I am definitely able to underline the need for speech therapists. My particular interest is not just sympathy for those who suffer, but gratitude. I used to have a stammer as a child, and I am one of the lucky ones who was cured. Sometimes I notice a slight hesitation in my speech. It can come in peculiar circumstances, which makes me wonder what sort of tension encouraged it or occurred to bring it on. Apart from that, I feel that my cure was just about total. But before that, as a child, life was a misery. My school mates might show too much sympathy for a person who was blind or lame; and a deaf person might, but not always, be regarded as a bit of an old fool. But a stammerer was the butt of any joke and jibe.
The trouble was that one might look perfectly normal—just as the noble Baroness, Lady Vickers, said about deaf people—and physically fit in every other way, but when it came to talking one's face might distort and odd sounds come out until each word finally arrived. That was not conducive to confidence, and I know it resulted in considerable inferiority complex. There were exceptions, and I knew of one boy who used his defect to great advantage. He raised laughs, but always with him, never against him, because he got away with proverbial murder, cheating masters and twisting any event round to the way that he wanted it. Such cases are rare, but his proved ability, whether right or wrong, gave him confidence.
With a speech disorder—and here I am not detracting from the recommendation to help others overcome other disabilities—anything that a sufferer can do well must be encouraged. Nature often gives rewards when something has been taken away. With a speech defect, as I have noticed with many other people who suffer from it, there seems to be a talent and ability for music. You cannot stammer while you sing. I seemed to develop a talent at school for piano and violin together with singing; and I must admit that I almost buried that talent because of a stupid shyness. I was terrified at the idea of performing before people.
All this took place over 40 years ago and after this time I cannot be certain whether this shyness of mine was the indirect result of an inferiority complex from the stammer or just a childish trait which should have been knocked out of me. Those are my memories but, through them, I am grateful for being able to speak. I look back with particular thankfulness particularly at two speech therapists who helped me. My particular needs seemed to be breath control and relaxation. I add my request to my noble friend Lady Young that, as I am certain she will, she will do whatever she can so that Her Majesty's Government will encourage recruits to the speech therapy profession and place them in useful and prominent positions.
§ 8.51 p.m.
§ Lord Segal
My Lords, I, too, should like to add my own word of thanks to the noble Baroness. Lady Masham of Ilton, for initiating this debate. The very large number of speakers this afternoon and, if I may say so, the length at which they have spoken, hear eloquent testimony to the concern felt on all sides 125 of the House for the plight of the disabled, especially in these days of economic stringency, with cuts taking place on every side almost irrespective of need or helplessness or the suffering they may entail. Others have dealt at length with the problems which the disabled have to endure, especially where financial considerations are involved.
I intend to deal briefly with one point only, and to elaborate the plea which was made by my noble friend Lord Renton in his speech, with every word of which I find myself in full agreement. I refer to the much criticised paragraph 53 of the Government's White Paper. This turns down flatly the Warnock Committee's recommendation that there should be a specific educational element in adult training centres. This is dismissed out of hand by the Government as being simply not practicable since these adult training centres can only function efficiently under a single direction. This attitude of the Government serves only to emphasise the difficulties that separate departments inevitably face when they tend to overlap, as they must, when dealing with the complicated problems of the disabled.
Although I had the privilege of serving for 13 years as chairman of the National Society for Mentally Handicapped Children, and still have the honour of serving as its honorary treasurer, I am expressing now my own personal views and speak for no one but myself. For many years our national society campaigned to secure the same educational opportunities for mentally handicapped children as for normal children. We welcomed their transfer from the Department of Health and Social Security to the Department of Education and Science to which the most reverend Primate referred so eloquently in his magnificent speech earlier this afternoon. This was a very important step forward but the results have not been wholly satisfactory. Our mentally handicapped children seem to have fallen not between two stools but between three. Responsibility for their care has been divided between the DHSS, the DES, and the Department of Employment. There are grave dangers that the mentally handicapped may eventually become the Cinderella of each of these three departments.
Surely in this Year of the Disabled we can at least follow the example of other countries—notably Denmark, Sweden and Holland, and especially Denmark—and not only appoint a Minister for the Disabled but also give him a complete ministry of his own. Why can we not integrate those dedicated civil servants of the three departments who have to deal with all the many problems of our mentally handicapped into one comprehensive department, able to cater for all their needs from every possible angle, even though initially they may not be centred under one roof? These should all be made directly responsible to the Minister for the Disabled and to him alone. One is aware of the bureaucratic upheaval that this might possibly cause, but it could be accomplished at virtually no additional expense, merely a nominal transfer of personnel from one department to another. At the end it would become a logical step forward, despite certain objections that might be raised.
Parents of mentally handicapped children, naturally enough, do not like to have their children branded as mentally retarded. To them, they are only slightly backward or slow developers. So, while we must pay 126 due regard to the wishes of the parents in every individual case, the interests of the children must be made paramount. They will still have their lives to live long after their parents are gone. So why not embark on this departmental integration now during the Year of the Disabled?
We have heard a great deal this evening about the integration of the mentally handicapped into the wider community. But we have heard very little about the need to integrate those sections of our three Government departments dealing with this problem. Now that we have a new and vigorous Minister for the Disabled, let him be given wider scope and wider powers to follow in the pioneer footsteps of one of his predecessors, the first Minister for the Disabled, Alfred Morris. We need a new approach to the problems of our mentally handicapped and to deal with their problems as an integrated whole. I conclude by saying that we should establish now an independent Ministry for the Disabled under an independent Minister. Let that be our major contribution to the International Year of the Disabled.
§ 8.58 p.m.
§ Baroness Trumpington
My Lords, to be the 27th speaker is a tribute in itself to the initiative of the noble Baroness, Lady Masham. I can only offer my sympathy to Speakers Nos. 28, 29 and 30, because I know what they are going through at this moment. The noble Baroness has not only provided us with a golden opportunity to debate the well-known and often-discussed physical and educational needs of those who are disabled or in any way handicapped, but she has also given us the chance to bring to the attention of your Lordships (and, I hope, the general public) some problems which are rarely given a public airing despite the misery they cause to vast numbers of individuals and their families.
I made my maiden speech during a short debate on housing for the elderly. When my friends asked me what I was going to talk about I said: "Mostly about incontinence". They laughed, but my elderly friends did not; neither did my paraplegic friends. Today's debate allows me to return to this subject in a most natural way. I must offer my gratitude to those doctors and the British Foundation for Age Research who have enthusiastically encouraged me and helped me with the more technical aspects of what I wish to say. This is a time when we take it for granted that our children will know the facts of life. I see no reason why these facts should not include the less palatable aspects which can apply not only to their age group but to their parents and to their grandparents. It is for this reason that I make no apology for using words that I do not normally use nor indeed for bringing to your attention a subject which very few of us are prepared to face up to until it is too late.
Incontinence may be caused by many conditions and represents a symptom not a diagnosis which is under-reported by the sufferer and therefore under-estimated by most doctors. The seriousness of the problem is highlighted when one realises how prevalent the condition is at all ages. Although one is apt to consider old people as the main victims, incontinence can affect 127 children usually because control has never been gained or as a result of some major physical disability.
In one study 15 per cent. of five to 14 year-olds were occasionally incontinent and more than 5 per cent. chronically affected. Frequent incontinence was found in 7 per cent. of women aged between 15 and 65 years and occasional incontinence in 19 per cent. The figures for men are lower but still worryingly high. There are of course differing forms of incontinence less common but obviously more devastating although more responsive to treatment. Some experts have suggested that stress incontinence may occur at some time in 50 per cent. of young healthy women and of these it may occur daily in 6 per cent. These women will normally cope with their disability without even consulting their doctors. It is only when some additional factor is introduced, such as child birth or ageing, that the condition becomes even more intractable and out of control.
At least 6 per cent. of the general population is incontinent of urine, which, translated into direct figures, represents three million people in the United Kingdom. Perhaps one and a half to two million are over 65 years of age and between quarter and one half of elderly people admitted to geriatric departments have the condition. Nurses in these departments spend more than a quarter of their time dealing with the condition.
The extent to which sufferers are really coping is difficult to gauge. Many children and young adults suffer great psychological distress and social isolation. Society tends to ostracize the sufferer who is loath to admit or discuss the condition. Sadly, the common reaction to incontinence is to suggest a mopping-up operation rather than investigating the cause from the point of view of treatment. Simple reasons for incontinence, such as immobility and the use of diuretic medicines, are therefore missed.
