It is a year to the day since we published the report. It takes quite a while for these debates to work their way through the system, but that does not mean that this one is any less important. Human rights matter most to vulnerable people, and adults with learning disabilities are among the most vulnerable people in the UK. We began our inquiry two years ago, in the light of shocking revelations about the treatment of adults with learning disabilities, including years of abusive practices in Cornwall, neglect and institutional abuse in Sutton and Merton, and six deaths in NHS care, described by Mencap in its report “Death by indifference”. Those tragic events suggested that the human rights of adults with learning disabilities are not well respected in the UK. Indeed, 10 years after the introduction of the Human Rights Act 1998, we still found it necessary to underline in our report the fact that adults with learning disabilities have exactly the same human rights as everyone else.

Throughout our inquiry, I had mixed feelings of admiration, sadness and anger. I had admiration for the huge number of family carers, battling against the odds; admiration for the dedication of professional carers, such as the one we met at the Home Farm Trust, who helped to take someone with extremely profound learning difficulties on holiday to Spain; and admiration for the many people with learning difficulties achieving so much for themselves when given the chance to do so, despite consistently unfair low expectations.

I was saddened by the story of the Lewisham college teenager who could not go out with her friends, because there was no one to take her and she was not allowed out alone, and by the story of the other student I met there, who had experienced the death of no fewer than five of his school friends during his school life. I felt anger at the many tales of avoidable discrimination, blatant hostility and neglect. We on the Committee learned a great deal ourselves—probably more than in any other inquiry in which I have been involved. We learned how people with learning disabilities have been dehumanised through stereotyping for centuries, suffering discrimination and ill treatment and seeing a lack of respect for their rights as part of everyday life. We learned how low expectations mean that people with learning disabilities are unlikely to have a job, are more likely to live in poverty, will not have normal social relationships and will continually suffer a lack of privacy and dignity. We were told, “No one is up in arms about how little choice we have over our everyday lives.” We all need to recognise that people with learning disabilities have the same rights as everyone else and are entitled to equal treatment.

Under my chairmanship, the Joint Committee on Human Rights has emphasised how the Human Rights Act can improve the lives of everyone in the UK. Too often, the Act has been derided as a charter for criminals, with nothing to offer ordinary people, or it is regarded by public bodies as another regulatory provision with which to comply, ending in a legal department tick-box exercise. We argue that the Human Rights Act has the power to transform the provision of public services for the benefit of all. By focusing first and foremost on the rights of service users, public services can be tailored to meet the needs of users, rather than those of providers. I shall give examples later of how the Human Rights Act could help the delivery of services to adults with learning disabilities.

Does my hon. Friend share my wish to advertise more the positive impact of the Human Rights Act, particularly for people who need care services? There are myriad examples of people who have been abused or denied proper services—older people, people with disabilities and people with learning disabilities—and who have been able to restore their rights because of the Human Rights Act. It is ridiculed in many areas of the press and we should advertise its successes far more widely.

I agree. Such positive stories do not fit the media narrative. This is not just about case law; there have been plenty of cases in which the Human Rights Act has been used in a positive way to help the rights of people who are at a disadvantage. It is also about trying to instil a change of philosophy and approach in public services, so that people need not go to court, because public services are delivered in a positive, human rights-compliant way—that is, in a way that is respectful towards the service user. We found plenty of examples of that, not only in this inquiry, but in many similar inquiries that we have undertaken.

During our inquiry, we received more than 200 submissions, including dozens from people with learning disabilities and their carers. We took advice from the British Institute of Learning Disabilities on how to engage adults with learning disabilities. We took oral evidence from people with learning disabilities. We visited Lewisham college, where we spoke with learners and staff in their school of supported learning. We met members of a local KeyRing housing and support network in south-east London. We visited people with more complex and profound learning disabilities at a resource centre in Bidford-on-Avon and at home in supported accommodation in Evesham.

We published our report a year ago in formats including easy-read and audio versions, which we believe is a first for Parliament. A key barrier facing people with learning disabilities is the lack of accessible information, both about matters of interest to them and about their rights. The Government reply was published in May 2008 and we received a further reply in January this year, when the latest version of “Valuing People Now”, the Government’s delivery strategy for adults with learning disabilities, was published. We also published a report on the UK’s plans for ratifying the UN convention on the rights of persons with disabilities, to which I shall return.

I very much welcomed the positive spirit in which the Government engaged with the Committee during its inquiry and the serious consideration that they have given to our report. However, I have a number of questions to ask my hon. Friend the Minister about the new version of “Valuing People Now”, even though I am pleased to note that the document addresses a number of our key concerns. The Government’s strategy for adults with learning disabilities is now more explicitly rooted in human rights and equality, and it is for the Government to deliver that rightly ambitious agenda.

There was some good news, too. The old long-stay hospitals have largely gone, but there is still, unfortunately, institutionalised living, with the needs and lifestyle of the individual sacrificed to those of the institution or organisation caring for them. Most people with leaning disabilities now live for much longer and many more survive childhood. There are many active self-help groups. Spending on adults with learning disabilities has doubled, yet there remains huge pressure on budgets. Person-centred planning, the Supporting People programme and direct payment systems all help to encourage independent living. There is much good practice, as we saw on our visits, but there remains a yawning chasm between the policies of “Valuing People” and “Valuing People Now”, and the everyday experiences of adults with learning disabilities.

I shall now deal with some of the key themes of our report, including supporting adults with learning disabilities in their everyday lives, parenting, health care, the criminal justice system, information provision and advocacy. Those issues affect people with learning disabilities throughout the country every day. I shall conclude by considering what the Government and we in Parliament can do to respect the human rights of adults with learning disabilities better and to improve their lives.

One of the main ways in which relatively minor changes could have a disproportionately beneficial impact on adults with learning disabilities is by supporting social relationships and community participation. We heard how staff rotas in residential accommodation too often determine when adults with learning disabilities can go out and when they must return home. Residents may be able to go out only if they are in a group, accompanied by carers. One resident told us, “Our carers’ shifts change at 9 pm, so we have to leave the leisure centre at 8.30.” Another told us that his carer had said that he could not kiss his girlfriend—the carer said, “We’ve got to draw the line somewhere.” Many complained, “We’re stuck at home”, “We’d like to go to bingo or the pub” or “We have to go out in a group.” Maintaining family contact was sometimes difficult if the person with learning disabilities was placed by the council in out-of-area accommodation.

Tightening local authority eligibility rules has led to the prioritising of those with complex needs at the expense of those with less serious problems but, inevitably, smaller sums can disproportionately benefit the less disabled. A small amount of money can go an awfully long way. The factors that I have set out inevitably discourage adults with learning disabilities from forming friendships and relationships—the type of interaction that most people take for granted. In “Valuing People Now”, the Government say that they will work with the Care Quality Commission to address that problem. I welcome that: relatively small changes in practice will make a huge difference to the lives of adults with learning disabilities. Will the Minister confirm that that is a priority area for improvement?

Housing and genuine choice about housing are of great importance. A high degree of independence is possible with appropriate support, as our visit to KeyRing and our discussions with its residents showed. Indeed, one resident said that she seemed to be looking after the carer, rather than the other way round. There is an unnecessarily strong risk-averse approach to helping people to live independently, which closes down options to the detriment of choice. Paid employment is also very difficult to obtain. In that respect, there has been very little progress, and it is often hampered by benefits issues, yet people with learning disabilities are, with the right support, motivated and reliable employees, as we saw, for example, at Lewisham college. I have visited a similar project in my constituency and seen the same there.

Adults with learning disabilities have the same right to vote as everyone else. In practice, however, it is all too common for staff in polling stations to jump to the conclusion that they lack the legal capacity to vote and they are turned away. We in political parties, too, can be guilty of such assumptions when campaigning. The test is whether the individual has the capacity to understand in broad terms the nature and effect of voting, and has the ability to make a choice between the candidates. We called for more guidance to be made available to returning officers, so that they can train their staff to respond correctly to voters with learning disabilities. The Government said that that was a matter for the Electoral Commission. Will the Minister take up that matter with the commission?

What my hon. Friend says is important. When I first stood for Parliament in 1992, I was shocked to find that I could not translate into some form of symbolic representation who I was and why I was standing. There is no way to do that other than through those who work with people who have learning disabilities. Things may have improved in the wider electoral process, but surely there should be some service to allow us to communicate our electoral material so that all people can make a choice? Otherwise, some people, I am sure my hon. Friend agrees, are excluded from the process.

I very much agree with my hon. Friend. I shall say a little more about Parliament later, but the main political parties ought to consider whether it is possible to produce electoral material in easy-read format. Much material is produced in minority community languages, and I produce a lot of localised information in those languages. However, my hon. Friend is right to say that producing such information in easy-read format can be difficult.

The Committee made a series of recommendations on parenting. Too often, it is assumed that adults with learning disabilities cannot look after their children properly. That leads to family break up and the forced removal of the children, with associated harm to the children and their parents. Often, all that is needed is some targeted support to keep a family together, allowing parents to demonstrate that they can look after the child, and that they can respond to risk in a way that is both proportionate and necessary. For instance, we were given the example of a learning difficulties mother being asked to demonstrate on a robot baby that she could look after her child; she found it rather difficult to relate to the robot, so it was not a good test.

The Government’s good practice guidance should reduce the risk of parents and children being wrongly separated as a result of such unjustified assumptions. However, we heard evidence that the guidance is not being implemented. Routine information that is normally given to parents without learning disabilities is not provided in an accessible way to those who have such disabilities. How is the Minister monitoring the implementation of the guidance, and what can he do to deal with examples of bad practice?

I thank my hon. Friend for giving way, and I apologise for the fact that I have to leave early to catch the plane.

My hon. Friend mentioned the Government recommendations. Given our expectations of an equality Bill later this year, does he agree not only that the role of public bodies at present should most certainly be confirmed, but that if we can improve upon existing legislation in respect of public authorities, the Bill is a good opportunity to do so?

I am grateful to my right hon. Friend. He has a good and strong record in standing up for people with disabilities. I look forward to more detailed comments from him when we debate that Bill. I assure him that my Committee will take a close interest in the measure, both generally and from the perspective of this debate.

The Committee was gravely concerned about the wealth of evidence that we received about degrading experiences in health and residential care settings. We heard of a teenage student at a Scope residential school who was in hospital for three days. He was given no food; the hospital staff said that they “didn’t know how to feed him”. We were told of a person with Down’s syndrome being locked in a minibus in a garage overnight; on another occasion, the carers broke his foot when forcing him back on to the bus in which he had been locked.

We also heard of a lack of dignity and privacy. One person said, “Although I was given a key to the front door, there was no key to my own room”, and “When I clean my room, they do it again”. Someone with visual impairment and scoliosis who could not help bumping into things was strapped into a wheelchair. The Sutton and Merton inquiry into physical and sexual abuse found that the staff did not know that they were doing anything wrong. That is all compounded by the fear that people have of complaining. They think that they will get the blame, and they face negative and patronising attitudes, and often blatant discrimination.

We welcome the Government’s commitment to using the NHS operating framework to require health authorities and trusts to draw up action plans to deal with shortcomings in the care of adults with learning disabilities identified by the Healthcare Commission. Will the Minister update us on progress with that initiative? How can he ensure that the work leads to real improvements and not just more bureaucracy? We took a keen interest in the pilot programme run by five NHS trusts. Supported by the British Institute of Human Rights, they have adopted a human-rights approach to their work. The recent evaluation of the pilots was positive, and referred to improved practices and outcomes. We would like that initiative to be rolled out nationwide. Will the Minister tell us what is happening to spread that good practice, and will the initiative be rolled out countrywide?

We welcome the establishment of a human rights advisory group in the Department of Health. Will that group seek to champion human rights in social care settings as well as in the NHS? Will it work alongside the Care Quality Commission on that matter? The Committee recommended that people working with vulnerable adults should be under a duty to report suspected abuse. The Government agreed to consider whether new legislation would be practicable and useful, and are now encouraging a debate on the question. Again, I press the Minister to look at carefully at this. Our clear view is that new legislation is necessary to help identify and prevent abuse.

Adults with learning disabilities are particularly vulnerable to crime; they are also vulnerable within the criminal justice system. They are particularly vulnerable because of their lack of knowledge of their rights and because of their low expectations. That often leads to the acceptance of ill treatment without comment or complaint. They do not always realise that they are the victims of crime or that they are being treated as such by the authorities. They are vulnerable as a result of social marginalisation, living in a segregated environment and depending on others who may be the abusers; and they are susceptible to manipulation and exploitation as a result of communication difficulties.

It is hard to believe that some evil and ignorant people can target those with learning disabilities. It is hate crime, and it should be seen as such and heavily punished. I shall give some examples. Steven Hoskin was tortured and thrown off a viaduct. Kevin Davies was locked in a shed and tortured. Raymond Atherton was beaten and thrown in a river. Brent Martin was beaten and left to die in the street. The Equality and Human Rights Commission has researched the experience of those with learning difficulties as targets of violence and abuse; I understand that it will publish its findings in late April.

The scope of the problem is underestimated. “Valuing People Now” talks of better guidance and reporting arrangements. Will the Minister consider publicity to highlight the issue and to get the message across that abuse of people with learning disabilities is not abuse, but potentially criminal assault?

