I beg to move,
That this House welcomes the intention of Her Majesty's Government to introduce a Bill to improve the arrangements for the industrial rehabilitation, training and resettlement of disabled persons; and urges Her Majesty's Government to base its proposals on the major recommendations of the Piercy Committee and of other bodies concerned with the welfare of handicapped persons.
The reference that I have made to the intentions of the Government in the matter of further services for the disabled were contained in Her Majesty's Gracious Speech when she opened this Session of Parliament. Her Majesty then said:
A Bill will be introduced to improve the arrangements for the industrial rehabilitation, training and resettlement of disabled persons."—[OFFICIAL REPORT, 5th November, 1957; Vol. 577, c. 6.]
The Motion goes further than that statement. Its purpose is embodied in its second half, which urges Her Majesty's Government, not only in regard to the proposals that they are ready or prepared to lay before Parliament for the industrial rehabilitation and resettlement of disabled persons but in any further proposals or administrative arrangements which they may make in the development of those services, to take cognisance of the recommendations of the Piercy Committee and also of other bodies concerned with the welfare of the handicapped. I hope that in that context the Minister will be prepared to accept the Motion.
The bodies which are concerned are the great voluntary bodies, the local authorities and, indeed, all those who are closely and intimately concerned with the health and welfare of handicapped persons. I would point out that I use the words "handicapped" and "disabled" to cover the same ground. As the House will be aware, it is generally the custom of the Ministry of Labour to use the word "disabled" and of the Ministry of Health to use the word "handicapped." I have never been able to understand why there should be that difference. Broadly speaking, I believe that the words mean the same thing.
I have a great deal of sympathy with the Parliamentary Secretary to the Ministry of Labour, who, I understand, is to wind up the debate, because I am aware that the terms of the Motion cover a field which is not entirely his responsibility. In fact, as I have said, the welfare, training and resettlement of the disabled is spread over a whole range of Government Departments. In the Gracious Speech there is no mention of the word "welfare"—upon which subject I should like to say a few words later—nor is there any reference to professional, higher technological or commercial training.
As I have said, these responsibilities for the care of the handicapped range over a number of Departments. It is not my intention, nor, I imagine, the intention of any hon. Members who engage in this debate, to relate this problem to geriatrics. The hon. Member for Canterbury (Mr. L. Thomas) a fortnight ago, in a very able presentation of the case for the aged, met with a very warm response from the Minister of Health, and I am hoping that the right hon. Gentleman will respond in a similar way today. Nor do I propose to touch on mental handicap because, as we all know, the Royal Commission, under the chairmanship of Lord Percy, has issued its Report and I am hoping the House will have a later opportunity to discuss that very momentous and important document.
I feel privileged, and, indeed, very humble, to have the opportunity to move this Motion. It is the result of the first Ballot that I have won ever since I have been in the House, and I could not believe that I had won it when I heard my name called. I suppose that, being Friday the 13th, this is my lucky, or, possibly, my unlucky, day; I do not know.
I think I should declare a personal interest—not a financial one—because I was alarmed to discover that it is just fifty years since I started my career, if I might elevate it to that term, among the disabled as a young assistant master in a blind school in south London. Since then, great progress has been made, but the problems are just the same. One is tempted to be a little nostalgic. One can look with a certain amount of pride at the developments which have occurred in our attitude towards, and our achievement in connection with, handicapped persons. The need is the same, namely, the full development of the potentialities of the disabled.
We have seen a major change of emphasis. We owe a great deal to the voluntary societies which, over many centuries, have played such an important part in the care of the handicapped. The Church has played a great part, too, and during this century we have seen the change of responsibility from the voluntary societies to the State. It is a natural development not only in this country but in other countries. Of course, the great landmark was the Blind Persons Act, 1920, which placed firmly on the State, acting through the local authorities, of course, the responsibility of looking after blind people.
That was a great achievement in the march of social welfare. It was brought about very largely by the devotion and the drive of blind persons themselves. I have been fortunate—indeed, honoured—to know very many of them. But I think we can say that it took war to find the potential of disabled persons. During the last war, when we scraped the barrel for manpower, it was Mr. Ernest Bevin who saw the possibility of mobilising what had been up to that time power that was not understood and had not been assimilated or assembled. The result of this work was the great Disabled Persons (Employment) Act, 1944, another great charter, with which we always associate the name of the well beloved George Tomlinson.
All this time in the development of social services we have had to contend with the circumstance that affects us all, namely the need to find adequate resources. It seems to me that there is never a time when we have enough money to do the things that we ought to do. We seem to have a lot of money for the things that we ought not to be doing. But that, of course, is a matter of opinion. It is perfectly true that some of the services attract huge sums from charitably-minded people of good will, but that seems to me to be a rather transitory and not entirely reliable source. We hope for the time when we shall be able to rely upon sufficient resources to finance all these developments that we have in mind.
In the charitable field there is fierce competition. There is hardly any part of our national life in which the competition to encourage the good will and help of well-disposed persons is so great as in the attraction of charitable funds. Some charities attract huge sums—and good luck to them—but it seems to me a pity that a great many of the societies that do equally good work in other fields, and who have no popular appeal, are all the time working on the razor edge.
No doubt, in the course of this debate there will be criticisms indeed, I hope to make one or two myself—but I hope that we shall not forget the great work that has already been accomplished in this country in the welfare services for the disabled. I have already mentioned how these services have developed from voluntary effort and, I am happy to say, to ultimate State responsibility but not State participation. I hope that that will continue.
There has been a fashion in recent years to decry this country and to say that we are not as powerful as we were, that we have not as many battleships or battalions or financial resources as other countries. But in one respect we stand pre-eminent. I believe our record in the welfare services for the disabled is outstanding and is an example and a pattern to the rest of the world. Others are still following our lead.
I was in America this summer and I was interested to see how closely their set-up follows our own pattern. But they have a long way to go yet. In some things they are extraordinarily good, but broadly, over the whole field, although they are getting along, I do not think that they have yet caught us up. Still, let us not he complacent. I should hate to think that anything that I have said in the last few minutes would lead people to believe that we have accomplished our aims—far from it.
What do we aim to do for the disabled? Surely we wish to enable them to live as complete a life as their disability will allow. By "complete" I mean a whole life, so that they can play a part in the community and make their own contribution to society. We wish to lessen their dependence on others as far as possible. If we can establish in the disabled person's mind, whatever his disability—whether blind, deaf, crippled, spastic or paraplegic—the knowledge that he himself is someone, an individual, we have accomplished something.
Above all, let us remember that we are dealing with individuals, each with his own capacities, needs and feelings. We put them into classes for administrative purposes and we tend to make big generalisations when we talk of the blind, the deaf and the crippled as if they were all the same. That leads to misunderstanding of the problem in the public mind. I am sure that most people think that every blind man is a musical genius and that every deaf man is half-witted because he cannot converse as freely as we can. Whatever we did, we should fail if we did not realise that each is a man with his own aspirations, capacities and spiritual and emotional feelings.
The broad aspects of the problem of rehabilitation, training and resettlement of disabled persons was examined by a Committee under the chairmanship of Lord Piercy, set up by both the Minister of Labour and the Minister of Health in March, 1953. My hon. Friend the Member for Rossendale (Mr. Anthony Greenwood), who is not in the Chamber today, was a member of that Committee.
The Committee reported in November, 1956. It is a most interesting, lucid and valuable Report, and I am sure that the Minister will be the first to acknowledge how indebted we are to Lord Piercy and his Committee for the very close examination they have made of the problem and for the recommendations in the Report, although one reserves the right not necessarily to agree with all the recommendations.
The Report attracted a great deal of interest and it has been examined by all concerned. I have had a large correspondence about it, particularly after it had become known that I intended to raise the matter in the House today. If I read all the correspondence it would make a better speech than I can make, but that would take much longer even than I intend to take. It might be a good idea if I helped hon. Members by handing it all over to the Minister!
It is a pity that the House has not had an opportunity to discuss the Report before the Government frame their proposals. With the exception of a short Adjournment debate last June, initiated by the hon. Baronet the Member for Leeds, North-East (Sir K. Joseph), in a most able and sympathetic speech, the Piercy Report has hardly been mentioned during the year which has elapsed. May I therefore urge the Government, before putting their proposals into a Bill, not only to take into consideration the recommendations of the Piercy Committee but also to elicit the views of other bodies, particularly the voluntary bodies which have had a long and noble history in helping the disabled person to overcome his handicap.
It seems to me that there are two main categories and that they require different approaches. First, there is the congenitally disabled person or the person who loses a faculty very early in life, so early perhaps that subsequently in the case of vision he may have lost the memory of vision and in the case of hearing he may have lost the memory of sound. There are other similar groups where, owing to the onset of the new and terrifying modern diseases, people have become disabled in very early life. In this connection, we have a new group which we call the post-meningitics. These are children who would have died in the old days before the introduction of the antibiotic drugs, whose lives are now saved but who endure suffering from one of the major disabilities.
All the people in this category are in a class by themselves. They have not any acquired skills and they have not acquired social adjustments and relationships in life. They present a problem which is very different from that of people who become disabled later in life, who may have had an economic and social life in the community and who may have acquired skills, trades or professions which it is impossible for them to continue because of accident, illness or other causes. Of these, many acquire infirmities late in life, because it is, unfortunately, true that old age does not come alone. Very often it brings loss of vision, loss of hearing, acute arthritis, and many other disabilities which are the concomitants of advancing years.
In the former category, consisting of those whom, broadly speaking, I call the congenital, it is most important to get early diagnosis of the symptoms. I am sure that my medical hon. Friends on both sides of the House will agree. I cannot stress that point too much. During my life I have been a headmaster of many schools dealing with handicapped people, and I used to find it a tragedy to see children who had been borne with a major disability first attending those schools at the age of 9, 10 or 11. This was mainly because of parent resistance, lack of knowledge of the facilities available or other causes. I urge the authorities to take every step to see that this early diagnosis is carried through. Hon. Members will find that the Piercy Committee stressed that point very strongly.
I am proud to say that in this country we have a very extensive range of special school provisions to deal with these people when the disability has been recognised. There is need, however, to educate not only the child but also the parent in dealing with these special cases. Latterly, one is pleased to see, a number of parent associations has grown up. We know that there are parent associations for ordinary children, but today there are parent associations with residential accommodation to enable the parents to live, mix and learn with their children. In some of the units attached to our hospitals, too, parents are encouraged to attend.