The cost of treatment of this condition to the National Health Service is considerable. Some years ago it was estimated that 120 million incontinence underpads were used yearly in the United Kingdom, and, at current hospital prices, that works out at £7 million a year. There are a large variety of aids available for the symptomatic treatment of these patients, but too often the nurses and doctors have not been sufficiently well educated in these techniques to be able to proffer the correct advice.
Incontinence is not usually something you "have to learn to live with". It can often be cured or helped after suitable investigation, given relatively simple equipment and medical and nursing expertise. Cure or control may considerably reduce the cost both in terms of appliances, attendance allowance, and incontinence laundry—apart from the reduction in human suffering. Improved rehabilitation facilities, and better buildings with more toilet facilities, may help incontinent victims of all ages; and one could ask the question: How many conveniences are convenient? Incontinence may be a chronic condition or develop rapidly, causing acute crisis. In a recent survey many districts had a waiting period of at least five days before commodes could be provided for patients at home. Even where incontinence pads are provided and there is an incontinence laundry, thought 128 is seldom given to the disposal of soiled items.
The disability is often wrongly accepted as part of the ageing process, not meriting further consideration; but the simple point to remember is that old age is not a diagnosis. The onset of incontinence is often a turning point in old age. Whereas a family may care successfully for an elderly relative in his or her own home, once this condition becomes manifest there is often no alternative to the departure of the aged individual to a hospital or home for the rest of his or her life, especially because, with little attention to investigation, cure, management and advice, few elderly sufferers are helped constructively. At a London teaching hospital with one of the few specialised incontinence clinics in the capital, only 5 per cent. of older patients with established incontinence had ever had the condition medically investigated. In many cases the sufferers had accepted the disability, and even when they had asked for medical advice this had been of limited value.
There is usually no need to accept incontinence as incurable. In recent years new techniques involving pressure measurements and video imaging have become valuable tools in the hands of researchers. Only lack of funds has prevented exploitation of investigatory techniques. Operations may sometimes help, but may leave the incontinence sufferer even worse off after the operation, especially if there has been no pre-operative investigation using the methods already mentioned. In some cases investigations might have shown that operations were not indicated.
Most of these techniques and some of the recent major advances in the drug management of urinary incontinence have been known for at least 10 years. There are a few specialised incontinence clinics in the United Kingdom and a somewhat larger number of urodynamic departments in hospitals throughout the country. However, it is clear that these services are not freely available to many sufferers from incontinence. In a recent survey of British geriatric departments only a third received substantial help from urologists. One-third received little or no help, and nearly a quarter of the departments studied had no local specialist interest in urology. Urodynamic studies were used only by one-fifth of the units.
There have been dramatic advances in the drug treatment of abnormal neuro-muscular function in other parts of the body as a result of intensive and expensive research programmes, largely financed by the pharmaceutical industry. Obvious examples of these are to be found in the treatment of heart disease and Parkinsonism. It is inconceivable that major medical advances would not have been made in the treatment of incontinence by combined pharmacological and diagnostic research, given the same funding and concentration of expertise. This problem, together with its potentially immense international market, should be a challenge to the British pharmaceutical industry. The most commonly-used drug in this condition is marketed by a Scandinavian company.
Since in these stringent times it is unlikely that the Department of Health will be able to divert any of its resources to this subject, there is a need for our charitable organisations to recognise this neglected problem and devote funds to medical research and to the setting up of units with medical expertise and for the training 129 and attachment of more special nurses. The British Foundation for Age Research has an admirable record in the sponsorship of research in this field. They are spending a total of £129,941 for the funding of five research projects. They have shown in fact a remarkable dedication of their funds to this subject. I fear, however, that it is not enough. Very often advances in research and therapy depend upon the establishment of specialist organisations such as those for heart disease, poliomyelitis, multiple sclerosis, spastics, rheumatism and arthritis. No such large organisation has yet emerged for incontinence, and one can only hope that in the future some well-endowed charity will take this as its main objective.
In conclusion, if I may paraphrase an article in the Nursing Times, the condition I have been describing has the unusual feature that it is repellent to the beholder and a subject of guilt and shame to the affected. Due to the personal nature of the disablement, other disabilities and diseases of a more respectable nature have been the object of much publicity, even though there are fewer sufferers. The total social consequences of incontinence have not been seriously considered by society, by governments and the professions, and therefore there has been no serious planning on a scale appropriate to the numbers requiring attention and the cost to the economy. This intervention may be construed as being an appeal to charities. Indeed, it is such an appeal and I hope that it will not fall on stony ground.
§ 9.11 p.m.
Baroness Ryder of Warsaw
My Lords, may I thank the noble Baroness, Lady Masham, for initiating this debate. A great deal has been said and more will be heard tonight. I am therefore especially conscious of time; but here we have before us the resolution made by the United Nations and the magnitude of this International Year of Disabled People. Its importance cannot be over-emphasised. What can we do to ensure that well-meaning statements, knowledgeable speeches and good intentions are not forgotten? To quote His Royal Highness Prince Charles, it has "the opportunity of a new beginning".
I should like to refer to two subjects: first, the international scene, and, secondly, our problems here at home. In the third world, alas! ignorance and prejudice exist, and so it seems to one who has the privilege of working there that it is of the utmost importance to influence people who have the opportunity to use the media to put over a more positive and hopeful message, and at the same time not to turn our backs upon the Brandt Report.
Ignorance leads to prejudice or complacency. There is an urgent and desperate need for improving the distribution of information. If only a greater emphasis could be placed on explaining to children in schools in this country at a much younger age just what the problems are, they would, as has already been proved, both now and later accept responsibilities and that interdependence is now a fact of life and we are all in it together.
The vista is so huge in the third world that there is really only time to mention how essential it is to concentrate upon preventive medicine. Many people 130 in this country now appreciate the importance of this.
Fifty years ago, tuberculosis, diphtheria and whooping cough were killing diseases in Britain. Now such instances are rare, but in the third world thousands still die annually from these infections. If opinion could be rallied to raise support and to put into the field more mobile health teams, armed with the necessary vaccines and immunisations, suffering could be relieved and lives saved. I am sure that we were all most deeply moved by the noble Viscount, Lord Mersey, who made an excellent and informative maiden speech on the colossal problem of leprosy.
I should now like to draw your Lordships' attention to the great needs which exist for residential homes in Britain. I mean a home in the best sense of the word; not just a place to live, but one that is personalised and has privacy, where each individual is able to lead a life of his or her own choosing, and to try to achieve his or her full potential in terms of independence—working skills, artistic and other talents.
The plight of the young chronically sick and of physically handicapped people is appalling. In 1974, the Government encouraged as many people as possible to remain in their own homes and to make use of the primary health care teams, who would be supported by home helps, occupational therapists, social workers, meals on wheels, laundry, incontinence pads, adaptions of loos, showers, doors et cetera. In 1980–81, alas, the enforced cuts are, of necessity, reducing these essential services and there are now people who simply cannot manage at home without these services. There are occasions when the stress and strain of keeping a frail, elderly or disabled person at home becomes too much for some families or neighbours, even to the extent of breaking up marriages and damaging family life. I speak from the heart, having the privilege of working, living and being with them. Surely, this is where help must be offered to take them into the kind of home that I have tried to describe.
Then there are those who require convalescence after surgery or, sometimes, cobalt treatment. Thousands of these require skilled nursing 24 hours a day, not in the environment of a busy hospital where they block acute beds, but in the more leisured atmosphere of a hospice or home for continuing care. There are those, too, who because of multiple disability or disease, cannot cope on their own. Here I should like to quote from notes on those we know:DC aged 30. MS diagnosed seven years ago. Research scientist of Bristol University. In hospital there for one year. Transferred back to his own county of origin to be near parents. Still in hospital waiting for suitable environment with younger people.Louise aged five. Severe brain damage. Mum a widow, lost her elder child in a fire at home. Louise cannot walk or stand. Total care needed. Since being admitted to this home she has made slight progress. Can now hold a special children's mug. Mum remains withdrawn, but her prospects are more hopeful.Couple both in their 70s. Wife admitted from bedsitter. Kitchen on floor above. Suffered several strokes. On ninth floor in hospital. Cannot see out of bed. Blocking acute bed. Intelligent, lively. Diagnosis: cancer. Husband has heart condition. He remains dignified, but at his wits' end.Another man in his fifties. Four strokes. Lived on top floor of tower block. Family had to go to work. Eventually admitted to hospital. Taking up medical bed, but could be more suitably cared for in a voluntary home at third of the cost".According to the Annual Register of General Statistics, 131 which was published in 1976, one-fifth of the 120,000 deaths were due to cancer. Seventy per 1,000 of these were in the 25–44 age group. Over the age of 65, the figure rises to 2,000 per 100,000 of the population. The Royal College of General Practitioners' working group on national terminal care policy, which published in 1980, stated that 42 per cent. of cancer patients, compared with 28 per cent. of patients dying from other causes, spent between two weeks and two months in an institution before death. The patient who is dependent on skilled nursing care, 24 hours a day, for relief of pain is searching for security and a place of dignity.