The Committee was also concerned to hear that adults with learning disabilities—whether accused of crimes, or as victims or witnesses—are not well served by the criminal justice system. We received a considerable body of evidence suggesting that not enough is done to explain what is happening when dealing with the police, and in court. We were told that when people with learning difficulties report crimes, they may not be taken seriously. The police do not consider the special measures already available to them to help people give evidence.

The Government told us that the Crown Prosecution Service was working on policy and practice for victims and witnesses with learning disabilities, but what is being done to assist those who have been charged with crimes? We were told of someone who was arrested for breach of bail conditions by going somewhere he should not have gone. He said: “If they’d explained things, I’d have been able to do what they said.” Another signed a statement, although he could not read it. We heard of people being interviewed without an appropriate adult being present.

We also heard of the pretty sorry state in the prison service—a lack of support, gaps in provision and the unreliability of screening in identifying learning disability. Prisoners were sometimes excluded from offender behaviour programmes because they could not do them, thus reducing the opportunity for resettlement, and ultimately meaning spending longer in prison because parole or early release was not available without doing the course.

At a certain point in my life, I spent a lot of time in prison—prisons, I should say. I was enormously struck by the proportion of prisoners I met who had learning disabilities; and I was struck by exactly what the hon. Gentleman remarks upon—the inability of the prison system to deal with that phenomenon. I was particularly interested in those parts of his report in which he deals with that problem. Does he believe that we need a complete change in attitude inside the Prison Service, making that one of its priorities?

The right hon. Gentleman is absolutely right. There are many people in prison with learning difficulties who, frankly, should not be there and who cannot cope. I can do no more than refer to the recent report from the Prison Reform Trust, entitled, “No One Knows: Prisoners’ Voices”, which supports in much greater detail the findings of my Committee. The Committee might want to return to that issue in the future.

Perhaps the Minister can reassure us that the police, judiciary, Courts Service, prisons and other criminal justice agencies are addressing the problem. Intermediaries can help to explain questions and proceedings in court to people with learning disabilities. However, funding has been devolved to primary care trusts, which could lead to a postcode lottery. Can the Minister comment on the role of intermediaries and ensure consistent provision for this service nationwide? Underpinning many of our concerns is a lack of awareness among public sector staff not just about how to respect the rights of adults with learning disabilities, but that those rights even exist in the first place. The Government told us that this issue was being addressed through the undergraduate and postgraduate curricula for professional, regulatory and educational bodies. We welcome this, but what is being done about existing staff?

A constituent of mine, Anil Ramani, who is a resident in supported living accommodation, went on a day trip from his day centre in Edgware, known as “the Space”, to Aldenham country park. The carers did not count people on the bus, even though there were three members of staff for just nine service users. They left him behind, without even noticing that he was missing until two hours later. He was not found until 11.30 am the following day. He had spent the whole night in the park on a bench. I am told by Barnet social services that lessons have been learned and procedures changed, but after union representations the staff concerned did not lose their jobs, which I find remarkable.

The problem affects more than just the public sector, however. Last year, a small group of people with learning disabilities and their support workers went to a karaoke night at “The Bull and Butcher” pub in my borough. The manager was hostile, made it clear that he did not want them there and harassed them until they left in distress. An appalling case of discrimination in the private sector!

The provision of information in appropriate formats for adults with learning disabilities is crucial. We were struck by the lack of easy-to-understand, illustrated information—council forms and leaflets are not much help or use to people who cannot read. People with learning disabilities should be involved in advising on how to produce better, accessible information. We expressed concern at the absence of a cross-Government strategy to provide accessible information, and we were not reassured by the Government response, which dwelt on resource constraints and the need for individual Departments to comply with the Disability Discrimination Act 2005.

A far more proactive approach is needed to help public bodies meet the information needs of all the people they serve. The commitments in “Valuing People Now”, such as to consider how to promote locally accessible information for people with learning disabilities, focusing on the NHS, are far too weak. I hope that the Minister will look again at this matter, therefore. Is there scope for the Equality and Human Rights Commission to help with information provision on the most important public services? It has already produced an easy-read version of a guide to the Human Rights Act 1998, and I understand that it intends to produce one on the disability equality duty.

Access to independent advocacy may well be the only way that many people with learning disabilities can secure their human rights. That is particularly true of parents, those with complex and profound needs, and those involved in the criminal justice system. Self-advocacy groups are also extremely important. We called for a review of the availability of independent advocacy, but the Government did not respond to this recommendation. “Valuing People Now” talks about improving the impact of advocacy, but not about making advocacy more widely available. I hope that the Minister can reassure us, therefore, that advocacy will not be a Cinderella service, neglected by central Government and inconsistently funded by local authorities, but can be seen as part of mainstream support for people with learning disabilities.

Friends of mine are trying to set up such an independent group, and the biggest problem is the lack of an obvious route for grant finance. The difficulty with seeking local authority finance only is that people will not be entirely independent of that local authority. That could create problems if they have issues that they wish to raise with the authority. I know that promises have been made, but they urgently need to be translated into action.

I agree with my hon. Friend. Many advocacy groups are dependent on charitable funds and live a pretty hand-to-mouth existence.

The then national co-director for learning disabilities, Rob Grieg, was extremely candid in his oral evidence to the Committee about the difficulties of ensuring that policies for adults with learning disabilities are implemented, even within the Department of Health itself. There is a lot to welcome in “Valuing People Now”, but the key test is whether it makes a difference to the lives of the people whom it is meant to help. I hope that the Minister will champion “Valuing People Now” across Whitehall and to front-line staff delivering services throughout the country. He needs to show real leadership to turn the document’s policy commitments into real, tangible, measurable outcomes for adults with learning disabilities.

One of our criticisms of the original valuing people strategy was that it lacked measurable targets. “Valuing People Now” is an improvement, but it is still not clear how the activities set out in the delivery plan will be measured against the strategic objectives. For example, the office of the national director for learning disabilities is expected to work with other agencies to take forward a programme of work and to consider how mainstream housing policies can be made more inclusive by 2012. However, what will be the practical outcome of this work, and how do we expect housing provision to have been changed by 2012 as a result?

I mentioned earlier the UN disability rights convention, which consolidates and clarifies existing rights from a number of other international treaties into one document, and sends a powerful signal that the rights of disabled people matter. The Government signed the convention at the first opportunity and are now working towards ratification by Easter. Given that the initial target of ratification by the end of 2008 was missed, can the Minister confirm that the Easter target will be achieved? I received a letter from the Department on 3 March, with the explanatory memorandum for ratification, which has now been laid before Parliament, but I hope that we can have some more concrete assurances.

We recommended that the Government should sign the optional protocol to the convention, which will allow for a right of individual petition, and I congratulate the Minister on accepting this recommendation and signing it. I hope that the Government can now sign the various other optional protocols that allow for individual petitions to other conventions—our country has nothing to fear by doing so. We expressed concern at the delay in ratifying the convention, which at the time of our report the Government failed to explain, but it has since become apparent that various reservations are being proposed. We published a further report on that in January, because we are not convinced that any reservations are needed, and we were critical of the lack of transparency in the process. The number of reservations and interpretive declarations has now reduced, but we are still not satisfied that the remainder are necessary.

Some of the issues that we are debating today will be relevant to the Equality Bill—as pointed out by my right hon. Friend the Member for Coatbridge, Chryston and Bellshill (Mr. Clarke)—which the Government have promised to introduce during the current Session. For example, we expressed concern that public bodies are not taking a positive approach to the disability equality duty. That mirrors our finding in this and other contexts that public bodies do not consistently promote human rights and do not fully understand their positive obligations under the Human Rights Act. My Committee will closely scrutinise the Equality Bill during its passage through Parliament. Can the Minister confirm that it will be introduced immediately before Easter?

I begin with two apologies: first, I have an appointment in my constituency so I cannot stay until the end of the debate; secondly, I shall touch briefly on the issue of employment, and if the hon. Gentleman was coming to that, I apologise for pre-empting him. Does he feel that, in some ways, the Government’s promoting employment in the public sector for people with learning disabilities might be a way forward? Perhaps we could do that in the House. Benefiting from the advocacy of Mencap, I had the opportunity to employ someone with learning disabilities. It strikes me that that might be a way forward for other hon. Members. They could promote that positive approach on an occasional basis.

That is a very worthwhile suggestion. As I said earlier, with the appropriate support people with learning disabilities are reliable and motivated employees. They simply are not given the opportunities that they should be, because of society’s generally low expectations of them. If they are given the chance, they will perform, as we saw on a number of our visits when we prepared the evidence for our inquiry.

The hon. Gentleman is right about Parliament. We have made a number of recommendations about how public bodies serve adults with learning disabilities, but how well does Parliament itself serve that group? We worked hard to engage adults with learning disabilities during our inquiry, but there is a lot more that we could do. For example, my Committee staff will prepare a summary of our debate today for publication in an easy-read version—Hansard is inaccessible to many people with learning disabilities. I have met the Commons outreach team and following on from that, I have written to the parliamentary authorities to raise the issue of accessibility. We will continue to press for that to be addressed. Indeed, I raised the matter during questions to the Leader of the House today when I asked about the importance of making such facilities available. I got—I think—a relatively positive response. I was told that the issue would be looked into. It is just not acceptable that adults with learning disabilities cannot access parliamentary material and services of relevance and interest to them.

In conclusion, our inquiry covered a wide range of issues in which the human rights of adults with learning disabilities were being routinely and deliberately ignored or casually overlooked. Such behaviour was found to be the main cause of the institutional abuse uncovered in Cornwall and Sutton, and by Mencap in its report. The Government are moving in the right direction, and I congratulate the Minister on publishing “Valuing People Now”. None the less, we need strong leadership. The Minister’s heart—and that of his predecessor—is in the right place. Moreover, the policies are right, too. The problem is the gap between such policies and the everyday experience of people with learning disabilities. There has been a lack of effective monitoring and we must plug that gap. We need a national culture change to recognise that people with learning disabilities have the same rights as everyone else. It is not just a question of being nice to “unfortunate people”. We must recognise their rights as equal citizens, and empower them by involving them in the development of policy and in the taking of decisions over their own lives. There is a very long journey ahead before the human rights of adults with learning disabilities are fully respected in the UK, and my Committee will continue to press the Government to do more.

I congratulate the Committee and the joint Chair on the excellent work that they have done on this important subject. I welcome the opportunity to talk about adults with learning disabilities and, by extension, the rights of their families. Too many people with learning disabilities are not being respected, and that is demonstrated by recent examples in the health sector.

It gives me no pleasure to have to highlight a case that was brought to me by the mother and sister of Martin Ryan, whose avoidable death was highlighted by the excellent Mencap report “Death by Indifference”, which was published in 2007. Throughout his life, Martin suffered from severe learning disabilities, Down’s syndrome, epilepsy and he had no power of speech. The health service ombudsman, Ann Abraham, carried out an investigation into Martin’s death. I understand that, when that report is published later this month, it will highlight that the death of Martin Ryan was avoidable.

I have met my constituents a number of times to discuss the treatment that Martin received after having a stroke and being admitted to Kingston hospital in 2005. I believe that Martin’s case demonstrates how adults with learning disabilities are often not granted the full rights that they deserve when receiving medical attention. I apologise to the Committee for going through the details, but it is important to do so.

Martin’s case is an extremely distressing one. He was admitted to Kingston hospital after suffering from a stroke. As a result of the stroke, Martin was unable to swallow, which often happens with stroke victims, and could not consume food or drink. Martin was put on a drip, but was unable to extract adequate nutrition from it. During the second week in hospital, Martin’s veins collapsed, and feeding by a drip was no longer possible.

After Martin had gone without adequate nutrition for 21 days, doctors decided to put a feeding tube directly into his stomach. Sadly, Martin was not strong enough to undergo the operation. Five days later, he died in hospital after 26 days without food or nutrition.

Martin’s case has received a great deal of national press coverage in recent months. The coverage highlighted his care and the possible findings of the ombudsman’s report. I have considered the ombudsman’s report in detail with Martin’s mother and sister. The report will outline a combination of different failures that led to Martin’s death. It is also likely to find that Martin was put at risk because specialist stroke services were not provided for him and that numerous communication failures within the team resulted in him receiving inadequate care. Moreover, Martin’s sister, Ann Ryan, has told me that the ombudsman’s report will find that there were a number of service failures in the treatment and care provided by Kingston hospital. Shockingly, the ombudsman will find that the failures occurred primarily because Martin had a learning disability.

The omissions and failures of Kingston hospital and of the individual staff members who cared for Martin constitute a failure to live up to the principles of dignity, equity and autonomy for all individuals that are discussed in the report. The circumstances in which Martin Ryan died are alarming. It is clear that, owing to a catalogue of errors, his life was put at risk and that he died as a result of inappropriate care.

The ombudsman’s report will find that Martin’s death was avoidable and that a number of service failures by staff at Kingston hospital led to his death. Yet despite that, I am concerned that there has been no effort that I am aware of on the part of the ombudsman to hold to account the individuals responsible for Martin’s death. Although the chief executive of the hospital gave assurances that the medical professionals involved would be disciplined for their actions, no evidence of that has been brought forward, nor has the Ryan family received any dialogue in relation to that. Such a failure in communications following a tragic death is wholly unacceptable.