It is also exceedingly important that the family doctor, who is a very busy man, should be made aware of what is available for a child when he diagnoses it as suffering from a major disability. I say this in no invidious way, but it is, alas, true that the average medical practitioner, who is very busy, has neither the time nor the knowledge to direct help to the parent. The doctor is the first person a parent will approach. I am pleased to say that the Minister of Health is now issuing a pamphlet to medical practitioners dealing with the prevention and alleviation of deafness. Another pamphlet deals with the prevention and alleviation of blindness. No doubt others will be issued in due course.
It is very simple to say to a man, "Get a hearing aid". That is very good advice as far as it goes, but what sort of hearing aid should he get? Should he get one of those which are sold by high pressure salesmanship with no ethical standards behind it? Or should he get a good one? The answer, of course, is that he should go to a trained otologist.
After the child has passed through the special school he comes to perhaps one of the most frightening steps of his career: that is, the step-over from the sheltered environment of a special school, very often a residential school, where he has had skilled training and loving care and where his wants have been understood—the schools know the capacity of the child—to the bleak world of competitive industry. This is difficult enough for a boy or girl in full possession of his or her faculties. For a disabled person suffering from one of the major disabilities, it is a very difficult time. The step between the school and the workshop or office is an exciting adventure to most youths, but those who are disabled require very special guidance.
The I.R.U.s—industrial rehabilitation units—perform a very useful function, but they are more advantageous to those who have already made commercial and industrial contacts. I am very glad that some of the societies are developing, what are called assessment centres. I commend to hon. Members the very interesting experiment carried out by the Royal National Institute for the Blind at Hethersett, where boys and girls are taken for a time and their capacity assessed. A boy who leaves an ordinary blind school might say that he wants to be a musician—perhaps he considers himself a potential Moiseiwitsch—but might find himself eventually doing a useful manual occupation. The boy's attainments should be assessed in the best possible manner.
There is a hostel for deaf boys at Wembley, where youths in the very difficult circumstances in which the deaf face the world, with their lack of language and communication, are tided over until they go into jobs. I believe that there is a special need for further investigation into these possibilities.
I wonder whether the Ministries conduct sufficient research of their volition. I admit that it is the duty of voluntary organisations who have considerable funds to indulge in this research, and they are the people who can do it, but when I was abroad I was impressed by the drive from the top that was evident in the Office of Vocational Rehabilitation, in Washington, where money is voted by Congress for special research projects. I should like to see a great deal more of that being done in this country.
There is need for further investigation into the possibilities of further training for spastics and this was recognised by the Piercy Committee. I hope that the Minister will watch with sympathy and interest the experimental training centre at Sherrards, Old Welwyn, and will appreciate the need for longer training than the six to twelve months that is generally conceded. That is one of the complaints of the Central Council for the Care of Cripples and it is particularly applicable in the case of spastics, with their brain injury and lack of orientation and other concomitant disabilities. It seems to me that we could very well extend the project of assessment.
There is a great lack of technical training. For the deaf, for example, there are only 100 grammar school places in the whole country and there are only 15 technical places for the boys, at a school founded by charitable foundation, and we are grateful to the Guinness Trust for the help it has given. We could fill that number of places three or four times. We are inhibited not by the lack of candidates, but by lack of money to provide the facilities.
What we want for this group of people is not rehabilitation, but habilitation, if such a word exists. They have to be, not rehabilitated to something they have known before, but habilitated to something they have never known in getting out in life. The preparation for life and, eventually, employment is one of the biggest incentives we can give to a handicapped person. There is no greater encouragement for a handicapped person than to feel that he is able to take up a remunerative and gainful occupation. It has a high therapeutic and psychological value.
One direction in which the special school system requires a great deal of expansion, in addition to the other ways I have mentioned, is the training for professional and higher posts in industry and commerce. In some respects, the Piercy Committee was too complacent. It thought that a great many of the handicapped people can get a job of some kind. I want to see the handicapped person, and particularly certain categories of persons, whom I will not name as I do not wish to indulge in any special pleading, get the job that is commensurate with his capacity. It is usually possible to get a job of some kind, but I should like to see a closer tie-up between the schools, the youth employment officer and any voluntary agency concerned with the future welfare of these people.
I hope I may be forgiven for taking up so much time, but I should like to say a word, also, about those who suffer from multiple handicaps. I consider that provision for these people is woefully inadequate, not only in early training, but in later training in life. I note with pleasure—indeed, with gratitude—the facilities at Condover Hall for the training and assessment of the deaf blind by the Royal Institute for the Blind, catering not only for the deaf blind, but for blind spastics and those suffering from the innumerable combinations of two or more such handicaps.
I have a particular interest in the deaf blind. They have a dual handicap, and are surely the most isolated and loveliest of all people. During last summer, I was privileged to attend an international congress concerning the deaf blind in New York and I met many men and women, from many countries, who had so mastered this terrible dual handicap that they were able to take an active part in the social and professional functions of the congress. Multiple handicaps, whether acquired or congenital, must attract an increasing amount of our interest and help.
There is one point that I wish to stress strongly. Before we can deal with the problem of the disabled, we should know its extent. At the moment, I submit, we do not. We know the number of people who pass through the special schools and the numbers on the disabled persons' register of the Ministry of Labour, who are defined on an employability basis. We know the number of blind who receive old-age pensions and National Assistance, but apart from the war wounded I doubt whether we know the number of limbless and I am sure that we do not know the number of those who are deaf or acutely hard of hearing.
It is true that the Government issued 400,000 Medresco aids. I wonder how many of them are now lying in bottom drawers or whether that number was a true appraisal of the needs. I wonder whether the issue of those aids has been followed up by showing people how to use them. I doubt whether the register maintained by a local authority under the National Assistance Act gives the information we want. It does not show anything like the correct numbers, because 30 per cent. of the local authorities have not submitted schemes and the Act is not mandatory, except in the case of the blind. Unless the disablement is such as to attract the provision of services, there is no need for registration.
I want to suggest that the Government could very well take a pilot survey in a rural or urban area, a kind of Gallup Poll. I am not frivolous in this and I hope that the Minister will not think that I am. I realise that it could not be done over the whole country, but it could be done on a central basis. Let us find out what is the real extent of the problem with which we have to deal. We could go on from there.
Yes. I am emphasising my point in a rather heavy manner, perhaps. I hope that the Government will take note of the recommendation in the Piercy Report and my stressing it.
The Report deals necessarily with the problems of rehabilitation and resettlement. I do not intend, because there is not the time, to go through the 46 recommendations. Most of them are admirable. Others I would accept with reservations, but I regret to say that some, to my mind, indicate that the Committee failed to appreciate the nature of the problem. There are most remarkable
remarks about spastics and the deaf. I cannot but feel that the Committee could not understand the consequential disability of deafness when it states:
…deafness in itself is not normally a barrier to employment.
I do not know of a bigger barrier.
Suppose a bank cashier becomes deaf and he has to switch over to another job or a job in connection with the public or higher professional branches. It is one of the biggest disabilities there is. It is true that the Report qualifies it by saying,
it might be a barrier to promotion.
Of course it is a barrier.
The Committee hardly seems to realise that spastics have brain injury, with all the awful consequences that follow from the lack of cerebral control. However, the greater number of the recommendations are of much value. They should, of course, provide for a very much more extended service.
I was disappointed with the recommendations about sheltered employment. The insistence on a relatively high economic output, if carried out too drastically, would mean a considerable loss in value of that service. It would be anti-social to disregard the feeling of achievement a man derives when he is taken out of his home, put into a factory with his fellow mates and, however slow he might be, is doing a job of work instead of sitting idly at home. I hope that the Minister will tread warily here. I would like to emphasise, too, the travel difficulties to these workshops of men in sheltered work. It is rightly stressed and it should be the aim to secure suitable accommodation near these places.
I would like to say a word about motor propelled vehicles. The British Limbless Ex-Servicemen's Association is very concerned about this matter. I think that the qualifications for the acquisition of a power vehicle are very drastic indeed, and I should have thought that by now it would be possible to have the two-seater vehicle in general use. It is a great tragedy for a man in his off-time when he goes out and has to leave his wife behind him, as was put to me very pointedly at a meeting I recently attended. Remploy is in a poor financial state and pleads for the support of its sponsorship scheme and the priority suppliers' scheme, which my hon. Friend who will second the Motion will deal with at greater length.
A committee has been set up to examine the question of home employment, design and marketing, and so on. I hope that attention will be paid to that. The Piercy Committee has not recommended any change in the quota regulations at present. That might be valid at a time of full employment, but today 12 per cent. of those unemployed are registered disabled persons and the ex-Service men's organisations are particularly anxious about this. One must commend the good will of employers generally, but I was shocked, not long ago, when the Parliamentary Secretary told me that the National Dock Labour Board at that time employed only 2½ per cent. of disabled persons. It is inconceivable to me that great national corporations like the Civil Service or nationalised industries ought not to be able to find within their own organisation suitable jobs for disabled persons. I hope that the Minister has looked into that and ensured that the regulations are complied with.
Perhaps the hon. Member would like to know that the National Dock Labour Board has now increased the number of registered disabled persons it is employing and that its present percentage is 3·4 per cent. My Department has been in constant contact with the Board. That ought to be put on the record straight away.
I thank the Parliamentary Secretary very much. I am sure that the House hears that with great satisfaction. It just shows how a great body like that can slip into evil ways, if I may say so.
I want to say a word about the work of the disablement resettlement officer. The Piercy Committee was unsympathetic to the specialist service, but conceded that where a voluntary society or local authority administered the specialist service it should continue for the time being if its services were satisfactory. The chief service in connection with a specialist set-up is carried on in blind placement by the voluntary bodies like the Institute for the Blind, other blind agencies and some local authorities. The Institute has been responsible for placing no fewer than 3,750 blind persons. We have the highest proportion of blind persons in competitive employment in any country.
I hope that the good work done by these local authorities and societies will be considered favourably by the Minister and that they will be allowed to continue and develop. The Institute for the Blind is the agent for no less than 72 local authorities. I was very glad to note that not very long ago the Minister of Labour sent out a circular to the disablement resettlement officers giving them special guidance on one of the most difficult problems, namely, how to make contact between a person who cannot hear and a prospective employer.
One of the most disquieting paragraphs in the Report is that relating to the welfare clauses of the National Assistance Act. Chapter IV says this about it:
Apart from the provision made for the blind, it is clear that in the field of local authority welfare services for the disabled, only the fringes have been touched so far and there is no doubt that there is need for fuller and better provision and scope for considerable development.
That makes sad reading.
The National Assistance Act has been on the Statute Book since 1948. Unfortunately, at that time the obligations were not made mandatory on local authorities. They have not been made mandatory since. Succeeding Ministers of Health have not felt that the time is opportune. When we have an indictment like that from a responsible body is should make us think. No less than 30 local authorities have not submitted schemes voluntarily. There is every inducement for their not doing so, because there is no direct grant for these services.
