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Baroness Thomas of Winchester
To move that this House takes note of the different challenges facing disabled people in the United Kingdom in 2018.
Baroness Thomas of Winchester (LD)
My Lords, I begin by declaring that I receive DLA and that I have Pompe disease, a very rare form of muscular dystrophy. This is the first debate I can remember that is widely enough drawn to give speakers the freedom to bring any aspect of the challenges that disabled people face to the attention of the House. I particularly look forward to the maiden speech of the right reverend Prelate the Bishop of London.
For myself, I ask for understanding that I will have to leave so much out, but I hope that, one way or another, a lot of ground will be covered. What might be left out are a lot of hidden disabilities, which can cause so much misunderstanding. I asked my noble friend Lord Addington whether he thought severe dyslexia made him disabled. “Only when I try to write”, he said—a great answer that can be translated into many other settings. In the hidden category might come fluctuating autoimmune diseases such as lupus, heart problems or autism. People with severe mental health conditions might not see themselves as disabled, but if they and others can easily walk away from a blue badge space in a supermarket car park they will be labelled as frauds. No one with these conditions must be overlooked, particularly by ESA and PIP assessors, or, for that matter, by HR departments.
This year, we are celebrating 100 years since women first got the vote, but it was more than that. They were excluded from so much of public life that it is no wonder the suffragettes were so militant. Today, we take it for granted that women can rise to the top in any profession, but the same is not true of disabled people. It was only 23 years ago that the noble Baroness, Lady Campbell of Surbiton, whom we miss today very much, and others were disruptively demonstrating outside Parliament against the widespread discrimination of disabled people. That led to the Disability Discrimination Act 1995. They then had to demonstrate again some years later to establish the concept of independent living, now enshrined as Article 19 of the UN Convention on the Rights of Persons with Disabilities, which is of fundamental importance to the lives of many thousands of us and which is under grave threat now.
Just for the record, independent living does not mean living alone. Although its basic meaning is simply the opposite of living in a residential care home, it also means enabling disabled people to participate in all areas of life. The main reason it is under threat is, of course, the lack of adequate funding for social care and for NHS continuing care.
The Independent Living Fund was a government-funded discretionary scheme, set up in 1988, working alongside local authority schemes to help people with high support needs live in the community. It helped 23,500 of the most severely disabled people to live independently. In other words, it gave them choice and control over the support they needed to go about their daily lives, hopeful that the barriers to equal citizenship would be progressively removed. Then, the global financial system went into meltdown and the fund was closed to new members in 2010. It was finally closed in 2015, with responsibility and funding passed to local authorities to administer. Crucially, the money was not ring-fenced. Funding for social care has been cut by £7 billion since 2010.
Many recipients were cut back to receiving just enough to fill very basic personal care costs, with the shadow of the residential home looming once again. As one person put it to me, “If you are more or less confined within the four walls of your home, your ambitions are diminished to mere survival”. I met a young man of 22 with Duchenne muscular dystrophy when I was in hospital earlier this year. His care package had been scaled right back because of funding cuts. When he asked how he was supposed to manage without full-time personal assistance, he was asked, “Can’t your girlfriend help you?”.
I am not asking for the ILF to be reopened as it was, but I am asking for a guarantee from the Government that the whole concept of independent living will be reconfirmed and enabled to flourish and will not become a postcode lottery. There is no statutory right to independent living, and while the Government pay lip service to its core tenets of increased choice and control, there has been no co-ordinated action across government after support for the Disability Action Alliance was withdrawn two years ago. There is a huge amount of fear that those who have been thriving in their own homes with support might have to move into residential care, with most of their freedoms taken away. The vision of independent living that led to the direct-payments legislation of the 1990s, passed with all-party support and championed in this House by the noble Lord, Lord McColl of Dulwich, is rapidly disappearing. The well-being principle, embedded in the Care Act 2014, is being abandoned.
My main question, therefore, to the Minister is to ask whether the Government will heed the voices of so many disabled people who do not want their lives to go backwards but fear this will happen if independent living is not given a significant reboot. Scope has called for a cross-government strategy—a good idea, which I endorse. Disabled people have a myriad of different conditions, but there is one thing that knits us together, and that is that being disabled is very expensive. Research from Scope has found that on average disabled people face extra costs of £570 a month—sometimes, I fear, because they are not getting as much DLA or PIP as they need. I shall return to PIP later.
One of the most expensive problems many of us with mobility impairments have to face is adapting our homes. A means-tested disabled facilities grant might be available from the local authority. This is capped at £30,000, which sounds like a lot of money but does not go very far if a through-floor lift has to be installed, doors widened and a bathroom changed into a wet room. One family whose son has Duchenne muscular dystrophy had to pay £70,000 of their own savings and racked up £15,000 in credit card debts to adapt their home. They were simply not able to carry their child up and down stairs anymore as he got older.
It is only in the past few months that the Government have finally announced that they are activating—although we do not know when—that part of the Equality Act which gives leaseholders the right, at their own expense, to adapt the common parts of the building where they live. Perhaps the Minister could say when we can expect that to happen. Surely the DFG should rise in line with inflation, and local authorities should be encouraged to ensure that new developments have at least 10% of houses built to lifetime homes standards. In May, the EHRC published an 18-month survey showing that only 7% of housing in England meets accessibility standards; 365,000 people said that they were in unsuitable housing. Few local authorities across Britain set targets for accessible housing, although there is strong evidence that such housing saves on health and social care costs in the future.
I now turn to the Government’s ambitious plans to get 1 million more disabled people into work in the next 10 years. There appears to be a lot of work in progress, which I am sure the Minister will tell us about and which I welcome. Access to Work is a great, if underadvertised, scheme to help disabled people in the workplace. It would make a lot of difference if it could be extended to volunteers and interns, and even made portable. I cannot, however, help coming back to the whole picture. Will there be enough personal assistants or care workers, post Brexit, to assist many working-age disabled people to get ready for the working day? Is there enough accessible public transport that can accommodate more wheelchair and mobility scooter users?
Are there enough accessible workplaces with suitable toilets? The lack of accessible and suitable loos the length and breadth of this country is a disgrace. Even Jobcentre Plus offices do not have them. In November 2017, Muscular Dystrophy UK—on whose board I sit—took over as co-chair of the Changing Places consortium, which is responsible for the campaign for fully accessible Changing Places toilets with a bench and hoist. There are quite a lot of these, but not nearly enough. This comment from a frustrated parent says it all: “The lack of suitable toilets in the UK is the blight of our life and excludes our son Mylor from accessing and enjoying everyday activities most of us take for granted”. The building regulations need to be changed. At a minimum, surely these toilets should be mandatory in all large new-builds.
Before I end, I must come back to my old adversary, the PIP process—the main disability benefit. The payments are a lifeline for many disabled people, but the process could be working so much better. We are constantly told that more people than ever are getting PIP, but, in light of the huge number of successful appeals, I think it should have a comprehensive overhaul. The descriptors need revisiting, with the ludicrous 20-metre rule abolished and 50 metres restored. Bringing back assessments in house from the outsourcing companies is gathering support. The assessors need to be better trained, whoever employs them, and have no targets to meet, internal or not. Above all, the hostile environment, which we hear so much about from claimants, must be banned.
To summarise, I long for there to be a cross-government collaboration with disabled people themselves, not their proxies, which has real clout in making independent living a welcome reality once again, and I would like to hear the Minister say that she will follow this up.
I shall end with a more upbeat message. Disabled people in the media are becoming more visible year by year as TV presenters, comedians, actors and reporters. Long may this continue. I look forward to the debate. I beg to move.
Lord Holmes of Richmond (Con)
My Lords, it is a pleasure to participate in this debate. In doing so, I declare my interest as set out in the register. I thank the noble Baroness for securing this debate and her excellent introduction. Her work and her commitment to this area need no introduction. I am also very much looking forward to the maiden speech of the right reverend Prelate the Bishop of London. Her career is impressive. From Westminster Hospital to the Palace of Westminster, via Tommy’s, Chel West and the marvellous Marsden, it is pretty clear that Bishop Sarah, if I may, has positively impacted people’s lives every day. I look forward to sitting behind her in your Lordships’ House in the years to come and to her wisdom drifting up to this Back-Bencher.
As the noble Baroness, Lady Thomas, said, there are many areas that one could cover in this debate: public transport, public realm, aviation, the built environment and so on. I shall limit my comments to just two areas: Channel 4 and public appointments.
At Channel 4, we took the power of the Paralympics to attempt not just to change attitudes towards, and opportunities for, disabled people but to change Channel 4 as an entity. In 2016, I was privileged to chair the channel’s Year of Disability, not least because I got to chair a group of people called the Year of Disability advisers, which made me chair of YODA. We looked in front of the camera and behind it and demonstrated that, sometimes, difference can be driven in a short space of time. We took the power of the channel and used personal testimony. Within seven months, we not only changed levels of self-declaration for disability in Channel 4 but increased it fourfold.
We saw the first audio-described advert. We attracted brands from across the world to put together an innovative advertising campaign involving disabled people and put £1 million into it. Have we cracked it at Channel 4? Not a bit of it. Are we on a journey? We certainly are.
I was honoured to be asked earlier this month by the Cabinet Office Minister to lead a review into disabled people’s participation in public appointments. Public appointments play such an important role in influencing and transforming our society, and not just in the organisations where they are made. However, when it comes to public appointments, how many people know about the full range of opportunities that are out there? Current open opportunities range wide from the Darwin commission and Commonwealth scholarships to data ethics, sea fish and no few in Work and Pensions, Justice and Business. There are many opportunities, but who knows about them? Who applies for them? Who is interviewed? Who is appointed? Who is enabled to thrive in those roles? That is the purpose of the review I am undertaking: to create an inclusive environment where disabled people can flourish through that public appointments process.
I will be going across the country to organisations, groups and individuals to hear their views. What are the barriers? What are the blockers? What needs to be done? I say to anybody out there: be in touch with me; contact me on Twitter @LordCHolmes; tell me your experiences of the public appointments process. How was it for you: good, bad or indifferent? Tell me what your experience was. If public appointments are not reflective of our society, how can we be assured that the best decisions are being made in many elements of our public life?
That is Channel 4 and public appointments, but there is a darker side to this debate, which is that there is still more than a deal of discrimination out there. Just by dint of having a guide dog, I can find myself excluded from restaurants, bars and minicabs. A number of years ago, I went to a restaurant and the guy blocked my entrance; I could not even cross the threshold. He said, “We don’t serve guide dogs”. I said, “That’s okay, I don’t eat them”. That is amusing, but not so amusing is the reality of such discrimination. When you experience discrimination, it is not a cerebral experience. You feel it in your heart and in your guts.
I have no doubt whatever as to my noble friend the Minister’s commitment to disabled people, so I want to ask her to outline the Government’s aspiration for disabled people in educational attainment, employment opportunities and public participation. What are some of the key success measures?