Martin’s mother and sister believe that the consultant, the matron and the ward sister at the hospital were responsible for the service failures that led to Martin not receiving adequate nutrition and for his subsequent death. They believe that the individuals should be named, brought to account and disciplined. Such a call is all the more necessary due to the fact that the service failures occurred because Martin had a disability. The family are not seeking revenge, but they want to ensure that those individuals are held to account. They do not want them to make the same mistakes again.

Naming the individuals in the ombudsman’s report—I ask the Minister to speak to the ombudsman about this—will send a strong message to professionals that they will be held accountable for their actions towards people with learning disabilities. If the ombudsman’s report does not name the medical professionals, I will name them in the House of Commons. Bringing such individuals to account is the right thing to do. As the report notes, it is essential to give people dignity and to treat them as individuals.

Finally, I hope that the Minister can exercise influence over this long-standing case—Martin passed away in 2005, and the “Death by Indifference” report was published in 2007. Naming the individuals would give closure to the Ryan family, and it would be in the public interest.

The hon. Member for Rochford and Southend, East (James Duddridge) has given us a horrifying example of what can happen when people do not fulfil their duties and do not honour their obligations to the patients under their care. Such patients have the same human rights as everyone else. My hon. Friend the Member for Hendon (Mr. Dismore) mentioned that some people do not recognise that. It is absolutely and explicitly accepted by the House that every human being has the same human rights and should have the same opportunities to exercise those rights. I welcome the fact that we are having this debate and that this report has been produced to provide some focus on the needs of people with learning disabilities. I congratulate my hon. Friend and the Committee on their work.

Let me start with a little discourse about the human rights approach, which is very helpful in this instance, but it is not the only way to look at learning disabilities. I will probably get into trouble for suggesting that the human rights approach cannot be adapted to be comprehensive in its assessment of the issue. As I was telling my hon. Friend before the debate started, human rights lawyer Sonya Sceats, who was one of his witnesses—she is also the long-term partner of my stepson—is convinced that the human rights approach is a way of addressing many issues. Although it is a very good approach, there are complex ethical and practical issues about the way in which we address the needs of people with learning disabilities that require us to go beyond the human rights approach.

I was trying to think last night how I could express that. I was trying to unravel the earplugs from my iPod. I do not know whether other hon. Members have this problem, but however carefully I roll up my earplugs when I put them away, they are always tangled in a knot when I unwrap them, and it takes ages to get them undone. Imagine how much more difficult it would be if I had 20 sets of earplugs in a box and they were all tangled together. I would have to unravel them one by one and then find one with the right plug before I listened to my iPod.

The complex ethical issues that we are discussing are a bit like that. If we unravel just one strand of complexity by looking at someone’s human rights, we do not necessarily see the whole picture. With people who have learning disabilities, we have to look at not only the human rights issues, but the practical issues, the risks, the financial issues and the family issues. Sometimes, when we unravel those strands, they point us in different directions and lead us to different strategies and possibly to different answers to the same question.

Perhaps I can give hon. Members an example of what I am talking about. One issue that the report identifies is relationships between people with learning disabilities. One of the most fundamental human rights is that people should be able to determine for themselves what relationships they become involved in, and people with learning disabilities have exactly the same right to have sexual relationships as anyone else. However, when we face such issues and the situations that arise when people with learning disabilities have relationships, we have to ask a whole range of questions. Are the people involved in the relationship able to give informed consent? Do they have the ability to make contraceptive choices? If a woman with a learning disability becomes pregnant, that raises incredibly complex issues about parenting.

When a person with learning disabilities is in their parents’ care, it can be incredibly difficult to get the parents to accept that their child is as entitled to a sexual relationship as anyone else. My daughter does not have a learning disability, but I find it pretty difficult to accept that she has boyfriends. Imagine how much more difficult that would be to accept if she was a vulnerable child or a child with a disability. Sometimes parents end up having recourse to the courts, and attempts are made to get sterilisation orders or orders to restrict people’s ability to have relationships.

When somebody is in the care of a local council, the situation can be even more complex. When some councils have realised that people with learning disabilities in their care are going to have relationships, they have done what they regard as the right thing, and it probably is the right thing: they have done risk-management assessments, bringing in psychologists to gauge the individual’s ability to give informed consent and educationists to discuss contraception. However, in doing that, and in taking that caring attitude towards the person with learning disabilities, have those councils restricted that individual’s human rights?

Let us face it, some Members of Parliament make unfortunate sexual choices, and no one does a risk assessment on us before we get involved in relationships. Perhaps there are one or two examples where people should have done a risk assessment, but it does not happen. We are allowed to engage in relationships at our will, whether they are harmful or not, and no one ever questions our absolute right to do that. Are we therefore breaching people’s human rights by doing a risk assessment and bringing in all the resources that I mentioned?

I do not have the answer to those complex ethical questions. However, I do know that people with a learning disability—complex or moderate—are as entitled to a fulfilled life as anybody else. We have to find a way of navigating through this moral maze. If we can unravel one of the strands by looking at the human rights issues and implications, that is good, but, as I said, many more strands need to be unravelled.

Another example of the complexities that sometimes overcome us is the closure of long-stay hospitals. If there was ever an example of people with learning disabilities having their human rights infringed, it is the fact many people with learning disabilities were effectively locked away in long-stay hospitals over many years. The Government had a commitment to close all those hospitals, and we often criticised Ministers because it was taking so long to do so.

To some extent, that was the fault of local health services, which were not addressing the issue quickly enough. However, it was often also down to the parents and friends of the person with the learning disability. They believed that that person was secure in the hospital environment, and they did not accept the possibility that he or she could have any sort of independent life. The move away from long-stay hospitals was a bit like the move into care in the community, and it had the same sort of reputation. People therefore asked whether those with learning disabilities would get the resources and the support that they needed in the community.

Often, therefore, the barrier to helping people to create an independent life was the people who most loved and cared for them and who wanted the best for them, rather than the Government or the local health services. Who is to say that those people were wrong in that assessment?

I am following the hon. Gentleman’s remarks carefully. He is dealing with extremely sensitive issues, and I respect very much the way in which he has put his case. However, I hope that he has had time to read a Select Committee report of some years ago, which dealt with adult mental and physical handicap and looked at the closure of long-stay hospitals. I was a member of that Committee, and we visited many people who had been discharged into the community. The hon. Gentleman might be surprised to hear that quite a number of them complained that they had not been consulted before they were discharged. One man in Norwich, who was quite elderly, said that he had never been so lonely in his life and that he wished that he had never been discharged. Should we not provide facilities for all, whatever their needs, rather than saying that long-stay hospitals are no good and that everyone should be in the community? Is it not right that those people should be consulted?

The hon. Gentleman is absolutely right, and he is making the point for me somewhat better than I was making it myself. What I am saying is that, if we take a human rights approach and assume that all long-stay hospitals must be closed, we perhaps overlook the fact that some people feel very comfortable in that environment and object to our taking such a paternalistic attitude. It will take a lot of work to convince them that it is necessary to close all the long-stay hospitals, if that is what we are going to do.

I have a good example of that. I am one of the Minister’s predecessors. I was a great campaigner for the view that older people did not want to be in care homes, and I never met an older person who wanted to be in one until I went to a fabulous new facility in extra-care accommodation—as the Minister knows, I am also a big campaigner for extra-care accommodation. The people there all had their own flats, but there were also some communal facilities, and I was going around everyone with my preconception that they were all happy to be in independent living accommodation. Indeed, they all told me how great it was—except for one man, who was sitting in the corner, so I sat down and chatted to him. I asked, “Do you enjoy it here?” He said, “No,” and I asked him why not. He said, “I’m lonely,” so I asked why. He said, “I made some mistakes in my life and I spent a large part of my time in prison. I’m not comfortable living independently any more. I want to be in an environment where I don’t have independence.” So it struck home to me that we must start not with our own ethical standpoint but by asking individuals how best to organise their lives. That is how we get closest to respecting their human rights—by giving them the dignity that they get from being properly consulted in that decision.

I was not going to intervene, but I was not planning to raise this matter when I make a speech. I do not know whether the hon. Gentleman has had the opportunity to ask the Chairman of the Committee whether during the inquiry he contemplated investigating the interrelationship between choice and rights. The hon. Gentleman ably highlighted the difficulty: does having a right necessarily invoke a choice? At what point is it appropriate for the risk and opportunity to be transferred from an individual, in the relevant circumstances, to something that the state must make available and provide through society’s methods? If the hon. Gentleman has not had the opportunity to discuss the matter with his hon. Friend, perhaps he would join me in urging him to investigate that as a supplementary inquiry to the original one.

The hon. Gentleman is right; that would make an excellent inquiry for the Committee in future. His intervention brings me nicely to my next point: if I had a criticism of the report—which is excellent, and provides an excellent basis for debate of the issues—it would be that I am not sure the complexities of the debate, in relation to allowing people to express their choice, have been entirely understood. I do not think that the report necessarily gives the Government enough credit, either, for the way in which they have pushed the agenda forward. We can all say that things should have happened more quickly, and that the Government should have done things more forcefully, but we all make mistakes. Perhaps I may tease my hon. Friend the Member for Hendon: his Committee produced an easy-read version of the report; he received witness evidence that the easy-read version should be printed on yellow paper—but it is printed on white paper. Perhaps there were complex publishing reasons for that, but the fact is it should have been on yellow paper.

I am speaking from memory, because I do not have a copy of the first print with me, but I think that that was on yellow paper. If someone has downloaded it, it was probably on white paper; it depends on what paper is put in the printer. I am pretty sure the original version was on yellow. We also produced it in DVD format, so people could do what they liked with it.

Perhaps that was the case, and it was originally on yellow paper. If so, the Government’s response would not work, because they published their responses on yellow and the Committee’s questions on white, so the differentiation between the two does not work.

A more serious point is that the Committee published the report in easy-read format, but my hon. Friend and his Committee have published many other reports of interest to people with learning disabilities, and this is the only one that I have seen in easy-read format. Thankfully, people with learning disabilities are now living to a grand old age, and are interested in the issues of aging, on which my hon. Friend’s Committee has produced a report which, however, is not in easy-read format. They live in the same world as the rest of us, and are subject to terrorism, but the Committee’s reports on the subject are not in easy-read format.

The short answer is that we do not have the money in the Select Committee budget to do that. That is exactly the point that I raised in a question to the Leader of the House today: we should be doing more of that in relation to everything that is of relevance to people with learning disabilities. I also made one or two points about other disability issues, such as the need for sign language interpreters for people who are hard of hearing. My hon. Friend is making a valid point, and if we had the money we would do what he suggests.

That is exactly the point that I was making. I have criticisms to make of the Government as well, because when I was a Minister, I made an announcement that Government documents would all be produced in easy-read format. Very quickly, and without anyone saying so, things changed so that health documents would be produced in easy-read format; and then it was health documents pertaining to learning disabilities. The very least that we should aspire to, in my view, is that every Green Paper and White Paper should be produced in easy-read format. That is the least that people with a learning disability are entitled to expect. One of their fundamental rights is to be able to be involved in the democratic process with the rest of us.

I am, however, quibbling with my hon. Friend the Member for Hendon, because the report is excellent. Nevertheless, we need to recognise the practicalities of addressing some of the issues raised in it. I am four-square behind my hon. Friend, for example, in recognising the fact people with learning disabilities do not have the access to health care that they should. We have tried to ensure that people with a learning disability are entitled to an annual health check. Quite often they do not report their health problems or seek access to their GP or health services. If we could be more proactive about spotting their health problems we could deal with that. One difficulty—which goes back to the point made by the hon. Member for Eddisbury (Mr. O’Brien)—is that many people with learning disabilities do not want to be recognised in their doctor’s records as having a learning disability; so how is the poor old doctor meant to contact them once a year to invite them to their annual health check? There are complex issues involved in dealing with that, and a measure of positive discrimination is required to get people with learning disabilities into their GPs’ surgeries.

Another matter about which I am passionate is independent living and the efforts we need to make to get as many people as we can into independent living. I am an adviser to the Learning Disability Coalition, as is the hon. Member for Buckingham (John Bercow), who is engaged elsewhere in the House this afternoon; otherwise he would have attended this debate. The coalition is a group of campaigning organisations trying to make sure that we put the right resources and support behind learning-disabled people, and I brought a delegation to meet the Minister earlier this week. In the delegation was a young lady called Victoria Willson. She is 38 years old, and was there with her mum, Jean Willson. Victoria has complex multiple disabilities; she is severely learning disabled, and needs 24-hour care, seven days a week. For a big chunk of the day, she needs two people to support her, to keep her safe. The rest of the time, she needs one person. Even at night, when she is asleep, she shares a carer with another disabled person, who lives in the same place as her. It is a complex level of support.

Victoria is a trailblazer for independent living for people with a learning disability, because her mum and family put the package of care together before it became part of the Government’s agenda, and had to fight to get it in place. They shared with us the cost of providing support at that level. It costs £3,463.17 a week. Social services pay 42 per cent. of that, the health service pays 37 per cent., the independent living fund pays 20 per cent. and Victoria herself contributes 1 per cent. from her resources and benefits. It is very expensive, but it means that effectively she is living independently. If her parents passed away she could continue the life that she lives. She has, at the age of 38, been living successfully in that environment for a long time.