I am very much afraid that the present attitude of the Government towards the block grant will further stabilise this unsatisfactory position, because local authorities will simply say, "No money, no work." Even to initiate a service requires money, and it seems to me that we are placing an unfairly heavy load on the local authorities when we expect them to accept this burden.
I apologise to the House for having taken so long, but there is so much to say on this and related topics. I must say a word about gadgets. There is available for the disabled an extraordinary range of appliances and aids. London County Council has a permanent exhibition at Victoria. The Institute for the Blind has gadgets for blind workmen, blind students and blind housewives. The National Institute for the Deaf has illuminated bells so that a deaf man can know whether anyone is ringing his bell. There are a good many other devices like those and there are household gadgets as well. I wonder how many hon. Members could peel a potato with one hand? If they go to the exhibition they will see how it is done. One takes a wooden block on which there are three nails, sticks the potato on, peels, and then turns the potato round.
People do not know about these things and I would urge the Minister to get in touch with the B.B.C. to persuade the Corporation to publicise them and to have a television show to demonstrate them. I dare say that this has already been done, but it would be a great help if it could be done again. I had better not say anything derogatory of the B.B.C. or it will not take up this idea, but I think that some of its programmes could well be spared for a programme much more useful and constructive. There are so many of these appliances and they are most fascinating.
I have ranged erratically over a wide field, but time does not allow me to do otherwise. I cannot conclude without a word on behalf of the housewives. I hope that the various services will realise what a large proportion of the handicapped people are housewives, who want all the help they can get, who want encouragement, want to be stimulated to do their own jobs for themselves if they can. They ought to be made aware of the help which can be given.
If all our services for handicapped people were as well developed and coordinated as are the services for the blind, although not at the expense of the blind, of course, I should feel happy that we were making a great advance towards our objective. What is needed is the integration of the work of the voluntary societies, the local authorities, and the State, which, properly, accepts final responsibility for the welfare of the handicapped, and if that integration is achieved I think that we shall go a long way in the near future.
My final word is this. We spend a tremendous amount of effort, good will, skill, devoted service and huge sums of money in the alleviation of physical disability. The main aim should be the prevention of disability, and this means steady and long research into the causes of preventible handicaps.
I beg to second the Motion.
I am sure the whole House will agree that we can congratulate ourselves that you, Mr. Speaker, drew the lucky number of my hon. Friend the Member for Lowestoft (Mr. Edward Evans) to enable this debate to take place on this Friday, the 13th. My hon. Friend has drawn on fifty years' experience of service on behalf of disabled people, and in his speech he has ranged over a wide variety of services and has put forward valuable recommendations, and we are indeed indebted to him for them. I am sure the Minister will duly note the recommendations which have been made.
I think we should record our pleasure that this morning the Minister of Labour and National Service himself, in addition to the Parliamentary Secretary, has found time to come here for the debate, and that we have also with us the Joint Parliamentary Secretary to the Ministry of Pensions and National Insurance and the Parliamentary Secretary to the Ministry of Health. It is very gratifying that they should have found time to come here today, and I believe that that is an indication not only of the enormous range of the subject which we are discussing and of the Government's responsibility in it but also of the Government's interest in and concern for the disabled.
I cannot claim anything like the experience of my hon. Friend the Member for Lowestoft with his half century of service for the disabled. My interest in the subject stems from the fact that directly or indirectly during most of my working life I have been in contact with blind people. My father's brother was a blind man. He was blinded at thirty. He was a great, strong man and a craftsman, and from the time he was blinded he neither asked for nor received help, public or private. Always he ignored his handicap. Always he pretended it did not exist. "I saw So and So yesterday," he would say. If anything was mislaid he knew where to find it. He saw through his great, strong hands, and with them he supported himself and his family.
Yesterday morning I was at 8, St. James's Square, not to see the Minister on that occasion but to attend a meeting of the Joint Industrial Council for the Basketmaking Industry. On the employers' side the majority of the members are managers of blind people's workshops. On the employees' side some of the members are employee basketmakers and members of the National League of the Blind. Yesterday one of them, a blind man, was chairman of the J.I.C. He has been chairman for the last twelve months. He and I for weeks were members of a committee which was appointed to revise wages and we were engaged in complicated calculations. "Blind Fred" sat with his Braille block on his knee, punching holes in the block. Believe it or not, but it is perfectly true that he kept tabs on us and would pull us up from time to time. He would say, "We did such and such yesterday"; or, "This is wrong. There is a mistake there." It was obvious that his fingers detected mistakes our eyes overlooked.
I mention this to emphasise what I think is true of all blind and badly disabled people, that they want neither charity nor pity, and that all they ask is the right to work and a chance in reasonable conditions to earn their living and live their own lives the same as anyone else. I want, therefore, to devote my remarks to the one subject of work for disabled people. They may be without eyes, without hands, without arms, without legs. We must see to it that they are not without hope. We must see that they have the hope and prospect of work and of living their own lives.
I submit that there are at present two threats to that hope and prospect, one threat private and the other public. The private threat lies in the activities of persons and firms who sell domestic articles from door to door at double or treble their real value on the brazen and often unfounded pretext that they are made or packed by the blind.
The Parliamentary Secretary will know that I raised this question with him a week or two ago, and he gave a most encouraging reply. Hon. Members may have noticed that yesterday in the Press there was a report of the prosecution of a firm which was calling itself Blind Homework Limited. It was neither limited nor registered. Such firms set themselves up with such names. One took the name Blind Employment. Last week I produced in the House a piece of rag not worth more than 3d. which was being sold at 2s. 6d. simply because on the envelope were the words, "Packed by the Blind."
In the prosecution I have just mentioned it was revealed that the firm had been paying the sales manager £15 a week and its blind workmen 65s. a week and its team of 30 canvassers 5s. an hour.
I am glad the hon. Member has raised this matter because many of us have been troubled by this form of business activity. Would he agree that there is probably a very good case for legislation to prevent people from exploiting disabled people in the way these businesses do?
I am very glad that the hon. Member takes that view. I have already raised the matter in the House and the Minister, having expressed his determination to find a means of putting an end to the racket, has invited the cooperation of all hon. Members. I am glad to say that this week there was an all-party meeting at which we considered a draft memorandum, a copy of which has been sent to the Minister, and he has agreed to meet us next week. If the hon. Member adds his support I am sure that he will be welcomed by the Minister and other hon. Members who are interested. I am sure that there is not a single hon. Member who, when the time comes, will not lend his effort and co-operation to ending this racket.
It is not only that the general public are being exploited. That does not matter so very much. The danger is that in that exploitation these racketeers will disgust the public, who will not know what is genuine or otherwise, and it will harm the blind. I have had many letters from people who have said, "I gave so and so to such and such a cause. Was it genuine or not? Will you please tell me?" We cannot have that situation arising. I am very glad that the Minister has shown himself so keen in this matter, as indeed he has in other matters which affect disabled people, and for which we are very grateful. I will not pursue that point any further as it is so well in hand.
I should like to concentrate upon the public threat to the expansion of employment for the blind and disabled. In this, unfortunately, the Government are the culprits, not because of any lack of goodwill or intention but, in my view, because of lack of method. Here again I absolve from that criticism the Ministry of Labour. The trouble lies in lack of cooperation in other Government Departments, and particularly in the Treasury; and because we say that of the Treasury in connection with many subjects it does not make it less true on this occasion, as I shall endeavour to show.
Realistic examination will show the real extent of this problem of employment for the disabled. As my hon. Friend the Member for Lowestoft has indicated, by far the greater proportion of disabled and blind people do not need sheltered employment at all. They can find employment in industry just as well as anybody else. The problem is thus not large. There are 4,000 blind workers employed in recognised workshops. There are 6,200 badly disabled employed by Remploy.
In addition, unfortunately, 3,800 severely disabled persons are registered as unemployed, and of these 2,700 live sufficiently near to Remploy factories that they could be employed if the work and the orders were available for them. If we add these figures together and make allowance for other organisations for the disabled, like the Lord Roberts Memorial Workshops, we have a total of 15,000 blind and severely disabled workers who require some priority form of sheltered employment. I ignore for a moment the orders required by Her Majesty's prisons, to which I hope to refer later.
In my experience, it is true to say that three of these workers, on average, will turn out the same output as one ordinary worker doing the same kind of work in the same kind of job. Therefore, 15,000 disabled and blind workers are the equivalent of 5,000 ordinary workers. Their total output is about £6 million a year in value. When we compare the 5,000 workers with the more than 20 million in employment in this country, and compare their £6 million output with the £16,000 million of national product, I think that it will be agreed that it is a drop in the ocean. If we cannot solve that problem without difficulty there is something wrong with us.
The taxpayer cheerfully provides £2½ million a year, on the average, for Remploy. I hope that I am right in disagreeing with my hon. Friend the Member for Lowestoft when he suggested that Remploy was in financial difficulty. I believe that for some years ahead there is no question of financial difficulty for Remploy.
I believe that there is not even financial anxiety in Remploy. Taxpayers provide £600,000 a year for blind workers, at £150 a year per worker, paid through the local authorities as a subsidy in augmentation of the blind worker's wages. No money could be better spent. I would not see them have a penny less, but it is absurd that Government policy imposes on these organisations the need to maintain expensive selling organisations and involves unnecessary and costly warfare with each other and with private industry.
As the House knows, I am president of the employers' federation of the basket industry. Its membership comprises ordinary commercial firms and workshops for the blind. It is an industry with a higher proportion of blind workers than any other. In 1932, when I was appointed, they were desperate days of grave, mass unemployment, and in the scramble for scarce orders the competition of non-profit making blind workshops was a serious factor. But in those days the managers of the workshops for the blind showed statesmanship. They refused to be stampeded into a position where they would be selling below cost or at prices which would not permit the payment of proper wages. Although the blind had a special position, the unions and employers' sides went forward together. I am not saying that there were no complaints. There were, though many of them were not justified.
The result was that a complete trust and understanding was built up. The position of blind workers is today recognised to the extent that in Government contracts they have the field more or less to themselves. Unfortunately, the Government, who should father and sponsor them, are not prepared to accord the same preferential treatment as the private firms who might have been expected to be their rivals.
The position is somewhat similar with Remploy, which is operating with considerable and growing success the sponsorship scheme. In this scheme, Remploy provides the factory space and the workers and the private sponsors put in the machinery and provide the "know-how," the materials and the orders. The country gains in increased production, and badly disabled workers get guaranteed employment at good wages. There is a saving to the taxpayer, because there is no expensive selling organisation or a large capital outlay. Here we have a position in which private firms are ready to sponsor Remploy, and the only people who are not ready to do so are Her Majesty's Government.
