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Disabled Persons (Independent Living) Bill [HL]

Volume 687: debated on Friday 15 December 2006

My Lords, I beg to move that this Bill be now read a second time.

As noble Lords know, the Bill received its Second Reading on 14 July this year, but there was no time for it to complete its remaining stages. So, here we are again, full of hope that noble Lords will support the Bill and pass it through all its stages. I said at that time that the purpose of the Bill was to transform the lives of Britain’s 11 million disabled people from frustration to fulfilment by providing a legislative framework for rights to independent living. It is an idealistic and a practical proposition, and it is a blueprint for the future of disabled people.

The Bill aims to change the whole ethos of the debate on disability from a discussion on how we take care of helpless people to a discussion of equal citizens who happen to have a disability. So how can we best help them cope and exercise the same choice, freedom, control and dignity that we all expect? I want to pay tribute to the Disability Rights Commission, its chairman, Bert Massie and its staff for their extremely constructive assistance. The extraordinary Caroline Ellis has worked extremely hard to make the Bill a success, and I put my warm appreciation on record. She has been of more help than any noble Lord has the right to expect, and I am deeply grateful to her for her efforts.

The springboard for the Bill is the appalling discrimination that disabled people still suffer. In realistic terms, they are second-class citizens and are treated as such. The Prime Minister has said that one in five British adults is disabled and that they can find themselves cut off from the opportunities that other people enjoy. They are more likely to live in poverty, to have fewer educational opportunities and to experience prejudice and even abuse. Most have low expectations. Only 50 per cent of disabled people of working age are in employment, compared to 80 per cent of non-disabled people.

The question before the House today is this: how can we rescue this one-fifth of our adult population from being an underclass? The answer must be nothing less than comprehensive legislation that will provide real opportunities of equality and independence and place specific duties on public authorities. There will be a duty on the Secretary of State to prepare and implement a national strategy for independent living.

Before I explain the provisions in the Bill, I shall say one further word on one urgent need for it. Seventy per cent of our councils offer services only to people whose needs are judged as “critical” or “substantial”. The rest can go to pot. The rights that they have are disgracefully minimal. For example, their right to services means help with being washed and fed, rather than comprehensive assistance and rights that would help towards independence. There are no positive rights in existing legislation to enable disabled people to choose where they live and no legal protection against their being forced to live in institutions against their wishes. That really is scandalous. There is no legal entitlement to advocacy, except in limited circumstances, or to communication support. It is simply impossible for disabled people to have independence when they have no communication support and no advocacy. There are no rights of support to cover a disabled person who moves to a different part of the country. They have to start all over again and negotiate a new care package from scratch and from many different sources. It is an awfully confusing business. The Bill provides that right.

People with mental health needs have no right to assessment or support for their needs. The notorious postcode lotteries prevent the provision of services all over the country. It is luck rather than judgment as to who actually gets what—fancy that in 2006. I hope that, like me, other noble Lords feel ashamed and angry at this neglect. It is basic neglect.

A basic element of the Bill is the provision of rights for disabled people and the imposition of duties on local authorities and the NHS. It is a twin-track attack. As a starting point for assessing needs, I want to emphasise the need for contributions from disabled people themselves. In the simple but profound words of Plato:

“Only the wearer knows where the shoe pinches”.

Disabled people are the best qualified to define their own requirements. This is one hundred times better than a local authority assuming what they are and simply handing out what it thinks is best.

At present, many disabled people are forced to live, first, in an institution against their will, and, secondly, with someone they do not want to live with. They are forced into it just because of their disability. It is absolutely unbelievable. The Bill empowers disabled people to determine where they live and with whom they live. If and when the Bill becomes an Act, it will be unlawful to force anyone into an institution against their will—and about time too.

Local authorities will have to identify all disabled people in the area and maintain a register of them. They will need to provide a wide range of assistance, such as communication aids and other forms of equipment, technology, independent advocacy and practical assistance in the home and elsewhere. Those are crucial elements of the Bill. Some people will say that they are all-embracing; in a sense, they are, but we must aim high. The neglect at present is so gross and so frustrating that we need to do something. This kind of element in the Bill will ensure that people are not left fighting alone with their disability. There will be a new system of individual budgets. The present range of different funding streams to help with personal care support, equipment and adaptations will be brought together, and disabled people will be able to use their individual budgets in the form of cash or services, or a mixture of both, to spend as they wish, on housing, equipment, personal assistance, transport or whatever they desire.

I assume that some local authorities will try to evade their responsibilities, although of course I cannot calculate how many. To outmanoeuvre them, the Bill provides that regulations will be made specifying minimum outcomes. That will effectively prevent local authorities wriggling out of their responsibilities.

I am anxious and hopeful that Gordon Brown will support the Bill. David Cameron says that, although he shares my aims and aspirations, such as extending direct payments, individual budgets and others, he is not convinced at this stage that legislation is the way in which to make all these changes. As we all know, however, history has taught us that the voluntary approach has failed and that there will be no new rights for disabled people and that no new duties will be imposed on public authorities without legislation. I firmly and deeply believe that simply requesting change is like the cooing of a dove in a cage—it sounds good, but it is perilous. This is what will happen when people are begging, pleading, asking and urging. We need strong legislation to ensure that these things happen.

I hope that Gordon Brown and other Members of both Houses will recognise the important economic benefits of investing in independent living. As people become more independent and return to work, earning from their employment and paying taxes, savings will be made in the social security budget. There will also be a big reduction in the use of health and social services as people become active and return to work. Vitally, the net costs incurred under the Bill will be far less than people first assumed when they saw these demands.

I was impressed by the comments on housing made my noble friend Lady Wilkins in an earlier debate. The provision of disability housing services is, of course, supremely important in the Bill. Each local authority will have to compile a list of accessible properties and disabled people requiring such properties and then—this is an important part of the answer—provide a matching service. The terrible shortfall of accessible housing will no longer be a bugbear, because people will be able to fit properties via the matching service. All new dwellings of whatever type will have to meet minimum standards of access—and about time, too. As a result, there will be a vast saving for local authorities by avoiding the very heavy cost of later adaptations.

It is not possible to do justice to the many provisions in the Bill in such a short debate. I hope that the House will accept that the thrust of the Bill is to transform the lives of millions of disabled people and to provide them with the necessities for real independence which we all take for granted but which are so cruelly denied them. Among the other provisions is the duty on the Secretary of State to prepare and implement a national strategy for independent living.

I offer these proposals to the House in the hope that we can initiate a movement to enrich the lives of disabled people with new rights for them and new duties on public authorities. None of it will be easy, and we can expect a great deal of opposition and indifference from various quarters. But the rewards for disabled people are enormous, and we can literally transform their lives with this far-reaching legislation.

Independence, dignity and freedom can transform the lives of disabled people, and we can do this job working together. We often use the words “freedom” and “independence” without realising what a lack of them means, and many severely disabled people lack those vital things. The Bill aims to put that into practice and ensure that something is done. Without those things, their lives are sadly diminished. It will be a far happier story if and when the Bill is passed and implemented. I commend the Bill to the House.

Moved, That the Bill be now read a second time.—(Lord Ashley of Stoke.)