When I was a Health Minister, I visited Wigan, which has a great record on promoting independent living, where I met a gentleman with complex learning disabilities who was living in residential care. To help him express his needs, the people working with him helped him to produce a life map—a pictorial map of how he saw himself and the world around him, and what he wanted his world to be in future. What did he identify in his life map? A little flat that he could live in by himself, and a girlfriend. Those were the things he wanted in his life. They set about using a personal budget to help him to achieve those things, and he now lives in the flat. I do not know whether he managed to get the girlfriend—that is not within the remit of the local social services—but he is now living an independent life. If people whose needs are that complex can live independent lives with the right levels of support, anyone can. Having said that, the barriers to living such independent lives are often the people who love the individual most—parents who do not think their children can be safe living independent lives. A huge effort is needed to make those things happen.

The hon. Gentleman is speaking with great sensitivity and, in many ways, nobody can disagree with him, but I am going to ask him the hard question. He just mentioned the amount that one individual lady cost in a week, of which she paid only 1 per cent. through, I suppose, some form of benefit. Where will the money come from to provide the quality of individual care that enables people to live independent lives, bearing in mind the massive cost and the huge pressure on social services departments and others that provide assistance for people with learning difficulties? I share many of his aspirations, but we have to come down to earth. Where will the money come from to make those facilities available?

The hon. Gentleman has cut to the heart of the matter, but I hope he will forgive me for not responding directly to his question. I intend answer it later in my remarks.

Access to jobs and work is often unfairly denied to people with learning disabilities. The point was made earlier that we could do more to help in Parliament, and we could certainly do more in government. When I was Minister, I asked the Department of Health to review the options for employing people with learning disabilities, and it identified a couple of posts. My hon. Friend the Minister might like to check whether learning disabled people still hold those posts. We need to be positive. Learning disabled people are also denied access to educational opportunities.

A very important section of the report is about the court services and law and order. Hon. Members will know that I have campaigned for a long time on behalf of autistic people, who suffer very badly when it comes to legal services. Policemen often do not recognise the needs of autistic people or people with learning disabilities, and the courts often are not geared up to help them. I recommend that my hon. Friend the Member for Hendon examines the Maryland curriculum from the United States. The state governor had an autistic grandson who got into some trouble with the law and realised that the police in the state did not have the necessary experience and training. He insisted that they went through a new training programme—the Maryland curriculum—and all law officers in the state are thoroughly trained to recognise the needs of autistic people. The curriculum would have to be adapted for use in this country, but as well as being adapted to help law officers when they deal with autistic people, it could be used to train them to recognise the needs of people with learning disabilities. I encourage my hon. Friend to look at whether the curriculum can be used.

The hon. Gentleman mentioned autism. The Autism Bill, which the House agreed to send to Public Bill Committee last Friday, will give a statutory responsibility to local councils to make an assessment of the number of people with autism in their area and provide services within their community. Is there a broader need to assess the number of people with learning disabilities within an area? I am a trustee of an organisation that tries to engage people with learning disabilities. Even with all the stakeholders contributing information, it is difficult to connect with that broad community. My gut feeling is that local authorities do not know how many learning disabled people there are in their area.

The hon. Gentleman is absolutely right. Modesty forbids me from encouraging him to read my speech in last Friday’s debate on the Autism Bill, but that is why I suggested the Bill ought not to pass into law. In a way, it would discriminate against other people with disabilities, whose needs we do not understand either. We need to find out how many people there are with a range of disabilities and start providing the resources for them. That is a campaigning theme of the Learning Disability Coalition, which I advise. It is desperately keen for proper surveys of the number of people with learning disabilities and the complexity of their needs. It is trying to raise funds for an academic study, and perhaps my hon. Friend could put his hand in his ministerial pocket and help. Certainly, we need such a survey if we are to resource provisions properly.

I am grateful to my hon. Friend for referring to the debate on the Autism Bill last Friday. I did not manage to make my speech—I hasten to add that I intended to speak only for 10 or 15 minutes. The Bill has a human rights context and a lot of the issues that it seeks to address are similar to those we found in the inquiry. That point was not made in last Friday’s debate, but I have been able to make it much more briefly now.

My hon. Friend is absolutely right that the Bill and the report have many things in common.

Before the hon. Gentleman moves on, I want to press him on a question that relates to what my hon. Friend the Member for Macclesfield (Sir Nicholas Winterton) said a moment or two ago. The hon. Gentleman is talking about interaction with the criminal justice system. Does he agree that, in some cases, making reasonable adjustments might actually lead to vast savings of public expenditure? That contrasts sharply with the situation that he and my hon. Friend were discussing, in which reasonable adjustments involve vast expenditure to support people in independent living. If we were to start with the cases in which there would be vast savings, we could use them to support cases in which there would be greater expenses.

The right hon. Gentleman is absolutely right, and the prison service, which he mentioned earlier, is a good example. If we did not put people with learning disabilities, autism or Asperger’s syndrome in prison, where they ought not to be, we would free up a lot more prison space for people who ought to be there. People with learning disabilities and autism spend far too long in prison, because they do not understand how to play the parole system. When the parole board asks them whether they would do the same thing in the same circumstances, they often answer honestly, and say that they might do the same thing again, instead of saying, “No Guv, I’ve learnt my lesson. I’m going to go out of here and wipe my slate clean.” They do not know how to play the game, and so spend too long in prison. There are big savings to be made on prisons, and if we could be more proactive about looking after the health of people with learning disabilities, the NHS would save a lot of money.

To address the question about resources asked by the hon. Member for Macclesfield (Sir Nicholas Winterton), one quickly comes to realise that, in many cases, the cost of keeping a person living independently is not much different from the cost of keeping them in residential care. It is true that the young lady I mentioned has a very expensive package of support, but we must compare that with the substantial costs of the package of support if she lived in some form of residential care. She would still need the same level of intensive of care, so we must consider the difference between the two.

My hon. Friend the Minister is busy trying to write the new Green Paper on adult social care, and I made that point when I went to see him yesterday. The only bit of funding to local councils that is not ring-fenced and that councils can spend on anything they want is money for adult social care. It used to be money for social care in general, but when we created directors of children’s services, we put the money for children’s social care with the money for children’s schooling and ring-fenced it. If the council wants to cut council tax or spend money on a pet project, the only budget that it can raid for money is the adult social care budget. That is why access rules were tightened, so that fewer people could access the budget, and that is why older people in our constituencies often find it difficult to access the care services that they need.

The adult social care Green Paper must address the issue of how to get the right amount of money into the adult social care regime. I will not make a political point, because the hon. Member for Edinburgh, West (John Barrett), who speaks for the Liberal Democrats, is probably a fervent advocate of free social care for older people. Actually, no; the Liberal Democrats have decided that that is a bad policy now, so in Scotland money for disabled children has had to be raided to keep the fund going.

What we need is a proper debate about the costs of supporting people with care needs. We need to be open and honest about the fact that in future, older people will have to provide a bigger pot of support for themselves and their care needs in old age. Younger people with disabilities have had no opportunity to build up a pot of money to provide for their care needs. Younger adults with care needs and people with learning disabilities have no choice but to go to the state for the support that they need. We need to think more openly and honestly about how we can help older people tap into the equity in their properties to support themselves in their old age so that we can free up more resources to help people with disabilities in younger adulthood. It will be a difficult debate for us.

It will be difficult politically for all the parties to address that debate, and it will be difficult for society, but we must have it, and the start will be the adult social care Green Paper that my hon. Friend the Minister is producing. He needs to be absolutely open and honest about the scale of the challenge that faces us if we are not only to help people with learning disabilities get access to the services that they need but to ensure that all people who need care services get access to care in future. There is a cost to be paid for that, and we must explain that to the people of this country. Having said that, I thank my hon. Friend the Member for Hendon for the report that has provided the basis for this debate, and I look forward to seeing what my hon. Friend the Minister produces in the adult social care Green Paper.

My contribution will be brief. This is an interesting and important debate, and I am delighted to follow the hon. Member for South Thanet (Dr. Ladyman), whose work on the issue is of long standing. This debate continues the dialogue that occurred during debate on the Autism Bill on Friday.

My first point is that if one steps back 100, 150 or 200 years, one finds a very different social attitude to such matters. Roughly speaking, that attitude was, “Devil take the hindmost”. People who could get on did, and those who suffered from one kind of disability or another were simply left out. One thinks of madhouses and all the other ghastly things that went on. Gradually, over a long period, society has come to the view, which was very well expressed in the Disability Discrimination Acts, that the rest of us need to make a set of reasonable adjustments to allow for the conditions in which some people find themselves. The hon. Member for South Thanet, in his remarks and in his fascinating interchange with my hon. Friend the Member for Macclesfield (Sir Nicholas Winterton), brings starkly to light the issues that we now face as the question arises of where reasonable adjustments start and end.

My second point, which helps us understand the answer to the first, is that if we are honest with ourselves, we will admit that it is a great deal easier to accept that people who suffer from straightforward physical disabilities should have adjustments made in their favour. It is simply a fact of being human that it is easier to grapple with physical disability than with mental disability of almost any kind.

A few years ago, quite a lot of people would have thought it an extraordinary proposition that people with public facilities would have to make adjustments for people with physical disabilities, but we are all completely used to it now. It is just part of the normal run of things. The report and this debate—as well as the Autism Bill, debate on the various other things that are going on—bring out the fact that we now need to make a further leap and get to the point where we recognise thoroughly that although they are more difficult to deal with emotionally, we must take mental disabilities of various kinds, including learning disabilities, as seriously, openly and comprehensively as we now take physical disabilities as a matter of course. That is a major leap forward for society that we have not yet made fully.

My third point is that part of the answer to the first conundrum lies in the recognition of the second point. If we recognise that people who suffer from learning disabilities, autism, Asperger’s syndrome and other such conditions have as much right to have adjustments made in their favour as those who suffer from physical disabilities, we are bound to consider both the cases in which society will encounter costs by making those adjustments, as I mentioned in my earlier intervention, and the cases in which costs would be reduced.

It is a good indicator of how far we have yet to go before we fulfil the ambitions expressed in the report that the Government—this is not a partisan remark about this Government; it applies to all Governments in recent years—have not even got to the point of seriously examining what savings we could make. To return to my point about the criminal justice system, it is extraordinary what a high proportion of the total costs of the criminal justice system are incurred as a result of the mishandling of things done by people with learning disabilities.

That is not the only extraordinary thing. It is at least equally extraordinary that vast numbers of people who suffer from no learning disability—neither autism, Asperger’s nor anything of the kind—but who are incapacitated to some degree by drug and alcohol dependencies engage the criminal justice system. It is extraordinary to what extent we do not try to address those issues in rehabilitation. We as a society incur shocking and unnecessary social and economic costs as a result.

My right hon. Friend is absolutely right. It would be interesting if the Minister mentioned in his response the number of people sent to prison by magistrates and judges because there is no suitable non-prison accommodation to which they can be sent due to the crime that they have committed as a result of their learning disability or mental illness. To my mind, it is criminal, if I may use that phrase, that people who are mentally ill or have mental disabilities or learning difficulties end up in prison because society cannot properly deal with them outside prison. I hope that he will provide the number, which would add up to a very large figure indeed.

My intuition is exactly the same as my hon. Friend’s, but I am pretty sure that the Minister will not be able to answer his question today, although I would be delighted to be proved wrong about that. I have been inquiring about this for many years now, and nobody seems to know the answer. If one talks to people who can give good anecdotal estimates, such as magistrates and prison governors, one finds what anyone who spends time wandering around our prisons or youth offender institutions will find—that an enormously high proportion of people in our prisons fall into one or other of the categories that I have described.

I may be able to help the right hon. Gentleman, as I used to have ministerial responsibility for health in prisons. The accepted figure is that 60 per cent. of people in prisons are suffering from either neurosis, psychosis or personality disorder, or from alcohol or drug abuse. So, only 40 per cent. of prisoners do not fall into that category. The proportion of people in prison who have learning disabilities or autism is another matter, which I do not think anyone has ever got to the bottom of.

That is indeed the accepted figure; I think it is wrong, but that is another issue. As the hon. Gentleman says, there is not even an estimate for the number of prisoners who suffer from learning disabilities and other permanent mental disabilities, and there are good reasons for that, one of which is that no one in the Prison Service has the ability to find out, which is pretty extraordinary. In courts, there is typically no provision to enable the magistrate or judge to determine the extent to which something has happened because the person involved has a learning disability.

That brings me to my penultimate point. There is a principle in moral philosophy that is just about as old as moral philosophy itself—that “should” implies “can”. One cannot reasonably demand that someone do something, on a moral basis, unless they have the ability to do it. That principle is entirely understood in discourse on moral philosophy, but it is almost entirely absent from people’s understanding of society. If all we Members gathered here were to look at all the letters we have had from constituents complaining that people who are in a particular condition benefit from certain kinds of treatment that are not available to them, we would find it a prevalent phenomenon that they are actually complaining that someone who cannot do something is getting an advantage that is not open to them because they can do it, but are not doing it.

It is understandable that people who are struggling and not having a particularly easy life, and who find that all sorts of things are not available to them, should find it difficult to accept that other people will have advantages such as there being vast expenditure to enable them to engage in independent living. It is perfectly understandable that there should be those resentments in society, but the challenge is to get over the very first thing that I mentioned—society’s great difficulty in grappling with the cases of people who suffer from mental, rather than physical, disabilities. We have to get to a point where society as a whole accepts that we are going to invest in people who cannot do certain things, and that we are going to make certain adaptations to enable them to live in a different way and to prevent them from getting into conditions that impose costs on society, such as crime. If we can get to that point, in the end, it can become something that is normal, accepted and probably self-financing.