Ultimately, it is even more than just considering the blockers, the barriers and the issues that face disabled people. We are talking about enablement, empowerment and addressing that most desperate of drains on our society: the fact that talent is everywhere but, currently, opportunity is not.
Lord Bruce of Bennachie (LD)
My Lords, I thank my noble friend Lady Thomas for introducing this debate and for her dedicated commitment to campaigning on behalf of disabled people at all times and on every possible occasion. I follow the noble Lord, Lord Holmes, in terms of his engagement in what could be done for people with sensory deprivation, which is I want to address. I declare an interest: I have a deaf daughter and have honorary roles in a number of charities for the deaf: Action on Hearing Loss, the National Deaf Children’s Society and DeafKidz International.
On 3 May, I asked a Question about video relay services and received a very disappointing and inadequate Answer. The Government estimate that only 25,000 people in the UK are sign language users, with the implication that they were not a priority, because the number is too small, and that attention should be given to the much larger numbers of people who have acquired deafness during their lives and do not rely on sign language. The 25,000 figure is not recognised by the deaf community, which tends to suggest a figure between 50,000 and 70,000, because it includes friends, family, employers and teachers. The figures seem to be derived from the 2011 census, the first to ask a question about sign language, but the questions were different north and south of the border. In England and Wales, the question was, “What is your main language?” In Scotland, it was, “Other than English, what language do you speak at home?” Not surprisingly, the replies were different too. In Scotland, 12,533 people gave a positive response. In England and Wales, with almost 10 times the population, the figure was 15,487.
I suggest the truth is somewhere in between. Yet the Government seem to be choosing the lower figure, because that suits the argument that there are not enough. But these people deserve to have their fundamental rights acknowledged. They are British people, using a British language, which for many of them is their only or principal means of communication. They deserve full recognition. I am not suggesting that they are not given any recognition, but they need more recognition than they have achieved so far. I am also concerned that, in the exchanges that followed my question, there was an unconscious division being made between those with acquired deafness—deafness that comes with age—and deafness that comes at birth or in early childhood. I suggest that to create that division is unworthy, unnecessary and unjustified.
I wholly support, and have campaigned for, providing communication support for all deaf people. The technology we have developed in recent years, including voice to text, subtitling, text and email, has greatly enhanced the quality of life of all deaf people. I introduced a Private Member’s Bill to that effect. When we add in cochlear implants, digital hearing aids and loop systems, it is easy to see how much has been achieved for deaf people of all forms of deafness, acquired at all stages of life. However, sign language users, who are thinly spread across the country, remain frustrated. The voice to text service is cumbersome and not effective and the video relay service is not as freely available as the Government maintain. In Scotland, users can register for access to a wide range of public services using video relay services between 8 am and midnight seven days a week. Why is that service not available in England and Wales? If the Government are not prepared to follow the US example, where it is available 24/7 for all purposes, why not offer it on a limited number of minutes, for example, to registered users? That could easily be absorbed by the telecom companies, which turn over £30 billion a year.
In a recent episode of the Swedish detective series “The Bridge” there was a scene which showed the lead character and her colleague calling out to a woman reading a paper and getting no response. When it transpired that the woman was deaf, the lead character, Saga, signed to her, prompting her colleague to ask if she knew sign language. She answered that she had learned some, but not enough to conduct a police interview. That scene demonstrated the value of teaching sign language as a proper subject on the school curriculum, as I know happens across Sweden, Norway and Denmark. It helps increase awareness of deafness, the sophistication and complexity of the language, and provides a potential pool of future sign language interpreters. Again, Scotland is leading the way on this. I know the Government have a moratorium on new courses or exams, but they have given a positive response, so will they allow the preparation of such a course, so that as and when new qualifications are allowed, it is ready to go? A video relay service would increase the effectiveness of the interpreters we have, raise the quality of life of sign language users and enable hearing people and deaf people to communicate at a distance at any time of the day or night.
The campaign for deaf people has very strong support. Young people are keen to see sign language developed and used, and I suggest that making it a language course for schools and enabling interpreters to be trained, and for it to be accessible by video, is a way to ensure that deaf people, with their own British language, are not excluded from society, but included, as they deserve to be.
Lord Patel (CB)
My Lords, I too look forward enthusiastically to the maiden speech of the right reverend Prelate the Bishop of London. I remember her work when she was Chief Nursing Officer, championing the cause of patients and their involvement, and introducing the concept of the modern matron. It is always a pleasure to take part in a debate led by my friend—I mean that in the true sense—the noble Baroness, Lady Thomas of Winchester.
I want to highlight the specific challenges faced by children and young people who suffer from life-limiting and life-threatening conditions. The needs of these children, who are often diagnosed at birth, is varied and often complex, making it crucial that they can access palliative care throughout their illnesses and their lives. The pressure on parents of having a child with a life-limiting condition is immense, and most relationships suffer, with 36% experiencing a breakdown of the family, making social care vital. A national study by Julia’s House children’s hospice and Bournemouth University found that 75% of couples caring for a child with a life-limiting condition have no access to respite care. The Carers Action Plan, launched at the beginning of June, says:
“The Department of Health and Social Care will fund a project on actions to promote best practice for local authorities, clinical commissioning groups, and other service providers and commissioners on carer breaks and respite care”.
Research by the children’s charity Together for Short Lives found that while 84% of clinical commissioning groups reported that they commission short breaks for children who need palliative care, more than one in five local authorities do not commission short breaks for children with life-limiting and life-threatening conditions, despite having a legal duty to do so.
The second issue concerns the grants to children’s hospices. Children’s hospices provide crucial support for parents and carers—92% of children’s hospice charities provided end-of-life care to children and young people in 2015-16. Despite this fantastic work, voluntary sector children’s palliative care providers receive, on average, 22% of their charitable costs from statutory sources, compared to an average of 33% for adult hospices. The NHS England Children’s Hospice Grant amounts to some £11 million per year—not a large sum of money—despite increasing costs and demands.
Medical advances mean that 55,000 young adults aged between 18 and 40 have life-limiting conditions in England. The Carers Action Plan also says that the Department of Health and Social Care will fund a project to support parent carers to navigate the transition from child to adult services as their child approaches the age of 18.
Will the Minister make sure that the project outlined in the action plan includes young people with life-limiting and life-threatening conditions in its scope? Secondly, in light of the fantastic work that children’s hospices do and the pressure they take away from the NHS services, can she commit to bringing about parity of funding between children’s and adult services, including by increasing the NHS England children’s hospice grant? If that matches the support given to adult hospice services, it will come to some £25 million per year—not a large sum, compared with a budget of £110 billion.
Finally, will the Minister commit to assist in providing NHS clinical commissioning groups, sustainability and transformation partnerships and local authorities with guidance reminding them that they are responsible for planning and funding short breaks for children with life-limiting conditions? I realise that the Minister is not directly responsible for what I am asking for, but if she agrees, will she pass this on to the relevant Minister and ask that answers be given in writing and placed in the Library?
Lord Shinkwin (Con)
My Lords, I thank the noble Baroness, Lady Thomas of Winchester, for securing this debate and I look forward to the right reverend Prelate’s contribution.
At a time when everyone has had to tighten their belt to get the British economy back on its feet, it is important to acknowledge the immense generosity of the Great British taxpayer in helping disabled people like me to face the challenges that go with living with a disability. The latest data from the independent OECD shows that the UK’s public spending on disability and incapacity is the second highest in the G7 at 2% of GDP—a record £54 billion.
But if our message to taxpayers is “Thank you”, what might taxpayers’ message be to Government? I can hazard a guess: “Give us value for our money”. For me, that means honouring the promise of the Disability Discrimination Act in time for its 25th anniversary in 2020. We on these Benches claim to be the party of business, so let us enforce the DDA and ensure that the immense market opportunities of tapping the purple pound—disabled people’s spending power—are realised. Let us shift the dynamics of the disability debate and break the unsustainable cycle of dependency. To echo the noble Baroness, Lady Thomas of Winchester, and my noble friend Lord Holmes of Richmond, let us optimise opportunity and help talented disabled graduates to emulate the success of their BAME and women counterparts by realising their potential in corporate boardrooms up and down the country.
What, then, is the message to disabled people about the challenges we face in 2018? Of course, every Government could spend more on benefits but that is by no means the biggest challenge we face. I realised that in the Republic of Ireland last month, I saw it in Argentina earlier this month and again on the Isle of Man only yesterday. In all three, the conspiracy of silence while majority votes were cast to make it easier for non-disabled people to terminate our existence before birth was shocking. So I say to colleagues, especially those with responsibility for women and equalities issues: do not patronise us by making it easier for non-disabled people to kill us simply for the crime of being diagnosed with a disability before birth, and then claiming it is all about equality. If equality has become so distorted that it now justifies a stronger group of human beings condemning another, weaker group to death for disability, right up to birth, we really are in trouble. I believe that this distortion of equality is the single biggest challenge we face because the statistics show that our very survival is under threat.
In conclusion, I ask my noble friend to convey to the Prime Minister and her ministerial colleagues that the Government are right to insist on devolution in Northern Ireland being respected because no human being is ever less human or less equal for being disabled—at any stage of their existence.
The Lord Bishop of London (Maiden Speech)
My Lords, I thank noble Lords for their warm welcome and am grateful for the practical support I have received from the officers and staff. I am humbled by the knowledge and wisdom represented in your Lordships’ House and I am very conscious that it is a privilege to be a Member. It is a responsibility that I will take seriously. I pay tribute to the noble and right reverend Lord, Lord Chartres, my predecessor as the Bishop of London, and his service in this House. I am glad that he continues to serve in his new capacity on the Cross Benches. When it was announced that I was to be the 133rd Bishop of London, my friend, the right reverend Prelate the Bishop of Salisbury, said that I was a nurse to my fingertips and a modern Boadicea. In this speech, I will try to channel more of the former and suggest that noble Lords speak to my right reverend friend about the latter.
I became a Christian as a teenager so my choice of career as a nurse was a vocation. It was an opportunity to reflect the love of God that I had come to know. I specialised as a cancer nurse and became a ward sister at the old Westminster Hospital just around the corner from here, and then later the director of nursing at the Chelsea and Westminster Hospital on the Fulham Road. In 1999 I was appointed the Government’s Chief Nursing Officer for England. While in that role I trained for ordination in the Church of England.
When I moved into the Church of England, I continued to contribute to health, first as a non-executive NHS board member and more recently as a member of the council of King’s College London. I am a passionate supporter of the NHS. It has touched my life in many ways: as a parent; at the time of the death of my parents; and, of course for many years as a nurse. I have seen examples in this country of world-class care and, as we celebrate 70 years of the NHS, I pay tribute both to those who had the courage and vision to set up the NHS and to those who continue to care within the NHS today.
