Assisted Dying Bill [HL]

Lord McKenzie of Luton Excerpts

2nd reading
Friday 22nd October 2021 Lords Chamber

[Lord McKenzie of Luton (Lab)]

My Lords, with over 100 speakers down, the Bill has had a good airing. I supported the Bill on its previous outings and do so again today. I congratulate the noble Baroness, Lady Meacher, not only on her approach to the issue but on how it is encapsulated in the Bill.

We look forward to understanding the issues the noble Baroness is looking to raise in Committee. For those who doubt the intentions of the noble Baroness so far as disabled people are concerned, I invite them to look at her record and the welfare reform discussions with the previous Labour Government.

I will refer to one personal issue as an illustration. Some 18 months ago I was diagnosed with pulmonary fibrosis—I think the noble Lord, Lord Leigh, referred to that. It is a respiratory disease with no current cure and, for most, no known cause. What I am very clear about is that the noble Baroness, Lady Meacher, has given us a choice as to how we proceed, protected by a range of stipulations. I hope yet to live to an old age and to confound my pension providers. I also hope that medical science will continue to flourish and produce new solutions to changing problems so that we no longer focus just on death, but on life afterwards.

Mesothelioma

Lord McKenzie of Luton Excerpts

Tuesday 9th December 2014 Lords Chamber

[Lord Faulks]

The position with insurers is that they have provided money. I will have to write to both noble Lords and the right reverend Prelate about what has happened to that particular sum. The question of the use of research funds is difficult. We think that research funds should be spent in the most effective way, and we think that publicly funding research is much more appropriate than hypothecating against insurers’ particular sums.

[Lord McKenzie of Luton (Lab)]

My Lords, would the Minister accept that throughout our deliberations on the Mesothelioma Bill the focus was on a 3% levy? It was 3% because the insurance industry insisted that beyond that it would have to be passed to consumers. By implication, if the levy is now 2.2%, presumably that falls into the pocket of the insurance companies at a time when compensation is not being paid at a 100% level, and, as has been asserted, there is insufficient funding for research.

[Lord Faulks]

It is absolutely not the case that there is insufficient funding for research. As I have said more than once, the case is that, at the moment, there is not a suitable number of applications for research. The funding is very much there. As to any question of insurers making some profit out of this, I will look into that. It is contrary to what the Government wish to achieve.

Public Bodies Bill [HL]

Lord McKenzie of Luton Excerpts

Tuesday 11th January 2011 Lords Chamber

Moved by

[Lord McKenzie of Luton]

33: Schedule 1, page 16, line 26, leave out “Disability Living Allowance Advisory Board.”

[Lord McKenzie of Luton]

My Lords, I shall also speak to Amendment 34. These two amendments start life as probing amendments. They in effect seek further information about the proposed demise of the Disabled Persons Transport Advisory Committee and the Disability Living Allowance Advisory Board. For the former, the October 2010 announcement merely recorded that the Government are exploring options for continuing to gain the disability advice that is needed through a more flexible, accountable structure. For the latter, it is proposed that the functions can be carried out between the DWP, external specialist advice and Equality 2025. It seems that in respect of these two particular organisations, the decision has already been taken that they will be terminated. What is to go in their place is as yet unclear.

We are promised consultation on the successor to DPTAC. Perhaps the Minister will advise us on the exploration of the options and on what precisely is so inflexible about the current arrangements. One complaint about the current structure that seems to drive the proposed change is that DPTAC has a degree of independence and takes forward areas of work that reflect its own priorities and not necessarily those of the Government. This seems a particularly perverse reason to close it down. Surely this is a case where independence should be welcomed. DPTAC can rightly claim that much of the improvement over the past 20 years in the mobility of disabled people can be traced to the work that it has undertaken.

The Minister will be aware that DPTAC started life as an informal group and, because of its success, was placed on a statutory basis in 1985 by a Conservative Government. The Transport Act of that year requires the organisation to consider any matter referred to it by Transport Ministers, and to give advice on any issue that is relevant to the transport needs of disabled people.

I am advised that DPTAC also has statutory functions through other legislation. For example, the Equality Act requires the Secretary of State for Transport to consult it before making rail vehicle accessibility regulations. Who will be consulted in future when such regulations are made? Has the Minister given equivalent consideration to other duties that are currently imposed by statute? I thought that we had common cause with the Government in recognising that disabled people were experts in their own lives. How will the Government ensure that their voices are not drowned out by those of transport providers?