My guess, although I cannot remotely prove this, is that if we got to a point at which everyone recognised the extent to which people’s scope is restricted and changed by learning and other mental disabilities, as we are beginning to do with physical disability, we would find that the savings at least matched the costs, and we could have a better society that would not impose on others grounds for resentment. I very much hope, therefore, that this extremely important report will lead to responses, not just this year or next, as this will take time, and not just from this Government, or the Government of any one party, but from all of us over time. I also hope that it will lead to changes that will lock in the idea that society as a whole has not only a duty to accommodate, but an interest in accommodating, the needs of those who have learning disabilities.

Today’s debate not only is on an important subject that requires parliamentary time, but is at the heart of what we in the House should constantly be pushing up the agenda. At a time when the economic downturn dominates the news and when tens of billions of pounds are being injected into a banking sector in which salaries and bonuses are paid in millions of pounds to some and six-figure pensions are paid to others, it is vital that we keep a focus on issues that, although they might not make the news headlines, are equally important in every way. To some people, these issues are the most important in their lives. People have struggled and campaigned for a long time for human rights and the individual’s entitlement to freedom, respect, equality, dignity and autonomy in everyday life. In the 21st century, those things are long overdue for many.

This debate has been excellent so far, and the speeches and interventions from hon. Members on both sides of the Chamber have been interesting and have added to the debate. I congratulate the Chairman of the Joint Committee, the hon. Member for Hendon (Mr. Dismore) on its excellent report. It has been good to see what is in both the report and the Government’s response. I found the comments of the hon. Member for South Thanet (Dr. Ladyman) very interesting, particularly about the rights and risks of adults with learning disabilities in forming relationships, because risk assessments are not taken for the rest of society at large, and it can be patronising to say that adults who have learning disabilities cannot make such decisions on their own. We all know that many people around the country cannot make decisions about relationships, contraception and other matters, but adults with learning disabilities are not always given the same rights and respect as other people or allowed to make the same mistakes.

We have heard the tragic case of the adult who was denied health care and about the end result. Other hon. Members will know of similar cases as, sadly, there have been too many of them, but I shall not go into that today. The interventions of the hon. Member for Macclesfield (Sir Nicholas Winterton) were also very interesting, because the cost implications and questions about where money will come from are often at the heart of many relevant issues. We spend tens of billions of pounds on the results of alcohol and drug misuse, such as crime and antisocial behaviour, which are not generally incurred by adults with learning disabilities.

One Friday evening in Edinburgh, I visited an accident and emergency unit where the vast majority of cases were self-inflicted, not by adults with learning disabilities, but by drunk people who had been attacking one another, some of whom then attacked doctors and nurses. We spend tens of million of pounds on such cases, sadly, but then we wonder where the money will come from to pay for services for some of the most deserving members of society.

In many respects, we have come far to get to where we are today. At his inauguration, Barack Obama spoke about how far things had advanced with race, from a time when his father would not have been served in a Washington restaurant 60 years ago, up to today and his election as the President of the United States of America. On women’s rights, we have moved forward in the past 100 years, from women having no vote at the time of suffragettes, to women now having the vote and being able to play a full part in society. On religion, right-thinking people in Britain today would never discriminate on religious grounds. Sadly, that progress on race, gender and religion does not extend to disabilities in far too many walks of life.

Adults with learning disabilities have often had childhoods in which their human rights were not even on the agenda. Too many of them have grown up being ignored, bullied, excluded from school and patronised. Too many of them have been given second-rate health care and education, poor access to justice or information and much more. Where we are today is not a great success for all, and many people feel that we must right those wrongs. Hon. Members from all parties must work together to ensure that equality and human rights are accessible to all members of society.

Just how special many disabled children are was brought home to all hon. Members last week by the sad death of Ivan Cameron. From my experience with my little granddaughter, who suffers from cerebral palsy and the milder form of epilepsy, I know that, after a long struggle through childhood, she is likely to reach adulthood. When she does, I want to ensure that we can look back on the days when disabled people did not have the same human rights as everyone else and say, “Those days are long gone.” She, and all children with learning and other disabilities, deserve no less in the future. The adults of today have already waited far too long.

Although much legislation is in place, a lot still needs to be done. Departments, local authorities, the NHS and many other bodies should be leading the charge to ensure that adults with learning disabilities live their lives in dignity. However, instead of leading that charge, far too many organisations are dragging their feet. Today’s debate ought to be about the way in which we can move forward towards genuine equality for all those with learning disabilities. We should consider how we can improve access to services, secure equal access to health care and education and end the marginalisation that too often accompanies a learning disability.

I welcome the excellent report that we are discussing and the two Government responses. As hon. Members have outlined, there has been genuine progress in some areas in recent years. However, I am sure that the Minister would concede that we have some distance to go before the rights and duties that exist on paper are translated into genuine improvements to the lot of those with learning disabilities.

As has been mentioned, the initial report from the Joint Committee was partly prompted by the shocking findings of the Mencap report, “Death by Indifference”, which has been debated in Parliament before, so I will not linger on the details. However, the hard evidence that people with learning disabilities face stark health inequalities is simply overwhelming. Among people with a learning disability aged 20 to 29 years old, mortality is nine times higher in men and 17 times higher in women. Other hon. Members have mentioned the independent inquiry into access to health care for people with learning disabilities that was published last year, which supported the findings of the Joint Committee’s report. That inquiry found that

“Adults and children with learning disabilities, especially those with severe disability…have significantly worse health than others.”

However, the parents and carers of adults and children with learning disabilities often find their opinions and assessments ignored by health care professionals. Health service staff, particularly those working in general health care, have limited knowledge about learning disability.

I welcome the publication of the Government document, “Valuing People Now”, and the stipulation that reasonable adjustments should be made to all services to reflect the specific needs of people with learning disabilities. However, perhaps the most worrying aspect of the report was that many the staff involved were unaware not only that their behaviour contravened the rights of their patients, but that there was anything unacceptable about their behaviour. That was compounded by the fact that many people with a learning disability were unaware of their rights, because they had never received the help necessary to understand them.

It is one thing to secure a right to something, but unless individuals are aware of their rights and society is aware of its corresponding obligations, change will be slow. As much as anything, the Mencap report showed that the battle of awareness and perceptions is still not won. It is clear that, in too many cases, mainstream health services still do not see people with a learning disability as their responsibility. Until we address the lack of understanding among some health care professionals, new duties will have only a limited impact.

Even securing the rights contained within the UN convention on the rights of persons with disabilities has been more of a struggle than we would have liked. I welcome the Minister’s written statement on the ratification of that convention and the signing of the optional protocol, but the delay has been, at least, unfortunate. Although I understand the need for certain opt-outs for Departments, such as the Ministry of Defence, I share the incredulity of many people who cannot understand why it has taken so long to organise what appear to have been relatively minor changes, most of which already have precedence in the Disability Discrimination Act 1995.

Social care, as anyone involved with an individual with learning disabilities will know, is fundamental to providing the opportunities and dignity in life than many of us take for granted. Although all Departments are experiencing budget constraints, it seems clear that current funding for social care will prove to be inadequate in the future. As mentioned by the hon. Member for South Thanet, the cost of care is increasing and when free personal care for the elderly was introduced north of the border, the costs were underestimated. There is no doubt about that; it is a very expensive business.

Funding ought to reflect increased demand and, considering that the number of adults aged 18 to 64 with a learning disability is set to rise by 20 per cent. between 2005 and 2041, we clearly need to look again at whether we can meet our obligations to people with disabilities under the current funding arrangements. Put simply, the consequences of the failure of funding to keep pace with need are tightening eligibility criteria. That is leading to more and more people being excluded from the social care services that they desperately need.

I look forward to the Minister’s comments on what his office can do to remind every local authority of its responsibilities to deliver and promote human rights. I add my support to the Committee’s calls for the Government to adopt a nationwide communications programme to provide adequate information for people with learning disabilities—both in relation to their rights and how to access redress if need be.

Has the hon. Gentleman given any thought to the role played by parents who look after an adult son or daughter with learning difficulties and the pressure is on them? If they die, what will be the additional cost of looking after their child outside what has been their traditional home? To my mind, carers are under immense pressure, and I say to the Minister that, without them, this country would be in grave difficulty. I pay full tribute to the carers of those with learning difficulties. How might we help those carers—for example, are there sufficient facilities to give them the respite care that they need from time to time?

That is a key factor in the entire costing of the massive costs that are involved in care. Whatever it costs to care—through trained nurses, support staff or whatever—a massive burden of care is currently taken on by families. Whether younger people are looking after elderly people or parents are looking after their children, the big worry is what will happen when they have gone. In many cases, the cost of care will be translated from the family to society at large. If we can provide care or assistance for those individuals, that will be a saving, not a cost.

We have talked about the cost of keeping people in care, but what are the alternatives? If we can get adults with learning disabilities into employment, they will help to make a contribution. Similarly, if we can get people out of prison into employment, there is a saving. Among the many costs that we do not know, I suspect that there is no hard and fast figure for the true cost for what parents or adults looking after people with learning disabilities save us. I only know that it must be a massive cost—I have no idea what the figure is.

In the Government’s response, I was pleased to see a commitment to the move towards a single equalities duty under the equality Bill and that the Government’s intention is to strengthen not undermine the existing public service duty. However, does the Minister share my view that a combined duty may not provide the emphasis and additional help and support that many people with a learning disability may need to access their rights? I am also concerned at reports that the Government are considering the removal of the sixth requirement of the current general duty, which allows public authorities to treat people with a disability more favourably if it is necessary to achieve equality. I am sure that hon. Members will appreciate the importance of the concept of more favourable treatment remaining in the Bill, and unless it does, disability discrimination legislation will be significantly weakened. Will the Minister give me an assurance today that that will be retained in the equality Bill?

In conclusion, this is a good report, and I welcome it and the Government’s response. However, although much progress has been made over the decades, we still have some way to go so that, in the not-too-distant future, such reports are redundant. We hope that in the future all people—adults with learning difficulties and the rest of us—are equal, because if we are all equal, we will not need to consider such reports.

I, too, begin by congratulating the hon. Member for Hendon (Mr. Dismore) and his Select Committee on the report, on holding the Government’s feet to the fire and on securing this debate. I would also like to congratulate the Committee on taking the possibly unprecedented measure of providing the report in an easy-read format, with audio summaries to support maximum access to it and to its findings. There was an interesting exchange about the fact that, wherever one starts, one will never be able to do enough to satisfy everyone, but an important precedent has been set. I hope that the lesson will be applied to many other activities across Parliament.

I am pleased that although the Committee understandably and rightly highlighted heinous recent failures in the care and support of people with one or more learning disabilities, it noted that marked improvements have come about over the past 30 years, stemming in particular from the reforms of Governments of all colours and stripes, including, I am proud to recall, the positive transformational reforms under previous Governments going back as far as the 1971 White Paper, “Better Services for the Mentally Handicapped”. I stress that we see this issue in the context of the remarkable progress made during the lives of the current generation—those of us who are here now have witnessed it for ourselves. I thought that my right hon. Friend the Member for West Dorset (Mr. Letwin) set that context particularly ably.

The nub of today’s debate is the fact that legislative progress—I emphasise the word “progress”—on the disability agenda has not been matched with practical progress in eliminating barriers and transforming attitudes of employers and society at large towards people with disabilities. Again, my right hon. Friend highlighted the moral imperative of making adjustments, and how the interests of society at large would be served by contributions that would come into balance, providing we take the right next steps. He called it a further leap in the case of mental disabilities. He made an interesting argument about how society’s interests could be served by taking that further leap.

We have only to look at the employment rate for disabled people, which is much lower than that for non-disabled people. It is 50 per cent. as opposed to 80 per cent., and has risen by only 4 per cent. over the past 10 years, despite the broadly benign economic conditions during that period. One can only fear the effect that the current economic conditions will have on people who have a disability. We have my right hon. Friend the Member for Witney (Mr. Cameron), his wife and family very much in our minds, thoughts and prayers at this very sad time after the loss of their beloved son. Ivan’s condition was central to the issues that are the subject of this debate. It was my right hon. Friend who launched the Opposition’s welfare-to-work proposals, which will help many disabled people back into work. We want to encourage a system whereby employers have more incentives and capacity to help disabled people find employment.

I was much encouraged by the comments of the hon. Member for South Thanet (Dr. Ladyman), who spoke with particular passion and knowledge, and made a moving contribution. I am sure that I am joined by the rest of the Members present in thanking him. I was also encouraged by the example that the hon. Member for Croydon, Central (Mr. Pelling) gave of employing somebody who had a learning disability in Parliament. He made his point with great impact.

I am genuinely pleased that the Government have now adopted—I will refrain from using the word “stolen”, given that this is such a consensual debate—our proposals, which are now contained in the Welfare Reform Bill. We support those plans, but we caution the Government that they will not be successful unless the approach taken is the one that is being advocated by others: it is vital to reinvest benefits savings to help more people into work, and to have cyclicality in the funding mechanism. I am pleased that the Government have signed up to the genuinely consensual, dynamic drive towards the personalisation agenda. The Minister and I are often on platforms together on that subject. It is part of our unity of analysis when it comes to such matters.