I cannot over-stress the abyss of despair and loneliness felt by a distracted spouse who has had no experience of nursing, particularly at night, or a desperate young wife with babies or young children. Often they have reached the end of their tether and in addition are in a highly distressed and emotional state.
Are we going to leave these people in a community where often facilities are nil or inadequate? Are we also going to leave others to vegetate in hospital, causing the country more and more expense and for whom these hospitals were not intended? Surely better use could be made of resources and re-allocation. Such conditions were highlighted in the research published in the Department of Health and Social Security journal Health Trends, August 1980.
Birmingham has a population of 5½ million; 10,000 new cancer patients are diagnosed there every year of whom 20 per cent. die, often at home and in totally unsuitable conditions, and some with no inside loo or running water. It costs approximately £78 a day to keep one of these patients in a hospital bed. In Berkshire, a working party decided after nine years that a continuing care home was required. Since this Foundation opened its home there in May, 1979, 245 patients have been admitted and nursed. But there are no funds from regional or area health authorities. Our costs in all the Foundation's homes are rising, but they are still only a fraction of the costs incurred in maintaining a patient in a National Health Service hospital.
So it can be seen that there is a void in our health service that is, and will have to be, filled by voluntary agencies. But I ask: is it fair to expect charitable foundations to face both capital and running costs? Voluntary agencies are more than willing to carry the extra load, but to deprive them of maintenance is to make the task nigh on impossible. Those of us in voluntary agencies appreciate that the country is in a recession and that resources here have to be fought for. Deplorable as it is, we also realise that many cuts have to be made. It is very sad, in a civilised Christian society, when the silent sufferers, for whom the health service has no room, are the last to be considered. But of course these are people with little or no influence on the political battlefield. Nevertheless, their friends, neighbours and others undoubtedly have.
We are in an age of high technology. More people are being kept alive in Britain. We therefore have an ageing population subject to cancer and other diseases. Medical technology can cope with a percentage of the curable ones, but the hard core, the silent sufferers, 132 require tender, loving care. It seems to me rather strange, although I do not wish to criticise, that British Airways and other nationalised industries never cease receiving infusion of cash totalling several millions, while those who have once been productive citizens—I am referring to the silent sufferers—continue to be ignored.
I believe that "constructive intervention" is the fashionable phrase in government circles today. If only that could be a phrase of reference to the people I have been referring to, as well as those in good health, then our society would be a better one for that. In the immortal words of Robert Browning:Oh, the little more, and how much it is!And the little less, and what worlds away!My Lords, if we were struck by a sudden earthquake or flood, funds, help and response would pour in. We are in effect now, in the field of disablement, in a similar situation without being sufficiently aware of the disaster. Therefore, we have to motivate the public, for I believe that national compassion can and will be roused. Let us therefore go out from here tonight with a rallying call for a campaign on behalf of all those who suffer, this year and in the years to come.
§ 9.25 p.m.
§ Lord Crawshaw
My Lords, I detect a strong sense of reunion this evening in our debate on the International Year of Disabled People. Over the years, I have had good reason to congratulate my noble friend who started the debate, for her performances on our behalf and on behalf of many other people, but this evening I am bound to say that my first impression and reaction is to congratulate her on her remarkable stamina, having been in this Chamber now for nearly seven hours and looking like being here a little longer. I feel that it is entirely right for your Lordships to debate this subject because of the political element inherent in physical and mental handicap. And that is a theme to which I will return in a moment. I believe that there is more direct experience of these matters here than in any other political assembly in the world.
The noble Duke, the Duke of Buccleuch and Queensberry, warned us not to overplay our hand and sicken the general public before the Year is over. I am bound to say that originally I was not enthusiastic about the International Year because it seemed to me to highlight segregation instead of integration of the disabled. After all, we all belong to other groups in society; we are not just disabled. If I may say so, we are a good deal more besides. I was considering making this my approach and reaction to the international year when I received a fascinating invitation to go to the United States of America next week to do a promotions exercise designed to encourage disabled Americans to do holiday tours of this country. This is being done principally as a commercial exercise, and look forward very much to seeing the effect of business and private enterprise interest in this field because I believe that Government departments and the social services may have a great deal to learn from private enterprise. I hope not only that we may be able to do something worth while for the American disabled, but also that the preparations that will be made for them here will be of considerable help to our own people later on. After all, history is full of examples of how we have called upon the help of our transatlantic 133 cousins, and this is just one example of the "international" in the International Year of Disabled People.
Turning to the domestic scene, I lay claim to being the second most experienced charioteer on parade today; that is, second to my noble friend Lord Ingleby. I think I have experienced most of the emotional volcanoes involved in this situation. I have had my bad moments and done my share of cursing over the past 28 years. My noble friend Lady Masham knows that the main impression that I left on one hospital was the extent of my vocabulary displayed while coming round from an anaesthetic following a painful operation. Blowing off steam is to me a natural phenomenon. But we should be careful in the use of naked aggression against the community at large. The disabled are still a minority, and tension created between the disabled and the rest of the community would in the end do a great deal of harm and be counter-productive.
I believe also that tension, pressure and impetuosity are often the cause of disablement and that a long spell of understanding and stable government would be of untold value to the existing and to the potential disabled, mental as well as physical. The noble Lord, Lord Wells-Pestell, very charmingly took some of us to task earlier on this afternoon for having been rather too quiet over the past year. I enjoyed, of course, being bracketed with the most reverend Primate the Archbishop of Canterbury and his colleagues for the first time. But I have felt that it was perhaps wrong to rock the boat if there was a chance of achieving that stability which could be even more valuable than the ramps and drugs and all the rest we have been asking for.
I have always felt that there is something more disastrous than physical disablement, and that is human degradation as the result of a demoralised and decaying society. I believe the disabled would forgo many things and put up with a great deal if they could really feel that this country was on the road to recovery. But a high rate of unemployment, for whatever reason, is not a factor which will inspire co-operation, because, as has been pointed out two or three times today, the disabled are perfectly aware that they come at the bottom of this heap. This was recently brought to my attention when it was pointed out to me only the other day that the British Tourist Authority, with whom I have been in touch, do not employ a single disabled person.
A reporter recently asked me whether, in my tour of the United States, I was hoping to change attitudes or improve amenities. My answer was simple: if the attitude is wrong you will not get the rest. I mentioned a moment ago that there are worse situations than physical handicap, and I believe that attitudes towards the so-called mentally ill, whose Year this also is, are correspondingly worse. There is a stigma attached to them which we do not have to bear. Of course, we know something of the attitudes in Hitler's Germany and in the Soviet Union. But I fear that the slate is not clean in this country. The Victorians had a habit of putting to one side anyone whose presence was inconvenient to powerful interests, but I had hoped that we live in a more enlightened age.
It therefore concerns me greatly—and I am sad to have to report it here—that a contemporary Member 134 of this House, known to me and to Lord Longford and to many others, has been detained and still is detained in a mental hospital, and the reasons for that retention are apparently something to do with financial irresponsibility. All I can say is: would all Governments please take note. I believe this to be the tip of an iceberg, an iceberg that we in this country cannot be proud of and one which the blood and the flower of two generations were spilled to melt. Once again I expect that fear is at the root of this iceberg. But I refuse to believe that filthy lucre was the idealistic target of Group Captain Leonard Cheshire and many others like him when they flew their dangerous missions a few years ago, and I am delighted this evening to have followed his wife who spoke in this debate a moment ago with such great authority.