I, therefore, ask the Minister of Labour to make a serious and determined effort to put this matter right. I suggest that he should try to obtain Cabinet approval of the principle that work should be given to the severely disabled without any question of tendering. We on these benches do not often commend the Government of the Union of South Africa, but they are far ahead of us in this respect. They say that the disabled require work and so they shall have first preference in Government orders for work which they require and which they are capable of performing. I hope that that principle will be accepted here.
Once it is established, I would ask the Minister to take action under two main heads. First, to establish a joint committee representing not only organisations of blind and disabled workers but also the Prison Commissioners. There should be submitted to that committee the inventories of the Government supply Departments and, as far as practicable, of the nationalised industries and the hospital service. That committee should be asked to indicate the types of goods on those lists which they are in a position to supply, or which they could supply if assured of the orders.
For example, in the prisons some form of light machinery could be installed, which would make goods not suitable for production by the blind or other workshops. This would relieve the pressure from the prisons on mat making, brush making and other activities particularly suited to the disabled, especially to the blind workers.
I am aware that something of this kind is already being done, but it is not sufficiently comprehensive. I elicited from the Chancellor of the Exchequer some time ago the information that the Service Departments alone have 7,000 items on their inventories. From a study of these, and of the inventories of the other Departments I have mentioned, I am sure that the amount of work available for disabled people could be increased. There would be more than enough to keep these 5,000 workers fully and happily employed in the kind of work most suitable to them.
As the Minister is aware, however, for this to be satisfactory to all parties, including the T.U.C. and the taxpayer, another step is necessary. This is a knotty point. I suggest that the second step is the revision of Treasury Circular 8/50 dated 6th October, 1950. This sought to ensure that a due proportion of Government contracts should be placed with disabled workers' organisations and Her Majesty's prisons and it listed so-called priority suppliers to whom, under certain conditions, preference should be given in the placing of Government orders.
Let me say at once that this circular has done a great deal of good for the disabled workers' organisations. I pay a tribute, in particular, to the Government purchasing officers for the understanding way in which they have applied the circular. Unfortunately, it contains contradictions and ambiguities which have led to differences of policy between different Departments, and to unnecessary and damaging, competition between different organisations of disabled workers.
For example, in paragraph 4, after saying that priority suppliers will be given a contract for the full quantity they are able to supply, and that they will not be required to compete in price with other tenderers, the circular adds immediately:
On occasion they may be asked to submit prices and if their price does not secure the order competitively, the contract will be
offered on the lowest tender or on the basis of a fair price.
I ask the House to note the immediate contradiction. How is the contract officer of the Department concerned to interpret which of those two courses he should follow? The mention of a fair price without any kind of definition is ridiculous.
What happens in practice? I can assure the Minister from my own experience, in protesting against certain Admiralty and other contracts on behalf of my members, that most contracts are put out to tender not only to priority suppliers but to private firms. Later the blind or disabled organisations may receive a phone call from the contracts department. The contracts officer may say "You put in a price of £5. We have a price of £4, You can have the order at £4." The blind workshop may know, that £5 represents the cost for materials, wages and only a small amount for overheads, since these are non-profit-making organisations. If they need the work badly enough they accept the contract just to keep the workers employed.
It appears that some Departments regard the lowest tender as a fair price. Thus there are many occasions when priority suppliers are quoting against each other, and the order goes to the organisation prepared to accept the biggest loss. This was never intended. It was never intended that the National Association of Workshops for the Blind, should have a quarrel with, say, Remploy, accusing them of quoting 25 per cent. below cost, and perhaps next week that Remploy should have a quarrel with them.
We never intended that there should be this struggle between disabled workers of various kinds who are equal in our esteem, and should be equal in their claims on our judgment and common sense. It is no use suggesting that, because they accept these uneconomic prices, the taxpayer will save money. Of course he will not, because he will have to make good the losses occasioned by uneconomic prices.
I submit therefore that the first thing to do is to settle a formula for a fair price, and then all these troubles will disappear. This would obviate the unseemly scramble between Remploy and the blind, and it would remove the valid objection to the ridiculous pricing system of Her Majesty's prisons. I do not know whether the House is aware—it should be public property because it is in the Report of the Prison Commissioners—that the method of costing is to ask what the materials cost and then add a percentage. It is not a very large percentage, but this method has led to endless and increasing trouble for over a century, because it has never been tackled properly. Such prices cannot be fair.
I submit that the formula for a fair price under these conditions should be proper trade union rates of wages plus materials, with an allowance for factory overheads. In most cases that would mean prices below the level at which open Industry could tender. At the same time it would mean that the fair wages clause would be safeguarded, and priority suppliers would avoid manufacturing losses. I suggest, then, that Government policy would be in line with the recommendation of the Piercy Committee if it extended the practice of costing contracts and restricted open competitive tendering.
To sum up, the necessary steps are as follows. First, we should widen the field of Government work available. That could be done easily. Secondly, we should give priority suppliers all the work where they are capable of supplying all that is required. If a Government Department requires brushes, mats or mattresses, for instance, the contract should go to the priority suppliers if they could meet all the demand. In cases where they cannot supply all the demand, they should be given contracts up to their capacity.
Thirdly, there should be agreed machinery for fixing a fair price for priority supplies in order to abolish tendering and competition. I suggest that the same committee which I suggested earlier should co-operate with the Minister in that respect. Fourthly, contracts should be apportioned between the blind, Remploy and other priority suppliers, including the prisons, according to their capacity and current need.
If this system were applied it would confer the added advantage that in slack times these suppliers could make up a certain amount of stock of standard goods, and so give better delivery when required. They cannot do this now because there is no certainty that the goods will he sold eventually. Some time ago, as the right hon. Gentleman knows, his Department and the priority suppliers worked out a scheme for "shelf" production. The idea behind this scheme was to put goods on the shelf in anticipation of requirements. That scheme fell down because the Government refused to fix a price prior to delivery. Therefore the disabled workers' organisations could not make up goods without the assurance that they would receive an acceptable price when the goods were sold.
A formula for fixing a fair price would overcome the difficulty, because they would know where they stood. It would also serve in those cases—mattress making is one example—where, for a variety of reasons, outside industry is normally able to quote a lower price than can the blind. Contracts could still be placed at a fair price, and the Ministry of Supply, which is already a large user of mattress materials, could supply all the materials and then hive off the packaging as a separate contract. It is the provision of work that matters, not the piling up of big turnover figures. It is work for these people's hands and brains that we are considering, not figures in books.
I would also suggest to the Minister that if he is in difficulty in his approach to this matter and he needs an ally he should try the Home Secretary. We are all aware that the Home Secretary is most anxious to increase the volume of work available in the prisons and I think that we are all with him in that. It is something in which he should be strongly supported. Unless the overall field of work is enlarged, however, and steps taken to agree fair prices, the position of the disabled organisations is likely to become very serious indeed. Where they are asked to compete with the prisons their position is usually hopeless.
If the overall field remained static or shrinks and the prisons maintain or enlarge their share, our high hopes for the blind and disabled will be wrecked and in the resultant outcry the hoped for reforms in Her Majesty's prisons will also be wrecked. I ask the Minister not to take this lightly. Only this week I have had sent to me three or four communications. I have discussed with the Home Secretary and with the Joint Under-Secretary all these matters and I believe that we may be making some progress. Yet we must insist on brushing aside the evasions of the Prison Commissioners in this matter.
I had quite recently a letter from the National League of the Blind about mat contracts in Cardiff. It has a fine workshop for the blind, but the workers there are short of work. The contract went to the Prison Commission at just over the cost of the material. The education department of the Glasgow Corporation this week, for the first time, placed with the Prison Commission a contract for brushes. I understand that a protest from the Joint Industrial Council of Scottish Institutions for the Blind is to go to the Secretary of State for Scotland about it.
On 9th December the National Association of Workshops for the Blind sent a letter to the Joint Under-Secretary complaining of grossly unfair prison competition and its present expansion in the field of local authority orders. The letter stated:
The extension of prison competition into the field of municipal work is an attack on the backbone of local blind employment schemes.
How can we as taxpayers directly or indirectly contribute £150 a week for the blind workers in the workshops knowing that they will be further handicapped if the prisons take this work out of these men's hands. That is something which we should not allow to go on.
I have a note dated 10th December from the Joint-Secretary of the National Society of Brushmakers, one of the oldest trade unions in the country. It expresses serious concern about this competition, and says:
This has been a problem for 100 years. I have before me a copy of a petition sent to the Home Secretary and M.P.s 80 years ago.
We must end this stupidity and enlarge the field and divide it fairly otherwise the disabled will be workless and eventually prison reforms will be handicapped. That would be indeed a tragedy which must not be allowed to happen.
I ask the Minister in the name of these thousands of brave handicapped workers to say to his colleagues, "The work is there for the asking and the disabled are going to get it. The necessary changes are not great but they are vital and we are determined to make them, and soon." I ask him to create these conditions and thus ensure that every badly disabled worker, will have the chance of full useful employment, the chance of a full busy life, the same fundamental right to work which is already enjoyed by every able-bodied person in this country.
I am sure that the whole House is grateful to the hon. Gentleman the Member for Lowestoft (Mr. Edward Evans) for raising this subject again today and dealing with it with so much sympathy. I should like also, to join with the hon. Gentleman the Member for Shoreditch and Finsbury (Mr. Collins) in recognising the presence of my right hon. Friend the Minister of Labour throughout this debate, and to put on record his presence during the previous debate, which I had the privilege of initiating six months ago. It is such a large subject that although I tried to scamper through the Piercy Report in eighteen minutes, six months ago, I do not intend to try to emulate the hon. Member for Lowestoft and cover the whole field.
I feel that this subject of work, which is essential to the disabled, has been so admirably covered by the hon. Member for Shoreditch and Finsbury that I need not follow him on that subject. I want to join with the hon. Member for Lowestoft in saying that, although from time to time I may use statistics, I am none the less conscious that I am dealing with human problems and people of flesh and blood.
Before I begin my main speech, may I say that I do not intend to mention the epileptics, spastics, the blind and the deaf, and all the other special cases which cannot he covered properly in the time at my disposal. My main purpose—and I say it with diffidence—is to deal with the medical aspects of rehabilitation and to suggest that if the medical profession lives up to the standard of its leading doctors there will be a smaller number in future of those people for whom rehabilitation will have to be sought.
