Care Bill [Lords]

Tom Clarke Excerpts

Monday 16th December 2013 Commons Chamber

[Mr Tom Clarke (Coatbridge, Chryston and Bellshill) (Lab)]

I apologise for not having been in the Chamber for most of the debate, Mr Deputy Speaker, because of other parliamentary activities. I have found the speeches that I have listened to of enormous interest and I wanted to speak in the debate given that I am the co-chair, with Lord Rix, of the all-party group on learning disability.

I felt I owed it to Mencap and the Care and Support Alliance to, at the very least, bring out some of the points that were made in the other place, not least by Lord Rix and Baroness Hollins. Those points are dear to me, as I followed the debates in the other place carefully. I welcome the fact that we have a Bill and that we are having debates. I do not want to be too critical of the Government—not just because it is the festive season—but we have talked about many of these issues for a long time. When I read what was said in the other place, I reflected that when we talk about carers we all share compassion for and concern about their role, but that that has been the case for as long as I have been a Member of this House. I can understand that some carers are perhaps becoming a little sceptical and cynical and if we can do something about the Bill, that might perhaps help us along the way.

Above all, I want to speak about advocacy. In the Lords, the Government tabled welcome amendments that introduced a right to advocacy in respect of social care assessments and for some of those involved in safeguarding inquiries for some people. That has the potential hugely to improve the process for people who would otherwise struggle to be involved in the assessment and care planning process. It also provides real rights and protection for those who are suffering abuse such as that at Winterbourne View and Mid Staffordshire, and I hope to have time to return to that later.

Furthermore the measure builds, if I may say so, on the principles of the Act that I was privileged to pilot through this House, the Disabled Persons (Services, Consultation and Representation) Act 1986. Those who are still around from that period will recall that advocacy was at the heart of what the Act sought to achieve. The demand for that advocacy is still there today. Advocates support people to articulate their needs and to make informed choices, and they make the process less intimidating. They support planning and reviewing care and help people to speak out if they are dissatisfied with care or when safeguarding issues arise.

Those who receive the support of an advocate will undoubtedly be better able to engage with the range of professionals and service providers with which they come into contact, and as a result they are more likely to experience positive outcomes. Although the Government’s amendments were welcome, we seek clarity in a number of areas. I know that this view is shared by Mencap and many other organisations, although I do not necessarily speak for all of them.

The Bill deals with facilitating involvement, for example. The clause on advocacy and safeguarding states:

“The relevant local authority must…arrange for a person who is independent of the authority (an ‘independent advocate‘) to be available...for the purpose of facilitating his or her involvement in the enquiry or review”.

It is not clear what

“facilitating his or her involvement in the enquiry or review”

means and whether it is constrained in any way or subject to some form of arbitrary decision. Perhaps the Minister might clarify that tonight.

Timely advocacy at the start of safeguarding inquiries seems to me to be essential. There have been countless examples of serious abuse and neglect affecting people with a learning disability which have been overlooked for a host of reasons. It is vital, therefore, that a person with a learning disability receives the support of an advocate at the early stages of a concern being raised, and local authorities must take this into consideration. Mencap is concerned that the local authority needs to arrange advocacy only if it is not satisfied that there is an appropriate person to represent and support the adult with a learning disability. It would like assurances from the Minister that this will not become a default position for family or friends.

Some family members may in some cases have the skills and the background to be an effective advocate and may wish to do so. Others, however, will be unable or unwilling to do so, and Mencap thinks it would be highly inappropriate if those family members felt pressurised so to do. Good advocacy is delivered by individuals skilled and knowledgeable in delivering appropriate, independent and empowering advocacy, and the local authority should ensure that this is the case.

I turn to the issue of abuse. Some time ago, after the Winterbourne report, I secured a debate in Westminster Hall and I am very glad that that matter was then discussed. As the Bill makes its way through the House, we have to deal specifically with the definition of abuse. The Bill needs to be strengthened. Only financial abuse appears and is defined on the face of the Bill. This seems to give prominence to one form of abuse, although others clearly take place. Lord Rix and Baroness Hollins tabled amendments in another place which sought to strengthen the clause and include other forms of abuse, such as neglect, which we know is more prevalent, and also physical, sexual and psychological abuse and so on.

Responding in another place, the Minister felt that abuse was a commonly understood definition and that defining it further in the Bill might restrict the scope of local authorities’ duty to inquire. Although Lord Rix agreed with the argument that a long, exhaustive list would be unreasonable, he said surely we must ensure that

“local authorities do not suddenly think that only financial abuse is to be considered when they look at this Bill”.—[Official Report, House of Lords, 14 October 2013; Vol. 748, c. 341.]

I believe that reference only to financial abuse is unbalanced and critically makes other forms of abuse appear less relevant or important. Again, recalling the recent institutional abuse and neglect highlighted by Winterbourne View, Mid Staffs and the confidential inquiry into the premature deaths of people with a learning disability, it is crucial that other forms of abuse are set out in the Bill. They may be covered by guidance, but evidence has shown that this has not protected people with a learning disability who may well be subject to multiple abuses. I agree with the Government that an exhaustive list might be wrong and difficult to defend. However, the Bill should be amended to include reference to physical, sexual and psychological abuse, as well as neglect. It can make further reference to “other as guidance may specify”.

I am delighted to have had the opportunity to take part in the debate. We have a lot of work to do. I have great regard for the Minister who is responsible for the Bill and I think he will do a very good job, but when we look at issues like assessment, choice and the rest, we must remember that we have given promises before and we have given commitments. This time we all hope they will be real and meaningful.