So, in 1981, I believe that attitudes must be our main target area, and if that is hit all the rest in the way of amenities and help will follow. We might even get parking spaces in central London; we might get reasonably accessible London taxis, buses, trains and Undergrounds. I have aspirations which go beyond all that, but the hour is late and I shall hand over to our thirtieth speaker.
§ 9.36 p.m.
§ Lord de Freyne
My Lords, I am last, but I shall be short. I am, and indeed I am sure we are all, grateful to the noble Baroness, Lady Masham of Ilton, for introducing with great skill this very vital debate, especially this year, 1981, the International Year of Disabled People. We have all listened with great interest to the previous speeches, all raising important points and giving many of us food for thought, and I think that it becomes more obvious that as a community we must all pull together especially with the difficulties of the limited resources that are now available.
I am grateful to the noble Earl, Lord Radnor, for raising the subject of dyslexia. I, too, have a deep interest as president of a charitable trust helping to raise funds to aid the dyslexic clinic at St. Bartholomew's Hospital—one of the few services available on the National Health. The British Dyslexia Association do marvellous work, and I find the leaflet published by them, which I have in my hand, particularly appropriate. It is entitled The Hidden Handicap. It is, indeed, often hidden but a very real handicap to the child with reading, writing and spelling difficulties that requires the skilled help of a dyslexic therapist.
I also have here a case history taken at St. Bartholomew's Hospital. It concerns a young man of 22 years of age who came with his mother to be assessed at the dyslexic clinic. His IQ is 116. The reason why his mother accompanied him to the clinic was that this young man could not read or write and therefore was unable even to recognise the buses, tubes, et cetera to get him to his destination. He was assessed as a severe dyslexic. His future is gloomy because of his age; his job prospects are almost nil; and behind him a life of defeat and the physiological lasting wound of being labelled "dumb" will remain with him always.
Concern is generally shown by parents who often write to me. Indeed, I have here another comprehensive 135 letter from one mother telling me of the difficulties she has faced with two dyslexic sons. She has been fortunate to receive skilled help and a sympathetic approach from the school. Her concern is for early assessment for other children less fortunate.
In Her Majesty's Speech at the State Opening of Parliament, Her Majesty said that Her Government wish to consider the special needs of children in education. I was immensely heartened by that. I hope that we shall see great strides made to assist dyslexic children and I hope that your Lordships' House will not fall into the trap of thinking that just because these children show no particular outward handicap, their handicap is not very real. They are desperately in need of help and every encouragement should be given to those who work in this field so that more and more therapists can be trained, making early assessments so that treatment where needed may commence.
Though resources and educational cutbacks are with us, I should like to see that an option to train as a dyslexic therapist is offered in our teacher training schools. I am pleased to offer a ray of hope on this score. One London college has accepted this offer from the dyslexic clinic at Bart's to train students, and I hope that many of them will take up this option.
Finally, there is an old Chinese saying:The world cheats those who cannot read".I often think how very true that is. Let us hope that 1981 will give more hope to these children and their parents. I should like to make one further remark to your Lordships. When I had the honour to make my maiden speech on dyslexia in this House a certain member of the staff listened and then scratched his head. He wanted to do something. So he scratched his head and decided on this 40th birthday that he would jog from Westminster Bridge to Brighton with no publicity whatever. He did so and brought in almost a four figure sum.
§ 9.41 p.m.
My Lords, we have arrived at the time of night when those speaking below the line, as it were, must try to dismiss the universe in a few easy phrases. This is an immense subject, but after the splendid speeches that we have had—and today we have not just had well-intentioned speeches; we have had knowledgeable and very well-informed speeches—there is really almost nothing left to be said. However, even at this late hour I must thank the noble Baroness, Lady Masham, for providing an opportunity for your Lordships' House to show itself at its very best. Nowhere was that better illustrated than by the splendid maiden speech of the noble Viscount, Lord Mersey, who focused his own and your Lordships' attention on crucial aspects of a very important subject indeed and a potent cause of disability throughout the world—leprosy. After that splendid maiden speech, I, speaking as a doctor, will leave your Lordships' House rather better informed than when I came in, and that is not a very common experience for me.
I return to the speech of the noble Baroness, Lady Masham. She said that it was a long speech. I am bound to say that it did not seem long. It was a very succinct speech; it provided an admirable summary 136 of the matters with which we should all be concerned, and I really hope that her speech is read and re-read by all those in central and local government who have to take decisions which are likely to affect the disabled. Perhaps the noble Baroness will forgive me if I single out one matter on which I venture to disagree with her. She referred to the abuse of the orange badge scheme. It may well be that there has been some abuse. My own view is that there has not been very much abuse. However, there has been some and what there has been should be eliminated.
However, from my own experience in this field, I am bound to say that there is a tendency for certain people to believe that one is not disabled unless one is in a wheelchair, on crutches, or one has a white stick and a dog. I have presented a television programme on the disabled over many years. I have had complaints from people saying "It was appalling. I saw a man get out of a car with an orange badge and he was as fit as you are, or at least he looked as fit". There are many people who are very seriously disabled who do not like to advertise it, but who often have orange badges. I hope that we do nothing whatever to make some of those people feel reluctant to get the kind of help that they need. As has been said by the noble Earl, Lord Snowdon, and others, mobility is absolutely crucial to the disabled. I hope that we do not minimise or reduce the orange badge scheme merely because of a little abuse here and there.
Perhaps I might set the record straight at once by saying that there were far more things in the noble Baroness's speech with which I wholly agreed, and in particular I agreed with her when she said it was time we made mandatory the provisions of the Chronically Sick and Disabled Persons Act. She said in particular. that we should make mandatory the provisions regarding access. I would go further and make mandatory most of the provisions of that Act. I was one of the sponsors of that Act in another place with Mr. Alfred Morris. We worked for hours finding out what provisions were essential for the disabled to enable them to compete on equal terms with the able-bodied.
We gave a great deal of thought to what it was reasonable to require local authorities to do, but at the end of the day we finished up with an Act which required local authorities to do this, that or the other to such an extent as was reasonable and practicable. My experience as a doctor working in this field is that what has proved to be reasonable and practicable in one area has sometimes proved to be wholly unreasonable and impracticable in another. If it is decided that something is absolutely essential for disabled people in Bognor Regis, then the same thing is essential for them in Bolton, Bury and Blackburn. I am not for taking away the freedom of local authorities to take decisions, but it is high time we considered making most of these provisions mandatory.
I very much endorse too her plea for what she called an organiser of volunteers in areas. That is important. If one accepts that the present Government's philosophy is that much of the kind of work we are talking about should be undertaken by the voluntary sector—I do not quarrel with that—there must be a realisation that to fulfil those functions, the voluntary sector is one in which the pump will have to be primed; they will need assistance and professional guidance and expertise in 137 administration. And if volunteers come forward—and there are many people with time on their hands who could volunteer for this sort of work—there is nothing more inhibiting to them than to go along, offer their time and service and then find their time is wasted. Any money that can be spent on assisting the voluntary sector to have the right kind of professional expertise will pay in the long run, and in my view that is absolutely necessary.
I also agreed with the noble Baroness when she referred to the possible dangers of the new provisions with regard to sick pay, making the employer responsible for the first eight weeks. Employment is vital to the disabled, or those of the disabled who are capable of fulfilling a job. I spent a great deal of time professionally working in connection with the Disabled Persons' Employment Register, trying to get firms, even Government departments, to fulfil their quota of employing disabled people. The difficulty was to persuade employers that disabled people were often much more reliable employees than the able-bodied. The disabled person is used to being ill and having pain, and is determined to succeed and keep a job. When one can finally persuade an employer to take on a disabled person, often that employer finds that he has a faithful worker who turns up regularly, has almost no absenteeism and is a very good servant. The new provisions may make certain potential employers look twice before taking on a disabled person, knowing that he may be responsible for the first eight weeks of sick leave, and I hope we do not put the clock back. It means educating employers in every way we can to understand that it is worth employing disabled people.