My Lords, I strongly support this Bill, introduced by the noble Lord, Lord Ashley; I have great admiration for everything that he has done over a lifetime helping those with disability. I must declare an interest in that I have a daughter with multiple sclerosis who benefits from the Access to Work scheme. It is marvellous and enables her to continue working in a very responsible job in the Department of Health. I was somewhat surprised at the figures from the Department for Work and Pensions, which showed that only four people in the whole Department of Health get assistance to go to work. There must be more people with a degree of disability who merit help, but this information came out simply when Access to Work payments were transferred from the DWP to the local department. All departments, except the Department for Work and Pensions, were listed, so we wonder how many are employed in that department.

I am aware of the extreme difficulties of succeeding with Private Members’ Bills. My history of these Bills is on hedges—I seemed to be at it for ever. In the end, the Government added the issue to the Anti-social Behaviour Bill, a very happy solution. But, knowing how important it is to deal with the technicalities of these Bills, and as a strong supporter of this Bill, I thought I should raise this point today. I serve on the Delegated Powers and Regulatory Reform Committee. In the previous Session, we considered this Bill and noted many technical flaws. I understand that the Clerk of the committee has written to the noble Lord, Lord Ashley, to explain the position, and the flaws were published in a report on 30 June 2006, in the previous Session.

When the Bill came to our committee again on Wednesday, we were rather surprised to discover that none of our points had been taken up and the Bill had not been improved or amended to meet these requirements in any way, which is why I thought that I should raise this issue. Supporters, such as the Disability Rights Commission, do a great deal and have sent wonderful briefing on this, which I will not go into because it would take too long and I know that others will bring out its points. The case is so well known that it almost speaks for itself. But, if we place this on the record in Hansard, the supporters will know to look at these technical flaws. I refer them directly to that report.

Most of the powers in the Bill are conferred on the Secretary of State or the National Assembly for Wales, but the Bill does not specify who is to make the regulations—the report lists the relevant clauses. The Delegated Powers Committee recommends that,

“it should not be left to implication that these powers too should be exercisable by the Secretary of State or the NAW”.

Another point relates to the powers to make further provision. Again, the report sets out in detail the clauses concerned. It states:

“As this is a private member’s bill, there is no memorandum to the Committee”—

the “memorandum” is usually a detailed statement sent by the government department involved explaining the logic behind its points, but we do not receive one with Private Members’ Bills—

“to explain the delegations and so it is not apparent to us why these powers are needed or appropriate. Accordingly we draw them to the attention of the House so that a further explanation may be given”.

On the parliamentary procedure, the report states:

“All of the powers conferred on the Secretary of State by the bill (except that in clause 24(2)) are made subject to affirmative order by clause 36(2), including commencement orders and orders applying to the bill with modifications for the Isles of Scilly. We draw this to the attention of the House because we do not think this can have been intended, as the only power in the bill which seems to warrant affirmative procedure is that in clause 3 to extend the definition of ‘disabled person’”.

These are highly technical points. By putting them on record in Hansard the people working on the Bill will have the opportunity to study the defects and to consider how to overcome them.

I have found from personal experience that the Public Bill Office is marvellous at helping to draft amendments. The amendments to this Bill would need to come forward in Committee. It would be rather onerous on the noble Lord, Lord Ashley, to be asked to table all the amendments himself. I am sure that, if the Public Bill Office were to issue a list of the required amendments, many Members of the House would be willing to table amendments and to speak to them. This would not be opposed by anyone in the House because we all want to see the Bill go through. That deals with the technical points.

I agree with the noble Lord, Lord Ashley, that this might cost far less than expected. The noble Lord referred to housing. I have always been upset that in this country a house or residence of any type designed specifically for a disabled person is not necessarily passed on to another disabled person. I have seen expensive adaptations being ripped out and I find it tragic that there is not a central place to which they can be taken. A neighbour of mine put in a chair lift and used it for only about a year before she died at a great age in her 90s. But afterwards, when the executors asked me to try to find someone to take the chair lift or to use it, there was no system into which it could go to be re-used or to benefit anyone. I considered it very wasteful that something like that, which had cost a lot of money, was just discarded.

In Australia—and, given the cricket, I hardly dare mention Australia, although this test match seems to be a bit more even—certain properties are designated for disabled people. Very often a charity or a similar organisation owns the building. That organisation will give a person a lifetime lease or tenancy of the property, and when that person dies—if the spouse survives, he or she can remain there for the remainder of his or her life—the house is not converted into a “des res” for anyone to live in; it continues to be a useful property for another disabled person.

Under “disabled” I include those people who have not a lifetime disability but a disability due to their lifetime and wearing out in old age. Many people come into that category, and there will be many more as life goes on—although yesterday, at the Royal College of Physicians, we were all cheered to be told that we would live longer but not live badly any longer; that the difficult period of our lives will still be fairly short at the end. That was good news.

There is a vast and growing need for help of all kinds for disabled people. The provisions referred to in the Bill—the rights of choice, short breaks, mental health support—are very important. I could go on and on, but I will not do so because the argument is well made. I want only to express my support for the Bill and to draw these technical matters to the noble Lord’s attention.

My Lords, I wholeheartedly welcome this Bill, so comprehensively explained and compellingly argued for by the noble Lord, Lord Ashley of Stoke. I applaud his unfailing spirit and tenacity and regret the absence of that other tireless campaigner, the noble Lord, Lord Morris of Manchester, who sends his apologies. This House and many other people, not only those with disabilities, owe them both a great deal.

At the previous Second Reading, the noble Lord, Lord Ashley of Stoke, said:

“I hope that today I have planted a seed in Parliament that will be transformed into a mighty piece of legislation, giving to Britain’s disabled people the freedom and independence they cherish and which they have been denied for too long. The Bill is a blueprint for the future, but the time to embrace it is now”.—[Official Report, 14/7/06; col. 957.]

We need a design plan to help resolve the problems highlighted in the excellent debate last Thursday of the noble Lord, Lord Bruce-Lockhart. I hope that the technical, detailed points of the noble Baroness, Lady Gardner of Parkes, may firm up the blueprint.

I should like to add my thanks to the Disability Rights Commission as a whole and, to quote the noble Lord, Lord Ashley, to the extraordinary Caroline Ellis. The DRC has described the Bill as a timely response to the crisis in social care. Our social care system is certainly in need of wholesale reform. That is not just the view of the Bill’s main supporters; it is what several senior local authority managers are saying. The current system is unable to meet the needs of those who use the services and will be unable to meet the challenges of growing expectations and demographic change. The symptoms are clearly visible: the majority of councils can now provide nothing to those with more moderate needs; families and carers are at breaking point; and shocking case studies are gathered by the DRC in its recent Independence Day report on disabled people prevented from working, kept apart from their families and deprived of basic, essential support.

At that Second Reading, I concentrated on personal care. I will spare your Lordships a repeat, except to explain and declare my interest. I will then touch on a couple of wider implications on which I hope the Minister might give her views, follow up with a question I raised last time and ask a new question. I said in that debate:

“I must declare a close interest, in that I have for the past four years needed increasing amounts of help with personal care: washing, dressing and getting out of, and now getting into, bed. I am in receipt of a higher rate of disability allowance, which in no way covers all the costs. I do not qualify for any further financial help. I add this only to make it clear that this is not a personal moan, but one on behalf of all those who cannot manage and are not in control of their lives”.—[Official Report, 14/7/06; col. 968.]