They say you can take the nurse out of nursing, but never nursing out of the nurse. I am the Bishop I am today because of that first vocation to nursing, and compassion and healing are constants at the heart of who I am. I would not go so far as to say that this House needs a ward sister, for fear of being taken the wrong way; but I hope that in my time here and with my background, I can bring as much to this place of the pastoral and spiritual as I can of the professional.
I worked in London both as a nurse and as a priest before moving to the south-west as Bishop of Crediton in the diocese of Exeter. The people of Devon are thrilled that, as the Bishop of London, I come to your Lordships’ House with some understanding of rural life. Alas, the diocese of London has fewer farms. We serve a population of four million, covering 277 square miles of Greater London, north of the Thames and west of the Lea, from the Isle of Dogs in the east to Staines in the west and as far north as Enfield. Your Lordships will be delighted to know that you are sitting in my diocese.
London is of course world-facing. It is multicultural and multi-faith. It is a city of energy and diversity, open to all. But it is also a city of inequality and deprivation. As we have seen most recently in the tragedy of Grenfell Tower, it is also a city where people can feel ignored, marginalised and—often justifiably—angry. I am the Bishop of London, but I intend to be a bishop for London. And I will do so alongside those other distinguished bishops for London in this House, my right reverend friends the Bishops of Chelmsford and Southwark.
Along with celebrating 70 years of the National Health Service, I have been delighted to celebrate 70 years of the Paralympic movement. At evensong at St Paul’s Cathedral earlier this month we watched a demonstration of wheelchair fencing under the dome. It was a reminder of how sport can enable people with disabilities to flourish. We should not lose sight of the fact that in the UK, one in five of the population has a disability of some sort, the majority of those people acquiring their disability in later life.
Our churches, like our society, need to up their game when it comes to being welcoming and accessible places for people with disabilities. There are some good examples, including the Disability Advisory Group at St Martin-in-the-Fields, here in London. The driving force for their mission is to change attitudes towards those with disabilities—as not simply people presenting pastoral or practical challenges, but equals who bring unique potential to aid our renewal and mission as a church. In wider society, unlocking potential for those with disabilities brings benefit to us all.
As we celebrate 70 years of the NHS I am aware that for people with disabilities, going into general hospitals can be one of their biggest challenges, because their specific needs—such as their spinal needs—are often not met. Therefore, hospitals disable them. I know that as we move forward, there will be more challenges for the NHS and more difficult decisions, which is why I welcomed the recommendation in 2016 of the Equality Act 2010 and Disability Committee, chaired by the noble Baroness, Lady Deech, which called for a cumulative impact assessment of the decisions made in the public sector on disabled people.
I am immensely grateful to all who have welcomed me today, and look forward to the rest of the speeches in this debate, and the many debates to come.
Baroness Brinton (LD)
My Lords, it is a real honour to be able to speak after the new right reverend—and right honourable, for she is also a privy counsellor—Prelate the Bishop of London following her powerful maiden speech, in which she demonstrated her extraordinary life dedicated to Christ since her teens. We in this House note that she joins us as the third most senior cleric in the Church of England and the first woman in this role, after a meteoric rise from 2015 when she was made the Bishop of Crediton. She and the right reverend Prelate the Bishop of Gloucester were the first two women to be ordained as bishops in Canterbury Cathedral, and weeks later she was the first woman in the Church of England to lead an ordination service.
We have heard this afternoon of the impressive breadth of her experience beyond her priestly ministry and, indeed, of her many firsts in the Church. Bishop Sarah began her nursing career just over the river at St Thomas’ and around the corner at Westminster Hospital. It culminated in her appointment as Chief Nursing Officer and director of patient experience for England in 1999. It is worthy of note that she was the youngest woman to hold that position. Her passion for putting the patient first transformed nursing, perhaps most memorably through the new role of matron.
In her recent enthronement sermon at St Paul’s Cathedral, Bishop Sarah remarked that 150 years ago that week suffragettes had placed a bomb under the seat in which she had just been enthroned as the first woman to be Bishop of London. She said—I hope she will allow me to quote her—
“Let me reassure you, I do not come carrying bombs—or perhaps not literal ones, anyway. But I am aware that, as the first woman Bishop of London, I am necessarily subversive, and it’s a necessity I intend to embrace”.
This House and its predecessor, the King’s council of barons and bishops, have seen subversive bishops before, and I know that in welcoming the right reverend Prelate the Bishop of London to your Lordships’ House we see before us a woman who will not be afraid to tackle difficult issues and who will speak truth to her faith and to power.
I thank and congratulate my colleague and noble friend Lady Thomas on securing this debate. Like her and the noble Baroness, Lady Deech, I was a member of the Lords Equality Act 2010 and Disability Committee. Today, in the brief time that is left available, I want to focus on the availability of short-term care and social support for disabled children in our country today. We have already heard from the noble Lord, Lord Patel, about the issues facing children’s hospices, so I shall not repeat those points. However, I want to highlight the Disabled Children’s Partnership’s survey of parents, which found that 64.9% of family members surveyed thought that the quality of social care services had worsened over the past few years; that over three-quarters of family members thought that the quality of health services had worsened over the past few years; and that nearly half said they knew there were plans to reduce social care for children in their area.
Some 49,000 babies, children and young people with life-limiting or life-threatening conditions need palliative care from the point at which their conditions are diagnosed or recognised—which is often, but not always, at birth—until the end of their lives. Parents usually provide the bulk of the round-the-clock care that these often seriously ill children need at home. It is crucial that they are able to access care and support throughout the trajectory of that child’s illness.
Most disabled children receive no regular support at all from outside their close family and friends, and the number who receive social care services—and the number of hours of support per week—is reducing. Yesterday, local councils warned of further cuts to come, and evidence gathered by the Local Government Association shows that local authorities are overspending their children’s social care budgets by £600 million. Can a national inquiry looking at the children’s palliative care strategy, including short breaks, and a family- centred and holistic approach to health and social care interventions, be established very soon? The Government need to issue joint guidance on short breaks to the Secretary of State for Health and Social Care and the Secretary of State for Education, and they need to make sure that funding matches the increased demand for children’s palliative care and that direction is given on commissioning responsibilities. It is vital that services—such as those at Nascot Lawn, which I have spoken about in your Lordships’ House many times, and which sadly is going to close—are not closed over the head of the services that these children need.
My grand-daughter has various life-limiting illnesses, and she regards them as special. Aged two, she talks about her feeding tube as her “special tube”. If disabled children can see the specialness and normality of their lives, it is up to us as a country to ensure that we provide the special support that they need to live their lives to the full.
Baroness Masham of Ilton (CB)
My Lords, I am most grateful to the noble Baroness, Lady Thomas of Winchester, for bringing this necessary and humane subject before your Lordships today. I am so pleased that the right reverend Prelate the Bishop of London has made her excellent speech today, which adds importance to a matter that can so easily be discarded when there are so many demands on our overstretched country.
There are very many different categories of disabled people, all needing different things. Some of the conditions are very rare and complex. I make a plea to the Government to make some of the forms which have to be filled in for benefits or the blue badge scheme more simple and relevant to the different groups. I have noticed, in 2018, that there seem to be more and more people, and a percentage of them will be disabled. There are long queues at A&E, and patients have long waits for operations, many of which are cancelled at the last minute. I have noticed that many more disabled people are using electric wheelchairs. With an electric wheelchair, one has to use a ramp as they are too heavy and too difficult to tip.
It is difficult to fathom why, when some places have steps, the attitude differs. In Harrogate, in James Street, there are two shops side by side with an identical four-inch step. One has a ramp and the other does not. The ramps are now very light, easy to move and do not cost very much. If only the Government had listened to the noble Lord, Lord Blencathra, who had a Bill this year on access, this unequal, casual attitude might have been rectified. I consider the noble Lord an expert, as in another place he had several senior ministerial positions and now uses a wheelchair. As the country moves on, disabled people need helpful and clear legislation, otherwise they will not be able to live independently.
Forty-four years ago, I founded the Spinal Injuries Association with colleagues, as I know how valuable the support of voluntary organisations are to severely disabled people. A year ago, Martin was injured and sustained a T10 spinal injury at the Manchester Arena bomb explosion. Garry, one of our peer support officers, who is spinal cord injured himself, went to support him. Martin says:
“I remember Garry coming to see me, it was the day I’m being told I’ll never walk again. I’m meeting this incredible person, who is telling me that my life can be good”.
When Martin was told he had a spinal cord injury and understood that he would never walk again, he was upset, but he realised that he was surrounded by his family and friends; so with Garry’s help, he is getting on with his life. SIA is always pleased to help wherever possible.
So many accidents happen, with long-term injury leaving the person paralysed. It can happen with traffic injuries, diving accidents, horse riding, building and falls of all types. After the correct hospitalisation, patients may have to contend with getting suitable housing, schools, universities, changes of employment, and with having to drive a hand-controlled car and, if they have a partner, being accepted and living in the community, which may need a great deal of adjusting.
When I drive around I often notice new buildings and new housing estates going up. Can the Minister say whether any of these are for rent and, if so, would they be adapted for someone using a wheelchair? In Australia, rented accommodation suitable for disabled people is reserved solely for lease to them. Can we not do the same in this country? This debate covers many aspects of life, but disability is so diverse, it spans so many government departments. Is it not time for them all to come together to solve the individual disabled person’s needs?
Baroness Eaton (Con)
My Lords, I declare my interests as found in the register. I thank the noble Baroness, Lady Thomas of Winchester, for bringing this important debate to this House today. I also thank the right reverend Prelate the Bishop of London for her inspirational maiden speech.
Disability of varying kinds is a feature of the experience of many families, my own included. In every country this can bring challenges but also great joy. Some 15% of humanity lives with a disability. Many go about raising families, founding firms and stunning us with their sporting prowess and the quality of their scholarship and public service, not least in this House. Thousands, though, face extreme stigma in communities, economies and legal systems so weak or complex as to put them perpetually at risk. So while today we are focusing on challenges in Britain, I will, in passing, commend Ministers in the Department for International Development who in London next month will co-host the first ever Global Disability Summit. This imminent important gathering puts our deliberations today in their international context.
As the chairman of the charity Near Neighbours, which seeks to build community cohesion and integration in England’s towns and cities, I am sadly and increasingly aware of how exclusion and hate crime is becoming more widespread in parts of our society. Some families find it hard to give their children—especially their daughters—the chance to work, study, love or travel freely. Some in local neighbourhoods wish that others who live there “had never been born”. Meanwhile, others have religious or ethnic traditions that actively exclude members of their community who could make powerful contributions.