The Minister will be aware that DPTAC publishes guidance and statements, carries out research into disabled people's experiences, promotes accessible transport and solutions, and develops training. Who will do this in future and where will the funding come from? I will give one example. The DPTAC Olympic working group has been working closely with the delivery authorities on an accessible transport system for the Olympic and Paralympic Games in 2012. Why is it imperative that this should be changed now? Big strides have been made over the past decade towards more accessible public transport. Rights of access to public transport are in place, along with end dates for the accessibility of all buses, coaches and trains, and a new EU directive on access to air travel for disabled people.

However, the Royal Association for Disability and Rehabilitation contends that a major investment in accessible transport has not yet been matched by a major increase in disabled people's confidence in getting out and about. It states that there remains a huge amount of awareness-raising to be done and some gaps in the regulatory framework to be plugged, for example around taxes. It states that, despite considerable progress, the building blocks are not fully in place to deliver a truly integrated system that guarantees independent, safe mobility. Such a system is vital for ensuring that disabled people have proper access to services and jobs. RADAR acknowledges that DPTAC has greatly influenced progress to date and that there is a great need for its role in future. The loss of an independent voice will need considerable justification by the Minister if we are not to return to this on Report.

The Disability Living Allowance Advisory Board was set up in 1991—again by a Conservative Government. Its statutory role is to give advice on request to the Secretary of State for Work and Pensions, to advise medical professionals working for the DWP on cases as and when requested, and to produce annual reports. The board draws members from across the health and social care field and must include at least six disabled people. The Government's justification for its demise is that they now have available to them a number of sources of advice, including medical practitioners and experts in the disability field such as Equality 2025. We acknowledge that. They suggest that the board has not been commissioned to provide any advice since November 2008 and that this position is likely to continue. One presumes on this basis that the board is not being consulted on reform of the DLA.

As we know, the Government propose to introduce the replacement to the DLA—the personal independence payment—in 2013-14, and will start with a reassessment of the working age case load. It is proposed that there will be no automatic entitlement to the PIP, and each case will be looked at individually to consider the impact of the impairment or health condition. Key to the benefit will be an objective assessment of individual need, which is being developed in collaboration with a group of independent specialists in health, social care and disability, including disabled people. Does not this description fit the Disability Living Allowance Advisory Board? Are you not in danger of removing it from the scene at the very point when its expertise might be brought to bear in aid of government policy?

It is accepted that the Government have sought to involve a wide range of individuals and organisations in the consultation, and that is how it should be, although the Minister might explain why the consultation period is shorter than the recommended 12 weeks and included the Christmas and new year breaks. Although we hold no particular brief for the board—it might perhaps be refreshed rather than terminated—we are entitled to ask the Government what mechanisms they will put in place to ensure that disabled people and experts working in health and social care can monitor the implementation of the new arrangements and provide independent advice to ensure that the descriptors are accurate and relevant, that the process will be fair for disabled people, and that assessments are carried out by appropriately qualified individuals with capable and confident decision-makers—in other words, learning the lessons of the ESA.

Now is not the time for a detailed debate on the proposals to reform the DLA other than to say that we will examine the detail of the final proposals specifically to see that they maintain the principles of a universal benefit that recognises the additional cost of living for someone with a disability and supports those who can work as well as those who cannot, and that disabled people are fully involved in the design of the gateway. We accept that the Government have made clear that they accept their obligations under the UN Convention on the Rights of Persons with Disabilities to consult disabled people in the design and monitoring of decisions and policies affecting disabled people.

However, the removal of the mobility component of the DLA for people living in residential care has increased apprehension in the disabled community that the thrust of policy has more to do with budget cuts than with the modernisation of support for disabled people. Removing this disability component will have a huge and regressive impact on the independence of thousands of disabled people, with many left unable to afford to leave their homes and denied the independence that most people take for granted.

Appropriate advice from the advisory board on this proposal would have made it abundantly clear up front the damage that it would inflict. Promise of a full consultation after the announcement and before implementation will not do much to allay the fears of some 80,000 people whose lives will be impaired if this proceeds. If the advisory board is to go, what will replace it? How will the independent knowledge and expertise of disabled people and others be systematically brought to bear in shaping and monitoring government policy. I beg to move.

[Baroness Turner of Camden]

My Lords, I support my noble friend’s amendments and speak as someone with recent experience of the situation. I was disabled for six months and realised in that time how difficult life can be if you do not have mobility. It is often difficult to move outside your own front door, to do your shopping, or to come to this place, which I like to do. You rely entirely on the services available to enable you to go outside your front door. Unless there is a body to see that the facilities you need are available, many disabled people will simply be prisoners in their own homes.