The decision by the Joint Committee on Human Rights to carry out an investigation into the human rights of people with a learning disability came in the light of reports from the soon to be scrapped Healthcare Commission and the Commission for Social Care Inspection into abuses faced by people with a learning disability in Cornwall, Sutton and Merton, as well as “Death by indifference”, a Mencap report that carried great influence and is greatly to be admired. It revealed the avoidable deaths of six people with a learning disability while in the care of the national health service.

CSCI and the Healthcare Commission are to be scrapped at the end of this month. They will be succeeded and subsumed by the new Care Quality Commission, and many of us are actively engaged in discussions with the new officers and executives of that commission in an effort to ensure that many of the benefits developed by the previous bodies will be carried through. The JCHR’s report, “A Life Like Any Other? Human Rights of Adults with Learning Disabilities”, was published in March 2007, and the two subsequent Government responses were published in May 2008 and January 2009. It is important to note that this is a question of UK-wide import, and that the devolved Administrations, too, welcomed the report. I do not believe that that point has been made in this debate.

The report charted the broad human rights implications of failures in the care and support of people with one or more learning disabilities. It noted that the evidence suggested that adults with learning difficulties are more vulnerable to social exclusion, poverty and isolation, and that public authorities, including local authorities and primary care trusts, are finding “Valuing People” difficult to act on. A contributory factor—I do not by any means suggest that it is the only one—to that failure is the need for the Government to ensure that resources match the demands placed on local authorities in particular and other local bodies to deliver what the Government have said that they should deliver.

The Committee found that people with learning disabilities were more likely to be taken into care, and that they were discriminated against in the criminal justice system. That was discussed earlier in this debate. Although the issues are cross-cutting for Government, the Department of Health is the lead Department, and the Committee duly singled it out for not promoting the human rights of people with learning disabilities. To that degree, it is both welcome and important that a Minister from that Department is here today.

The Committee made it clear that this is a burgeoning issue, as the number of adults with learning disabilities in the UK is growing, due in part to better neonatal and lifetime care and, it is argued, to women becoming mothers at an older age. The growth in the number of people with a learning disability has been estimated at between 3 and 5 per cent. a year. The personal social services research unit predicts that the number of adults aged 18 to 64 with a learning disability will rise by 20.6 per cent. between 2005 and 2041, and new research by the Centre for Disability Research found that the average estimated annual increase in new entrants to services will be 3.2 to 5.5 per cent. per annum between 2009 and 2026.

Above all, we simply must never lose sight of the fact that each and every one of the people we have in mind is an individual. They are part of a family, and they have carers. It is vital that we do not allow statistics to blind us to what is ultimately the basis of a debate on human rights, which is that individual human beings have rights. We must ensure that we can define and understand them, and find the means by which, through a balanced and civilised society, we can protect them. My hon. Friend the Member for Rochford and Southend, East (James Duddridge) made that point extremely powerfully through his sensitive and moving account of the fairly well-known case of Martin Ryan. We now look to the next step which, we hope, will produce the necessary sense of resolution and ensure that lessons have been learned. My hon. Friend’s points about accountability and a sense of justice will have been heard, and those who are charged with taking the case forward will no doubt read with grave care what he had to say.

The Government provided two responses: one in May last year and one, coinciding with the publication of “Valuing People Now” in January. It is worth noting that that document is, in many respects, a response to the shortcomings of the Government’s initial document, “Valuing People”. Has the Minister reflected on how to avoid repeating those shortcomings? We look forward to his reply. It is disappointing to hear the Government reannounce measures. The Minister well knows that we get very cross when they announce things that have already been announced, because it tends to undermine the importance of the matter. On this matter, however, I welcome reannouncements. It is important to emphasise the issue, and when things have been announced but not acted on, we welcome any reannouncement that ensures we make progress and help the Committee Chairman to keep the Government’s feet to the fire. The usual accusation on reannouncements is therefore tempered by that fact.

The “Valuing People” White Paper said:

“The Government will enable all people currently living in long-stay hospitals to move into more appropriate accommodation by April 2004.”

However, in the April 2008 comprehensive spending review, the Government announced funding and

“support for 3,000 people with learning disabilities to leave NHS accommodation and be supported to live independently.”

That was not new money but a reannouncement of £175 million to take people with learning disabilities out of campus accommodation, which was itself announced by the Minister’s predecessor, the hon. Member for Bury, South (Mr. Lewis), as way back as 9 August 2007. I place that on the record in the hope that we can move from words to action.

I am sure that the Minister will want to update the House on the responses to, and progress of, “Valuing People Now”. Some concern has been expressed that, even after the Committee’s warning that there are measurable targets for action in the report, such as the dementia strategy, which was published at a similar time and, no doubt, after a similar amount of financial filleting, it still contains very few goals, aims or targets—whatever word the Government prefer to use—beyond the welcome and worthy words about how the future should look. It is absolutely vital to couple words with action and funding, however, if we are to give people the confidence that we are moving from debate to action. Even in the delivery plan, there is little direct action to improve lives; it is mostly about carrying out studies, with no promise of action in the light of what they might find, and about creating new bureaucracies. Furthermore, there appears to be only three mentions of human rights in the so-called delivery plan.

The questions on funding are also absent from the delivery plan. Mencap said that it

“remains concerned that Valuing People Now will fail to improve the lives of all people with a learning disability without a substantial increase in funding, especially in social care, which is desperately needed to meet the existing and predicted increase in demand for services”.

I am told that the Minister said that the national director for learning disabilities is a lone-ranger post, although I may be wrong, and he will want to correct me if I am. However, the previous director, the Government’s own appointee, stated that an estimated additional £1 million for each English local council would be needed over each of the next 10 years to provide good-quality social care to support people’s right to a life based on independence and dignity. That would amount to an extra £1.5 billion above current expenditure, so it would be helpful if the Minister outlined the Government’s proposals on that challenge.

The Committee recommended the introduction of a positive duty on public authorities to promote respect for human rights, and leadership and action from the Department of Health, the Office for Disability Issues and the Equality and Human Rights Commission. The Committee said that it was

“deeply concerned about the Government’s negative response to our recommendations on the need for an express positive human rights duty for public authorities”.

Obviously, we can debate the value of such pronouncements outside the context of proper funding of their contingent liabilities; however, it would be interesting to hear in what way the Minister feels that simply re-emphasising existing legislation and guidance will make a difference in developing a human rights-based approach locally, and how it will overcome the disappointment of those commentators whom I have just cited.

One area that the Committee addressed was the tightening of eligibility criteria, and the Government prayed in aid the comments from the then ongoing review by the Commission for Social Care Inspection, under its chair, Denise Platt. The consequences of the failure of funding to keep up with increases in demand mean that a large number of people are excluded from social care services, or “lost to the system”, as Dame Denise put it, through the tightening of eligibility criteria. Funding shortages mean that 73 per cent. of councils now support only people with critical and substantial needs. Those with mild and moderate needs receive little, if any, support. Indeed, 34 per cent. of respondents to the Learning Disability Coalition’s survey, “Tell it like it is”, said that their daytime activities had been cut.

On the eligibility criteria squeeze, the Committee Chairman highlighted how a more modest and earlier intervention would be best for people with learning disabilities—best for ensuring that they were well supported—and how, equally, it could be best for society and the taxpayer, because early intervention can lead to much lower emergency expenditure later.

The learning disability budgets of three quarters of councils were under pressure in 2005-06, and in 2006-07 they were overspent by 2.7 per cent. For example, Hertfordshire county council already projects an overspend and, overall, expects a 5 per cent. increase in expenditure—beyond the Government’s maximum provision of 4 per cent.—when compared with 2007-08. Dame Denise’s review has been published and is pretty damning of the Government, so I hope the Minister will explain how the Government are going to address that concern after those findings.

Interestingly, the Committee identified that many human rights failures pertaining to older people’s care also pertain to the care of people with a learning disability, and an issue that other contributors to the debate have not covered is malnutrition. The Committee Chairman and I have debated it in the past, and he is very supportive of my concern. I am sorry to say that the Government seem quite anxious to sideline the issue, however. I do not accuse the Minister present of that, but I have the bruises on my back to show for causing intense irritation to his colleague, the Minister of State, Department of Health, the hon. Member for Exeter (Mr. Bradshaw), who continually challenges the idea that malnutrition is a problem in our society and health and social care services.

I was deeply concerned this week to find that the Government have refused to publish figures on the extent of malnutrition last year—figures that they happily published for the year before. According to the written parliamentary answer that I have received, however, they say that this year it is too complex and costly to do so. Perhaps the economic climate has bitten at the Department of Health, but I fear that it is more likely a wish to avoid the embarrassment of having the injustices in our society brought to light when it comes to declining performance on malnutrition. The issue sits fair and square within the human rights framework. I have been grateful for the Committee Chairman’s support, and I hope that his Committee will continue to monitor the issue closely—certainly, I shall.

The Committee also felt that the ability to make complaints falls within the human rights framework, as the Committee Chairman will well remember from discussions during the passage of the Health and Social Care Act 2008. I hope, therefore, that the Minister will explain how the legislation on complaints, which is in the Health Bill now before Parliament in the other place, will benefit those with a learning disability—in publicly owned services, in publicly funded services and in privately funded services. If the Government had heeded the calls, including those made by me during the passage of the Health and Social Care Bill, the legislation currently before us would not be needed as it would already be in place and the suffering would already have been reduced.

The Government also pledged, in their first response to the Committee, to address the issue in the NHS operating framework. I hope that the Minister will outline how that has been done. I note that it is a new, popular Government response—the same has happened with dementia—because it places the burden on local hospitals and primary care trusts without mentioning the funding, especially any funding that might be attached to it, passported or carried through. In making sure that we are holding the Government to account on their responses, it is vital that we understand that, when they place a burden on others to deliver on the general point, they have also addressed where the funding will come from, rather than simply expecting budgets at local level to be adjusted, prioritised and squeezed ever further because what is spent in one area means that spending has to give in another.

I was pleased to see that the Government agree with the Committee’s position on parents with a learning disability and on the need for support, so that their children can live and grow in that situation. However, in their response the Government did not mention the resources that will no doubt underpin this agreement. Again, I hope that they will take this opportunity to clarify what they are going to bring forward by way of resources to deliver on that agreement.

I see that the Minister will have a long time to answer all these questions and that will be helpful, as he will be able to cover all the points that have been raised.

As mentioned by the hon. Member for Edinburgh, West (John Barrett), who speaks for the Liberal Democrats, two pieces of legislation that are pertinent to this debate are being considered: the United Nations convention on the rights of persons with disabilities, and the equality Bill. There was some expectation that the equality Bill might arrive this week. I hope that we will have some indication of when that will appear.

On the United Nations convention on the rights of persons with disabilities, we in the Official Opposition broadly welcome it and are pleased that the UK was one of the first states to add its signature, on 30 March last year. However, despite the previous Minister for disabled people indicating that the convention would be ratified by the end of last year, the new Minister has admitted that this date has slipped to spring this year. Spring technically finishes on the summer solstice on 21 June, but, as with the Green Paper that we are so eagerly awaiting from the Minister, we are all desperately hoping that he means before Easter, which, in parliamentary time, means before 2 April. I hope that he will confirm that. The delay in ratification has seriously damaged the opportunity for the UK to be represented on the UN committee. The Government have already stated that they do not see a gap between our current legislation and the convention, so it is difficult to understand why there has been such a delay in ratification.

The hon. Member for Edinburgh, West also mentioned the signing of the optional protocol. Having resisted it, the Government have now signed it. But it is worth those who have been pushing for this move considering what force it will have after the Government have applied their reservations to the protocol, particularly in the areas of defence, education and immigration. The Disability Charities Consortium is arguing forcefully that these reservations should not be applied. It will be telling to see where the Government go with that debate. The Minister has the knowledge—I would like to say comfort—that the Official Opposition understand the need for some of the reservations and opt-outs, not least in relation to the armed forces, as the Liberal Democrat spokesman also mentioned.

I have no doubt that when the Minister gets to his feet in the next few seconds, the main thrust of his response will be that the Government are about to publish a Green Paper, and he will mention the other things that are about to come. I said at the outset of my remarks in this important debate, which we all care deeply about, that in respect of many of the issues we have spoken of today, the nub of it is the implementation and funding that goes along with the rhetoric, the aspiration and the agreed set of principles, on which there is more or less a uniform view throughout the House.

I am anxious that, given the growing cracks in the system in this area—any Government who have been in office for 11 years must account for the system—the Government have been serially deferring reports that lead to action, and one report has been begetting another and so on. Sadly, there is no indication as yet that the Green Paper will break this cycle. I fervently hope that the Minister will dispel my concerns. But if he does not, I hope that he will at least set out the options for a new system, with the funding implications, so that we can have a full and informed public debate and ensure that the debate fostered by this important report shows how we can link social care services with the funding, and with the people with need. We clearly have to do that for society; it is a moral and philosophical demand upon all of us.