Over 60,000 families were impacted by race hate crime in 2016-17. In 2017 the Community Security Trust recorded 2,254 hate attacks on members of the Jewish community. This was a 10% increase on the previous year. Disabled Britons will recognise these trends. In the same two-year period of 2016-17, hate crime against disabled children rose by an astonishing 150%. Indeed, nearly 6,000 disabled people endured hate crime; sometimes an attack will be because of both their disability and their race or religion.
It is heart-breaking how the patterns of hate crime facing disabled people have come to mirror—and at moments surpass—those faced by other communities more generally. Hate crime against disabled people can be controlling and can involve very close carers or family members as perpetrators. Crimes can involve money, sex and access to housing. They include open abuse in the street or in seeking work. They are hard to record, not least because victims prefer to report to third parties rather than to the police. Typically, they increase in frequency and severity.
Beyond this are the subtle and repeated exclusions. There have been legal cases where hospitality for disabled people in temples and other places of worship has been felt to have been compromised. Discussion of disabilities arising from genetic conditions is often almost impossible, especially in certain cities such as Bradford, where I live. I even noticed that, in Roman Catholic canon law, until 1983 epilepsy was a block to ordination—and it is unclear today whether physical disability or historic mental illness remain so. The upshot can be isolation, alienation and other unwanted challenges where they ought not to be easily accepted.
I am aware that the Home Office has a hate crime action plan. I am also aware of pioneers, such as Boston’s Ruderman Family Foundation, which has given very large funds across America and Israel to make the activities and architecture of synagogues and charities fully accessible. But might we do more? The trick, it seems to me, is how we combine civic energy and resources right across government. I would be especially pleased to hear from the Minister whether she might be able to explore how the lessons of the work of the Ruderman Foundation and those like it might be replicated here. I would be delighted also if she might consider inquiring how the Government’s recent integration strategy, the new Carers Action Plan and successful Disability Confident campaign might be more fully harnessed to mitigate some of the risks that I have described. These programmes are laudable on their own but might benefit additionally from being more actively linked.
If the challenges that disabled people face are as harsh as I have described, often arising from complex and cross-cutting issues, our response must be equally fleet of foot. Disabled people in all our families deserve it.
Baroness Ludford (LD)
My Lords, I thank my noble friend Lady Thomas for this debate and I appreciate being able to follow the right reverend Prelate the Bishop of London; it is an honour. I wanted to take part in this debate not only because it is a very important subject but because of my experience—my second-hand experience and observation—as the wife of a person with a physical disability; to be specific, a prosthetic leg, following a leg amputation three years ago. I want to focus on issues of accessibility in public places. I have become aware of how much still needs to be done in this regard.
Disability and limited mobility is the overlooked equality characteristic of all those covered by the equality legislation. Obviously there is a huge spectrum of conditions—we have heard about deafness, visual impairment as well as physical disability—but, when you add up all those involved, plus family members, a very high proportion of the population is affected. It is not a niche concern. A lot of us, even if not currently classified as having a disability, are either partners or members of the family of people who are, or can expect to be, in that category—and a lot of us will get frail in our older age. I think it was the right reverend Prelate who said that one in five people would have a disability as they got older.
I have been able to observe the challenges that my husband faces, and I will give an example. Obviously, people are in different situations, and those who are wheelchair users have their own challenges, but, as someone who is walking—though with difficulty—he gives us an example of the failure to think of those with limited ability to walk. He often takes a train from King’s Cross and requests assistance, but the information desk at which he has to report is further from the main entrance of the station than the platform to which he has to go. He is expected to walk a long way to the information desk for assistance. That is a lack of joined-up thinking about people’s needs. Hotels are another challenge, as getting a stool for the shower often takes some persuasion and, when provided, has been known to be too big to allow the shower door to close. It ought not to be exceptional to have to ask for these kinds of physical supports.
A lot of help would be given if handrails were more common. In one hotel in central London a handrail would have helped to get up a set of stairs. The person whom I asked said, “No, we are listed so we can’t have a handrail”. I would be surprised if the legislation on listed buildings prevented installing handrails. If it does, it needs to be changed. My point is that this kind of assistance would help a lot of people. It is not disability-specific; it could help a lot of people as we age and as we live longer.
Liberal Democrats are known as “pavement politicians”, but the appalling state of many pavements does not help those with limited mobility. I am sure it does not help those in wheelchairs and it certainly does not help those with a prosthetic leg. You also have to deal with the problems of more aggressive cyclists, skateboards and scooters on pavements. There needs to be more concern and awareness that many more of us will need much better accessibility in public places, not only now but as we get older.
Lord Low of Dalston (CB)
My Lords, I declare my interests as set out in the register. I join others in congratulating the right reverend Prelate on her impressive maiden speech and also the noble Baroness, Lady Thomas, on securing this debate. It is extremely timely because the challenges facing disabled people are at a critical point. There is something of a stand-off between disabled people, their organisations and the Government, and the Government just do not seem to be listening.
In Being Disabled in Britain—A Journey Less Equal, the Equality and Human Rights Commission recently assessed the state of equality and human rights for disabled people in Britain and concluded:
“While progress has been made in some areas, the overall picture … is that disabled people are facing more barriers and falling further behind. … millions of disabled people … are still not being treated as equal citizens and continue to be denied the everyday rights non-disabled people take for granted, such as being able to access transport, appropriate health services and housing, or benefit from education and employment. The disability pay gap is persistent and widening, access to justice has deteriorated, and welfare reforms have significantly affected the already low living standards of disabled people”.
Since 2016, the UN Committee on the Rights of Persons with Disabilities has published two reports examining the UK’s record on disability. In both reports the committee expressed serious concerns that the level of protection and support provided to disabled people was not adequate. In 2016, the committee considered a formal complaint under the optional protocol from a number of organisations of disabled people and found that, as a result of austerity measures, there was reliable evidence of “grave or systematic violations” of disabled people’s rights to an adequate standard of living and social protection, to work and employment, and to independent living. After reviewing the UK in August 2017, the committee published its concluding observations, which raised significant concerns about disability rights in the UK and made over 80 recommendations for action by the UK Government and the devolved Governments of Wales, Scotland and Northern Ireland.
In March this year, the EHRC published a cumulative impact assessment of the impact of changes to the tax and benefit system since 2010 on different groups—something the Government said could not be done. Households with one or more disabled members are significantly more adversely affected than those with no disabled members. On average, families with a disabled adult have lost about £2,500 a year since the changes in 2010. If the family also includes a disabled child, the impact is just over £6,500—over 13% of average net income. This compares to a reduction of about £1,000 for non-disabled families. Negative impacts are particularly large for households with more disabled members and more severely disabled members. On average, disabled lone parents with at least one disabled child fare even worse, losing almost £3 out of every £10 of their net income. In cash terms, their average losses are almost £10,000 a year. Figures from the Institute for Fiscal Studies and Professor John Hills of LSE tell a very similar story.
Of all the challenges facing disabled people, one of the greatest is the Government themselves. When opposing the £29 a week cut to employment and support allowance which the Government introduced in 2016, I said:
“By this action, the Government have betrayed the trust of disabled people and they should not be surprised if they forfeit it for the rest of their time in office”.—[Official Report, 7/3/16; col. 1074.]
That is still my view, but the Government could still begin to turn things round if they got behind the UN committee’s recommendations and began implementing them—and reversed the cut to ESA, of course. A good start would be for them to begin engaging with disabled people and their organisations, which they are not doing at the moment. They could hold a summit with organisations for disabled people to co-produce an action plan for taking the rights of disabled people forward or, slightly more long term, they could set up a task force with the same agenda, like the Labour Government did at the beginning of their term in 1997. I should be most interested to hear whether the Minister would be interested in taking either of these ideas forward with her colleagues.
Baroness Wyld (Con)
My Lords, I add my congratulations to the right reverend Prelate the Bishop of London on her powerful and moving maiden speech. It is an honour to follow her, and I look forward to getting to know her here and outside the Chamber.
I will talk today about disabled people in public life, picking up on the comments made by my noble friend Lord Holmes, because this was my area of focus during my time in Downing Street. I have spoken before about the work the Government have done to increase the number of women on public boards and the very clear outcomes achieved. But it is important that we acknowledge that we simply have not had the same success in attracting or appointing more disabled people to sit on the boards of government departments, public bodies and advisory bodies. All of these have hard and soft power to affect lives across the nation. We will not get the solutions to the problems your Lordships are exploring today unless we empower more of those we also want to help.
I can say with genuine confidence that there has not been a lack of will. But the statistics from OCPA on disability—and, indeed, on BAME—show that while there has been some slow progress in recent years, we need to work harder. I therefore warmly welcome this review, to be led by my noble friend Lord Holmes, and I can think of no better person to lead it. I will offer some early observations.
Although there is growing evidence-based consensus across public and private sectors that diversity improves outcomes, there is a long way to go. I look back to recent years, when the Cabinet Office held events to attract more people into public appointments. Many people—I have to say, they were usually able-bodied men—told us privately that it felt like identity mattered more than merit. I want an open conversation about this because we should tackle it in the context of why it matters that we attract more disabled people into public life.
Disabled people are held to the same standard as anyone seeking a role in public life. Just as those who are not disabled will not always get a job, a disabled person may go through the process and not be appointed, but as long as the opportunity has been there and the process has definitely been fair, that can be an entirely appropriate outcome. However, that does not mean that we should not be out there, looking for and encouraging the best talent in disabled communities to come and help us, and identifying the barriers to making this happen. We can hear from today’s examples that public life benefits so much from first-hand experience and knowledge of the specific issues that disabled people face. That life experience really matters.
As the noble Baroness, Lady Thomas, said, we also need to be clear that we are not looking to disabled individuals to participate simply in issues specific to disability. To be honest, in the cross-governmental meetings that I went to, I genuinely think that we became guilty of that sort of siloed thinking that can happen when you have simply got a bit stuck on what seems a difficult issue. I hope, therefore, that the review will explore ways to widen awareness of the range of roles across public life, from our museums to our regulators to our lottery distributors and beyond. This needs to recognise that there is no homogenous disabled strand of society, just as there is no homogenous group called “women”. Both the public and private sectors have rightly invested huge amounts of time and energy in thinking about the multifaceted reasons why women have not always had equality of opportunity. We need to invest the same time and energy in listening actively and responding to disabled communities, because the steps that we have taken so far in outreach and unconscious bias training—which, to be fair, were not aimed simply at increasing numbers of women—have not sufficiently brought other groups through the pipeline. There is a breadth and depth of experience of dealing with modern employment and society among disabled people that we fail to tap into at our cost.
We can be optimistic. Disabled people are already leading agendas in public life—we need only to look around this House. Without minimising the barriers faced by disabled people in terms of prejudice and perception gaps, there is also evidence that, culturally, we as a society increasingly understand that different does not mean unable. My children are growing up watching people with different disabilities read the bedtime story on CBeebies, and they cheered on Lost Voice Guy winning “Britain’s Got Talent”, commenting not that he is disabled but that he comes from Newcastle, like their mum. I think my girls would be absolutely amazed to know that we have had to commission this review. Let us make sure that ours is the last generation that has to do so.