Recent reports from In Control, a body which comprises Mencap and Valuing People and is developing new systems of self-directed support with local authorities, similar to those proposed in the Bill, supports the case for change. Its initial pilot—I think there were six—demonstrate major improvements over a range of outcomes, increased numbers of disabled people in paid work, and strengthened family cohesion. Everyone who was in residential care at the start of the pilot, including those with learning difficulties, was able to move into the community, in many cases at a greatly reduced cost.

In Control says that the efficiencies released by reform could be absorbed by more people claiming rights to support, but that is precisely what needs to happen. We need a system that can deliver real choice and participation for the many rather than inadequate care for the few.

I turn now to the wider-scale effects on women and carers. As the Minister will know, the DRC has worked closely on issues of reform and investment in social care with Carers UK and the Equal Opportunities Commission, both of which have expressed strong support for the Bill introduced by the noble Lord, Lord Ashley. This is not just a Bill for disabled people; it is now seen as a Bill for carers; it is a Bill for women struggling to build up adequate pension provision for the future; and it is for the one in four families affected by disability. It will contribute to greater gender equality and it is strongly supported by the EOC, which concludes in its briefing:

“The reality of an ageing population means that social care can no longer be regarded as a ‘private’ matter. This Bill will help ensure that there is support for disabled people, people with health problems, older people and carers in 21st Century Britain”.

I hope that the Minister might comment on the benefit for women and agree that the Bill could have a major beneficial impact on the life chances of the 175,000 young carers who, according to research by Barnardo’s, Carers UK and the Joseph Rowntree Foundation, provide day-to-day support for disabled parents, primarily because their parents are not receiving adequate statutory support, or because they fear involving social services.

The Bill provides explicit rights to disabled people to be supported with parenting and other key aspects of daily life, and new safeguards to ensure that families can stay together. Over time, this will surely eradicate the serious educational disadvantages and the health problems that so many young carers face. I know that my noble friend Lady Finlay will talk a bit more about young carers.

I raised some specific points for clarification at Second Reading. I asked why earned income was not excluded from charging assessments for disabled people in residential homes, and cited the case of Doug Paulley, the talented web designer who has been headhunted but cannot take up the job because of the huge financial disincentives. He could keep only £20 of anything he earned, and the rest would be absorbed by care home fees. I argued, first, that the life chances report said that that should be looked at. Secondly, I said that, as it would not affect a huge number of people, it would hardly make much impact on public spending while having the huge benefit of enabling people like Doug to work. The Minister said that she would look at the matter, and I hope that she can give me an encouraging reply or say that the Government will treat it as a matter of urgency.

My final question concerns the impact of the Employment Equality (Age) Regulations 2006 on disabled people’s choice of carers, and on specialist care agencies. Peter Henry, who is tetraplegic and needs 24-hour help, also runs a care agency, which specialises in the recruitment, employment, placement and management of live-in carers for spinal-injury disabled adults. I have used the agency on several occasions, and can vouch for the quality of the specialist training and the appropriateness of the placement of carers.

His concerns are both as a service user and provider. As a service user, he prefers an age range of 21 to 45 because of companionship and shared interests. You are inviting someone to share your life and to go everywhere with you. Motor insurance is prohibitively expensive if the carer is under 21. It is a physically demanding job, so an older person cannot really do it. It requires intimate personal care. Spinal-injury trained carers are trained to do things such as manual evacuations, which the average carer is not trained to do. There is also the issue that an adult can choose who enters his home to share his life. He has a choice.

As a service provider, Peter Henry matches the carer to the client. Again, that is based on choice and lifestyle. He has done some research, and can statistically prove that clients strongly prefer the 21 to 40 age range. Until now he has advertised for carers in that age range. He has been trying since the summer, so far without success, to ascertain whether his company can use Schedule 8 to the regulations, by which they could deem the advertisement age band a genuine occupational requirement, or indeed any other clause to exempt his advertising and recruitment. The Minister has a copy of his letter, so I will not go into further detail; suffice it to say that he cites bits in the Sex Discrimination Act and the Race Relations Act that would deal with the problem from that point of view. Indeed, the Bill of the noble Lord, Lord Ashley, contains clauses that may be able to deal with it.

I hope the Minister will be able to give an answer—and, I hope, a positive one. If it is negative, I hope we can take the issue further and try to resolve it. I look forward to her reply, and wish the Bill a speedy journey much nearer to the statute book this time than it got previously.

My Lords, I am delighted to be able to congratulate my noble friend Lord Ashley of Stoke on reintroducing his Disabled Persons (Independent Living) Bill, especially so early in the Session. I also add my thanks to the Disability Rights Commission, especially Caroline Ellis and Dr Graham Nixon for their help and advice. Organisations of and for disabled people have given the Bill their warmest welcome, and endorse the words of the National Centre for Independent Living:

“It is now becoming an essential piece of new legislation”.

I also congratulate the Minister on her announcement, in her closing speech when the Bill was introduced, previously of the review by the Office for Disability Issues of independent living. I hope that the Government’s appointment of the two disability experts, Dame Jane Campbell in the chair and Dr Jenny Morris to lead the team, demonstrated their commitment to tackling the wide range of issues that need action if the Government are to attain their objective of opportunities for all disabled people by 2025. That task is no easy one, and it desperately needs this Bill for it to succeed.

There is one great sadness today, however. I know I speak for all noble Lords in missing the enormous contribution the noble Lord, Lord Carter, would have made to this debate. He has fought for the independence of disabled people, for our dignity, choice and control, all his personal and political life. He would want to be here, and he is very much in our thoughts. We send him and his wife Teresa our warmest love and best wishes.

As I said when the Bill was introduced, I believe the Government need this Bill. In the words of NCIL, it will,

“provide the practical steps necessary to turn the Government’s visions into concrete reality”.

NCIL goes on to say that,

“we have seen the presentation of the Prime Minister’s Strategy Unit report, Improving the Life Chances of Disabled People, the piloting of individual budgets, the White Paper, Our Health, Our Care, Our Say, the Disability Discrimination Act 2005 with the new disability equality duty, all demonstrating this Government’s commitment to the principles behind independent living. And yet, in spite of this commitment in policy and principle, in practice social care appears to be in crisis”.

As the noble Lord, Lord Ashley, has already pointed out, 70 per cent of local authority social services departments are now offering community care support only to disabled people whose situation is critical. NCIL goes on to say that,

“reports we are getting from our member groups indicate that direct payments are now being offered in smaller and smaller support packages. Many disabled people now have considerable difficulty getting support for anything other than basic life and limb support, with little or nothing available to support family life, or community-based activity”.

I spoke at length when my noble friend first introduced his Bill and I hope not to repeat myself. But I want to concentrate again on the crucial issue of housing. I particularly welcome Part 4 which deals with housing, as I believe that accessible and affordable housing is the very bedrock of independent living. Our housing stock lasts decades, much of it for over a century, so it is essential that we act now to provide for the independence of generations to come.

Yet, accessible housing it is not regarded with the urgency which it deserves, but I welcome the mention that it has received today. In its 2003 survey of physically disabled people the charity John Grooms found that 40 per cent of the respondents lived in houses that made them unnecessarily dependent on other people. Evidence from the 2003-04 Survey of English Housing published in April 2005 indicates that an estimated 1.4 million disabled people in England are in need of specially adapted accommodation. Of that total, nearly one quarter currently live in unsuitable accommodation.