May I start by thanking my hon. Friend the Member for Hendon (Mr. Dismore) both for chairing the Joint Committee on Human Rights so effectively and for leading the debate this afternoon with his usual commitment and intelligence? I thank him for his kind words—he said that the hearts of Ministers and their policies are in the right place—and for warmly thanking us for our commitment. He also talked about the need for a cultural change if we are to progress this agenda. I will say more about that in a moment. I will endeavour to answer all his questions, but if I fail to do so I will ensure that we write to him on any of the specifics on which he was asking for clarification.

This has been a good, thoughtful, provoking debate across Government, with all parties involved. I know that the hon. Member for Rochford and Southend, East (James Duddridge) has had to leave the Chamber, but none of us can sit here and listen to the cases of abuse that he and my hon. Friend the Member for Hendon described without feeling tremendous revulsion at what has happened. I am unable to comment on individual cases that are still the subject of investigation, but we understand, and expect the report that was mentioned to be published shortly. Certainly, preventable deaths of people with learning disabilities are unacceptable. If anything positive comes from tragic cases of neglect uncovered in “Death by Indifference”, it must be a reminder of the need for constant vigilance across local services.

The Mencap report, together with the Joint Committee’s report, “A Life Like Any Other?”, provided us with an urgent call for action to apply better safeguards across the system, to improve the skills and sensitivities of professionals and, above all, to ensure that a person’s human rights are sacrosanct, both in public services and in the way that wider society responds to people with learning disabilities. We listened to those concerns and responded decisively.

My right hon. Friend the Member for Leicester, West (Ms Hewitt) promptly commissioned Sir Jonathan Michael to chair an independent inquiry. I am pleased to say that Sir Jonathan himself acknowledged our progress since then. He said that the steps taken in “Valuing People Now”

“will significantly reduce the risk of untreated ill health and avoidable death that my inquiry found.”

I will come back to “Valuing People Now” in a moment, but first I want to make a broader point about the clear commitment across Government—I speak as a Health Minister—to developing policies in line with the Joint Committee on Human Rights’ recommendations.

On health, last year’s NHS review is a case in point, with its focus on patient quality and patient experience as the driving force for reforms. That philosophy is now codified for future generations in the new NHS constitution. In social care, “Putting People First” provided the same call for local services to become more responsive and more sensitive to the individual needs of service users and their carers. That general philosophy, which I hope is shared by all parties—the hon. Member for Eddisbury (Mr. O'Brien) mentioned the personalisation of services—provides the bedrock for more specific reforms that we have introduced. They include the first national dementia strategy that we published last month; the carers strategy—hon. Members referred to carers’ important role for adults with learning difficulties—and the independent living strategy that we published last year; our ongoing work to promote dignity and respect throughout all health and social care settings; and the development of the social care Green Paper, which is due this spring. All those policies have come just from the Department of Health in Richmond house, but the same commitment stretches throughout Whitehall in a whole host of wider commitments.

The work of the social exclusion taskforce is ongoing, and when I was a Minister in the Cabinet Office, I had responsibility for its work. That and this year’s new opportunities White Paper have put a spotlight on improving social mobility among the most excluded groups. Our cross-Government public service agreement 16 will increase the number of adults with learning disabilities in paid work—that was raised during our debate—and in settled accommodation over the next three years. The hon. Member for Edinburgh, West (John Barrett), who speaks for the Liberal Democrats on the subject, mentioned our new strategy on employment for people with learning disabilities, which is due this spring and will present a specific action plan to support people in finding and remaining in work.

All those measures within the Department and across Government are underscored by our commitment to ratify the UN convention on disability rights. As hon. Members have said, the Command Paper and explanatory memorandum were laid before Parliament on 3 March. Our ambition is to achieve that ratification in the spring, and I confirm that we signed the optional protocol on 26 February.

Mention has been made of the Commission’s support for a positive human rights duty, and I want to put on the record that section 6 of the Human Rights Act 1998 makes it explicit that it is unlawful for a public authority to act in a way that is incompatible with a convention right. In addition, section 9(1)(d) tasks the Equality and Human Rights Commission to

“encourage public authorities to comply with section 6 of the Human Rights Act 1998”,

so we are not persuaded that additional legislation is needed.

In “Valuing People Now”, we are bringing together all the work that I outlined.

That is an important statement, and I am grateful to the Minister for what he has just said. Having concluded that the Government do not believe that there is justification for further legislative measures, will he explain, in addition to having explained the Commission’s role to urge the Government to comply, who will have the teeth to seek redress for non-compliance if there is a failure?

We are not here to debate the Bill or the convention, so I will not address the specifics of that question, but the hon. Gentleman will have an opportunity to make his points during the passage of the Equality and Diversity (Reform) Bill. He asked me earlier when that will be, and the answer is soon. I think the House will congratulate the Labour Government on introducing a comprehensive equalities Bill that will introduce measures that will make a huge and, hopefully, irreversible difference to the equality and treatment of many more people in our society.

On the same issue, but at a slight tangent, the Minister referred to section 6 of the Human Rights Act 1998, and a key issue is what we mean by “public authority”. My hon. Friend will be aware of the continuing debate about that, which will result in a one-off measure for old people’s homes, but the issue will remain at large for the wider privatised/contracted-out public services, particularly social services, in which there has been increasing private provision. One concern that my Committee has raised on several other occasions and which will be addressed in my private Member’s Bill is that we must ensure that those who provide public services through private means or systems are covered by the 1998 Act to enable that direct enforceability for any breach of the Act.

I will certainly draw attention to the point that my hon. Friend raised. He will know far better than me how his private Member’s Bill will get on, and the procedures that may or may not be used to ensure its successful conclusion.

In line with the Joint Committee’s recommendations, the whole of the “Valuing People Now” strategy was written entirely from a human rights perspective, and I was interested to note that my hon. Friend the Member for South Thanet (Dr. Ladyman), although welcoming that approach, thoughtfully teased out a number of complexities that arise when we take a human rights approach. That is exactly the sort of thinking and debate that we must continually address. We must start with a human rights-based approach, and I hope that that is agreed throughout the House.

The “Valuing People Now” remit was broad. We want to ensure that we deliver change everywhere for everyone, and in response to the progress that the original “Valuing People” report made, the “Valuing People Now” strategy focuses particularly on people with complex needs, people with autism, and people from black and ethnic minority groups. I had a meeting with Victoria Willson and her mum, Jean, and the Learning Disability Coalition only yesterday, and I was profoundly struck by the fact that someone with such complex needs was living an independent life, and had been doing so for the past 20 years. People may say that that cannot be done, but clearly it can and is being done. There may be debate about resources, but the fact that it can be done tells us that such examples should be not the exception, but the norm.

The scope of “Valuing People Now” is ambitious, because we want to transform the way that people with learning disabilities view the world, and the way that the world views them. That central vision, leadership and commitment is in line with the Joint Committee’s recommendations. As has been said repeatedly this afternoon, I know that it wanted strong words to be translated into hard action. That is exactly what is happening, and our efforts are yielding real results on the ground.

People with learning disabilities now have more choice and more control over their lives. For example, 2,000 people now receive direct payments, which they can use to pay for the care or services that they want. Many are now progressing from direct payments to individual budgets. During a visit to Chelmsford, I saw how those budgets are transforming people’s lives. I met a young man with learning disabilities whose life was completely different. He was working, had a girlfriend, and was living an independent life. It was not only his life that had been transformed; the life of his family had been transformed because of what he was able to do with his independence.

All that is part of a much wider drive to grapple with the issue of how to give people with learning disabilities more freedom and independence. It is right that more people with learning disabilities are living in their own homes, and enjoying a richer and more varied social life. I am particularly pleased that improved advocacy, to which my hon. Friend the Member for Hendon referred, and better information and advice mean that more people with learning disabilities can shape their own future, and are being treated as equal citizens in our society.

My hon. Friend also referred to funding. Average spend on advocacy services has leapt by more than 40 per cent. since 2004. I dare say that he would like to see more, but I want to put on the record how much difference that has made to the lives of adults with learning disabilities.

The hon. Member for Eddisbury spoke about support for people with learning disabilities who want to make complaints about how they are treated. The Department will be developing materials to help such people and their families to understand their rights of redress and how to complain, because that is an essential part of what advocacy can do.

One reason why I have come to the debate and sat through certainly three quarters of it so far—I was a moment or two late—is that I was approached by East Cheshire Advocacy. It is extremely active in my constituency and the adjoining areas, but it needs help and funding to be able to continue to provide that very worthwhile advocacy, and not least, as the Minister rightly said, to complain, because that is often what people are unable, or feel themselves unable, to do. Is the Minister understanding of the modest sums that that charity needs to provide the excellent services that it does, and not only in east Cheshire? I have quite close contact with it and meet many of those who go to its weekly meetings. Does the Minister appreciate that it cannot operate on thin air?

Of course. Quite rightly, many third sector organisations—user-led organisations in particular—not only support and help in the development of policy, but campaign, either for an individual or for a group of people whom they represent, to improve services in their area. That is a core part of what charities should be about. Some Opposition Members thoroughly disagree with the idea that charities should campaign for issues in support of their beneficiaries. However, Government Members see that as a core part of what the third sector exists to do and has done for many years, and we want it to be strengthened. That does mean that sometimes such organisations bite the hand that feeds them, if I can put it that way. Good. That is right. Local authorities and central Government, when we fund third-sector organisations directly, should expect a partnership to include criticism as well as support and engagement. That applies not least to advocacy organisations.

We are developing a funding programme for user-led organisations because we want to see them in every local authority area. There will be more announcements about that in due course, but if local authorities, no matter what their political colour, believe in personalisation and developing services and tailoring them to meet the needs of individuals, then enabling those organisations and the individuals who represent them to be funded to do that work and to promote the needs of the individual is a critical part of the commissioning process overall when services are being developed.

I therefore urge the hon. Member for Macclesfield (Sir Nicholas Winterton) to go back to the local authorities to which he was referring. I am not sure of the political colour of the council in his constituency, but if it is of a similar colour, perhaps he, as a member of the same party, will be able to persuade it of the point, rather than relying just on the exhortations of a Labour Minister.

I am greatly encouraged by that response to the intervention from my hon. Friend the Member for Macclesfield (Sir Nicholas Winterton). My constituency has a portion of east Cheshire—the new east Cheshire coming into being on 1 April—within it. The Minister’s response is hugely encouraging, and not only given that we have those advocacy services. The Health and Social Care Act 2008 is relevant. It is vital that the LINks—local involvement networks—should also be properly funded. There are big questions at the moment about whether the funding will be adequate. I hope that the Minister will have an opportunity to take some of the points that he has just made, which were very welcome, back to ministerial colleagues to ensure that there is a co-ordinated Government approach to a proper funding base for those various organisations. That has been a running sore for nigh on 10 years, since community health councils were scrapped. At last, the Government are beginning to recognise that there is real value in government in having good advocacy and, indeed, complaining services, which do need some form of public funding support to make them sustainable.

I am perfectly happy to take those points back, because I do this all the time inside Government—support third-sector organisations. From memory, as a former Minister with responsibility for the third sector, I believe that funding for such organisations, which was about £5 billion a year in 1997, was £10 billion in 2006, so in the past 10 years funding and resources for third-sector organisations have doubled. I encourage local authorities, when making decisions about how to allocate funding and doing their commissioning, to recognise the essential role that many third-sector organisations play as advocates, in helping policy design and in delivering services to people in their area.

I am pleased that people with learning disabilities, as a result of the progress that we have made, are now connecting with their communities more fully and that more are living independently. Various hon. Members mentioned long-stay hospitals. For the record, I point out that by the end of this month there will be just one remaining long-stay hospital, with just 20 residents. Notwithstanding the point that my hon. Friend the Member for South Thanet made, we can say that we have made real progress in encouraging independent living—not people living on their own, lonely, but independent living with support. The numbers living on national health service campuses have also dropped, from about 3,000 in 2006 to 1,000 today. I think that that issue was raised by the hon. Member for Eddisbury.

We are already seeing real change, and that is only the tip of the iceberg. We have responded to the JCHR report. We have listened and taken action to ensure that the promises made in “Valuing People Now” translate into an even brighter future for people with learning disabilities, but to do that, we have further to go. Further reform is needed in three key areas.

The first—this connects with many of the concerns about policies and action on the ground—is better governance and accountability at national, regional and local levels. We have developed a new command structure—a new set of controls to ensure that we deliver the “Valuing People Now” commitments everywhere and for everyone. At the top of the pyramid is a new learning disability programme board, which I co-chair, supported by two national directors for learning disabilities, one of whom has a learning disability. The board includes cross-Government representation and the active involvement of people with learning disabilities and family carers. That board will link to new regional learning disability boards and strengthened local partnership boards, ensuring that all the agencies link up to deliver on the promises that we set out in “Valuing People Now”. The national programme board will also produce an annual report and an updated delivery plan, holding the regions and local areas to account on their performance.

I reject the criticisms from the hon. Member for Eddisbury that we are not monitoring, driving, leading and making change happen. We have put in place a structure to do precisely that. I confirm, as a point of detail, that it will include monitoring the implementation of the good practice guidance on parenting. That will go out at local level. We want to ensure that that guidance is shared with primary care trusts and NHS trusts. On top of that, we have put in place specific measures to improve health services, which we know were a particular concern for the JCHR.

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Two hon. Members are seeking to intervene. I shall give way to the hon. Lady first.