I raise this aspect, as I say, with diffidence, and, I hope, without impertinence, by stressing what the Piercy Committee has already brought out and what medical men themselves have told us. I yield to name in my admiration of the medical profession. I believe that it is the second most difficult profession bearing in mind that the architect, who has be both an artist and a businessman, and who aims at the absolute on so many planes simultaneously, has an even more difficult job. Although I am going to suggest a few improvements which the medical profession might bring in, I am not venturing to criticise it.
There are two main facts about the disability situation. We have in our lifetime seen a revolution in medical treatment. I believe that if one looks at the old textbooks one will find the doctrine that anyone who has had an operation has to lie in bed, three weeks, perhaps, for appendicitis, two weeks for childbirth and for a relatively long period for almost any physical ill.
Now patients get up so quickly after operations that there is a completely new attitude to the problem of rehabilitation. I am sorry for the firms that make plaster. This is due to the research brains and skill of the leading medical men in this country and in the world. It means that for rehabilitation the patient no longer has to wait for some weeks after an accident. It can start immediately the ambulance picks him up from the ground after any serious mishap. If that attitude of mind prevails in the medical profession it will spread to the families confidence and hope will be given to the individual himself and I believe that we shall have far fewer of those people who, through no fault of their own, are made hopeless by the wrong medical attitude giving them no prospect from the beginning.
This is where I want to introduce my second main point. I think that doctors in general agree that there are people who suffer disability who have such a zest for life that they are determined to get better and because of this determination no amount of obstacles will quell their resolve to get better. These people will get better despite doctors, family and everything. There are other people—and I am not criticising, because I have been lucky enough not to have had such an accident—who, from the beginning, give up all hope. The only chance for the rehabilitation of these people is, from the beginning, to ensure that their medical treatment and the family attitude is one which will help them to live a relatively full life in the future.
These are the two factors which seem to dominate the situation. Let us examine the implications. All doctors, as the Piercy Report says, should be taught in their training about the facilities available for rehabilitation and the effects that modern treatment offers. There is no need in hospitals for great empire-building departments concerned with rehabilitation as a subject spelt with a capital "R" if every doctor and nurse has the right mental attitude towards mishaps. I do not pretend that this is easy, but it is the practice of many of the best doctors and nurses already.
In the Manchester Guardian this morning there are two examples of rehabilitation which show the chances which are available to ingenious treatment. There is the case of a clergyman who, for thirty years, has been suffering from what was regarded as incurable melancholia, but when he was given a dog to look after he recovered his zest for life. It is true, the doctors say that he was about to recover his zest for life, but they reckon that the dog helped. The other case is that of the Belfast experiment with home treatment for house-bound elderly folk. It has been found that a few visits by a physiotherapist restore them to a far better condition of health at far less cost and inconvenience than taking them to hospital.
I will tell the House of an experience that I had recently in America. A Detroit motor executive who lost a leg in an aeroplane accident was so filled with admiration for the Bader book that he has adopted the following practice. When he reads in a Detroit newspaper of someone who has lost a limb, he goes straight to the hospital and presents a copy of the Bader book to the individual. He walks round the bed deliberately, as easily as he can, and waits until the patient gets bored with the sentimental sympathy which he thinks is being extended to him by a fit and fully limbed man. Only then does this imaginative executive say, "I lost a limb three years ago." The effect on the patient, who has perhaps almost given up hope of a full life, of finding that the man he thought was fully equipped with limbs has only one leg is that of a tonic. This sort of mental attitude can reduce the number of people for whom the hon. Member for Shoreditch and Finsbury urged that work should be found.
The Piercy Committee uses the admirable phrase "planned and purposeful rehabilitation." There is a danger in the case of those people who have the second sort of personality to which I referred, particularly those whose normal earnings are scarcely above the disability pay which the State now provides. Their incentive to return to full life may be diminished if the promise of full rehabilitation is not offered to them from the very start. The key time is when the mishap occurs, or, in the case of childhood, when the child leaves the special school and goes to employment.
What can the State do, or what can be done, to reduce this vital gap between the mishap and the positive, planned, purposeful attempt at rehabilitation? There are three things. First, all the Ministries concerned can press for the adoption of the attitude to which I have referred. I hope that the Parliamentary Secretary will tell us whether his right hon. Friend the Minister of Health has yet sent round the circular covering this field about which he told us six months ago.
The second thing relates to medical standards. It is a matter of the medical profession teaching students and present-day practitioners the attitude which, I am told, is absolutely accepted for treatment these days.
What can the State do? There is a third thing. I make no apology for referring to statistics. I would ask the Minister to arrange for the publication each year of figures showing, for each hospital region or medical executive committee area, the figures as between the time of accident and rehabilitation or return to work, whether it concerns housewives, factory workers, farm workers, or anybody else. Then, by comparing one region with another, the public will be able to bring intelligent criticism to bear upon those areas where, for some reason—not necessarily for medical reasons—the full advantages of modern treatment are not being gained.
The second resolution is the recognition of the personality of the patient. This is very important. I am told that very often the zest for life which leads to a positive attitude to rehabilitation goes with a skill. It is not always a corollary. However, a craftsman, a man with an interesting job, who is proud of his work and has been earning well, will tend to be in the first class. A relatively unskilled and low-paid man will tend to give up comparatively easily. This is not an argument for reducing disability pay, but it is an argument for urging the medical profession and the families of the injured to bring to bear a positive attitude towards rehabilitation as soon as possible.
Those are the revolutions to which I want to draw attention. They dominate the situation covered by the Piercy Committee. I now want to ask the Minister to answer a few questions arising out of the Committee's recommendations. When the Minister last spoke, he told us that a number of the recommendations had been accepted, and I propose to ask him about the ones to which he did not refer.
First, the D.R.O.s are to have a longer training. This is an admirable advance. May we be told how long the training will be, and whether the programme of training has been agreed by a fairly widespread body of opinion, or whether it is the same programme writ longer?
The Parliamentary Secretary, in his very sympathetic reply last time—nobody doubts his interest in the matter—rejected my thoughts that the D.R.O.s, however admirable they may be, could be helped by higher access to private firms. That is to say, if they could number among them retired tycoons who could lift up the telephone and speak to brother tycoons there might be some improvement in opportunities. I suggest this admirable though their activities and the activities of the welfare officers of most firms are.
With regard to technical medical inquiries, I am told—I find it hard to believe, but if it is so it is worth considering—that a consultant attending a disability interviewing committee gets paid, but the moment the disability interviewing committee becomes a resettlement clinic, the same gentleman attending it is not paid. It is a small point, but it may give rise to unnecessary obstacles to the establishment clinics which the Committee emphasises so much.
Again on the subject of resettlement clinics, I would urge that the Ministers concerned with producing statistics about the, I hope, ever-increasing number of hospitals which organise resettlement clinics should not be satisfied merely with a report that a number of technical people meet once a month. There should not be just a formal compliance with the idea of resettlement co-operation. It is the actual fact of real co-operation between the almoner, the doctor, the local authority social worker and the D.R.O. that really matters. The follow-through of decision is what counts. I suggest that the statistics relating to the results of the resettlement clinics will be a far better discipline for all concerned than any amount of formal compliance with recommendations.
I wonder whether the Minister is considering the first recommendation of the Piercy Committee that a survey should be made of all those who have been out of work for a disability reason for more than six months to ascertain whether any further facilities that might be made available would help them back to work quicker.
Those are all the questions that I want to ask. Before I close, I should like to divide the subject into two aspects, the humane aspect and the economic aspect. There is almost no limit to the humane side. We want to restore these people to as full a life as possible. There may be some difficulty with the economic side and it may not always be possible to find jobs exactly suited to the disabilities and residual talents of some people. It is, therefore, all the more important that such facilities as the State provides by way of education, adult education, wireless and television should he made available to reduce the boredom inseparable from reduced activity of life.
I have tried to concentrate on the medical aspects of this subject, because whatever the Government do, and they do a great deal, the front line of the troops in this battle against disability will remain the doctors and the families of the patient. The higher the standard of the doctors and the more dynamic their attitude, the more confidence the families will have and the more they radiate to the patient confidence that he will return to a fuller life, the less disablement there will be.
—on some of the members of the profession to which I belong. I cannot disagree with the hon. Member. My only regret is that the hon. Member is not able to transfer some of his enthusiasm to members of my profession.
One of the difficulties is that when we are medical students we have to learn so much about so many different aspects of medicine that the enthusiasm with which we start is greatly diluted before we become qualified. However, what the hon. Member has said is true. The psychology of the disabled is all-important, as I shall try to show as I develop my case.
We are all grateful to my hon. Friend the Member for Lowestoft (Mr. Edward Evans) for introducing the subject. There are two points with which he dealt which I want especially to underline. The first is the importance of the early recognition of disabilities of all sorts, and the second is the need to realise that many disabled people have a special psychology and that in dealing with them it is necessary to realise that they have scars on their mental as well as on their physical make-up.
The hon. Member for Lowestoft has said that he has spent most of his professional life dealing with the blind. I have spent most of my professional life dealing with the deaf. I want to say how important it is, in all these congenital afflictions, as well as afflictions which arise in early childhood, to get the case recognised at the earliest possible moment and to deal with it as soon as possible.
With the deaf, the mother can often recognise the condition and, if she is an intelligent woman and carries out instructions, her child may begin to lip-read even at the early age of eighteen months and begin to make some sounds which can be interpreted as speech as early as three years. If there is any residual hearing, it can be developed and it is astonishing how children with that defect will with pleasure, as soon as they get used to them, take hold of the mechanical aids and put them on so that they can communicate with the rest of the world.
Again, spastic disease can be recognised as early as the fourth month of life. I know less of this through direct experience. If the mental condition of the spastic child is normal, under proper and continuous training he can become a useful citizen, almost irrespective of the severity of his physical handicap.
I do not want to discuss it at length, but a child with a mental deficiency, if the condition is recognised and distinguished from deafness—many deaf children are thought to be mentally defective unless very careful examination is made—can have a great deal done for him, if the case is recognised early.
In Middlesex and in the County of London there are establishments to which men and women go daily. If necessary, they are carried by special bus to the centres and there these mentally deficient men and women undertake occupations of which they are capable. I have been to these institutions and I have seen such people chopping wood and making boxes and doing very useful work. They are delighted by the fact that when they go home at the end of the week they take with them a wage packet—not a big one, but a wage packet—just like the rest of the family.
It is unfortunate that many parents of what are called mentally retarded children—it is unfortunate that that term should be used, because it is not only retardation, but some mental deficiency—seem to hide these children as soon as the disease is recognisable. They think that there is some weakness in themselves or in their family and instead of getting help at once they tend to hide the children until they are near puberty, when they become difficult to manage.