The current housing situation of disabled people is dire and the demands of our ageing society, the growth of single households and increasing expectations among disabled people will only make the situation worse. Yet, sadly, the Government’s action, or inaction, since the summer has failed to acknowledge the urgent need for action. As a result, the housing clauses set out in Part 4 of the Bill are even more necessary. First, on the inaction, we continue to await the Government’s response to the research that they commissioned from Bristol University, Reviewing the Disabled Facilities Grant Programme, which the ODPM promised for,

“the early part of 2006”.—[Official Report, Commons, 27/10/05; col. 13WS.]

That research clearly set out the need for a strategy across government departments that considered the costs and benefits of disabled facilities grants, linking them with other housing, health and social care policies in order to achieve the best use of resources. I hope that we will not have to wait much longer for the Government’s response.

In the past few weeks the Government have published the revised PPS3—the planning policy guidance on housing and the revised code for sustainable communities. Neither of those has addressed the urgency for strong government action on accessible housing and both documents have ignored the DRC’s recommendations. The DRC had argued that, as a minimum, all new housing should be designed to the lifetime homes standard to meet the needs of occupants as they change over time. While PPS3 places welcome emphasis on insisting that local authorities should plan strategically for the long term and states that developers and planning bodies must take account of the need to cut carbon emissions, the requirement that homes are built to the lifetime homes standard remains just a voluntary matter.

While I welcome the Government’s commitment to environmental issues, the Department for Communities and Local Government has failed to seize this opportunity to incorporate lifetime home standards into building regulations, despite being urged to do so by successive government reports. These include the Prime Minister’s Strategy Unit report, Improving the Life Chances of Disabled People, the Social Exclusion Unit report, A Sure Start to Later Life, as well as that of the Lords Science and Technology Committee. The DRC is firmly of the opinion that this would not represent an additional burden on business. In evidence, it cites the fact that Habinteg Housing Association states,

“that building to LTH standard adds less than 1 per cent to a housing scheme's development costs. This is then repaid in reduced expenditure on adaptations”.

The DRC also points to the situation in Northern Ireland, and states that there,

“the cost to building to Part R (the equivalent to the English Part M) or increasing the standard to LHS ranged from £165 to £545 dependent on house size, layout and specification”—

that is hardly a large sum—

“This additional cost would be recouped between 3 to 10 years due to reduced expenditure on adaptations”.

That is but one example of spending wisely in the present in order not to waste money in the future. Housing is but one aspect of this extremely important Bill, which also makes provision for not wasting government resources and spending wisely for disabled people. It is a broad and wide-ranging Bill, offering solutions to the current wasteful, over-bureaucratic and utterly frustrating situation which disabled people face today. It offers the Government a new legislative framework which could ensure that their vision of equality of opportunity for disabled people by 2025 would indeed become a reality. I hope that they will grasp the opportunity with both hands.

My Lords, I am pleased to take part in this debate and wholeheartedly support the noble Lord, Lord Ashley of Stoke, on an incredibly vital Bill. I declare an interest as an independent provider of care, supporting independent living.

Jenny Watson, chair of the Equal Opportunities Commission, said of the Bill:

“Lord Ashley’s Bill should be welcomed by us all—because one day, we all may need the support that it provides”.

It should be unacceptable to us in 21st-century Great Britain, often cited as the fourth or fifth-largest economy in the world, that we still have too many people living in circumstances quite unsuitable for even a basic existence. Some 1.4 million disabled people live in homes that need some form of adaptation, and nearly 330,000 live in homes totally unsuitable for their needs.

Recent years have seen a decline in what is available in care packages for the disabled and elderly. They are often reduced without warning and usually with no back-up support to family members. Earlier this week, we discussed the deficits in the NHS and the profound effect that was having on other government departments, having to pick up care provision without adequate support, funding or training. Time and again, the very people who need help and support in ensuring that they do not burden the state and that they enjoy access to as much independence as possible are being driven to lives of isolation and entrapment in their own homes, with little or no access to the outside world.

The work of our unsung voluntary and paid carers saves the country huge amounts of money, but we cannot keep removing the pillars of support enabling them to do so. The current level of bureaucratic tape and the many different departments which must be dealt with are a particular worry. There often seems to be no partnership thinking at all. Every department follows duplication, triplication and more information required before a sensible package can be discussed. The user has little control in any planning of care or provision.

From my own personal experience in care provision, I know that people have often been encouraged to live independently but without proper aids or support packages in place. I could give numerous examples, but shall give only one or two. A service user’s only requirement for access to the outside world was a ramp, so that the wheelchair he sat in all day could go out of the house. One and a half years later, there was no ramp, but the service user had passed on. My other service users want to go out shopping, but there are few facilities for adapted taxis to come and pick them up, or for trained care support to assist them with their shopping. If there are no facilities for day centre placements, most service users spend hours home alone. How much companionship can a television offer?

While we all maintain that our human rights are breached if we cannot access services which we believe are ours by right, how can it be right that, in planning and developing packages to enable people to live as independently as possible, those people have so little say in the matter? We all demand and expect that we are given proper opportunities for education, employment and training. We all expect and demand that, if the system fails, we will receive compensation and support. Local authorities need to work much harder in partnership with employers and educationalists to ensure that opportunity is not denied. They must offer greater access, not only to enhance individuals’ lives, but to reduce the costs to local authorities.

The funding of social care has to be seriously revisited. As our ageing population is set to outgrow our working population, it seems only sensible that time, money and thought spent now will alleviate many of the problems being stacked up for the future. Will the Minister assure the House that no further cuts will take place to care packages being carried out now, and that she will revisit how care packages are assessed and see how these can reflect a more interactive participation in the wider community?

My Lords, I am grateful to be able to speak in the gap. Like others, I wish the noble Lord, Lord Ashley, well with this important Bill, which is dear to his heart and to so many disabled people.

Dame Jane Campbell has already been mentioned by the noble Baroness, Lady Wilkins. It is important to remember that, when she campaigned for direct payments, she had experience both of being someone with severe disability and of having been a carer, having cared for her first husband during his terminal illness. I will focus on carers in this brief time.

The Bill sets out two very important principles. The first relates to the requirement to consult carers on strategy and on defining the duties of local authorities. The other is in recognising the fluctuating requirements of people with disability. Things are not fixed. They get worse and sometimes they get better.

Carers are not all adults. Many are children. It is estimated that 175,000 children and young people in the UK help to care for a sick or disabled member of the family and there may be many more than that. Some of these youngsters provide a great deal of care. It has been estimated that 18,000 children aged between five and 15 provide 20 hours of care a week. Nearly 9,000 provide at least 50 hours—more than seven hours a day. Most of these young carers are looking after a relative with a health problem or disability. Very often, the relative is a single parent because, sadly, the partner has not been able to stay the course and has left. But the child, who loves the parent however disabled that parent is, of course will carry on and want to provide care. Nearly a quarter of these young carers have no support other than that offered by the young carers’ project run by Barnardo's. Young carers are aged between three and 18 with an average age of 12. It seems astounding that so many children in primary school are taking on the role of carer.

