Disabled People

Baroness Browning Excerpts

Thursday 9th May 2019 Lords Chamber

[Baroness Browning (Con)]

My Lords, I congratulate my noble friend Lord Borwick on bringing this very important debate to the Chamber today. I am very pleased to follow the noble Lord, Lord Addington. The point that he made about the breadth of disability is very important because, for many people born with a disability, it will impact on them for their whole life. People might become disabled due to disease or accident, and then there is the frailty of old age. We must not forget parity of esteem and make sure that we recognise mental health and cognitive impairments, which sometimes also link to a physical disability. Therefore, it is a broad spectrum.

I welcome the prospect of what artificial intelligence will bring to that very wide and diverse group. Medical genetics, biopharmaceuticals and personalised healthcare offer us all—particularly those in the disability group—an opportunity for increased support and, in some cases, even a cure. But we should not focus only on machines and technology; as has already been mentioned, people are involved in caring for other people with a disability. We must make sure that people are at the forefront: people who are properly trained, who understand the nature of the disability, and—if I may say so—who are rewarded in an appropriate way for the important work that they do.

I want to talk about money—I know it is vulgar but I will do it, even in the House of Lords—and by that I mean money from the Government and money that people contribute personally to disability care costs. I shall speak first about money from the Government. Yesterday, the Alzheimer’s Society, of which I must declare I am a vice-president, announced that it believed the Government should provide a dementia fund for people with a diagnosis of dementia. People living with dementia face higher charges for care than those with other conditions, many of which allow for free care on the NHS. This is due to a lack of social care funding.

No one should face increased costs from developing dementia. Through the Green Paper on social care, which we are yet to see, the Government must ensure that people with dementia no longer face a disproportionate financial responsibility just because of the condition that they have developed. It is a disease. There are 850,000 people living with dementia in the UK, and that figure is expected to rise to more than a million within the next two years. The progression is rapid. The system of support for people living with dementia is unfair, unsustainable and in need of a long-term overhaul to ensure that they receive affordable, high-quality and appropriate care. Despite living with a health condition just like people with cancer or diabetes, people with dementia get most of their support from the social care system and do not receive most of it free at the point of use.

According to research by the Alzheimer’s Society, people with dementia typically pay £100,000 in care costs, with 15% to 20% higher costs than people without a complex condition, and in some cases more. There were 70,000 avoidable hospital admissions of people with dementia in 2016-17; this represents an increase of 70% in the last five years. Although the Alzheimer’s Society is looking to the Government to provide a dementia fund, noble Lords can therefore see that adequate provision would create savings throughout the health and social care system. Training for those in adult social care who interact with people with dementia is also really not up to par; it is not up to tier 2 of the dementia training standards framework. I hope that will be addressed when we eventually see the Green Paper.

Dementia costs the UK economy £26.3 billion per year, an average of £32,250 per person; that is enough to pay the energy bills of every household in the country for a year. But the people affected by dementia shoulder over £17 billion of care costs—an extraordinary amount that represents two-thirds of the total costs. It would take someone around 125 years to save for their dementia care costs if they saved at the same rate as for their pension. There is a need for the Government to consider very seriously this request from the Alzheimer’s Society for a dementia fund that will assist with increased training and the financial costs that the public bear.

The other area I want to touch on is money and the individual. All Governments, of all persuasions, in recent years have failed to take the opportunity that the tax system could offer to those with dependants who have a disability.

We can talk about many issues here. I declare an interest as a vice-president of the National Autistic Society, and I have raised the subject of autism on the Floor of both Houses for many years. I have a very personal family interest in the subject. Regarding autism or any other disability, we spend a lot of time talking about education, social care and getting into employment, all of which are incredibly important, but when you talk to parents of a child with a lifelong disability you find that the one thing that haunts them is, “What happens to that child when I am no longer here?” It does not matter if the child is four or 40.

There are parents around the country whose children, including adult children, have many different disabilities, and they would quite willingly make provision for their child in their own lifetime, to make sure that that child or dependant was able to survive to a more suitable standard of living and in a more sustained way when their parents were gone. Yet we have inheritance tax rules in this country which have said for decades that under the lifetime gifts rules you can gift only £3,000 per year, and even if you are able to make a substantial gift to a child to make provision for them for later on, you have the difficulty of the seven-year rule. I know there are trusts. I have looked at trusts; I have spent a lifetime studying them, and I have to say that solicitors do very well out of them. I will say no more than that. Sorry, I am looking at one or two lawyers around the Chamber. Some are nodding. How very honest of them.

When the Government look at inheritance tax and taxation generally, could they please look at people with responsibilities for disability? Can we not change the rules so that such people are not penalised, but are able to take the opportunity to use money that they themselves have earned to make provision? Many of them are very willing to do so.