Therefore, the first thing I want to see is that any defect in children should be made a notifiable disease. The medical officer of health working with the family doctor could then discuss the best thing to be done for the child and training could commence as soon as possible so that there was no waiting period. Through his health visitors, the medical officer of health could visit the case at intervals to see that treatment was being maintained and that the best was being done for the child.
When handicapped children leave school, it is very important that they should be encouraged to take up training for some definite occupation and not go into any form of blind alley work of which they are capable. When such children leave school, they are more amenable to teaching than at any other time. In many cases they are keen, capable and ready to learn. I know that training takes a long time in some cases, but it is important that everything possible should he done for these children at that time.
In older people, as was so well stressed by the Piercy Committee, as soon as it seems probable that there is some residual disability, assessment should be made and there should be preparation for training for the type of occupation for which the individual is capable.
I frequently go to a chest hospital in Oxfordshire, the Peppard Chest Hospital, because I know most of the people working there, and I find that, when patients in that hospital, recovering from tuberculosis, are found to be capable of starting a fresh job when they leave the hospital and are incapable of returning to their old, training is commenced. It is not just occupational therapy or diversional therapy to keep them amused. As far as possible, training is begun in the kind of work that will be available to them, and of which they will probably be capable after being properly trained, when they leave the sanatorium. The last time I was there, I remember seeing a man who had been working in heavy industry. He was keen and intelligent, and was being trained for accountancy, because it was felt that he was capable of training and would be able to undertake that work later.
That brings me to my second point, concerning the psychology of disablement. There can be no doubt that people such as those I have been describing, who have been training for future useful work will get well much quicker. On the other hand, I have seen in my own constituency men who, without any training after some disability, have been turned out of hospital, perhaps after a stay in a convalescent home, sitting at home brooding and wondering what they will get in the way of compensation and whether they will ever be able to do any useful work in the future.
I have also seen some of these same men a little later working in a Remploy factory. In my constituency, Barking, there is such a factory, providing very useful wood work, and I can say that the change in the psychological condition of the individual is very great. These men are hoping to get back to normal industrial activity, and a great many of them do.
A short time ago, the Parliamentary Secretary was speaking to some Members of this House about the reorganisation of the Remploy companies. I hope that today he will tell us more about this, and whether the Remploy workers are now engaged in other industries. Perhaps he could tell us whether the companies are now accepting contracts not only from the Government and similar sources, but from other industries for doing part of the work in which a particular industry is engaged.
I wish to stress that there should be no gap at all between the recognition of disability and the beginning of treatment. But when a patient has an established disability, I would suggest that the king-pin in the whole scheme is the disablement resettlement officer. I want to appeal for a better training for these officers—psychological as well as physical training. They have to be psychologists doctors and industrialists as well, because they have to know the conditions of labour in their areas if they are to find the right occupations for the disabled under their care.
They should be better trained, their status should be increased and we should demand a higher standard of education. These officers should be second only to the manager of the employment exchange, so that we shall be able to get the best type of man. They will want to know all about the industries in the area with which they are concerned, and, because of that, they should not be changed too often.
There are two other points with which I should like to deal briefly, and they concern two special cases of the tuberculous and epileptics, and both these classes are in the same difficulty, because other people are not too anxious to work with them, and, in regard to the tuberculous, they are quite right. There was a circular from the Ministry of Health which appeared about three years ago, and I have not heard that it has ever been withdrawn, which suggested that even infectious tuberculous patients could be employed in normal industry provided that they and the conditions of their work were under medical supervision. I realise that the reason for this circular was that the Minister was afraid that infectious tuberculous people might try to get into unsuitable industries, where reasonable protection against infection could not be provided.
For all that, I think this is a very dangerous proposition. A week or two ago, in a supplementary question which I put to the Minister of Education, I cited a case in Clitheroe where certainly 13, and probably 30, cases of tuberculosis in children had been traced to an individual who was engaged in the school meals service.
As fresh cases of infectious tuberculosis are becoming less common, it is more easy to trace the disease to the individual who infects, and I suggest to the Minister that these people with infectious tuberculosis are much better dealt with in sheltered workshops in which they can be prevented from infecting others. No matter how much it may cost, and I agree that it may be expensive, it is important to provide facilities for the occupation in work of people who are a public danger because of their infection, so that others may be protected.
The other class with which I want to deal is that of the epileptics. When I go to my "surgery", as Members of Parliament call it, as I shall be doing this evening, I find that the most difficult cases to deal with, after housing cases, are those of epileptics. It is very difficult to find suitable occupations for them, partly because people are frightened. Directly someone has a fit, even if very slight, all the young women are apt to run out of the workshop or factory screaming, with the result that that individual, man or woman, has to go. Another reason is that they may be irritable, and are sometimes difficult to work with.
I would make a special appeal to the Minister of Health to try to do something to obtain employment for these epileptics in hospitals and local health institutions. People who are already engaged in health administration ought not to be frightened of them. Special places should be provided where people who are liable to suffer from epileptic seizures can undertake work for which they are trained. I appreciate that this work will have to be very limited in scope, and will probably mean employment in the clerical division. Certainly, they could not be put in charge of the sick. But there are spheres in health administration where such people could be occupied, and I should like to know whether the Minister is doing all that he can to provide occupation for them.
Once again, I thank my hon. Friend the Member for Lowestoft for raising this subject. There is much else that could be said about it, but time is limited.
I am very glad to have the opportunity of following the hon. Member for Barking (Mr. Hastings) because we served on the same committee of the London County Council for many years. It was than a hospital committee, but it also dealt with people's welfare. I also want to add my congratulations to those which have been expressed to the hon. Member for Lowestoft (Mr. Edward Evans) for raising this matter. He is probably one of the most knowledgeable people in this House and in the country on this subject, and we are grateful for the lead that he has given today.
I want to make a few points, particularly in connection with the welfare side of the Piercy Report. First, every effort should be made to rehabilitate any person, whether he has been disabled through accident or has a disease, even if the disease is known to be incurable. Many people are suffering from diseases for which there is no real cure, but in the meantime those people can be enabled to lead happy and satisfactory lives. I suggest that all these people should be given their chance of rehabilitation because I believe that everybody, whatever his handicap, should be allowed to take his proper place in life.
We know that there are many people in this House who suffer from various handicaps but who, nevertheless, take their places here. We admire their courage in so doing, and they prove to us that, whatever may be his disability, there is a definite place in life for everyone.
Rehabilitation also gives these people something definite to live for, and the fact that they feel that people are taking an interest in them and finding them of use makes them less of a burden to themselves and to their relations. I want specially to address a few remarks to the subject of the welfare services for the disabled. The Report says:
It is clear that only the fringes of the field have yet been touched.
and it goes on to mention the responsibilities of local authorities, as being
…to meet the social and occupational needs of those disabled who do not come within the employment field.
In many cases disabled persons can do an enormous amount to help themselves, through the welfare services. I want to mention the disabled friendship dubs, the Inskip Club, and the type of organisation that we have in Plymouth. I am rather nervous about having special clubs for special diseases. I believe that it is very much better to have disabled fellowship clubs, where all kinds of disabled people, whether they be disabled as a result of accidents or from disease, can meet together and help each other. In that atmosphere they are also less likely to talk about their symptoms, which is an encouragement to them to rehabilitate themselves.
I can give an example of what can be done with a club such as we have in Plymouth. This club has its own drama society, and it produced a play in which every actor was very disabled. Four were on crutches and one was a paraplegic. They performed the play so well that one completely forgot their disability. The club has a choir, and it meets every fortnight. It provides its own funds by running garden parties and having flag days. It has a disabled chairman.
This type of club should be encouraged in every big city. It may not be so easy to form in country districts, owing to the distances which people would have to travel, but it is one way in which the disabled can be helped. Hon. Members may be interested to know that last March twenty-nine completely disabled people came to this House, all the way from Plymouth. They had lunch downstairs, which, I am glad to say, was attended by the Minister of Pensions, and afterwards we pushed them round both the House of Commons and the House of Lords. Such visits are very encouraging, because they show what can be done. Plymouth is 230 miles from London, and the visit was a very great adventure for these people.
As the Report points out, more hostel accommodation is needed in order to provide for the welfare of those who need employment. If more of this accommodation could be provided, not too far from the various places of employment many more of these people could be given work to do. More occupational therapy could also be provided. This could be done not only through paid personnel but through voluntary organisations. More use could be made of Red Cross personnel, who could go to the homes of these people and give them occupational therapy. Furthermore, there is a need in the hospitals themselves for more physiotherapy. This fact was also brought out in the Report. If people can be given more physiotherapy they can go home sooner, and therefore get back to work sooner. I gather that one of the difficulties in this respect is the shortage of physiotherapists.
Astley Ainslie Hospital, in Edinburgh, which has a department for training both medical and social cases following their operations or illnesses, has had an enormous success in starting this work while the people are in hospital. It means that these persons can continue the work when they go home.
I understand that in this kind of physical rehabilitation, we still lead, at any rate in Europe. I had the interesting experience of going to Germany as a member of a delegation last year and seeing the latest German equipment. They had up-to-date equipment because their previous hospital had been bombed, but they still said that British methods were best, and Swedish second best. We are still working with old equipment. We should have more equipment and it should be more up-to-date.
I was interested in the question of personal aids, as mentioned by the hon. Member for Lowestoft. One of the difficulties in this respect is that these aids are still extremely expensive. I should like to know whether they could be provided at a cheaper rate through the National Health Service. Many people could be helped if only they could afford to buy these appliances.
I hope that consideration will be given by both private builders and municipal authorities to the need, as mentioned in the Report, for some specially constructed houses with wider doors, and so on, for injured persons. Many people are not able to go home because, if they are in wheelchairs, they cannot get in or out of their houses. There may be too many steps, or it may not be possible to put in a ramp. These difficulties are preventing certain disabled people, especially paraplegics, from going back home.
Another point I should like to mention relates to the need for better co-operation between the many organisations dealing with the disabled. We appreciate all the work that is done by the many organisations, but I think we are in danger of getting too many splinter groups, and, to my mind, having worked for many years with voluntary organisations. I think this is leading to a waste of time, effort and money. There are too many organisations, and if we look in the newspapers we become rather worried about the number of pleas that appear every week requesting support for these societies. I strongly plead for an amalgamation of effort between these various societies.
I should like to draw the attention of the Minister to the question of home workers. We are all interested in these people working in their homes, but it appears to me that there is very little incentive for them to do more than just sufficient work to earn £1 a week. As I understand it, they are allowed to earn £1 a week—only £52 a year. If they earn anything over that sum, financial assistance is reduced. The difference between being allowed to earn £1 a week—and I understand it is cumulative over the year and being self-supporting on, say, £5 or £6 a week is very great. It is a vast jump.