I have absolutely no doubt that my noble friend the Minister will encourage all Front-Bench colleagues and advisory teams to engage fully with the review led by my noble friend Lord Holmes. I should like to see another push, led from the top, for truly diverse shortlists and appointment panels that go beyond the gender debate. I look forward to insightful and action-focused results.
Baroness Howe of Idlicote (CB)
My Lords, I thank the noble Baroness, Lady Thomas, for her important debate, which I am pleased to take part in. I also warmly congratulate the right reverend Prelate the Bishop of London on her inspiring maiden speech.
I shall talk about the challenges that deaf children face in education. There are more than 50,000 deaf children in the UK, but it is what is sometimes called a low-incidence disability, meaning that many parents and teachers will come across a deaf child only occasionally. Indeed, more than 90% of deaf children are born to hearing parents who have no prior experience of deafness. Around 80% of deaf children attend mainstream schools, where they may be the only deaf child enrolled. It is because deafness is a low-incidence disability that local authority specialist education services for deaf children play such an important role. These services employ teams of teachers of the deaf who can work flexibly and go where the need is. In particular, they can ensure that families and teachers have the specialist advice and support they need so that deaf children can develop good language and communication skills.
The National Deaf Children’s Society has raised with me a number of concerns about the future of these services. First, there is concern about the impact that funding cuts are having. Its analysis has found that over a third of local authorities are planning to cut funding for specialist education services for deaf children. These cuts amount to £4 million in these areas. It has told me of its frustration that the Government continue to maintain that funding is at a record high. This may be so, but it does not allow for funding pressures on local authorities also being at a record high. For example, we are seeing a growing number of children with special educational needs and disabilities, many of whom need a placement at a special school. I hope the Minister will take away the message that there is a need to do more to ensure that funding is adequate, both now and in light of the Government’s spending review next year.
Secondly, there is concern about the sharp decline in the number of teachers of the deaf. Research shows a 14% decline over the past seven years. Many services report that they cannot recruit new teachers of the deaf. It seems clear that there are systemic challenges around how teachers of the deaf are trained and recruited. I would be grateful if the Minister could let me know of any plans to address this. Will the Government consider introducing a bursary scheme, for example, to fund the training costs of new teachers of the deaf?
On a related note, I understand that the Department for Education has commissioned a review into teachers of the deaf qualifications. I would be grateful if the Minister could confirm that this review will look at the totality of the work of teachers of the deaf, including with families in the early years. I would also be grateful if she could confirm that families will have an opportunity to feed their views into this review.
Thirdly, there is a concern about how local authorities are held to account for the quality of these specialist education services. It seems unfair to many that parents of deaf children receive so little information about the quality of the support their child receives. Ofsted inspections of local area provision for children with special educational needs, introduced in 2016, have started to address this. However, the National Deaf Children’s Society advised that these inspections do not look at services for deaf children, or indeed for any other group of disabled children, in any great detail. Will the Minister agree to look at ways of addressing all these things, perhaps by introducing new ad hoc inspections that look at different services for disabled children?
I conclude by saying again that specialist education services for deaf children play a vital role. A failure to protect these services will put the future of deaf children at risk. I very much hope the Minister will respond positively and constructively to the concerns I have raised.
Baroness Uddin (Non-Afl)
My Lords, it is an honour and a privilege to take part in a debate led by the noble Baroness, Lady Thomas. I welcome the right reverend Prelate the Bishop of London, who spoke eloquently about the challenges and progress of disabled people in our country. I look forward to hearing her and working with her more closely. There are two very good farms in Tower Hamlets that maybe we can visit together so as to reassure her that there is green space among us. Today I will make some observations as a mother, as well as a professional in the field, although there is a temptation to address so many outstanding issues that befall carers of people with disabilities.
In whichever manner we look at enabling the voices of vulnerable adults and young people, we cannot underestimate the serious lack of progress, especially for those who are beholden to our institutions for day-to-day services and care. I feel strongly that many in their thousands, even as we speak, remain unsafe at the hands of those who care for them. This is the last bastion of secrecy regarding sexual and physical abuse yet to be addressed, although I accept that we have been privy, through social media, to secret recordings of abuse of vulnerable adults taking place in a number of our institutions. As the noble Lord, Lord Shinkwin, said, the conspiracy of silence is deafening.
I say this with a great deal of pain. Two decades have passed since I withdrew my son from education just after he was 16 years of age. There were years of toing and froing between different education institutions and the NewVIc sixth form. He had come home crying on numerous occasions, but one day he was utterly distressed and absolutely refused to board the bus to that place where he adamantly felt unsafe. He had returned home with soiled pants on many occasion. I never received any explanation. I was told that they knew best, that I was expecting too much, and so on.
That day I asked my son for the umpteenth time for an explanation. He said that John, his aide, had hurt him in the toilet. I shall refrain from discussing or detailing any further distressing information he then disclosed to me. I took him to the vice-principal the following day and asked for an explanation. Although she “felt” my anxiety, she found it implausible that my son could possibly be speaking the truth. I knew her well. Although she was highly educated, and had knowledge of the law and of her obligation and duty to protect, in fact she was arrogant and all but ignorant of basic human values and decency. More importantly, even my son as a disabled person had rights. She could not comprehend that a paedophile could have filtered through to her staff team working in disguise as a carer with vulnerable young adults. She did not accept that abuse of a person with a disability in her charge was possible.
Of course, I am referring to a time, not in the distant past, when such things were denied, and it was not accepted or acceptable to speak of unspeakable abuse of trust or of sexual or physical abuse of people within our institutions. This was a fact. So my “suspicion”, despite that fact that I was a local authority social worker, could be dismissed as a preposterous notion coming from an overbearingly anxious mother. Noble Lords are all too familiar with me being overbearing on some required occasions. They will also agree that, when facing such serious detriment to one’s child’s well-being, a little leniency for anxiety should be accounted for. What irks me and haunts me to this day, two decades later, is the simplicity with which my concerns—indeed, allegations—were summarily dismissed. The teacher in that powerful place had not for one nanosecond considered the possibility that my son with learning disabilities could have been assaulted and that he was speaking the truth. She refused to accept any responsibility for ascertaining the facts or investigating the matter. I withdrew my son from there and all other educational institutions and no one since has bothered about his or our well-being.
Maybe we will say that we are in a better place these days, that tolerating abuse would not be allowed today and that we have begun to acknowledge that there are predators who deliberately seek out opportunities to work in our institutions which allow access to vulnerable people, particularly those whose communication skills mean that they may not be able to explain abuse in a normal way. Indeed, we might have examples of many institutional failures.
I have confidence that such allegations these days would not go unattended and that a full investigation is now mandatory. In fact, it may have been then—laws to protect have always been in place. Fair and just implementation has always depended on the proverbial gatekeepers and on individual leadership to produce good practice. I have worked in the same borough since, and spent time as a team leader in social services in teams where services to disabled people were taken very seriously.
What may not have changed is the experience of vulnerable adults and young people and children with predatory sexual and physical abuse, particularly those with learning disabilities and communication disabilities, whether they are in nursery or are adults. The overall assessment of where we are in the UK on disability rights and policies is more satisfactory than when I sought help for my child in the early 1980s, and his needs were dumped in the bin of prejudice and sheer incompetence. Such instances potentially cost us much more than welfare benefits and healthcare provision.
I want to make just one point: I am not alone, and organisations like Include Me TOO say that many of their members of ethnic minority backgrounds have suffered significant unacceptable levels of discrepancies in their services. Many believe, rightly or wrongly, that diagnosis, assessment, education and support services remain accessible only for those whose parents are already well resourced educationally, financially and in their status.
Lord Addington (LD)
I congratulate my noble friend on raising this topic. It has been a long time since we had a debate that looked at disability in the round. I also congratulate the House because we have not turned it into a competition of suffering between various forms of disability, saying, “Oh, my problems are so much worse”, or complaining about, “The intensity here, the numbers there”, and so on. That can happen, and we have all been pulled into it on various occasions.
One thing that comes out is that we have travelled a long way, but we have done it in a very messy way. What we do in Parliament is have a nice, big, sexy debate about legislation, then we put down the regulation, the politicians forget about the regulation and it is done badly. What tends to happen is that you have gaps between intention and implementation. Then we get dragged back to it when something goes wrong.
What this often leads to is that we have a right that is not fulfilled because people are not trained or are not informed about the possibilities, and then we have a degree of conflict and missed opportunity. I suggest that, in the case of disability, we have a way out, which is becoming apparent and will, if we choose it, deal with some of these problems. It is in the form of assistive technology. It is now time for me to declare my interests. I am dyslexic, I am president of the British Dyslexia Association and I am chairman of Microlink, which is probably the biggest company in Europe dealing with assistive technology and puts packages together to help people.
What I have found in my use of technology is that, 20 years after I first talked to a computer and it produced a text, people are still surprised by it. I am further appalled that the people installing the standard operating systems on all the computers we are given in this House do not know that quite an impressive set of assistive technology is built into them. I know because I have just had this conversation with them. They are not alone. I have further discovered that the House of Commons DWP Committee has just had a nice big report come out looking into exactly the same thing and stating exactly the same thing. We are not using what is there because half the people do not know it is available.
The waste of human potential and everything that goes on incumbent in that is ridiculous. People do not know that, with a little training, you have a little button or app that you can tap into on a computer that will do things such as read text back to you, allow voice input, allow coloured screens and allow good screen readers. Indeed, some people actually challenged the technology that those who are partially sighted use, or so I was told today when talking to an expert in the field. I am afraid that one goes to the Mac, but let us not mess about with it.
You have these things that people do not understand. The main skills required in modern jobs are often those where you have to communicate through a computer and do your job through it. Ways for other groups to get into and at that information and transport it through are available. What are the Government doing to make sure that everybody knows it is there? What are they doing in education that might suggest that the best way to communicate a text in answer will not always be with a pen and paper?
It is one of the absurdities of our world that when senior civil servants have to take exams they have to be taught how to write with a pen and paper again to take the exam. What becomes normal in, and beneficial to, the whole of society would become beneficial to large numbers of the disabled community. It is taking that cultural step of what is readily and easily available and making it work and go through.
My work with Microlink has taught me one other thing: when it comes to supporting people with disabilities in the workplace, the first thing not to do is make a line manager in any organisation who has a budget for something else allocate some of that for disability. That is according to all our biggest clients, including Lloyds and Barclays. You put it in a central place, take it out and get the support. That way, the person gets the help they need. In commercial activity, this cuts down on job vacancies and people leaving. Unless the Government can take this example and make easily available what is readily available, they will not get the benefit out of this.
I hope we will look at this in the round. If we do not, we will waste huge amounts of resources when we have the resource readily available.