I agreed with what the noble Baroness and others said about prevention. The noble Earl, Lord Snowdon, talked about this aspect of the matter, and how right he was; but I wish to mention one aspect of prevention to which reference has not been made. I agreed with much of what was said about birth injuries, neo-natal care and many other matters into which I will not go now; but no mention was made of something which is rather disturbing, and here I must choose my words with great care. I refer to a growth in recent years of genetically transmitted diseases. As I say, I must be careful in choosing my words, but in many ways western society has taken Darwinism by the scruff of the neck. There is no longer the survival of the fittest. We take active, vigorous and very proper steps to ensure often that the least fit survive—survive and reproduce. One of the consequences of that has been a growth of certain genetically-transmitted diseases. I have in mind bodies that are wholly well-intentioned—it is difficult to say this—such as the British Diabetic Association, with which I have worked so closely. It does admirable work for diabetics, but at the end of the day it tends to become a social gathering because diabetics join it for company. Then we are all surprised when diabetics marry diabetics, and we are even more surprised when the number of diabetics in society tends to rise. I am sorry to pick out that one example; there are many others.
All I am saying is that we must recognise a trend, and we must realise that it is worth putting more money into genetic counselling services, which exist in a very rudimentary form, and into publicising those services 138 and helping people to take advantage of them. I am not saying put the clock back in any other way. I am saying, recognise a trend, provide for it, and then perhaps we shall be able to prevent many forms of disability from becoming increasingly prevalent.
The noble Baroness did another service for us by making no specific mention of the elderly. Whenever people discuss the disabled there is a tendency immediately to start talking about the elderly, and I am very glad that that has not happened too often tonight, since I believe that we should not automatically categorise the elderly as disabled. It is a fact that very large numbers of people in going through life become older in terms of years but never become physically or emotionally dependent on others. They do not become disabled; they just get old and then die. Let us remember that merely to be old does not mean that a person is necessarily disabled, as many noble Lords have pointed out. However, we must remember that if the elderly do become disabled, they are doubly disadvantaged, and then we have of course to take very special steps.
I should have liked to comment on many points made in other speeches. The noble Baroness, Lady Young, stated quite categorically that the Government support the aims of the International Year and she spelt out some of the things that the Government are going to do. We shall wait with hope and see, my Lords, and we shall prompt them, if necessary. I was interested in what the noble Lord, Lord Wells-Pestell, said. He appeared to have gone on the transfer list and to be awaiting bids from the Bishops' Benches. We shall have to see about that, too.
At this hour I shall content myself merely with a reference to one other speech, that of the noble Duke, the Duke of Buccleuch and Queensberry. Not only did he dismiss the Royal Academy of Dramatic Art as a bunch of amateurs (which I thought was rather interesting) but he also focused our attention on cuts which in the end could prove to be very expensive indeed. As he rightly said, cutting home helps, or compelling local authorities to reduce the number of home helps available, will inevitably increase the costs of the health authorities. Our hospitals could be full of disabled people who could go home were there adequate domiciliary services provided by local authorities. So I hope that the Government realise that compelling local authorities to make cuts in certain directions could in the long run prove to be very costly indeed.
I chose the noble Duke, the Duke of Buccleuch, as another speaker whom I wanted to quote because I believe that he is an admirable example, as indeed have been so many who have spoken in the debate, of someone who has in every sense come to terms with, accepted, and overcome a disability. I knew the noble Duke in another place both before and after he became disabled, and I am bound to say that to me he seems to be exactly the same chap. He does the same things, in the same vigorous way, and I often forget that he is disabled, unless I bump into his wheelchair, or it bumps into me. He has accepted, come to terms with, and overcome his disability.
That leads me to refer to another group who have been referred to only slightly today and who so very often come to terms with their disability. I refer to 139 the visually disabled, the blind. They have been so successful in focusing their efforts on developing aptitudes in which their visual handicap does not really matter that we forget that they are handicapped in any way at all. Because we forget, we perhaps do not give them quite as much help as they need; and I am bound to say that the visually handicapped, the blind, are able to lead full, rewarding and fulfilling lives, in competition with the rest of us, at a price. Everything costs them more, and I am bound to agree with the National Federation for the Blind that it is perhaps time that we recognised that it costs money to be a fully active integrated person in society if one is blind, and perhaps we should recognise that with a blindness income, or an allowance.
I would go further, I think, and agree with the Disablement Income Group that it really is unreasonable, and perhaps unjust, that one's financial predicament should depend on how one got one's disability. A person who loses a limb at work may perhaps get enormous damages and live very comfortably; a person who suffers the same damage, whatever it is, at home, may perhaps live in poverty. I am not saying one can equalise all these things totally, but I believe that the Disablement Income Group are on the right theme in campaigning for compensation and an income for the disabled irrespective of the cause of the actual disability.
The disabled person needs money, and his needs are identical to those of the able-bodied person. He needs food, clothes and housing, and that means that he needs an income. That means he needs employment which can provide an income, and if they do not have employment (and even if they have employment) they need opportunities for recreation and other activities. Those three things—employment, recreation and other social activities—need mobility. How right the noble Earl, Lord Snowdon, was to focus our attention on the essential nature of mobility in order to enable the disabled to compete on equal terms in every way with the rest of us. The disabled need personal relationships, and that, of course requires understanding. They have emotional needs; they have sexual needs, which are very often not fulfilled without proper understanding from the rest of us; but above all they need a place in society and an influence in society.
With all that in mind, our aim should be to help 140 the disabled towards success and fulfilment in fields and activities in which their disabilities are least evident. We should remember that severely disabled people have reached the very top of the tree in every field of human activity. In politics, the record is full of the disabled getting to the top. Some, perhaps, have become more mature and more understanding because of their disabilities. I think that perhaps President Roosevelt came into that category. The same is so in business life, in the professions and in the arts. The arts are strewn with very severely disabled people who have been right at the top. So, indeed, is sport—fields in which one would expect one needed physical ability.
If I may digress for a moment—and I shall be very brief now—I am often reminded that my main interest in sport was cricket. Some of your Lordships will remember Fleetwood-Smith, the remarkable Australian left-arm spin bowler—perhaps their best left-arm spin bowler ever. There were many other fine spin bowlers, like Clarrie Grimmett, Bill O'Reilly and others, but they were right-armed. It is not generally known that originally Fleetwood-Smith played for New South Wales as a fast opening right-arm bowler. He would never have got into a test team: he was quite good, but not very good. Then he got poliomyelitis, and was paralysed in his right arm. He changed over, and became a left-arm spin bowler, and in the end, perhaps, became the best that the Australians ever produced.
I am not saying that every disabled person can get to the top of the tree. What I am saying is that he can try. That is all the rest of us can do—try. We may not succeed. If we can give disabled people opportunities to try, and the realisation that it is worth trying, then we have done a great deal, I think, to integrate them into society. We must encourage them to realise that the onset of a disability is not necessarily the end of rewarding life. Indeed, it can be the beginning.
My Lords, in my view Britain leads the world at talking about the disabled, though I am bound to say that the Americans come fairly close. Perhaps we lead the world in understanding the social, economic and political needs of the disabled. But do we lead the world in what we actually do? I very much hope that the International Year will prove to be a year, not in which we talk a lot more about the disabled but in which we do something.
§ 10 p.m.
§ The Earl of Longford
My Lords, it is a privilege to follow the noble Lord, who does so much, day in and day out, for the disabled. When he was referring to the disabled who had risen to the top I could not help thinking of my revered leader for the evening, Lord Wells-Pestell. His disabilities may or may not be familiar to the noble Lord, but I think we know that he shows no signs of them at any time. I should like to join with noble Lords in their tributes to the noble Viscount, Lord Mersey, who seems to have moved his political situation in the course of the day. At any rate, I would join in paying a tribute to him for a most interesting speech; and, of course, to the noble Baroness, Lady Masham, who is beyond compare. Some years ago—in fact, 10 years ago—when I had the honour of introducing Alf Morris's Bill and of carrying it through this House (with the assistance, of course, of the noble Baroness and others in the armchairs, and of others not in armchairs) I said something that was not original, perhaps, but which was at any rate something to which I attached a lot of importance. I said that suffering, while it can often degrade, can also ennoble, and I applied it then to those who were most active, speaking from wheelchairs in this House. I should like to repeat that now and extend it to the noble Duke and anybody else greatly afflicted who is with us.
Of course, there may be a question mark in some people's minds as to what I am doing here at all at this Dispatch Box. It is 13 years since I stood here or at the Box opposite, having spent 22 continuous years—a record, I believe—on one Front Bench or the other. When I arrived today I was expecting to play my usual inconspicuous part, but for reasons unknown—perhaps because the debate was going on so long and it was rather difficult to recruit alternative staff—I was drafted in, and so I find myself here again. The one lesson I remember learning in 13 years in Opposition—what were called "the wasted years" at one time; and old politicians will remember that phrase—and nine in Government was that the Minister is expected to comment on all the speeches, or at any rate on the speeches of anyone who survives. That task does not fall to me. I do not propose to cover all the speeches and to say how brilliant they were, although they were brilliant and moving.