Therefore, I suggest to the Minister that he should encourage people to earn as much as they can—this would not cost the Government any more—and then I think more people would reach the state of feeling encouraged to support themselves. People may work for a great many weeks in the year and then they may have a bad period. If they have a good year and feel fit, there is no encouragement to them to do more than £1 worth of work a week because they can get only £52 a year.
I should like to refer to the blind. I have served with the London County Council welfare services for the blind. I served also with the Metropolitan Society for the Blind and at one time with the National Institute for the Blind. At the present time I am very interested in the Royal Commonwealth Society for the Blind. I should like my right hon. Friend to look again at Recommendation 37 in the Piercy Report, because I hope he will not make this a Ministry of Labour service. As was mentioned by the hon. Member for Lowestoft, seventy-two local authorities have been successful in using the services of the Royal Institute for the Blind.
We in the society in which I am now interested have a blind director, and I am certain that a blind or partially blind person who understands the rehabilitation process involved in enabling a blind man to take up work is the best advocate for enabling blind persons to obtain work. When such people can go to the top-level men in industry and demonstrate personally what a blind person can do, the employer is far more likely to take the blind person. I hope there will be no change in this system.
It is very important—and this was brought out in the speech of the hon. Member for Lowestoft—that everybody should be treated according to his disability and should be rehabilitated according to his capacity. Every person who is disabled in any way should be treated as an individual, because individual disabilities react rather differently on people's mentalities. It is very important to remember that.
There is at present a committee under Dr. J. C. Nicholson—he is working on the Nuffield Foundation Grant—which is looking into the problems of the reorganisation of voluntary organisations and co-operation with Government Departments. One great difficulty with regard to voluntary organisations, which this committee is seeking to obviate, is the great number of trustees who are tied to certain works within a voluntary society. I urge the Minister not to formulate any definite opinion on the voluntary organisations and their working with the Ministries until this report is ready. I understand that it will be ready in June or July, and I would like consideration to be given to this report, which I believe will be valuable, before any definite decisions are made.
As the hon. Member for Lowestoft is now in his place, I should like to end as I began by complimenting him on introducing this subject and on giving us the benefit of his great knowledge on what I think I may describe as his life work.
The Parliamentary Secretary to the Ministry of Labour and National Service, like everyone else here this morning, will surely consider this to be an excellent Motion. At any rate, he ought to, because it includes the words:
That this House welcomes the intention of Her Majesty's Government to introduce a Bill…
and only on very rare occasions can anyone on this side of the House welcome any intention of the present Government.
I am not sure that I myself would have used these precise words. Being a less pleasant person than my hon. Friend the Member for Lowestoft (Mr. Edward Evans), I might have said:
That this House deplores the delay of Her Majesty's Government in introducing a Bill.
Indeed, even my hon. Friend the Member for Lowestoft, for all his good temper, was moved to say that it was a pity that the House did not discuss the Piercy Report before the Government framed their Bill.
After all, it was in March, 1953, that the Minister of Labour and National Service announced to the House that he had appointed a Committee to inquire into the rehabilitation of disabled persons and to make recommendations. Thereafter, the committee sat for three-and-half years. It held 54 meetings, heard and read evidence from nearly 200 people, and made visits to hospitals, Remploy factories, sheltered workshops and other establishments in England and Scotland. The committee made 46 recommendations. It published its Report, which was quite a long one of more than 120 pages. Yet apart from a short Adjournment debate, not one word has been said by any of the three Ministers responsible—the Minister of Labour and National Service, the Minster of Health and the Secretary of State for Scotland—since the Report was published thirteen months ago.
It is true that the Committee reported to the Ministers and not to Parliament. Nevertheless, it can hardly be regarded as a personal and private matter between the Ministers and the Committee, because if so, there would have been no need for announcements in the House or for a public inquiry or for the publication of the findings of the Committee.
I hope that nobody will tell us that one reason for this long delay is that no Parliamentary time was available. If one considers the programme of debates merely over the last few weeks one might be pardoned for concluding that the Leader of the House sits up all night wondering how on earth he will find things for the House to talk about. Apparently the more trivial the subject the longer we talk about it.
We have been babbling for hours this week about Park Lane and Milford Haven and whether maintenance allowances should be deducted from the pay packets of runaway husbands. Last week and the week before, every now and again a Bill popped up called the Isle of Man Bill. I know little about that Bill and not very much about the Isle of Man, but if the people of the Isle of Man want a Bill, then all I can say is, "Let them have it", but why should we keep on nattering about it all the time when such important subjects as the treatment of the disabled are passed over in silence? Even now we should not have had a discussion on this subject but for the fact that it was raised by a private Member.
While I am on this question, I should like to know how many more of these Reports are hanging about and have never been discussed. At this time last week a private Member moved the Second Reading of a Bill which would give effect to the recommendations of the Crook Committee on the registration and training of opticians. I do not know the date on which Lord Crook and his colleagues reported, but I well remember that the Committee was appointed by my right hon. Friend the Member for Ebbw Vale (Mr. Bevan) when he was Minister of Health, and he left that Ministry about eight years ago.
It would be interesting to find out how many of these Reports are still left without discussion, because it is a deplorable waste of time, talent, energy and expense to set up these elaborate Committees of Inquiry and then, their Reports having been published, to leave their findings without discussion and without examination.
If I agree to consent to this Motion, therefore, welcoming the intention of Her Majesty's Government, I merely do so on the good old principle of better late than never.
I hoped at the beginning that this debate would not strike a discordant note. Unfortunately, that is not to be. It interests me that the hon. Member for Thurrock (Mr. Delargy) is criticising the fact that there is not sufficient Parliamentary time to do this, that, and the other, and yet he has taken up a few minutes in the debate without putting forward one constructive suggestion to deal with the welfare of the disabled. I think that he might have made his criticism on some other occasion.
Is the hon. Member perfectly happy about the thirteen months' delay which has taken place in the examination of these findings? Does he think I am wrong to criticise the Government for neglecting the disabled people for the last thirteen months?
I entirely disagree with the hon. Member that the disabled have been neglected during the last thirteen months. I am sure that that is not the feeling of the House this afternoon.
Each of the preceding speakers in the debate has wisely concentrated upon one particular aspect of this vast work. Indeed, it is impossible to cover the whole field. I propose to follow that excellent example by confining my remarks to one aspect of the problem, and the aspect with which I propose to deal is that of the severely crippled, who are in a class of their own. In this respect, I want to deal with the question of sheltered workshops for such people and the rôle which voluntary organisations can play in dealing with this aspect.
The last time I spoke on this subject in the House was two-and-a-half years ago. I will go as far as to agree with the hon. Member for Thurrock that we should have liked to see a lot more happen in the last two-and-a-half years, let alone the last thirteen months. The fact remains that we have been moving forward, and I feel that we have probably been making haste very slowly.
We have plenty of evidence with which we can deal at the moment. We have the latest Report of Remploy Limited, which deals with one aspect of the problem, and we have the Report of the Piercy Committee, which tells us what should be done about the remaining categories of the disabled. I want it to be clearly understood that I am not standing here this afternoon in the rôle of a critic of Remploy, because I am one of the greatest admirers of the work which Remploy has carried out. Who could fail to be impressed by the wonderful results which they have achieved under the chairmanship of Sir Alec Zealley?
The fact that we admire an institution, however, is no reason for debarring us from constructive criticism. I was concerned to read in the Report of Remploy Limited that out of every £ which is spent, 7s. is paid in salaries and wages to disabled employees and 3s. 4d. in wages and salaries to able-bodied employees. It is not possible for us here to decide whether that is right or wrong but, with the experience which I have had of sheltered workshop accommodation, the figures seem overloaded in favour of the able-bodied, and I feel almost certain that it would be possible to employ a larger proportion of disabled people in the Remploy factories than are employed at present.
I want to mention, I must confess somewhat diffidently, a matter affecting a Remploy factory in my constituency, the Radcliffe Remploy factory. It employs 165 Section II disabled people; 80 of these are British and 85 are Polish. The 85 Polish employees occupy the residential hostel accommodation at the factory. I can see the hon. Member for Lowestoft (Mr. Edward Evans) looking at me rather quizzically. I believe he realises that there is a little diffidence on my part in mentioning this matter, because when we deal with the question of disability we are concerned with the disability of people, and not with race, colour or creed.
The fact remains, human nature being what it is, that it is rather galling for some of my constituents to feel that they are denied entry into the Remploy factory in their own constituency because slightly over half of the present employees, people who are not of British nationality, are occupying the accommodation.
Some of them are naturalised and some are not. Some have married British girls and taken British nationality.
I agree that this is a very difficult problem to solve, but a number of disabled people living in the district find that, due to their immobility, even if employment were available, they would be unable to travel to the factory. They see the available hostel accommodation occupied by people who are not of their nationality. While I would not presume to offer any solution to my hon. Friend this afternoon, I wish that he would give the matter a little thought and realise the problem that it presents.
Is not the obvious remedy to build more Remploy factories? I know not what the disabled population may be in the hon. Member's area, but in Merseyside we have hundreds and hundreds of disabled men, for whom a new Remploy factory is wanted. It is the Government, and nobody else, who are the impediment in the way of getting it.
I do not quarrel about that. If the Government were to extend the Remploy factory programme, I should be the first to support it. That is one possible solution. Neverthlees, I have had a number of opportunities of going round the Radcliffe factory and I cannot speak too highly of the work that it does.
I have dealt briefly with the Remploy side and I would like now to deal with certain of the questions and recommendations contained in the Piercy Report. I am particularly interested in those passages relating to the rôle of the voluntary organisations. There is one particular item of information contained in the Report which should be explained to the House in some little detail.
There are in this country 38 workshops for training and employment operated by voluntary organisations. They employ 766 people, or an average of 20 per workshop. Most of the workshops are residential in character. It is unnecessary for me to describe to the House the system of Ministry of Labour grants for capital expenditure, training and deficiency allowances, but in the last year which is quoted in the Piercy Report the amount of that Ministry of Labour assistance worked out at £120 per head for each of those 766 people employed in workshops run by voluntary organisations. It has to be remembered that these workshops are mainly residential. That amounts to a total disbursement by the Ministry during the year 1954–55 of £94,000 to the voluntary organisations for carrying out this vital work.