Lord Luce (CB)
My Lords, it has been a most humbling experience to take part in this debate and listen to the very moving contributions that have been made. It was very ably led by the noble Baroness, Lady Thomas, and had an inspiring maiden speech by the right reverent Prelate the Bishop of London.
I will concentrate on what the Government are doing to help the millions of people with long-term health conditions to stay in work or to get back to work if they have been put out of their job. I have particularly in mind people suffering from musculoskeletal pain, chronic pain and the overlapping mental health problems, simply because I have experienced it for more than 45 years myself.
For the past 10 years, I have worked with the Chronic Pain Policy Coalition, focusing on the more than 8 million who suffer from chronic pain and back problems. Very many need multidisciplinary support. If we look back seven years to 2011, after 50 years’ experience of the sickness absence system, a fresh proposal came forward under the leadership of Dame Carol Black, with a report entitled, Working for a Healthier Tomorrow and a second report, Health at Work—an Independent Review of Sickness Absence. There were clear proposals on how to make it easier for people to stay in their jobs, including, first, the establishment of a health and work advisory assessment unit and a fit for work service, emphasising the capacity of the patient to return to work and not their incapacity; and, secondly, to include an occupational health work-focused assessment for employees off sick, or likely to be off sick, for more than four weeks.
On top of that there was a proposal for an advice service for employees, employers and GPs on this subject. The benefit for everybody if it succeeds would be employees with a better quality of life and retaining their jobs, employers with a more productive workforce, and, for the Government, there would be overall economic benefits. Indeed, looking back to 2000, when the last figures were available, chronic pain cost the economy well over £10 billion.
The Government have made progress and there is a higher proportion of disabled people in work now than four years ago. I welcome that, but much more needs to be done. Last November the Department for Work and Pensions produced a Command Paper entitled Improving Lives: the Future of Work, Health and Disability. Having read that, I conclude that the Government sense that the fit for work service experiment, as conceived by Dame Carol Black, has failed—or, at the very least, stumbled badly. The Government seem to be proposing in that paper that there should be a fresh approach to this challenge, not least in strengthening the occupational health service—at the moment, there are very few people in that profession—and helping employers and employees in different ways to improve the service.
The Government have set the challenge that we must be in a position by 2019-20 to set out a clear direction and strategy for future reform. To their credit they have set up an expert working group on occupational health to champion, shape and drive the work, plus an interministerial group to co-ordinate. I should emphasise that most employers, especially small businesses, cannot afford to employ occupational health people, and it is these small businesses that are most vulnerable and need most support for their employees. There are some good examples of employers who have a very good occupational health service, helping their employees and co-ordinating with the health service. So I look forward to hearing from the Minister her and her Government’s assessment of the former fit for work scheme and how the Government have decided to learn the lessons of the last four years to remove the obstacles to the success of the scheme and to make it work properly, to the benefit of all concerned.
Lord Borwick (Con)
My Lords, first, I declare an interest in this debate, as the father of a son with learning disabilities and a trustee of a charity helping deaf children to learn in mainstream schools. I, too, pay tribute to the noble Baroness, Lady Thomas, for securing this debate and for her tireless work in this area. The prize named in her honour, sponsored by Bespoke Hotels, has done much to encourage designers and architects to take into account those with disabilities when they travel. I also pay tribute to the wonderful maiden speech of the right reverend Prelate the Bishop of London.
Disabled people face an enormous number of challenges, but each of those challenges is there only because a disabled person is trying to achieve something. If a disabled person faces the challenge of driving a car, they do so only because they want to drive a car. That is different from the barriers faced, say, 20 years ago. Then, they would have been told that driving was not something for them. So, as barriers to ambition have fallen, challenges have appeared. That must be celebrated. The more that disabled people achieve, the more that challenges become apparent. Changing the mindset to deal with obstacles and challenges is important.
Lee Ridley, better known as the Lost Voice Guy, recently won “Britain’s Got Talent”, the ITV prime-time reality show. He has cerebral palsy—but of course, that did not matter: he had the audience laughing in the aisles and the viewers at home dialling in to vote for him in their millions. What the Lost Voice Guy proved is that overcoming the challenge is the most important thing. His disability actually played to his advantage; it defined his act, allowing his comedy to shine through. There are many people who regard themselves as defined by their disability and believe that their barrier is the most important thing in their lives. I think we have to see the glass as half full.
The technology of cochlear implants, for example, has improved drastically in the last 20 years, and, as with most new technology as it develops, the price has come down drastically. Improvements in technology are something that we should be encouraging and celebrating, especially in the fields of language and communication. There are many people who are physically disabled, but I might say that I am impaired in the very many different languages that I cannot speak—such as Gujarati, to choose one at random. But there are now apps that translate entire paragraphs of foreign languages just by hovering the camera over the page.
Traditionalists may balk at this—surely a cultured person will take the time to learn a language. However, these apps and technologies increase, not reduce, communication. The crucial thing is that technology takes away my fear. The fear of a mistake is inhibitive and intimidating. By simply using technology, I am no longer afraid to make a mistake in talking to locals. New technology will deal with my problem in Gujarat, which is my inability to communicate in Gujarati. Similarly, technology must help people with physical disabilities.
I have so far spoken about positivity and technology. The tech entrepreneurs are the sum of those two parts. They are some of the most positive people in overcoming the challenges faced by disabled people. Seemingly, more brainpower than ever is expended on helping disabled people live better lives. In times gone by, the approach was almost functional—a person could not walk, so build them a wheelchair. That is a good thing in and of itself, but today’s problem solvers dream bigger. These days, it is actually cool to solve these problems. Technology is changing the lives of disabled people forever and for the better.
There are more reasons to be cheerful. I have a friend who was born with no arms and no legs, but he has a driving licence. He might have a claim to be the most disabled person with a driving licence, but is it not wonderful that he has one? While he is competent in controlling his vehicle, there must be many others with a worse condition who cannot drive. My friend has freedom. He is able to live on the spur of the moment. He is less dependent on others and less dependent on the state. His independence and freedom mean that he has milk in his coffee if he has run out and needs to go to the shops—everything that people without a disability take for granted.
When automated vehicles are on the road, almost all will be able to share the joy my friend has in his freedom. We should be positive about seeing the benefits of that type of technology. We are often too negative and let the problems of the past make us gloomy about the future. The noble Baroness, Lady Thomas, has a prize in her name which asks people to be innovative and positive, and to overcome challenges. We should adopt that mindset as we seek to make the lives of disabled people a whole lot better.
Baroness Jolly (LD)
My Lords, I join noble Lords in thanking my noble friend Lady Thomas of Winchester for initiating this excellent debate. I think it is the first that I can remember in getting on for seven years in which we have discussed such a wide range of disabilities. As often happens in this place, a huge range of experience and expertise has been demonstrated, which brings me to my second point: to join noble Lords in welcoming the right reverend Prelate the Bishop of London. I am delighted that she brings with her expertise on the south-west as well as on health. She will enrich our debates.
When we think of a disability, invariably it is physical and often visible. For those with a learning disability, it is not always physical and not always visible. When considering the challenges those with disabilities face in the UK, we need to remember that it is about making that person’s life the best it can be: how they can experience a meaningful life, ensuring their safety, well-being and interests are met.
Many organisations work in a person-centred way and some do not. I declare my interest in the register as chair of Hft, a charity supporting those with learning disabilities through independent housing and support services across England. I will talk about learning disability and the challenges faced, and about what two young people with learning disabilities did about them.
Person-centred models exhibit the right and freedom of choice, while always keeping in mind a person’s health and safety. People with learning disabilities enjoy engaging in hobbies and interests, just as we do, but sometimes extra support or care are needed to take part in these activities. Charitable organisations such as my own ensure that those with learning disabilities can do the things they love the most while also having fun in a safe and independent environment. Socialising is part of most of our daily routines but for those who live in a sheltered environment, meeting and chatting to friends can be challenging and opportunities infrequent. That is precisely why Luv2meetU and Hum Tum were created at Hft. Luv2meetU, a friendship and dating service, brings together people with learning disabilities at Hft-run events: games, sports, nightlife events and more. Hum Tum allows adults with learning disabilities of south Asian heritage to bond on social, cultural and religious levels. The funding we raise as a charity goes towards running those sorts of events.
The noble Lord, Lord Holmes of Richmond, spoke about disability on TV. I was delighted recently that “Silent Witness” had a storyline about a young couple with learning disabilities who were in love. It does happen. The point is for people to connect, laugh, share stories and feel that spark with someone special. We take these things for granted. Those with learning disabilities should not feel alone—don’t we all need that friend who understands?
We have considered the challenges facing those with learning disabilities but it is also critical to consult trusted friends and families. At Hft half the trustees are family members of those supported by the charity. At our council, the human elements are never forgotten. Family members can articulate to other trustees and executives issues that those without that experience could not understand in the same way. This offers invaluable insight. It would not be right or fair for charities to make critical decisions about those they care for without the consultation of the very people whom they support. The voices of those with learning disabilities must be heard, especially when it comes to preferences in care.
That is why our staff and people with learning disabilities are partnered up at local, regional and divisional level. Each house and region has a group where concerns and questions are posed and deliberated. These councils are to ensure consistency of communication and that shared knowledge and experience lead to better understanding. We call the meetings Voices to be Heard. It is worth mentioning that a frequent topic of concern is “mate/hate crime”, where somebody befriends you and hate comes out of it. The noble Baroness, Lady Uddin, demonstrated that admirably today.
Two people with learning disabilities in our care travelled to Geneva to share their personal experiences of the effects of austerity with a United Nations hearing. The noble Lord, Lord Low, mentioned this earlier. They are two members of our national Voices to be Heard council. They attended the 18th session of the United Nations Committee on the Rights of Persons with Disabilities. The hearing invited disabled people to share their personal experiences to help inform the committee’s investigation into how the UK Government’s austerity policies have impacted on people with disabilities. Hft’s evidence fell under Article 19, the right to inclusion and participation in the community. Each addressed the 18 members of the committee, warning that increased pressures on care funding are impacting on the opportunity for people with disabilities to live the life they choose. We believe that this violates the rights enshrined in Article 19 of the CPRD:
“Living independently and being included in the community”.
Since February last year, through its It Doesn’t Add Up campaign, Hft has been aiming to raise awareness of the funding pressures faced by social care providers following the introduction of the national living wage in April 2016. This has not always been reflected in money given by the Government to local authorities to fund care packages. Data from the campaign was used to respond to calls for information from the UN Office of the High Commissioner for Human Rights on service provision for persons with disabilities. This was a great opportunity for Henry and Becky to have their voices heard at the highest level and to play a key role in driving positive change against the austerity measures disproportionately affecting people with learning disabilities. They argued that inadequate funding of the social care sector was prohibiting providers properly supporting adults to live independently.