The noble Baroness, Lady Trumpington, referred to incontinence and was looking at me rather hard. She can be assured that I have my own much-esteemed doctor, Lord Stone, beside me. If there is any trouble in the way feared by the noble Baroness, I have my own doctor to put matters right.
§ The Earl of Longford
My Lords, the noble Baroness may have been glancing round at some of the older Members of the House as her eyes descended on me; but I have Lord Stone to put matters right. Anyway, if there is any incontinence it will be only rhetorical incontinence; and I hope not too much of that.
I propose to say a few things that I had prepared when I came to the House about the Warnock Report and the aftermath of that, and then I may, if there is time—and there may be just time—to say a few rather 142 sharper things, speaking as one does on behalf of the Opposition. But let me first say a few words about the Warnock Report. I am not like one of those journalists who spend a lot of time concealing their sources. It can be taken that what I am saying now was prepared with some little assistance, at any rate, from my old friend, the dynamic philosopher and headmistress, Mrs. Warnock.
There is no doubt that there is a central idea in the Warnock Report and it can be simply stated. Instead of thinking about specific handicaps, we should concentrate on a child's total educational needs; that is to say, to the help that is given or ought to he given if a young person is to have the same chance of attaining the desirable educational goals as other children. I suppose you could say there is more emphasis on education and less on purely the medical approach. However you like to put it, that is the central idea stated in the Warnock Report and accepted as a philosophical concept by the Government. Although I may have something a little sharper to say about the Government later, at this point I should like to congratulate them on accepting that idea.
While we are talking about the Warnock Report, there is a general agreement—it has been mentioned several times in the House today—that so far as practice is concerned, implementation is concerned, very little is being done for the over-16s. Perhaps the noble Baroness, Lady Young, will say a little more about that, though I realise that in winding up a long debate like this she is not in a position to announce some great new emphasis of policy. I am informed on good authority that when the Warnock Committee—although it sounds rather incredible, and the noble Baroness I think is aware of this—completed their report they were under the impression that there would be a statutory obligation on local authorities to extend education where required from 16 to 19. That by no means seems certain. Perhaps the noble Baroness will tell us how she understands the legal position, whether it is clear, unclear or otherwise.
If the answer is unfavourable, that there is no such obligation when it was understood there was an obligation in the Warnock Report to extend education beyond 16 and up to 19, I can only beg the noble Baroness to look into the question of introducing new legislation. It is a rather unusual event but it seems to have happened and the committee, with all the assistance of the Civil Service, were left under a wrong impression—at any rate the position is by no means as clear as they thought it was.
The general issue, of course, takes us from the Warnock Report. I lay very great stress on the Warnock Report. I think that the general question has been dealt with in many different ways by different speakers. It is, I am afraid, impossible to discuss this without reference to the resources made available to the disabled, and it is impossible to discuss that question without reference to Government policy. When the Bill was carried through this House I was just a messenger boy, a bearer of the sacred flame. But I had the honour of carrying it through this House. There were no party politics in it then. Mr. Alfred Morris (with whom this will always be associated honourably) speaking not so long ago, took pride in the fact that it was an all-party effort.
143 Today it would be an affectation to pretend that members of my party, for whom I am speaking this evening, take any but a critical view of the attitude of the Government. Now, the attitude of the Government may not be the attitude of all Conservatives. The noble Duke, in a rather more subtle manner than any of which I am capable, conveyed what might be understood to be criticism. We know that there is Conservatism which is not represented in the Government at the present time. If anybody disputes that they do not read the newspapers, because anybody who reads the newspapers knows that Mr. Norman St. John-Stevas was dismissed from the Government the other day and afterwards announced that he stood for a compassionate, caring Conservatism. So do not let me talk as though the policy which the Government are pursuing at present is the only possible Conservative policy. There is a policy we might associate with Mr. Norman St. John-Stevas or with some of the more illustrious "wets", or all sorts of people.
At any rate, there is a Government policy being implemented in regard to the disabled and, speaking for the Labour Party, we are extremely critical. I think that many people, for various reasons, do not want to quarrel with the Government, and I understand that too. I am engaged in various forms of social work and one wants to stand on good terms with the Government: that is one way of playing it. But speaking from this Box, I must leave the noble Baroness in no doubt that we are disgusted with the attitude of the Government towards the disabled. It is not that the noble Baroness lacks compassion any more than Mr. Norman St. John-Stevas or, if I may say so, I do, but it is a policy which has been decided upon because it is felt that this is the only policy which will help the country to overcome its economic difficulties.
There is a point which the noble Baroness may not be able to clear up this evening, and if that is the case we shall have to pursue this further. She said—I apologise if I misunderstood her—that the present Government were devoting more real resources to the disabled than did the last Government. I wonder, did I hear her correctly?
§ Baroness Young
What I said, my Lords, and I believe it to be true, was that the amount of money that the local authorities were spending on social services was higher in real terms than that spent by the last Administration.
§ The Earl of Longford
My Lords, that would have to be demonstrated. I think the ipse dixit of the noble Baroness is not going to satisfy a lot of people, but I thought she was speaking of the disabled. Perhaps she was speaking of the social services generally. In view of the cuts that are being imposed on the disabled, it would be very extraordinary if that were true. I am not a great mathematician but I could just work it out and it could be true, because the amount would have increased between the Labour Government being in power and this Government—but on the face of it it is rather difficult to see how a policy of severe cuts is one which could actually lead to more being spent than was spent a year or two ago. It is difficult to understand how that could happen, and until it is demonstrated to 144 me much more clearly I and, I think, others here just will not believe it. We are capable of being convinced, of course.
There was a Minister with special responsibility for the disabled who stated at a conference not so long ago that if he had to apologise for anything it was for cutting too little and too late. That was a Conservative Minister: he apologised—and he was talking of the disabled—for cutting too little and too late. That suggests that the cuts were presumably not enough to satisfy him. But they were quite substantial. I can only ask the noble Baroness whether she agrees with any cuts at all. She was not telling us that there had not been any cuts, presumably, nor that they were just a sort of figment of the Socialist imagination. There are cuts and a policy being followed with a view to dealing with inflation, we assume.
But let us pass away from that for a moment. I should like to say how moved I was by the speech of the noble Lord, Lord Renton, because he was kind enough to refer to me. I was, as he said, chairman of the National Society for the Mentally Handicapped, as was the noble Lord, Lord Segal. I wonder whether he and others would agree with me that it is rather extraordinary how separate the movement to try to help the mentally handicapped has been from the movement to try to help the physically disabled. When I was involved years ago, we were not particularly in touch with the physically disabled, and since I have been more recently associated with the physically disabled I have not been in touch with the mentally handicapped. The Warnock Report tries to cope with both, but there is a question there which perhaps the noble Duke, who, I believe, is chairman of the coordinating committee, can deal with more effectively than anyone.
Before I conclude, I want to say this. Let us assume that the Government consider that serious economies must be made and that the social services must not be exempt. It is impossible to say at the same time that the Government are increasing the social services. They are cutting them for reasons which. in their eyes, make economic sense. That is their principle. If I may just quote the most reverend Primate the Archbishop of Canterbury and others, is one going to ask, assuming that there are to be cuts all round: are the disabled to stand on the same footing as everybody else? If I understood the most reverend Primate, he would regard them as specially vulnerable.
I hope, therefore, that the noble Baroness will at any rate consider what I am saying now and will carry further the message that comes from many of us here—though she cannot really pronounce on it tonight—that even if there have to be cuts, if that is the policy which seems to be correct to our present rulers, who have been democratically elected, then the disabled ought not to have to bear their share. For a long time, they were totally neglected. They are still a long way behind the general run of the community, and they are one of the most vulnerable—perhaps the most vulnerable—elements in the country. So I hope the noble Baroness will realise that, quite apart from this argument between her Government and the Opposition, there is an issue here which, in conscience, is very hard for the Government to cope with unless they alter their tone.
§ 10.17 p.m.