Almost half these young carers report mental health problems and that they are emotionally affected by caring. I have seen some of these carers when they come to apply to university. They are quite inspirational in what they have had to do and how they have managed to achieve against all odds because they have been motivated enough to want a career in the health service. These carers take on a huge amount of work. Those providing emotional support often do not know what they will be coming home to. Sadly, sometimes children come home and find that their parent has died while they have been at school. The trauma of that cannot be underestimated. They shop, they help pay the bills and they have to open doors to strangers. Other children are told not to open doors to strangers, but these children have to because otherwise nothing would happen in their homes.

The Bill sets minimum standards which will be crucially important. I hope that, in the consultation with carers, it will be remembered that these children and young people are also carers and deserve to be consulted just as much as adult carers. I also hope that the fluctuating requirements outlined in the Bill will be respected as I hope this Bill will be implemented into practice.

My Lords, the noble Lord, Lord Ashley, is nothing if not tenacious. To bring this Bill back so quickly and to bring it back when it gets a chance to be properly aired and discussed in Parliament is a very important act. I extend my congratulations to those who have been helping the noble Lord and assisting him behind the scenes, including the Disability Rights Commission—and Caroline Ellis will probably be almost as red as the Benches, she has been thanked so much.

The Bill is a coherent and sensible approach to getting these issues together. However, what struck me when I looked through it was that there was nothing new here. Virtually every single clause has been debated in the past five or 10 years in Parliament. I appreciate the timely reminder of the noble Baroness, Lady Gardner of Parkes, that we must get the Bill right technically; she does an important service to this House by saying that. But every part of the Bill has been discussed at least once, if not dozens of times, and if best practice and encouragement worked, we would not be here. That is probably the historical lesson to draw from this.

If a voluntary approach is to work, it must be given considerably more push from government. That refers to government as a whole, not to a particular party. The amount of pushing required to get previous Conservative Governments to do work on this matter was also quite monumental at times. I know that every step of the process will get slightly easier as the weight of time and precedent comes behind it, but we still have to push pretty hard. I hope that the people at the top of government—the politicians in charge at the moment—realise that they must take the whole machine, bang heads together and get people to co-operate. If it requires a Bill to do that, a Bill should be introduced. To bring in a little bit of politics, although it is unusual in these events, perhaps we could do without another couple of Home Office Bills, which all seem to do exactly the same thing as the Bills from seven or eight years ago. Possibly then we might get a bit more room for these types of measures. I leave that one sitting as the elephant in the room—but we must ensure that we give enough time and effort to this Bill.

The noble Baroness, Lady Verma, is gaining a worrying reputation as a rising star in this Chamber. She put her finger on a very important matter when she pointed out that blatant self-interest was involved in this for all of us. We must get this right, because it will affect all of us, directly or indirectly, given the ageing profile of the population and the fact that more people with disabilities live longer.

Noble Lords have alluded briefly to the issue of costs. At the moment, what happens is that by not doing X or Y we pay double for Z later. I am sorry for pausing—a dyslexic should never use the alphabet in his examples! By not meeting immediate costs and maintenance, you end up with a damned great repair bill later. That is effectively what is happening. Provisions for disabled people are being squeezed because they can be. Because there is not the legislative priority behind them, of course they are pushed aside. They may be brought back under other initiatives, but then they are pushed aside again. They will always be under that pressure until we get something that ensures that we tackle immediate needs head-on.

In education debates, we have looked at the situation for those with disabilities or special educational needs and it has been established that we must have something that guarantees that the problem will be dealt with up front, in legal terms. We are rapidly approaching that situation here, because we are not addressing the problems. We would not be here again today if we had addressed those problems on previous occasions.

I have a technical question for the Minister. Is there one aspect of the Bill that is not covered by some form of voluntary guidance? The question might be a little unfair, but we should discuss it in Committee. If we do, we can start to look at how far the Government’s thinking has developed at least on what should happen. Could we also have a little guidance on how fully the cost implications of the Bill have been considered? What potential savings have been identified in the government think tank? Expense will probably be the last defence offered against implementing the provisions. I do not agree, as I said, but it would be helpful to know the Government’s thinking.

I have made one or two notes and thought about raising other issues, but I shall instead finish by saying a few words about what will happen if we do not get this or similar legislation very soon. We will have to return to the issue again and again. The noble Lords, Lord Morris and Lord Carter, who are not in their places and are missed, have between them been thumping away on this for decades. However, as the noble Baroness, Lady Verma, said, even if they are not here, others will pick up the bat and press on.

Can the Minister please give us some idea how the Government intend to introduce a process, or a line of thought, to ensure that all these bits of best practice are referred to in guidance—the sop offered in so many discussions in Parliament—and introduced? If we do not get such assurance or a plan to work to, we will have to return with further Bills. Should we have to do that? We are not going to go away. We know that the Government will have to give in and give us something. Why not do it quickly so that we can all go on and do something else?

My Lords, the temptation on an occasion like this is to recycle the speech one made last time. I shall resist that temptation. I do, though, congratulate the noble Lord, Lord Ashley, on bringing his Bill forward again. However I must warn him that what he seeks is one of those issues that seem to take a long time to bear fruit. However, as my noble friend Lady Gardner of Parkes said, perseverance pays. I know, of course, that my right honourable friend David Cameron has written to the noble Lord on the subject of independent living for disabled people, saying that my party desires it for as many people as possible, both for those who are disabled and in the social care field more widely. I hope and trust that I have never given the impression that I believe anything different. If I have, it is certainly a subject that would cause my days on this Bench to be numbered.

What I do, and always have done, is base my consideration of any issue regarding disabled people on a very simple concept upon which no one anywhere has ever contradicted me: that disabled people are people first, disabled second. It follows from that that I believe that disabled people should have the same rights as able-bodied people. I believe that, on the whole, they have those rights but are unable to access them because of discrimination.

So, as the noble Lord, Lord Ashley, has highlighted this afternoon, disabled people still have quite a long way to go to catch up with able-bodied people. There have, however, been great strides in this direction. My right honourable friend Mr Hague introduced his disability Act in 1994, and this Government tightened it up in their amendment Act which we discussed in the 2004-05 Session. I hope that the noble Lord, Lord Ashley, will not have to wait yet another 10 years to get a Bill like this one on to the statute book.

Returning to my concept, I find that Clause 1, especially subsection (1), fleshes that out wonderfully. The problem is, though, that there are many areas of our national life where disabled people have become, or indeed always were, second-class citizens. I single out in particular transport, housing and healthcare. On transport, of course, we as a nation are getting there. More and more buses and trains are being equipped with sight and sound machines, for want of a better description, so that if you are blind or deaf you can be told that a train, for example, is now arriving at such and such a destination—something that an able-bodied person would be able to tell almost automatically. Why, oh why, though, does my London bus tell me only that it is stopping at the next stop and not what, or rather where, that stop is? Trains and modern black cabs—if you can afford to use them—now almost invariably have ramps for wheelchair users, and modern buses have low-level access. I am the first to acknowledge, though, that none of this is universal and that, as a nation, we still have quite a way to go.