This is an increasing problem, because, as we get older, more of us become disabled. I hope that I am not permanently disabled, but I do not know whether I will be. It is certainly a difficult life. It is no longer possible to pop round to the shops or to post a letter. You are entirely dependent on the support provided by other people. I am fortunate in that I have some very good neighbours and some very good friends, but not everyone is in that situation. There is no doubt that an increasing number of people can find themselves simply unable to move outside their front door.

We need to maintain bodies of the kind that is referred to here to ensure that the facilities that are available are maintained, because a lot of them are provided by local authorities and, as we all know if we have read some of the material issued by the Government, local authorities will have their financial resources cut. Will they be able to maintain some of the excellent services that exist in many places? We want to ensure that the services that we have are available and are improved so that many people are not simply unable to utilise services that ought to be available because the finance is not there. What will be done if those two bodies disappear? They should not disappear. It is evident that they have done a lot of work already to maintain services. We want the services to be improved. Please keep them and ensure that they are available to us.

--- Later in debate ---

[Lord Freud]

I ought to respond to that, especially to the creator of the board. The core point is that these advisory bodies are rather narrowly focused and we are now looking at a much wider set of obligations and a much wider capacity. We have the Office for Disability Issues, which was never thought of in the 1990s. That provides a whole range of channels into the community that did not exist. We are talking about moving from a narrowly focused piece of advice to a much wider set of interchanges with the disabled community. My noble friend was right. This has not been done for monetary reasons, but to reflect the world that we live in and to get advice on the broadest possible scale in the right way when we need it.

[Lord McKenzie of Luton]

My Lords, I am grateful to all noble Lords who spoke in this short but well informed debate. I am doubly grateful to the noble Lord, Lord Newton. I said when I introduced these amendments that I did not propose to press them today and I do not, but he has given me special food for thought when we come to Report. Like the noble Lord, Lord Newton, I was not totally convinced by the Minister's response although as ever he did a sterling job trying to hold the government line.

To summarise the contributions of all noble Lords other than the Minister, I say that they recognised the importance of hearing the voices of disabled people in these situations and not just a lone voice—a point made by the noble Lord, Lord Low. We need to hear about the full range of issues that disabled people face. We heard about the importance of an independent voice, as the noble Lord, Lord Newton, said—not just speaking when you are spoken to and asked a question. There needs to be an independent means for people to input. I agree with that point about not just responding when you are asked a question.

Each noble Lord who spoke did so from a particular standpoint. My noble friend Lady Turner spoke of her own challenges with mobility in recent times. She raised the issue of local authorities and the Minister reminded us of the equality duties imposed on local authorities. We have to recognise that the financial constraints currently imposed on local authorities are draconian—the worst they have faced for decades. That provides them with challenges.

I was not aware that the noble Lord, Lord Newton, was the creator of the DLA and DPTAC that we are discussing today. To date, before his Government’s measures, they have stood the test of time. We are not opposed to a recasting of DLA. I mentioned in my presentation the sort of issues we look to come out of the review. My noble friend Lord Knight of Weymouth raised some important issues. On the timing, I am delighted that DPTAC will at least outlast the 2012 Olympic Games. That is to be welcomed.

The other general theme on which all noble Lords focused was that of knowing, if you are going to get rid of something, what is going in its place. We had one veil lifted this afternoon in relation to the advisory board and the engagement on the recasting of DLA, although the noble Lord, Lord Low, rightly pointed out some of the problems with the consultation. If the input the Government are now getting is, as they argue, so important, valuable and different that it displaces the advisory board and DPTAC, how have they ended up with this huge challenge around the mobility component of DLA and the need to revisit and revise the numbers? There is an inconsistency in the Minister’s argument.

Prompted by the question on cost of my noble friend Lord Knight, the noble Lord, Lord Newton, said that if something costs nothing then we do not need to spend money on putting something in its place. We can get advice for free so why change it? I acknowledge the role of the ODI and the new engagement that it has brought to the whole issue of dealing with disabled people and their challenges. However, that in itself is not a reason for doing away with these bodies, particularly DPTAC. I was not aware of the issue raised by the noble Lord, Lord Low, about the Department for Transport having just one person along to their bus advisory board. How can that one person possibly represent the full range of issues faced by disabled people needing to access public transport and buses in particular?

There are some issues there that the Government need to be clearer on if we are not to take forward at least one of these amendments on Report. For the time being, I beg leave to withdraw Amendment 33 but we need to look at the record of this debate and think seriously about what we will do on Report.

Amendment 33 withdrawn.