Reductions in benefits are preventing people living as full a life as before, and benefits are now more about enabling people to survive rather than thrive—their expression, not mine. They expressed concerns about provision of Easyread resources in several settings, particularly in health and at elections. Do the Government have a view about where Easyread communications should, and could, be available? It is worth noting that last year, an awful lot of people with learning disabilities, carrying a polling card, were turned away from their polling station by the officer in charge, who told them, “People like you can’t vote”. We visited our MPs. It happened, and we are going to try to sort something out for the next election. However, that was really shameful.
The chair of the committee called the UK Government’s policies a “human catastrophe” for disabled people. It issued recommendations under all chapters of the CRPD. Regarding Article 19, it argued for adequate and earmarked ring-fencing of moneys so that local authorities are properly able to execute their responsibilities in enabling disabled people to exercise choice and independence. Our Government responded by saying that the UK maintains that it is a world leader in disability rights. The response will be published in the summer.
The sector feels that conversations about funding for social care are always about older people, not those with disabilities, despite the fact that within a few years the funding required for people with disabilities will outstrip that for elder care. Can the Minister feed back the frustration of the learning disability sector that, when discussing disabilities, the Government invariably refer to those with a physical disability and rarely to those with a learning one?
I commend to the Minister, if she has not already seen it, the British film “The Silent Child”, which won an Oscar this year. It is all about the power of sign language. The makers of that film went to see the Department for Education and they were promised a GCSE in sign language.
Those with disabilities share many of our own desires: a voice wanting to be heard, preference in the way our daily lives work, a friend or companion to call or hold. The challenge is enabling the quality and opportunity of those practices. Whatever the disability—whether it is hearing loss or lack of sight, mobility problems or a learning disability—it is all about making a life safe and worth living. We should all agree that that is something which brings value and happiness to everyone.
Lord McKenzie of Luton (Lab)
My Lords, let me begin by offering my congratulations to the right reverend Prelate the Bishop of London on a wonderful maiden speech. That passion for the NHS will sit well with us all in this House. Perhaps I may also say that if she is tempted to exercise the calm authority of matron in this Chamber from time to time, that may not go amiss—but of course, not on these Benches.
This has been a worthy debate and I join with others in thanking the noble Baroness, Lady Thomas, for its initiation. As the debate has highlighted, and the briefings we have received confirm, the challenges facing disabled people today are many and considerable. We have heard a very full range of contributions, so I hope noble Lords will forgive me if I do not touch on all of them.
The noble Baroness, Lady Thomas, spoke about the extra costs for independent living that disabled people face, and about DFGs and the aspiration to have 1 million more people in work—it was a very full contribution. The noble Lord, Lord Holmes, and the noble Baroness, Lady Wyld, spoke about the importance of disabled people and public appointments. I wish the noble Lord success in his review. The noble Lord, Lord Bruce, and the noble Baroness, Lady Howe, talked about the challenges for deaf people and the need for cohesion and specialist education. The noble Lord, Lord Patel, spoke about palliative care for children and the unfair funding of children’s hospices. The noble Lord, Lord Shinkwin, spoke about the generosity of the taxpayer. It depends quite where you stand on that as to who gets the benefit and who takes the hit. The noble Baroness, Lady Brinton, spoke about the Equality Act and short-term care support; the noble Baroness, Lady Masham, about the blue badge scheme; the noble Baroness, Lady Eaton, about the Global Disability Summit; the noble Baroness, Lady Ludford, about accessibility in public places; and the noble Lord, Lord Low, about challenges that I will come on to and strike common cause with him on in a moment. The noble Baroness, Lady Uddin, spoke about changes to address the position of vulnerable individuals and sexual predators; the noble Lord, Lord Addington, about dyslexia and using assistive technology more effectively; and the noble Lord, Lord Luce, about the proposals from Dame Carol Black—proposals I worked with her on a long time ago, when I was in a different role. I do not think we have ever cracked it, because I do not think that occupational health has ever been part of the National Health Service. With the benefit of hindsight, I think that we might have done something different there.
Independent evidence of the challenges facing disabled people can be found in an examination of the UK’s report to the UN’s Committee on the Rights of Persons with Disabilities—to which the noble Lord, Lord Low, and the noble Baroness, Lady Jolly, referred—following an investigation under the optional protocol. The committee expressed concerns about extensive evidence which shows that disabled people in the UK face significant challenges to enjoying their rights across all areas of life, including inaccessible housing, transport and information; barriers to achieving justice; inappropriate long-term placements for people with learning disabilities or autism, and the lack of provision for supported decision-making. The briefing from Scope refers to the challenges of accessing social care and employment, and the briefing from Sense refers to the longer-term planning and funding needed for the 1.7 million disabled people supported by their friends and families and the fear of what will happen when family carers are not able to provide that support on an ongoing basis.
Concerns have been raised in particular over three areas of rights for disabled people: an adequate standard of living and social protection, work and employment, and independent living. In my limited time, I want to say something on the first two. As for standards of living, as the noble Lord, Lord Low, mentioned, we now have the benefit of a cumulative impact assessment of tax and benefit changes between 2010 and 2018 commissioned by the EHRC. The conclusion that households with one or more disabled members will face large and disproportionately negative impacts from the changes is to be deprecated, and let us not forget that for most of this period we had a coalition Government who were complicit in these matters. Households with at least one disabled adult and a disabled child could face annual cash losses of more than £6,500.
These changes result mainly from the changes to the benefit system, including the freezing of working-age benefits, changes to disability benefits and reductions in universal credit rates. Concerns should focus not only on the structure of the key benefits—PIP, ESA and universal credit—but on how they are administered. The abolition of working-age DLA and its replacement by PIP was announced without any prior consultation and with the express aim of cutting expenditure by 20%, a deliberate hit on disabled people. We know that the implementation of PIP has been little short of a disaster, with the Government just having had to announce a fifth review of benefits for disabled people to identify those entitled to back payments.
Disability Rights UK, which has been pursuing statistics on the DLA-to-PIP move, reports that half of DLA claimants who were in receipt of the higher mobility rate were refused it on moving to PIP, with many losing their right to join the Motability scheme. The introduction of the 20-metre rule has been particularly damaging. Both PIP and ESA have been bedevilled with poor administration from application to assessment to decision-making and to challenge. Surely it is time to bring it all in-house and not to renew contracts, on a short-term basis or otherwise.
New claimants of ESA have lost entitlement to a work-related activity component. The application of sanctions continues to be problematic and the bedroom tax continues to bite—more than two-thirds of households subject to the tax include a disabled family member. Statistics in the NAO report on universal credit, published recently, reveal that while 20% of initial payments for universal credit claims overall are not made in full and on time, two-thirds of claims involving a limited capability for work element are not. The report also said that overloaded DWP staff are finding it difficult to identify vulnerable claimants, such as those with a mental health condition, for instance, and that the case load for work coaches is set to increase fourfold, and that of managers by sixfold.
If the benefit system is failing disabled people, how are they being helped into employment? The Conservative pledge to halve the disability employment gap has been watered down to getting 1 million more disabled people into work. Perhaps the Minister can tell us how all this is going. Recent figures show that the disability employment gap remains stubbornly at about 30%.
The Work and Pensions Select Committee has pinpointed that funding for specialist employment support for disabled people will fall from about £1 billion under Work Choice and the Work Programme to about half of this over the lifetime of the Work and Health Programme. It seems that the majority of employment support for disabled people will be by general rather than specialist support in the future.
We believe in a social model of disability—a society which strives to remove the barriers that restrict opportunities and choices for disabled people. There is much to do if we are to make progress, given the austerity years. One of the most depressing pieces of information provided in our briefings came from Scope and its new research report, The Disability Perception Gap. It found that negative attitudes and prejudice remain a major problem for disabled people, the data having hardly shifted since 2009. If we could put the same effort into addressing this as we do and have done on Brexit, we might at least make progress in tackling prejudice and discrimination.
The Parliamentary Under-Secretary of State, Department for Work and Pensions (Baroness Buscombe) (Con)
My Lords, let me begin by joining all other noble Lords in congratulating the right reverend Prelate the Bishop of London on her inspirational maiden speech. We look forward to many more contributions from her in the future.
This has been an excellent, thoughtful and—I feel in so many ways—a positive debate. I thank, in particular, the noble Baroness, Lady Thomas, very much for this opportunity for all of us to share information, and indeed to discuss, as she said right at the beginning, a debate that is widely drawn. I want to make it clear straightaway that I shall share this debate with our Minister of State for Disabled People because so many different issues have been raised, and I apologise in advance if I cannot address everyone on the Floor of the House this evening. I make it clear, too, that in those areas that are the responsibility of the Minister for Health or the Minister for the Department for Education, I will make sure that the concerns are passed on.
The Government are fully committed to making sure that disabled people can overcome the barriers they face in their day-to-day lives. With 13.9 million people in the UK—that is 22% of our population—reporting a disability, it is very clear we must do everything we can to break down the barriers so that disabled people can be empowered and achieve their aspirations. There are more than a few disabled role models in this House—both past and present—who have overcome those barriers to achieve great things in their careers. Indeed, as the noble Baroness, Lady Masham shows—I think she has been here even longer than me—it can be done. But this will not happen overnight; there will be no mythical day or year when disabled people will wake up and everything will be accessible and inclusive.
With reference to my noble friend Lady Wyld, we are making real progress and I feel strongly—I am an optimist, of course—that this is generational. Her children will wonder why there is a review. My children, who are older than hers, will feel that too. With an ageing society, where most people acquire a disability as they grow older, this is becoming even more important. We know that currently 45% of people at state pension age have a disability. I say to the noble Lord, Lord Bruce of Bennachie, that we are not separating the young from the old but we need to recognise that different people have different needs and we need to be as bespoke as possible.
Although we have made good progress, we are not complacent and know we all need to do more. This is not just about my department but about every department making sure that their policies and services are accessible and inclusive. Nor is this just about the public sector—the private and third sectors must play their parts as well to ensure that we all live in a country that is accessible and inclusive. We all know that there is no point in building accessible housing if the disabled tenants or owners cannot access the transport system. An accessible transport system does not help if disabled people cannot access their employer’s business or their school, college or university. And how do disabled people spend their money if they cannot access shops, leisure facilities or online services?
Numerous noble Lords raised very good points on a number of issues during this debate. I thank the noble Baroness, Lady Thomas, for raising the important issue of personal independence payment assessments and appeals in this House on 19 June in an Oral Question. I agree with her. We need to be more holistic in our approach, which is why I must commend the hard work that my colleague in another place, Sarah Newton MP, the Minister of State for Disabled People, has been doing to ensure that disabled people can meet their aspirations. I have to tell noble Lords that I have never seen a Minister work so hard.