I wish that I could say the same of the housing and health and social services of this country. First, I shall deal with housing. In our debates on the 2005 Bill, we pressed the Government hard on the need for local authorities to have a list of properties in their area that were suitable for disabled people. The noble Baroness, Lady Wilkins, waxed lyrical on this issue. Even though the best local authorities already have such lists, the Government refuse point blank to make it a general requirement, for what I regard as a most spurious reason; namely, the need for constant revision and the fact that all dwellings would have to be surveyed originally. What nonsense. A reporting requirement is all that is necessary. There can be no downside in landlords and owners having an obligation to inform the local authority of adaptations making their properties suitable for disabled people. Nine times out of 10 they would need planning permission anyway. The Government pride themselves on joined-up government, not always realistically, as I pointed out on Wednesday, so why not joined-up local authorities? Anyway, if Liverpool can do it, why not Hounslow or wherever?

I think that the real grouse of the noble Lord, Lord Ashley, is about access to health and social services, on which I am afraid an unhappy picture emerges, as we have heard. It has been the law for some time now that health services in residential homes are free. However, it just is not happening, mainly I suspect because there is no definition of health services and because, unlike in Northern Ireland and Scotland, health and social services are not run by a single authority in England and Wales. The result is that each guards its budget very carefully, to the huge detriment of those it should be spent on. If they are conjoined into the same health and social services authority, this simply does not happen, as I know from my time in Northern Ireland. Where the money comes from the pot, people benefit.

This joined-up thinking extends to the right of an individual, disabled or not, to refuse residential care. Why should people be shovelled into inappropriate “boxes” against their will? The answer surely is that it is more convenient, though by no means cheaper, for social services. The figures speak for themselves. As the noble Baroness, Lady Wilkins, said, the government-commissioned report Reviewing the Disabled Facilities Grant Programme tells us that the average cost of independently provided homecare in 2005 was £4,800 and that the cost of residential care is now £36,000 to £40,000 a year. The Government’s response was due early this year. It is now almost next year. Why the delay?

Then in care homes, we know all about the problem of social service workers and the health service making the necessary investment in things like chiropody, physiotherapy, rehabilitation—perhaps after a stroke, in which I declare my usual interest—and general confidence-building. There simply is not enough joined-up thinking here, when some of the requirements must come out of the NHS budget and others from the local authority. The answer of the noble Lord, Lord Ashley, to this is to have a joint pot of money, distributed to individuals to promote their capacity for independent living and to spend as they want. This proposal causes great sucking of teeth. “How”, the authorities ask, “will we know that the money is being spent appropriately by the recipient?”. What no authority is prepared to answer is the question: does it matter? Does it matter, that is, as long as it keeps people out of hospital and care homes? Speaking personally, I do not think that it matters one jot.

The same applies to dying in dignity. We in this Chamber are lucky enough to be able to exercise that right. Millions outside, however, are not. It is rare indeed for people to spend their last days in a hospital ward with dignity, especially in mixed wards, which have been so much in the news lately.

There are occasions—far too many, I am afraid—when disabled people are expected to conduct their own affairs with officialdom. I agree that it should be automatic for someone with motor neurone disease, deafness or mental health problems and so on to be able to take an advocate with them to, say, the jobcentre, hospital or local housing authority. I am not, however, saying that the advocate should necessarily be paid for by the state, or indeed at all. I am saying that there should be no bar to access, and I shall be exploring that in connection with the Welfare Reform Bill.

In the same way, why cannot one part of officialdom trust another? I ask your Lordships to envisage a situation where a person becomes disabled. He is assessed for his needs in one part of the country, lives there for a bit and then wants to go and live with, or closer to, another member of the family many miles away. Why should he then have to be reassessed, with all the trauma and extra costs to the authorities that that entails? Those costs are huge. I am told that assessment and commissioning amount to 32 per cent of the total cost for people with learning difficulties, 19 per cent for physically disabled people and 26 per cent for families with disabled children. To have to incur these costs again and again, and sometimes even again, is, to quote the late Lord Hailsham, stark staring bonkers.

To sum up, the heart of the noble Lord, Lord Ashley, is, as usual, in the right place, as is shown by the ringing endorsements that he has received from both the Director-General for Social Care and the Local Government Association. I warn the Minister that the noble Lord always gets his own way in the end.

My Lords, I also pay tribute to my extraordinary noble friend Lord Ashley. In laying this Bill, my noble friend has provided another excellent opportunity for this House to debate crucial issues around what independent living means for disabled people. I celebrate my noble friend’s tireless efforts over many years to further the interests of disabled people and his many achievements in this field. I also note the very apt observation from the noble Lord, Lord Skelmersdale, that he always gets his way.

Many noble Lords have spoken of the need to transform the lives of disabled people. I hope that the journey from frustration to fulfilment has already begun, although I recognise that there are still huge challenges, not only in terms of access to services but also in terms of equality and the need to raise expectations. I emphasise that we support the principles which underpin the Bill and that we are wholehearted in our determination to identify and remove the barriers to independent living which disabled people encounter day to day.

This Government clearly set out their position on what we wish to achieve to improve the lives of disabled people in our White Paper, Improving the Life Chances of Disabled People. I believe that we have a fine record on extending the rights and opportunities for disabled people. My noble friend Lord Ashley is right that we need to change the ethos of the debate from taking care of helpless people to a discussion about equal citizens who happen to have a disability.

That is why this Government introduced the Disability Discrimination Act 2005, although I realise that it is just one part of the jigsaw—albeit an important one. The disability equality duty section of the Act, which came into force at the beginning of this month, places a new statutory duty on public bodies to eliminate discrimination and harassment of disabled people. It will no longer be lawful for public bodies to design services or carry out functions without first thinking about how disabled people are affected. It is therefore particularly timely to be discussing today the principles of independent living.

Just last week, my honourable friend the Minister for disability, Anne McGuire, opened the conference “Making Equality a Reality” to mark the first anniversary of the launch of the Office for Disability Issues. The Minister renewed the Government’s commitment to transforming the lives of disabled people and delivering true equality.

We know that it will not be possible for us to deliver equality that is real for disabled people without engaging them fully in the process. This is why, at the conference, my honourable friend officially launched Equality 2025, the new national forum of disabled people, and announced the names of the 21 members appointed. All members of Equality 2025 are disabled people and will bring a wide variety of skills and experience to the table to work at the heart of government on policy development and delivery. A key role of the group, which does not represent any particular impairment or organisation, will be to make sure that it reaches out and accesses the voices of disabled people across the country, particularly those whose voices are often not heard.

The launch of the Office for Disability Issues a year ago was a real demonstration of our commitment to ensure that work across government would be driven forward to deliver the Government’s vision set out in Improving the Life Chances of Disabled People, which is that by 2025, disabled people should have the same opportunities and choices as everyone else.

Over the next two years, the ODI aims to: influence and challenge government departments to work together effectively to design and deliver support to give disabled people choice and control; ensure that disabled people see real benefits from our civil rights legislation; drive improved outcomes for disabled people through innovative projects; and bring the voice of disabled people into the heart of strategy. In one short year, it has already set up and supported an advisory group of 13 disabled experts to make recommendations for the remit and role of Equality 2025, has taken forward a project to improve the information available to disabled people, their families and carers and has been closely involved with the Department of Health-led project piloting individual budgets for people with disabilities.

The ODI has also launched the cross-government review of independent living, the ambitious programme mentioned by noble Lords, which is led by Jenny Morris, a highly respected independent-living expert. The review takes a life course approach from young people in transition to adulthood and includes older people. It is being shaped and steered by an independent expert panel, which has already met three times and is chaired by the redoubtable Dame Jane Campbell. She is a woman who I greatly revere.