I am most grateful to the Minister. A thought has struck me, following his announcement that there is only one long-stay hospital, with 20 people living there. Has there been an initiative, in view of that, within the health and dental education services? I ask that because when people lived in short or long-term stay hospitals, they had specialist dental and medical care—professionals who were used to people with learning disabilities. Out in the community, in whatever way people live, it is a different ball game. Has there has been an initiative within the national health service and the education of doctors, nurses and other professionals to deal properly and sensitively with those who have these disabilities?

The hon. Lady addresses the very points that I was about to come on to. We have put in place specific measures to improve health services for adults with learning disabilities. This year, as hon. Members may know, we have introduced a directed and enhanced service for annual health checks for people with learning disabilities—my hon. Friend the Member for South Thanet referred to that in his remarks—that will allow doctors to keep a close eye on the health of those individuals, pick up any early warning signs and give people more information, advice or, indeed, a referral if they need more help.

In addition, every PCT must ensure that people with learning disabilities have personalised plans to support them. More broadly still—we are going from the bottom up—the new NHS operating framework makes it clear that PCTs should secure health services that make “reasonable adjustments” for people with learning disabilities. We shall work with strategic health authorities to review progress on delivering that outcome.

I take my hon. Friend back to what he said about his new command structure and the importance of involving people with learning disabilities. Will he talk to his colleagues at the Department for Work and Pensions, to ensure that people with learning disabilities who attend such meetings do not find themselves excluded from receiving jobseeker’s allowance because they are not available for work; that they do not have difficulty when claiming expenses because they have to be declared; and that they are given an honorarium to cover their time and effort in attending those meetings without losing benefit, pound for pound?

I am sure that those points will be made with vigour at the meetings of the national board. The DWP is a member of that board, and it will have the opportunity to debate those issues and to raise them directly with others. I shall, of course, ensure that my hon. Friend’s comments are fed into the system.

The second key pillar of reform is that of better skills and awareness to help professionals at all levels. On one hand, that means better commissioning within PCTs and local authorities. I am very conscious that there is still patchiness in provision across the country, which reflects a lack of consistency in commissioning standards. As a result, we will publish new guidance to build up commissioning skills within local authorities, specifically on promoting better health and well-being for people with learning disabilities.

From April, we will transfer NHS learning disabilities budgets, and the associated commissioning responsibility, for all social care for adults with learning disabilities to local authorities. That change will allow the NHS to focus on its primary health-care responsibility for people with learning disabilities, yet give local authorities a clear role in delivering high quality, community-based care services.

How urgently is the Minister treating the matter? Many of us have copies of the excellent briefing paper from Mencap and the Learning Disability Coalition. Although those bodies welcome the Government’s strong commitment to improving health services for people with a learning disability, they highlight certain matters. My hon. Friend the Member for Eddisbury (Mr. O'Brien), the shadow spokesman, highlighted the fact that among people with learning disabilities aged 20 to 29, the mortality rate is nine times higher in men and 17 times higher in women. They also highlight other areas. Are these a priority for the Government?

The hon. Gentleman is absolutely right. We need to improve front-line skills so that those statistics and the tragedy that they represent can be addressed directly. We need to ensure that whatever discipline the professionals may be in, they are aware of the issues faced by adult with learning disabilities.

In social care, the work force proposals set out in “Valuing People Now” will be taken forward through a new adult social care work force strategy, to be published later this year. GPs and primary care practice staff will receive training and advice to help them meet the needs of people with learning disabilities; that is clearly essential if the annual health check programme that I mentioned earlier is to function well. Across the NHS, we have launched an awareness campaign to teach staff about the disability equality duty, leaving them in no doubt about their responsibilities to uphold the patient’s human rights. I was struck by the point made by my hon. Friend the Member for Hendon that training that could deliver relatively small changes in practice can have a large impact on people’s lives. That is something we look forward to.

I take the Minister’s point about training, but we must ensure that we train not only new entrants to the various professions and services but those who are already there. The big problem is to get the message over to those who were not inculcated with that sort of approach at the beginning of their career.

Yes, it is clear that we must raise awareness among existing staff; it is not just about new entrants. In a way, the fact that people in the relevant services hold those attitudes shows that we need to see a culture shift across society. We have to challenge discrimination, and open doors for adults with learning disabilities.

I return briefly to the question of employment. The employment of adults with learning disabilities is a key building block, and public service agreement 16 and the new employment strategy that I mentioned will resonate across communities. We need greater visibility, and with it greater acceptance, better understanding and higher expectations for people with learning disabilities. To pick up on a point made by my hon. Friend the Member for South Thanet, who was one of my predecessors, I expect the public services to show leadership. I want to use this afternoon’s debate to throw down a gauntlet, particularly to the national health service. The NHS is by far the biggest employer in the country, and the third biggest in the world. There is no reason why it should not employ more people with learning disabilities in appropriate roles.

I believe that primary care trusts and NHS trusts can learn a great deal about how to do that from the work that is already going on. There are excellent examples in Leicester and Norwich; I would describe both authorities as being well ahead of the curve. Authorities around the country are already making a difference. I want to see that change start at home. I cannot answer the question put to me by my hon. Friend the Member for South Thanet on the number of people with learning disabilities employed in the NHS, but I am mindful of that point and will take it on. The societal change that we need should start with the NHS.

I remind my hon. Friend that there is a bigger employer than the NHS, although the work force is split over several hundred employers; it is the one for which he is responsible—social care. My experience of those with more simple or moderate levels of learning disability is that they are tremendously caring. They could provide many caring roles to others with more serious learning disabilities, and they would be sympathetic and understanding. I would encourage my hon. Friend to think of the social care world as being a place where many such people could find employment.

That is a good point. Indeed, all employers should consider such opportunities. We should not have stereotyped predispositions about the particular roles that people might play. We can identify a person’s skills and strengths and find roles and responsibilities in a variety of settings and organisations. From memory, I believe that South Lanarkshire council authority has realised a remarkable achievement, given the number of people with learning disabilities whom it employs in a variety of roles. I suspect that it is driven by one individual, who is intent on championing that in his local authority. We should have such champions in every local authority, driving forward such changes. We need to support change through wider action, and there are encouraging moves afoot.

I want to pick up on some of the points raised in the debate. The Home Office seeks to take strong action on hate crime, and specific guidance will be published for crime and disorder partnerships. The Crown Prosecution Service is consulting on how it should approach witnesses with learning disabilities. Lord Bradley is currently undertaking a review into diverting individuals with mental health problems and learning disabilities away from the criminal justice system—a subject that occupied much of our debate. We expect that review to be published shortly, and we will respond to Lord Bradley’s recommendations.

Even now, work is going on in the criminal justice system. “Valuing People Now” seeks to address the problem, and work is under way to ensure that the specific needs of offenders with learning disabilities are included in the delivery programme on offender health. We are monitoring the implementation of the forthcoming good practice guidance for commissioners of forensic services for those with learning disabilities; and offender management processes should include a health screening programme, so that we can identify an offender’s learning disability and any physical or mental health problems that they may have. That should be the start of an individual health action plan for those in the criminal justice system.

Good practice is being developed on learning disability awareness training for prison staff to help them identify and understand the issue, and to communicate better and manage offenders in custody with learning disabilities.

My right hon. Friend the Member for West Dorset (Mr. Letwin) touched on that matter, and has conducted a study into it, as the Minister will know. I visited the young offenders institution at Thorn Cross, near Warrington. One of the most telling points that emerged concerns those on remand, although it applies to convicted young offenders serving a custodial sentence as well. Very often those sentences are so short—this is irrespective of the merits of such short sentences—that by the time that a young offender has been assessed, not enough time remains to convert the assessment into an appropriate programme of learning, whether for a certificate, diploma, GCSEs, A-levels or even a plastering qualification. Such assessments show that at least 60 per cent. of young offenders have some form of learning disability or disadvantage. We need a cross-Government examination to ensure that, off the back of such an assessment, there is a continuing commitment to remediate the learning disability through a continuing programme of education after the young person is released.

It is tempting for me to be drawn into this debate. I was once a Skills Minister responsible for offender learning and education inside and outside the prison system. Back then, I was very concerned, but huge progress has been made to ensure that young people and adults assessed in the system—perhaps for their literacy and numeracy needs, a national vocational qualification or an apprenticeship, for example—are not simply reassessed as they move through or out of the system. We do not want a process of continual reassessment of needs without providing the training and skills required to meet those needs. That problem is now being addressed directly by my colleagues in the Ministry of Justice and in the Department for Innovation, Universities and Skills.

In two regions, we are piloting a campus model in which prison and probation institutions work together and treat the offenders whom they are managing like students on a university campus—that is not quite the right model, but Members will understand what I mean. It will enable somebody to move around the system, continuing their education and skills training, without having to repeat something—either the assessment or a part of the course. That requires investment in IT systems and good communication. The criminal justice system is complex, but huge steps have been taken. From memory, the two regions where the pilot is being conducted are the west midlands and the eastern region. That new approach will join up our approach, so that those barriers do not get in the way of people moving in and out of the system. Of course, that will also apply to adult offenders with learning disabilities.

What are the Government doing about adults with learning difficulties, perhaps complicated by a mental illness, who are sent to prison because of an offence that they have committed, not because they wanted to commit it, but because their illness and learning difficulty led them to do so? What alternative facilities or care will be made available for such people? They should not go to prison, because no adequate psychological or medical services are available to treat them.

I shall not get drawn into that debate. All that I can tell the hon. Gentleman is that Lord Bradley, whom I mentioned earlier, is conducting a review into how individuals with mental health problems and learning disabilities can best be diverted from an inappropriate route through the criminal justice system and in the direction of other services and support. That diversion might happen at different stages throughout the system. Once that report and our response to it are published, we will have a chance to examine whether we have fully grasped the issues that need to be addressed.

My hon. Friend the Member for Hendon asked about the Electoral Commission and the voting rights of adults with learning disabilities. I can confirm that, of course, the Government are happy to work with the Electoral Commission and other bodies to identify possible improvements to make the electoral process more accessible to people with learning disabilities. The office of the national director and the Ministry of Justice will work with the commission to explore the issues that he raised. Furthermore, the Department for Children, Schools and Families is working to improve the support available for the parents of children with learning disabilities, ensuring that they know their rights and can hold local services to account. All of that is fundamentally important if we are to change what I call the cultural landscape surrounding people with learning disabilities.

I found the contribution from the right hon. Member for West Dorset (Mr. Letwin) fascinating. Over the past 10 years, funding for adult social services has increased by 50 per cent. in real terms. The changes that I have just described came about because we have ensured that local authorities have been given more resources to meet the needs of adults with learning disabilities. I was intrigued by his contribution, given that he is writing the Conservative party manifesto. If I understood him correctly, he said that resources to pay for care for adults with learning disabilities and to ensure their human rights could be “self-financing”—I think that he used that word. That appears—I do not know whether this is the case—to be the clearest signal that the Conservatives do not intend to invest additional resources in adult social care for the most vulnerable people and that any improvements would come from savings in other services that they receive. That might be unfair, but organisations reading this debate might want to explore that interesting item further with the Conservative party and to ascertain exactly what its intentions are.

To sum up, we have had a clear debate this afternoon. The Government have a clear, cross-Government vision. We have stronger governance and accountability across national, local and regional areas, we are developing better skills across the work force, and we are taking steps to develop a healthier culture across society at large. Now that we have put those key components for change in place, they are already making a difference to people’s lives, and they will do even more for people with learning disabilities in future.

I do not want to say a great deal. We have had a very well-informed debate. My hon. Friend the Member for South Thanet (Dr. Ladyman) said that our report had not got into the full complexities of the issue, and I would be the first to concede that we did not do an exhaustive job. We tried to pull together the key themes that emerged from our inquiry. Each chapter could have been an inquiry in its own right, and we are keen to look again at the justice system and prisons, because that is where we feel that the greatest injustices are found.

My hon. Friend also juxtaposed human rights and relationships and so on. We have discussed the human rights-based approach today, but we have not defined what we mean by that, so I should like to explain that taking a human rights-based approach means putting the principles of fairness, respect, equality, dignity and autonomy at the heart of policy and planning; empowering staff and users with the knowledge, skills and leadership that they need; having meaningful involvement and participation from key stakeholders; having clear accountability in the organisation; ensuring non-discrimination; and paying attention to the needs of vulnerable groups.

I do not think that the juxtapositions that my hon. Friend discussed involve ignoring human rights; indeed, they facilitate them. He talked about relationships and risk assessments, which, in fact, would not have taken place before, because such people were not allowed to have relationships in the first place. However, we have now started to facilitate them.

The hon. Member for Eddisbury (Mr. O'Brien) talked about choices versus rights—another long, philosophical debate that we do not have time for today, particularly as it might stray into the debate about economic and social rights. I would simply say that, in this context, we are talking not about unconstrained choice, but about fair choice, including the reasonable adjustments mentioned by the hon. Member for West Dorset (Mr. Letwin), and equality of opportunity as far as we can achieve it. In that context, we can square the circle.

Overall, I was very encouraged by my hon. Friend the Minister’s reply to the debate. As I said at the beginning, we have been impressed by the commitment shown by him and his predecessor and by the way in which policies are developing. The real issue is how to turn those policies into action. I think that that was both the starting point and the finishing point of his reply.

Question put and agreed to.