As my honourable friend announced in May, she is setting up an inter-ministerial group which will drive forward co-ordinated action across government. It will be chaired by the Secretary of State and will focus this Government’s approach to breaking down the barriers that disabled people face. The inter-ministerial group will ensure that disabled people are at the centre of decisions that are made about their lives. We will be reinvigorating the way we work with disabled people and their representatives to inform the IMG. We are keen to ensure that more disabled people can be involved and we are exploring how we can maximise the use of technology to reach every region in England.
My noble friend Lady Wyld made the excellent point that diversity and inclusion make for better and inclusive decision-making across all protected characteristics. Since the 2012 Paralympic Games, we have seen a marked increase in disabled people on television in drama, comedy and current affairs. But it is not only visible impairments that are being discussed—Susan Calman’s “Mrs Brightside” podcast discusses depression, for example. The old attitudes that disabled people face are being eroded, albeit not as fast as we would all wish.
The next area to see an increase in participation for disabled people will be public appointments. I am pleased that my noble friend Lord Holmes will be using his vast knowledge and expertise to lead the review that will make recommendations on how to encourage more disabled people to apply for public appointments. This was a point also raised by noble friend Lady Wyld. Inclusive leadership is not just about our own country, but sharing that leadership with countries that have not achieved the level of access and inclusion we have achieved so far, a point made by my noble friend Lord Shinkwin. The Secretary of State for International Development will be hosting a global summit to galvanise the global effort to address disability inclusion in the world’s poorest countries.
A number of noble Lords asked what the Government have done to improve access for disabled people. This Government understand that to achieve real access and inclusion, departments need to work together where their interests overlap. We have set up the Work and Health Unit, a joint venture between the Department of Health and Social Care and my department. Its aim is to create a society where everyone is ambitious for disabled people in respect of work and to understand and act positively upon the important relationship between health and work, something that was touched on by a number of noble Lords and most particularly the noble Lord, Lord Luce. We published the Improving Lives Command Paper in November 2017. We have set a target of 1 million more disabled people in employment by 2027 and we really mean to meet that target.
The number of working-age disabled people in employment in the UK reached around 3.5 million in the second quarter of 2017. This was an increase of 104,000 since the second quarter of 2016 and an overall increase of nearly 600,000 since the second quarter of 2013, when the series started. I say to the noble Lord, Lord McKenzie, that I disagree entirely; we are not failing the disabled community. We are working to support disabled people to stay in work as well as supporting them into employment. We are prioritising interventions on mental health and musculo- skeletal conditions.
So many points were raised around the whole issue of learning disabilities, most notably by the noble Baroness, Lady Jolly, who spoke with real authority on the subject. We are encouraged by the early evidence of the impact of the implementation of our SEN reforms, improving the lives of children and young people with learning disabilities. But we are not complacent—far from it. There is much more to do and we are committed to seeing this through. As the SEN reforms continue, we are confident that they will make a significant difference to the life chances of children and young people with special educational needs. The noble Baroness referred to Easyread documents. Where appropriate, we provide these, but I will take back her concerns on the extent to which such documents are available.
The noble Baroness also referred to hate crime, as did my noble friend Lady Eaton in her passionate speech, which presented a different angle but one of equal importance with regard to this issue. I will certainly ensure that we look at what the Ruderman Family Foundation is doing to help people from different communities who also happen to have a disability, if I may put it that way. It is a double challenge that we need to confront. In terms of hate crime itself, we launched an action plan in July 2016 with five different criteria. Those criteria are Home Office-led and I understand that they will be refreshed with the hate crime action plan in 2018. We will work closely with our wide network of stakeholders to make sure that the action plan remains fit for purpose, is cross-governmental and absolutely respects those issues raised by noble Lords today.
I also listened with care to what the noble Lord, Lord Patel, had to say about the tough issue of care of children with life-threatening illnesses in hospices. I assure him that I will pass his questions and concerns to my noble friend Lord O’Shaughnessy, Minister for Health. The noble Baroness, Lady Brinton, also raised these issues. I am sure my noble friend will want to respond in writing, as will my noble friend the Minister for Education, on some of the issues raised by other noble Lords.
With reference to the speech by the noble Baroness, Lady Uddin, I have enormous sympathy—which I am sure all noble Lords will share—for her son and the appalling experience he endured. I am glad that, since that time 20 years ago, we have introduced—as the noble Baroness will well know—strong safeguarding measures across the public, private and third sectors. But of course, there is always more that we can do.
I turn now to the question from the noble Lord, Lord Luce, about progress on the evaluation that my department commissioned on the Fit for Work service. On 21 June, we published a report online presenting findings from the evaluation. We remain committed to that and will use our learning from Fit for Work to inform our thinking. We are also working closely with the new occupational health expert group established this year. This group is chaired by Professor Gina Radford and consists of clinicians, employers groups, academics and representatives of charities. My officials would be pleased to discuss this work further with the noble Lord.
One might ask what the point of having a job is if you cannot get to work. The Department for Transport consulted on a draft accessibility action plan last year and will publish an inclusive transport strategy later this year. It will set out our key policy and investment priorities for improving disabled people’s access to transport. This document will also confirm our timeframes and proposals for monitoring delivery.
Since 2006, around 200 railway stations have been made step-free, and 75% of rail journeys are now through step-free stations. This compares to only 50% in 2005. I am looking to the noble Baroness, Lady Ludford; I hope she and her husband will accept that this is progress. It is not perfect, but it is progress. Where toilets are provided on a train, an accessible toilet that meets the requirements of modern accessibility standards needs to be provided by 31 December 2019.
The noble Baroness, Lady Masham, referred to the blue badge. We consulted on introducing new blue badge eligibility criteria for people with hidden disabilities. The Department for Transport is currently considering the responses.
Before we can get to work, we need to be able to get out of our home and move into the built environment, a subject covered by a number of noble Lords. The Government’s National Planning Policy Framework, which is currently being revised, defines “inclusive design” as:
“Designing the built environment, including buildings and their surrounding spaces, to ensure that they can be accessed and used by everyone”.
However, the Government understand the concerns visually impaired people have about navigating around shared spaces. The Chartered Institution of Highways and Transportation’s review of shared space was published in January this year, and we are considering its recommendations.
We launched the Built Environment Professional Education Project in 2013, which was inspired by the 2012 Paralympic Games—the most accessible Games ever. The aim of the project is to make inclusive design an important part of the education and training of built environment professionals. To ensure a smooth transition from a Government-driven project to an industry-owned and led project, in 2016-17 the Construction Industry Council assumed responsibility for the project, but this Government are not just about new initiatives; they are also about improving what is already being done. An example of this is disabled students’ allowances, where we have commissioned an evaluation to seek disabled students’ views on support received from DSAs, as well as views from the higher education providers. This evaluation will report later this summer.
We are committed to ensuring that our welfare system is a strong safety net for those who need it. That is why we are spending £54 billion this year, noted by my noble friend Lord Shinkwin, on supporting disabled people and those with health conditions. That is a real-terms increase of £10 billion since 2009-10. This is around 2.5% of GDP and over 6% of all Government spending—up more than £7 billion in real terms since 2010.
We have also increased the amount of help an individual may receive from Access to Work. This is important in relation to some of the concerns raised by noble Lords. It depends on their individual needs and personal circumstances, but an individual can now have up to a maximum of £57,200 a year, which is an increase from £42,100 in April 2017. The grant is in addition to the Motability scheme and all other disability benefits. In September 2016 we launched the Access to Work digital service, so people can now apply online. In addition, we are continuing to develop our online offer and have introduced other channels to improve accessibility, for example through video relay service to assist BSL users.
I say to the noble Lord, Lord Bruce of Bennachie, that the Government are committed to ensuring that deaf people are enabled to fulfil their potential and play a full role in society. We fully support initiatives aimed at improving understanding of the needs of deaf people, giving them more say in how they access services and how the barriers they face can be removed or overcome. Deaf people are the largest group of customers supported by the Access to Work grant and their awards in general tend to be higher than those of other groups.
Technology has moved on. There are solutions that help both deaf and deafened people. Those in the deaf community have always been early adopters of new technology, email phones and video phones, as referenced by both the noble Lord, Lord Bruce, and also my noble friend Lord Borwick. The video relay service is an easy option for service providers to communicate with their deaf customers where that is reasonable. But we must not forget that in the deafened community, the majority of people with a hearing impairment are elderly, and that for the most part they do not use sign language. They need adjustments such as lip-speakers, speech to text, or note takers.
The noble Lord, Lord Addington, and other noble Lords, referenced technological solutions, which will continue to break down barriers, not only for the deaf community but for other impairment groups as well. We know about help for the visually impaired to navigate the London Underground, such as Wayfindr, and about Microsoft Seeing AI, which can read text and tell the user what is going on and can be downloaded by anyone.
But technology is not the only way: business can break down barriers. The Government continue to work with business to increase our understanding. The Disability Confident programme is part of that. We are challenging employers’ attitudes to disability, removing the barriers and ensuring that disabled people have opportunities to realise their aspirations. We are working with employers in this way to ensure a substantial contribution towards seeing 1 million more disabled people in work. Over 70% of local authorities are Disability Confident. The Government are leading by example: all main government departments have now received Disability Confident leader status. I could list a number of well-known companies that are already very supportive. However, the Government understand that disabled people still face innumerable barriers, and yes, the Government will continue to break those barriers down and drive all the sectors to do the same.
Several noble Lords, and in particular my noble friend Lord Holmes and the right reverend Prelate the Bishop of London, mentioned the Paralympics, as I did a few months ago. One of my proudest moments was representing Her Majesty’s Government at the Paralympics this year in South Korea. Indeed, I gave up trying to contain myself when the mother of one of our seven gold medallists hugged me and thanked me for being there. I was privileged to be there. Sport is one of the most brilliant catalysts for overcoming barriers.
The Government understand that there will always be more to be done, always another item on the access and inclusion shopping list. The Government will continue to take responsibility, working through that list. We understand that there will always be people who do not think that access and inclusion is happening quickly enough. Indeed, in contrast, at the Department for Work and Pensions we are lucky enough to share a brilliant special adviser with No. 10, Jean-Andre. He happens to have cerebral palsy, and he is ensuring that we constantly question, so that the list of what to do and what to do better is assessed.
In conclusion, the Government will continue to work with the public, private and third sectors to keep breaking down barriers until everyone, whether disabled or non-disabled, can participate in their community and aspire to and achieve their life goals. One of the most important words used in this entire debate is “talent”. There is plenty out there, and we want to make sure that we involve everyone with talent.
Baroness Thomas of Winchester
My Lords, this has been a most interesting debate, and I thank all noble Lords for getting across so much in such a short time. I warmly congratulate the right reverend Prelate the Bishop of London on her most impressive maiden speech, and I thank the Minister for her reply to the debate. I look forward to opportunities for us to continue the conversation about many of these challenges in the coming months.