One of the review’s aims is to consider and develop the business case for investment in independent living for disabled people. The review team recently commissioned work to build the economic case for independent living, and it has held discussions with other government departments and the expert panel overseeing the review. Many noble Lords demonstrated that there are economic benefits in investing in independent living; however, the economic case must be soundly established.

In the short term, the review has identified particular scenarios where removing barriers to independent living through cross-cutting approaches or by investment in self-determination could provide opportunities to reconfigure existing resources with better outcomes for disabled people. The review project team will continue to work with other government departments to develop potential options for affordable models. In answer to the noble Lord, Lord Addington, the review will look across all services, mainstream and specialist, to identify the barriers to independent living. The review will recommend to the Government the action needed to address those barriers, including considering the need for legislative change.

In bringing together the views and experience of central and local government, disabled people and representatives from relevant third-sector organisations, the review will develop imaginative new solutions across the whole range of public sector service and support and will make practical proposals for actions to support independent living. Detailed proposals for future action will be published next summer.

The ODI is not alone in driving forward action to support disabled people to live independent lives. As a Government, we have taken forward a comprehensive civil rights framework to lay the foundation for equality for disabled people. In addition to the new disability equality duty, the Disability Discrimination Act 2005 extended protection to a further 250,000 people by including within its remit people with HIV, multiple sclerosis—like the daughter of the noble Baroness, Lady Gardner of Parkes—and cancer. People with mental health conditions will also now find it easier to use the protection of the Act.

The Department for Work and Pensions is leading work on welfare reform aimed at supporting disabled people to exercise their right to work. The noble Baroness, Lady Darcy de Knayth, raised the issue of disregarding earned income for people in residential care. The department is currently undertaking a review of the charging for residential accommodation guidance, involving a range of stakeholders, including those from the voluntary sector such as Age Concern, Help the Aged and the Relatives and Residents Association. The issue raised is one of those being addressed by this group. Once they have completed their work, which is expected to be in the early spring of next year, recommendations will be put to Ministers in the Department of Health on possible changes to the CRAG and associated regulations. I will ensure that noble Lords receive a full reply at that stage with the conclusions reached, taking account of the arguments put forward in the earlier debate in July.

I note the issue relating to the Employment Equality (Age) Regulations, and I will write to the noble Baroness and copy that correspondence to all noble Lords. The noble Baroness mentioned the in-control pilots. It should be noted that the people in the pilots were by and large in receipt of very high-cost packages of care. Similar savings cannot be assumed for everyone.

We are aware that although this Government have done much to promote equality for disabled people, there are still challenges, as we discussed earlier this week at a meeting on independent living organised by the excellent organisation RADAR. We heard about the barriers which people still face and the concerns people have around issues like having multiple assessments—a matter referred to by the noble Lord, Lord Skelmersdale—variations in provision between local authorities and levels of funding. I understand these concerns, which are all too real. The Government are not complacent. In the Department of Health’s White Paper Our Health, Our Care, Our Say we set out a programme to deliver the strategic objective of focusing services around the needs of individuals.

In relation to disparate provision from different local authorities, one of the problems is that we all agree that decentralisation of provision is a very noble and good aim, and we are all aiming for it but it usually means a difference in the care available.

My Lords, does the noble Baroness agree that some system for passing around best practice would overcome some of the problems that have been identified this afternoon?

My Lords, I am always in favour of systems of best practice. That is an excellent idea. I will look into it. If it is not in being, it clearly should be.

People tell us that they want to take control of their lives and choose the way that they are supported. They want to shape their own future and make their own decisions. They know where the shoe pinches. The Government are clear that for social care, putting power in people’s own hands is the way forward. A modern system should put people in control by offering personalised services and giving them the freedom to choose the type of support they want. We are committed to driving this forward through the individual budgets initiative, the in-control programme and work on promoting and increasing the take-up of direct payments. These are not separate initiatives or fleeting experiments, but the future for social care in the next decade and beyond. We are determined to make this approach work and will bring together learning from the three programmes to tackle any barriers, share best practice and build momentum for that vision.

The individual budgets pilot programme being led by the Department of Health across government is a key driver in this strategy. We have commissioned a comprehensive evaluation of the pilots to make sure that we are gathering the evidence that comes out of them. This will identify whether they can be delivered within our existing resources, whether they are delivering benefits to the people who use them, and whether there are blocks to delivery which will need to be overcome. The evaluation will also look at whether there is a particular model or models of the individual budget programme that work best for people with different needs. We do not expect to have final evidence from the pilots until spring 2008. Therefore, it would not be sensible to have a statutory requirement for the introduction of the individual budgets approach until we have seen the results from the pilot projects, and have had time to consider all the evidence.

With the individual budgets initiative and services focused around the person, joint commissioning is needed to bring the services together. The evidence shows that partnership arrangements and joint commissioning are increasing significantly. Perhaps the greatest change in bringing health and local authorities together to meet individual needs will come through the White Paper on local government, with its emphasis on more robust local area agreements, which will enable services to determine jointly what people need in terms of health, housing and social care, and to plan, provide and fund in partnership joined-up thinking, as advocated by the noble Lord, Lord Skelmersdale. Each local authority will be required to have a lead member on health and well-being partnerships—the very person to knock those heads together, as advocated by the noble Lord, Lord Addington. The health service will have a duty to co-operate with local authorities through the statutory local-area agreements. I have heard noble Lords concerns that local authorities are raising the thresholds for access to care. It is, of course, for local authorities to ensure that they provide or commission services to meet peoples eligible needs, subject to their resources and with regard to guidance on fair access to care services. We know that local authorities have to make difficult choices. The Commission for Social Care Inspection has recently reported that most local authorities are making the threshold substantial, but that does not mean that the system is excluding those who need lower level services, although I hear the very clear statement made by my noble friend Lady Wilkins.

Key to ensuring that people receive the support that they need and want is assessing their needs in the right way. I have heard and understood the frustrations that too many people have encountered when facing multiple assessments. By requiring health and local authorities to implement a single assessment process, the Department of Health intends to ensure a person-centred approach to assessment and care planning for people regardless of organisational boundaries. This will ensure that people receive appropriate and effective support.

We are developing a common assessment framework for adults by building on, and extending the scope of, the single assessment process. As with the existing single assessment process, it is proposed that the common assessment framework will cover several domains in order to take a holistic view of an individual’s circumstances and to identify any risks to his or her independence, and the need for support.

There is so much I could, and would like to, say about carers and the measures that the Government have implemented to support carers of disabled people. By 2008, we will have invested over £1 billion in support for carers. But we must, and will, do more. I am pleased that the work on the new deal for carers, announced in the White Paper Our Health, Our Care, Our Say is well under way. We are very anxious to take a fully inclusive approach on this project, and the project director is working closely with carers’ organisations to ensure that we do so.

We are anxious to ensure proper support for young carers and the provision of short breaks for carers. I fully agree with the noble Baroness, Lady Finlay of Llandaff, that we owe a huge debt to young carers especially, and we must ensure that we consult them when we make policies. The Government are increasing the carer’s grant this year, which, as the noble Baroness, Lady Darcy de Knayth, pointed out, will assist women.

The Bill includes several proposals on housing and accommodation for disabled people. The Government fully recognise that it is extremely important that disabled people with access needs are housed appropriately and are given the correct priority for housing. That is precisely why we have amended the legislation governing the way in which housing authorities allocate social housing.