§ Baroness Young
My Lords, if there is one issue on which I think we can all agree, it is that we have had a good debate. We have had an outstanding maiden speech from the noble Viscount, Lord Mersey, who spoke so very knowledgeably about the dreaded disease of leprosy. I think that the whole House was riveted while he spoke, and I hope that we shall hear from him many times in the future. He was, as well, with the exception of the noble Baroness, Lady Ryder, the only noble Lord who referred at all to the international dimension of the International Year of Disabled People. At the same time, we have heard a great number of positive suggestions for action and have listened to many moving speeches based on personal experiences of disablement.
I know that my honourable friend in another place, Mr. Rossi, will read the report of this debate with great interest. I also know that one of his first actions, as Minister with responsibility for the disabled, will be to call together Ministers with departmental responsibility for action in the year of the disabled and make sure that their activities are co-ordinated.
It will be quite clear that at this hour, and in the time available, I cannot possibly answer all the points that have been raised. But what I will do, if there are outstanding points after the debate that I have not answered, is to write, or I will ask one of my colleagues to do so. I turn now to a number of matters which were raised, particularly, about the International Year of Disabled People. The first point which was raised by the noble Baroness, Lady Masham, was about the proposal that employers should be responsible for the first eight weeks of sick pay—a point which was also raised by the noble Lord, Lord Winstanley. The proposal to limit the duration of an employer's liability in any tax year should minimise, we believe, any detrimental effect that the scheme might otherwise have on the employment prospects of the disabled. It would be ill-advised to exclude the disabled from the scheme. It would stigmatise them, by suggesting that a disabled worker is more likely to be off work—an assumption that is not generally held to be true. That is something which I think both the noble Baroness and the noble Lord would agree upon.
The noble Lord, Lord Wells-Pestell, referred to the charges made by airlines for disabled people. I should like to say that I understand that, until recently, ambulance transport required for disabled passengers at Heathrow Airport was provided by the British Airports Authority at a nominal charge which was absorbed by the airlines. The BAA recently ceased to be able to provide this facility and the function is now undertaken by a private firm. A rather higher cost now falls to the airlines, but I understand that most airlines continue to meet the charge themselves and thus avoid extra expense for the disabled passengers. I am advised that a charge is involved only when the use of a fork lift ambulance is required to transport a disabled person to the aircraft and enable him to be put on board. Responsibility for the day-to-day operation of airline services rests with the airlines concerned. However, I understand that the Air Transport Users' Committee is aware of the position and will be considering the matter shortly.
146 The most reverend Primate the Archbishop of Canterbury raised the question of VAT on charities. As this is such an important point—many noble Lords have referred to the importance which all Members of your Lordships' House attach to the work of voluntary organisations—I should like to say something about it. A considerable proportion of the activities of charities already enjoy a large measure of relief from the incidence of VAT. Although they are certainly experiencing great difficulty, this is not solely due to VAT. For example, supplies made by charities for the relief of distress are regarded as non-business, if provided at consistently below cost. These are therefore outside the scope of the tax. Areas which in certain conditions may be zero-rated include the sale of donated goods, the export of any goods by charities, the supply to charities of certain scientific equipment for donation to hospitals and the supply of talking books and wireless sets to charities for the blind.
Nevertheless, charities are now seeking relief from VAT on all their purchases of goods and services. We believe that a general relief from VAT is probably not the right way to help charities. We recognise the value of their work, and the last Budget made important concessions designed to help them in the spheres of development land tax, capital transfer tax and income tax relief from donations under covenant. I understand that together these add up to a value of about £30 million. Reference has been made to the fact that local authorities are relieved of VAT for services, though charities are not. Local authorities are in a special position, in that they have to perform statutory functions funded by compulsory levies through the rates system. The relief from VAT is to prevent VAT from becoming an additional burden on the rates or the rate support grant.
We all listened with great interest to what was said by the noble Earl, Lord Snowdon, who raised a separate but important point about tax and asked for various tax concessions for disabled people with cars. I know that there are a number of areas in which various bodies seek tax relief. This is a matter which is outside my area of responsibility. However, I undertake to refer the noble Earl's suggestions to the Treasury. If I may, I will write to the noble Earl about this.
The noble Viscount, Lord Ingleby, asked a number of questions about the Chronically Sick and Disabled Persons Act. I confirm that Sections 4 to 7 of the Chronically Sick and Disabled Persons Act 1970 impose a mandatory duty on any person undertaking the provision of any building or premises to which the public are to be admitted to make them accessible, so far as is reasonable and practicable. I realise that some regard this as not being sufficiently strong. Nevertheless, I should stress that it is a statutory duty. The noble Viscount also asked whether all local authorities have appointed access officers. I cannot state that all have, but I do know that many have designated officers for this special responsibility. This is one way of ensuring that developers and others know where to look for information, and it is a way I would recommend to local authorities. But there are, of course, others. It is a matter which we believe is best left to the local authorities themselves to decide.
The noble Earl, Lord Longford, in his remarks, 147 challenged me about resources. I would say to him, as I would say to the whole House, that we all wish that there were more resources for the disabled and for a great many other deserving causes. We can all list our own particular ones. The real sadness about the background of resources, and this debate, is the fact that our country has not done as well as a good many other countries, and because it has not done as well we have not had the resources for the disabled, for social services and for many other good causes that we should all like. I do not think that it is for us this evening to apportion blame. What I think we ought all to do is to try to work harder to get the country going again so that we do have the resources that we should like.
But the fact remains that although much has been made of the effects of the cuts, we have consistently urged local authorities, when they are making necessary reductions in public expenditure, to protect the interests of the most vulnerable members of our society, and this of course includes severely disabled people. I am quite certain that they are as aware as many others who have spoken in this debate of the financial savings that accrue from helping people in the community at large rather than in any kind of residential establishment, or indeed a hospital. Local authorities have been faced with difficult decisions, but all the evidence is that they have consistently protected the personal social services. Far from being reduced from 1978–79 to 1979–80, expenditure on the personal social services actually increased. It was a small increase but nevertheless an increase. We cannot yet have firm figures for 1980–81 but the signs are that the personal social services are being protected.
I now turn to the second part of this debate, which was concerned with the Government's White Paper following upon the committee on children with special educational needs, under the chairmanship of Mrs. Warnock. Many noble Lords have paid a tribute to the work of Mrs. Warnock and her committee, and I should like to add mine. I have indeed been grateful for some of the remarks about the White Paper, and indeed I think most noble Lords have welcomed it, although I realise that many would wish that it went considerably further than it does.
The noble Lord, Lord Banks, speaking early in the debate, was particularly concerned about resources and, indeed, as I have already indicated we would all wish that we had more. Yet almost every noble Lord who has spoken in the debate has stressed, equally importantly, the importance of attitudes, and someone who I thought put that most movingly was the noble Lord, Lord Crawshaw. It is new attitudes which are required if we are to make the changes proposed by Mrs. Warnock and her committee and embodied in the White Paper. At the same time, we have to make better use of the resources that we have.
Perhaps I may now turn to answer a number of particular points that were raised. First, the noble Baroness, Lady Masham, and the noble Lord, Lord Renton, and the noble Baroness, Lady Darcy de Knayth, all raised the question of the named person. The Government fully support the idea of a named person to whom a parent can look for information and advice. However, it is simply not practicable to legislate 148 for a named person, and Mrs. Warnock herself appreciated the impossibility of giving meaningful expression to this concept in law. The legislation will, I hope, require local education authorities to give parents the name of an officer from whom information can be obtained, as soon as they commence formal assessment procedures, and I hope that this will be done.
A number of noble Lords, including the noble Earl, Lord Radnor, and the noble Lord, Lord de Freyne, raised the question of dyslexia, and I am hopeful that the removal of categories of handicap and the new arrangements for the assessment of special educational needs will end the arguments which have taken place over what is dyslexia. Whatever the cause or nature of the condition commonly called dyslexia, its manifestation is that the child has difficulty in reading, writing and spelling. The degree of difficulty should be revealed by assessment, and local education authorities will have to make appropriate arrangements for meeting the individual educational needs of children, whatever the cause. It is, however, wrong to say that local educational authorities are not making any provision for children with reading difficulties. A great deal is being done in remedial departments in ordinary schools and in specialised reading centres. In common with many areas of handicap, what is important is that the dyslexic child's problems are recognised at the earliest possible moment and appropriate action is taken to meet the individual needs.