The changes that we introduced under the Housing Act 2004 were intended to meet precisely the sort of concerns the noble Lord’s Bill has identified. The term “medical grounds” was being interpreted too narrowly by some local authorities, and disabled people were being disadvantaged as a result. The Government also want to see social landlords making the best use of housing stock, including accommodation that is accessible to, or has been adapted for use by, disabled people. We recognise that accessible housing registers can be useful, and the current statutory guidance to local authorities on the allocation of accommodation encourages their use.

The noble Baroness, Lady Gardner of Parkes, mentioned stair-lifts. These are usually provided under disability facilities grants, which have been doubled to £120 million since 1997, and the Government are looking for new ways to simplify and improve the delivery of the service to make it more flexible and accessible. The Department for Communities and Local Government will issue consultation options early in the new year for revising those grants.

In answer to my noble friend Lady Wilkins, the Government will take forward lifetime homes in the first instance through the code of sustainable homes, which will get the standard out to builders more quickly than through regulation. We will keep it under review.

A huge issue for many disabled people is to secure the support of their peers to help them to take the choice and control of their lives that we are aiming to deliver. The noble Baroness, Lady Verma, who has great experience in this area, mentioned user-led organisations, which are a key element in providing this peer support. A strong support network is essential. This is often best provided by bodies led by people who have themselves experienced the barriers that so many disabled people face in achieving equality and independent living.

Working closely with the ODI, the Department of Health is taking forward an ambitious programme to deliver the life chances report recommendation that by 2010 there should be a user-led organisation, modelled on centres for independent living, in every local authority area. Working in partnership with disabled people and key organisations, including the National Centre for Independent Living, the aim is to map the current position, identify barriers to the establishment and continuation of user-led organisations, and develop proposals to increase capacity. Early in the new year, the Department of Health will lead a series of regional and national conversations with disabled people, their families and representative organisations on how to deliver this key recommendation. Only this week my honourable friend the Parliamentary Under-Secretary of State for Health, Ivan Lewis, discussed with Dame Jane Campbell further options to make this goal a reality.

In answer to the noble Lord, Lord Addington, the Government have not costed the Bill, although work is in hand to establish the cost-benefit case for independent living. On whether anything in the Bill is not covered by evidence at the moment, some issues are not covered—for example, a register of disabled people, the duty to enhance the capacity of service providers and discounted disability benefits.

The Government are committed to working to deliver equality for disabled people, but that will take time, as will the improvement in public services which are necessary for disabled people. That is precisely why we have set out a 20-year strategy. I am grateful to my noble friend Lord Ashley for enabling us to have such a high-profile debate on these very important issues. However, the Government are not convinced of the need for all aspects of this legislation at this time. There are parts of the Bill with which we might disagree or that we believe are already achieved through existing provisions. There would also be major cost implications if all that is proposed were implemented at the pace implied in the Bill.

We should not forget that the substantial programme of work which the Government have set in train in publishing and responding to the challenges of the life chances White Paper, in delivering the Disability Discrimination Act 2005, in programmes to implement the White Paper Our Health, Our Care, Our Say and the local government White Paper will mean delivery of our shared goals without imposing new legislation. But debate on the detailed clauses of the Bill is for a later stage.

At this point, I am very happy to welcome the principles underpinning the Bill, and to congratulate the noble Lord again on enabling the House to address this issue, which is of importance to all of society, but is central to the lives of people with disabilities. I hope I have demonstrated that this issue is close to the Government’s heart and one on which we have already achieved much, but on which there are still many more challenges to be overcome. I am confident that this Bill will act as a catalyst for government and wider society to ensure that the transformation in the lives of disabled people from frustration to fulfilment is as swift as possible.

My Lords, this has been a splendid debate, which I have enjoyed enormously. I thank all noble Lords who took part, whatever their viewpoint—although with one or two speakers I would have liked a bit more give and less circumlocution. It is all very puzzling. My noble friend was right to point out what the Government have done. They have a good record, yet it is by no means good enough to satisfy the speakers in this debate. We have worked on this Bill for a long time. It is a marvellous Bill which is very necessary. Yet people say things such as “later on” and “we have not got the cash”. Both parties, I think, would say that. That is fine, but if the Government want to save cash, why not save it from other budgets? Why always choose disabled people?

To talk about 2025 is preposterous. Life chances is an outstanding report, but to refer to 2025 is ridiculous. We want specific commitments to working quickly. As I am not a Minister I can ask for this commitment. I know that Ministers have problems to face but I emphasise that the provisions in the Bill are fairly reasonable given the suffering of millions of people. Without these provisions, disabled people will have to go on for many more years in their present situation. The whole edifice of social care is rocky; there is so much wrong with it now. The Bill will connect all those things. We do not want instant implementation but, equally, we do not want it to drag out, because, if it does, we will get nowhere.

The noble Baroness, Lady Gardner of Parkes, rightly spoke about earned income being disregarded. As to the technical points, I have had no letter from the Clerk. This afternoon I received a message from an official in the Public Bill Office asking me to go and see her. I found my way to the Public Bill Office, which is hidden away in the bowels of the Earth somewhere, and she pointed out all the technical points and asked whether I could deal with them. This was about 10 minutes before I was due to speak. I am not blaming her—she was very kind and helpful—but I told her that I could not master all of those points. It is like mathematics; I glaze over when I see figures like that. She said that we could deal with it at a later stage, and I agreed with that. So, if there is a Committee stage, we can deal with the points mentioned by the noble Baroness. The lady in the Public Bill Office agreed that that is the best approach, and I am sure we can handle it. I am very glad that the noble Baroness has raised these very important points. If we do not get them right, the whole Bill will crumble.

My noble friend Lady Darcy de Knayth is right: if we are not careful we will just be helping the worst-off, as we do now, and not those with moderate disabilities, who suffer almost as much as the severely disabled. We should strongly press the point that all disabled people, regardless of the degree of disability, should be compensated through this legislation. I agree with my noble friend that we are discovering many more disabled people of all kinds, of all races and colour, old and young. The Bill will specifically help young people but I do not have time to go into detail. I am sure my noble friend is right.

My noble friend Lady Wilkins referred to the noble Lord, Lord Carter. I am deeply moved by his illness. His wife accompanies him at home and here; they are a wonderful couple. I do not know how ill he is but I hope he makes a full recovery. He is a very tough guy. As Chief Whip he did not wield a stick, but he was persuasive. I send him my warmest regards through my noble friend Lady Wilkins.

The Government have not done a cost-benefit analysis. We should have sorted that out much earlier but, one way or another, we must find out what the situation is. I am convinced that the Government do not recognise how much money could be saved through the Bill. They will save an enormous amount, and the costs are minimal. The Minister may be right in saying that it could be a heavy commitment, but heavy commitments do not necessarily mean heavy outgoings, especially if the other side of the equation—the savings—is taken into account. There are savings to be made through many thousands of people getting jobs, paying taxes, not going into hospital and so on. I fully agree with everything that the noble Baroness, Lady Finlay, said.

I do not think the hour is too late, but there it is. I ask the House to give my Bill a Second Reading.

On Question, Bill read a second time, and committed to a Committee of the Whole House.

House adjourned at 5 pm