I turn now to say something further on the problem of integration. I said something about this in my opening remarks and perhaps I should repeat, as so many noble Lords raised this point, that the Government wish to see as many children as possible with special educational needs educated in ordinary schools and this statement or principle will be embodied in the legislation. The Government do not believe—and indeed some noble Lords who have discussed this question today recognise this—that integration is the answer for every child. It is not just a question of a politician making a statement: it depends very much on a great deal of professional assessment and help. I would ask everyone interested to re-read Chapter 7 of Mrs. Warnock's report, where she discusses in great detail the problems associated with the question of integration. There is one obvious point, and that is the attitude of the receiving schools. It is no use and no help to a child to send it to a school where the attitude of the teacher is wrong, even if the law requires it. I do not believe this is the attitude of most teachers, because I think most teachers care very much about the disabled. Nevertheless, this is a factor to be considered.
But it is by no means the only one or the most important one. There are good reasons why the legislation cannot completely open up professional reports to parents. The reports can in some cases reveal matters that are perhaps best learned of in a different setting than a local education office. They might, for example, reveal that a child has not long to live, or is suffering from a degenerative condition. Instances also occur where congenital syphilis is the cause of a handicap and where maladjustment stems from a neurotic parent under psychiatric treatment. It is therefore possible to envisage that the interests of the parents and/or the child could be positively 149 damaged if the LEA was required to hand over professional reports. As I said, the legislation provides for close consultation with parents throughout the assessment procedures, and I repeat that they will be shown a copy of the statement of educational needs the local education authority proposes to make and be invited to comment. This will give parents far more information than under the present system. In addition, in post-legislative guidance to local education authorities I shall ask them, where there are no tragic or intensely personal circumstances revealed by assessment, to be as full and frank with parents as possible.
A great many noble Lords were concerned about what happens post-16; in particular, the noble Duke, the Duke of Buccleuch, the noble Baroness, Lady Fisher, the noble Earl, Lord Longford, and others. We recognise that a child's special educational needs do not stop at 16 or 18, and we are concerned that opportunities for education and training should continue to be available and that individual pupils and their parents should have the best possible advice about what they should do after the age of 16. A great deal is already being done in some areas. There is, however, a significant difference in the law for schools and for further education. Although in arranging the provision of schools local education authorities must take account of the need to provide for disability, there is no similar requirement in regard to further education. That is the answer to the question of the noble Earl, Lord Longford.
Ministers have accepted the need to clarify the law on this point, but since it is hound up with provision about schemes for further education requiring the approval of the Secretary of State it is, unfortunately, too large a subject to deal with as part of the current legislative proposals. A review of the law governing the provision of further education has been started, and it is envisaged that in due course a new statutory framework will be required within which special educational requirements will find their place. In the meantime, the Government will continue to encourage the development of post-16 opportunities.
At the same time may I try to answer the question raised by the noble Lord, Lord Renton, and the noble Lord, Lord Segal, about adult training centres. They were concerned that by law there should be an educational component in the adult training centre. I should say about the decision not to legislate for a specific educational element in adult training day centres that we did consider this subject in great depth. It was, however, not considered practicable to look within the programmes of these centres for a separate educational element, which would become the responsibility of a local education authority, while at the same time social training or training for employment would continue to be the responsibility of the social services department. These elements are not, of course, to be separated entirely and the work should continue to be planned and organised under single direction. However, it is most important that co-operation between social services departments and local education authorities continues to be fostered in order to assure the widest possible range of expertise to the trainees.
I, too, would like to pay my tribute to the work of the National Bureau for Handicapped Students, to 150 which a number of noble Lords, including the noble Baroness, Lady Elliot of Harwood, referred, which is a voluntary organisation set up about five years ago and which, as part of its activities, collects and supplies to handicapped students information as to courses and facilities both in higher education and in non-advanced further education, which it thinks might possibly meet their needs.
A number of noble Lords, including the noble Lord, Lord Rhodes, and the noble Countess, Lady Loudoun, referred to their concern about education in hospitals for the mentally handicapped. I was asked first about the numbers. There are now 58 schools in hospitals for the mentally handicapped catering for about 3,900 pupils. A further 200 or so, in hospitals where there are not enough children to establish a school, are receiving education under other arrangements made by local education authorities. I should make it clear that these figures exclude children who go out from hospital to a school serving the local community, which is encouraged wherever that is practicable.
There was some discussion about the government of hospital schools and we did, indeed, discuss this matter during the passage of the Education Act 1980. Hospital schools maintained by local education authorities were included in the provisions of the 1980 Act requiring parent and teacher governors. There are, however, problems about hospital schools where children may stay for only short periods and parents may not acquire very strong links with the school. If, therefore, it seems to a local education authority impracticable to arrange for elected parent governors, it may instead arrange for the appointment of people who are parents of children of school age.
Finally, I should like to answer the points that were raised again by the noble Lord, Lord Banks, and the noble Baroness, Lady Faithful], both about records and about teachers. Under the provisions of the 1980 Act, the Secretary of State has the power to make regulations governing the transfer of school records. My department is currently considering how this desirable goal of the transfer of information between schools might best be achieved. As many noble Lords raised the whole question of teachers and teacher training I should say that additional resources are, in fact, not available for the expansion of teacher training, but we believe that much can be done and, indeed, is being done, within existing initial and in-service training courses to alert teachers to the problem of recognising and catering for the diverse range of special needs encountered in the classroom. The noble Baroness, Lady Darcy de Knayth, asked about the use of special schools as resource centres. Local education authorities are well aware of the skill and expertise that is available in special schools, and their development as resource centres is a matter for each local education authority to consider individually.
In the course of this debate many noble Lords gave examples from their own experience about handicap and what is being done in the International Year of Disabled People. The noble Baroness, Lady Phillips, gave us a very interesting illustration of the work of the glove makers; the noble Baroness, Lady Vickers, of her work with the deaf; the noble Earl, Lord Halsbury, of his experience and the help that he has given to speech therapists; the noble Lady, Lady Kinloss, of 151 work in Yorkshire which covered many areas. I shall take up the point of the noble Lord, Lord Campbell of Croy, who made, I thought, such a very interesting suggestion about the use of volunteers, possibly for collecting information about a national register for the disabled. The noble Baroness, Lady Trumpington, raised the question of old age and the worrying problem of incontinence.
I believe that it was the noble Duke, the Duke of Buccleuch and Queensberry, who said early on in the debate, perhaps slightly tongue in cheek, that international years can do more harm than good. I very much hope that this will not be the case. I believe that this debate must make us all—both here and in the outside world—more thoughtful and more imaginative, and make each of us ask what we can do, not just in this year but in the years to come; and make us remember that the disabled need to be helped, but also need to be treated with thought, dignity and love—indeed, just as we should treat all mankind.
§ 10.41 p.m.
§ Baroness Masham of Ilton
My Lords, after this long debate I want to say only a few words. I hope that the noble Earl, Lord Snowdon, will come more often to your Lordships' House. He has much to offer and he works so hard for the disabled, which is much appreciated. I hope that the speech of the most reverend Primate the Archbishop of Canterbury will be taken up by all priests and ministers of the Church. This would be a good ecumenical exercise. The spiritual life is so important to many people with a handicap who have to try to understand life. I think that the noble Baroness, Lady Phillips, illustrated so well how difficult it can be to get done things which can be essential to a handicapped family. They wait so long; sometimes they die before they get what they need. Local authorities must become more efficient and they must make wise use of the resources they have without causing frustration and waste.
I should like to congratulate the noble Viscount, Lord Mersey, on his most interesting maiden speech. I hope that he will continue to make films on many aspects of disability. I—as do all complete paraplegics—have something in common with sufferers of chronic leprosy. We lose the feeling of our paralysed parts. Tonight, when I go to bed, I shall check my behind to see whether I have sustained a pressure sore. Maybe other noble Lords in wheelchairs will do likewise.
I should like to thank all noble Lords and Baronesses for their contributions to this debate and the noble Minister Lady Young for speaking twice. I hope that the Government will take note of some of the recommendations made in this debate by your Lordships. I also hope that the Government will take very seriously the speech of the noble Baroness, Lady Ryder of Warsaw. One important disability which has not been mentioned today is kidney failure. I hope that more kidneys will become available to save life during 1981. My Lords, I beg leave to withdraw my Motion for Papers.
§ Motion for Papers, by leave, withdrawn.