During the last year covered by the Remploy accounts, the amount per head was £443, and the Remploy factories are mainly non-residential. This figure is arrived at by dividing the number of 6,179 disabled people at Remploy factories into the Ministry of Labour grant of £2,737,000. I am not suggesting that Remploy receives too much from the Ministry of Labour, but I am suggesting that the voluntary organisations receive too little. I am not suggesting that the voluntary organisations should supersede Remploy, but I do suggest that the Ministry should encourage the voluntary organisations to work alongside Remploy, as is recommended in the Piercy Report.
There is one example which I should like to put to my hon. Friend the Parliamentary Secretary which. I think, could be dealt with very simply and which would make a tremendous difference. We are dealing with the problems of the severely disabled. The Minister of Labour can grant up to £100 per head per annum as a deficiency grant, but it is apparently laid down that this is conditional upon those people who are employed in these factories working a minimum of 30 hours a week.
It should not be forgotten that we are dealing with the severely disabled. It is quite often impossible for the severely disabled to get up to 30 hours per week in less than a very long time. It is within my knowledge that there are a very large number of disabled people whose total capacity at the moment is only 25 or 20 hours per week, but because of their severe disability the deficiency grant is not paid. It is time that this matter was looked into.
Secondly, the Ministry insists as a condition of making grants that there should be separate sheltered workshops and separate hostel accommodation for the two sexes. That may be all very well in large undertakings, but from my experience I consider it quite wrong to make that insistence when dealing with small groups or communities who do not have the money to put down to build either separate sheltered workshops or separate hostels.
There is no doubt that it would be cheaper if the grant were made even though the two sexes were working under one roof. When males and females who are able-bodied work together in normal employment, I fail to see why a distinction should be drawn just because they happen to be disabled. As for the question of hostels, we have both sexes living in hotels. I do not see the slightest reason why we should not have both sexes living in hostels, especially if there is adequate supervision. I should like my hon. Friend the Parliamentary Secretary to look into this matter.
I have had some figures given to me which illustrate the point I am trying to make. At the Papworth Village settlement for tuberculous patients, there is a 1,000-acre estate with five factories and 700 people on the payroll. At Papworth, it is possible to admit trainees who are capable of only three hours work a day; gradually, of course, they work up to as much as six or seven hours a day.
For that scheme, Ministry of Labour maintenance grants are paid to those under training and the local authorities are responsible to contribute 63s. per week for patients who are capable of working five hours a day. On the acceptance of the work, wages are agreed with the appropriate trade union and are paid accordingly. If that scheme operates at Papworth in connection with T.B. patients, I do not see the slightest reason why it should not operate in workshops under the aegis of the voluntary organisations of the severely disabled.
It strikes me that one failing in the Piercy Report is that a sufficient distinction is not drawn between employment and welfare. We all know that there is a distinction, but I sometimes think that, in practice, it tends to be much too arbitrary. Wages for training and sheltered employment are vastly different from maintenance costs, which are based on other principles. For example, for those doing less work in training or in sheltered employment, the wages are based on set hours of labour at fixed rates. Therefore, the more severely disabled a person is, the more severely he is penalised.
When we come to the other end of the scale we find that maintenance costs are based on need and not on the capacity to earn, which is a complete reversal of the former example. It cannot be denied that training and sheltered employment are all part of the treatment. It is a continuous process of the rehabilitation which is stressed in the Piercy Report. I suggest that useful employment, however small and on whatever scale it may be, should be classed as welfare.
The Piercy Report goes on to suggest that the whole object of the exercise is to get people into normal employment. No right-minded person will disagree with that recommendation. However, the fact remains that we have to see that the Ministry, so far as it lies within its power, deals with those people during the period when they are undergoing training in sheltered employment and before they are able to take up normal employment.
The third point which I want to mention, and which has already been lightly touched upon, concerns the young severely disabled. Their education is, in most cases, drastically interrupted. Nevertheless, during the time they are adolescent, or during the years until they reach adolescence, I think that they are much better equipped mentally to try to overcome their individual deformities. Unfortunately, when they are at the stage of leaving school there are many obstacles in the way of their further progress. I do not think that we have nearly enough facilities for vocational training of these young people after they leave school.
We lack the facilities for equipping these people to adopt an attitude towards life which will impart to them some usefulness. I believe that more residential accommodation is required for these people. We require more regular class work under skilled supervision and a graduated form of rehabilitation to suit each particular age group. All these things exist, but they do not exist in a sufficiently great measure.
Another of my criticisms of the Piercy Report—and, as I say, it is a constructive criticism—is that it tends to think more of the less severely handicapped than the more severely handicapped. There is no doubt that it is the severely disabled who are most in need of assistance, because quite often they turn out to be "nobody's baby." Medical officers of health are at a complete loss to know what to do with them. From my own experience, I have found them languishing in Class III hospital accommodation or in old people's homes. That is a terrific problem, but voluntary organisations are trying to deal with it.
I wanted to mention block grants, but they have been touched upon already. Without trying to talk about this matter in any partisan spirit, I was concerned even before block grants were mentioned, that chairmen of the various welfare committees up and down the country were seeing the big stick being wielded by chairmen of other committees on particular local authorities. What will happen to them after the block grant scheme comes into operation, and chairmen of education committees start wielding the big stick, I shudder to think. I do not say that in any controversial way, but only out of a genuine desire for the welfare of the disabled. I hope that my fears in that direction will not be justified.
May I conclude by giving one example which may interest hon. Members who have this matter closely at heart. When the hon. Member for Lowestoft moved the Motion he pointed out that he was an interested party. I, too, am an interested party, although I have no financial interest. My only financial interest, like the hon. Gentleman's opposite no doubt, is to try to extract as much money as I can from the pockets of the general public to further this voluntary work. Beyond that my financial interest does not go.
The Minister of Labour knows, and I think the Parliamentary Secretary knows, too, of the particular training centre which I have in mind, but I do not propose to name it, because it may sound too much either like advertising or pleading a special cause. The fact remains that this is an organisation with which I am particularly concerned.
A few years ago a house was purchased and 20 female trainees were taken into residential accommodation. As time went on the waiting list increased, and, of course, there was an obvious need for sheltered workshop accommodation. As the premises did not lend themselves either to extension for residential purposes or for sheltered workshop accommodation, it was decided to purchase other premises. These were found despite the fact that the organisation not only did not have any money in the bank, but had a substantial overdraft. Very large premises were found and the contract was signed. The association had something far more important than money—they had faith in the general public to provide the purchase price of the property.
Within twelve months the organisation had collected £30,000. That is almost exactly a third of the grant given by the Ministry of Labour in one year to all the voluntary organisations who are seeking to deal with this problem. This association now has 50 men, women and children in training. They are anxious to start sheltered workshops, but, for the reasons I outlined earlier, they are precluded from obtaining a Ministry of Labour grant.
I hope that the Minister will note, therefore, that at present 50 trainees are already under instruction, which is one-thirteenth of the total number under instruction in voluntary organisations in the country. Not a farthing has been received from the Ministry of Labour. It is proposed to start a sheltered workshop whether the Government assist or not, because we have faith that the people will provide the money necessary, and in a very short time we shall have 100 people employed in a sheltered workshop, about one-seventh of the total number so employed at present.
So I hope the House will realise that the voluntary organisations are playing a part, as I am sure the hon. Member for Lowestoft knows very well, but there is a limit to how far those organisations can go in trying to extract money from the general public. It is time that the Government looked into this matter more closely. I notice that the Piercy Report discards the suggestion that we have a national corporation to examine all aspects of this problem from the beginning to the more advanced stage at the moment, but I would reiterate a plea which I made when I was speaking on this same subject two-and-a-half years ago, when I suggested that probably the best answer today would be the setting up of a co-ordinating committee of all the Government Departments interested in the welfare of the disabled.
The Ministry of Labour, the Ministry of Health, the Ministry of Education, and the Ministry of Pensions and National Insurance are all interested in this problem. It is probably unnecessary to mention the Treasury. I believe that if such a co-ordinating committee were set up we could go a long way towards solving this vast problem.
Like most of the previous speakers in this debate I welcome the fact that my hon. Friend the Member for Lowestoft (Mr. Edward Evans) was fortunate enough to be able to bring our attention to this matter. I rather share the sentiments expressed by my hon. Friend the Member for Thurrock (Mr. Delargy) in not associating myself fully with all the words of the Motion, because before I welcomed a Bill I should want to know what it contained. I imagine that it was because my hon. Friend the Member for Lowestoft thought something would be better than nothing that he chose the words he did.
My hon. Friend the Member for Thurrock was quite justified in saying what he said. He said the Piercy Committee sat for three-and-a-half years before we had its Report, and that that Report has been in the hands of the Government for fifteen months. I am supposing that when the Parliamentary Secretary winds up the debate we shall hear a little more of what the Government's attitude to this matter is.
I want to deal with a different aspect of the matter touched on slightly by the hon. Member for Bury and Radcliffe (Mr. Bidgood). I share completely his view of what is likely to happen in con sequence of the block grants. I shall come back to that in a moment. I hope that the Joint Parliamentary Secretary to the Ministry of Pensions and National Insurance will be back on the Front Bench soon, because I want especially to say something about the National Assistance Board, for which she shares responsibility.
I think it is true, and it is certainly my opinion, that the most hard-pressed people in this country today are the home-bound disabled people. They are having a shockingly rough time at the moment. I doubt whether even Members of this House, much less the general public, are fully aware of what exactly is happening in so many of these terrible cases of home-bound disabled people. It is not so long since a couple of my constituents came to see me to draw my attention to certain facts which they had discovered and which had shocked them, facts about the way in which so many of these totally disabled people, homebound, probably all their lives, have to live, and about the conditions in which they are existing. I had to explain to those constituents of mine exactly what provisions existed for help. They had a very great knowledge of the circumstances of these unfortunate people who lived locally, and of the conditions in which they were living, and I asked them if they would be good enough to summarise for me on a factual basis some of these instances, so that one could get a first-hand and exact impression of the state of affairs.
I have here a whole lot of these cases cited. They are representative of a very much larger number. To illustrate the sort of conditions which exist and what is happening I shall recite the facts in three instances only. For obvious reasons I shall leave out the names of the persons concerned. I shall content myself with merely stating the facts as they were presented to me and merely in summary form, and I shall leave hon. Members to fill in the details, as their imagination can quite easily do. I take first the case of him I shall call Mr. A. He is aged 38. He has paraplegia from a birth injury. He cannot walk. He gets about the house on his knees. He has a wheel-chair in which he can be taken out. He lives with his mother and father. Father's left arm is amputated from the shoulder. Mother is now house-bound. Mr. A. receives £1 19s. per week National Assistance. Four years ago he received a pair of trousers and two pairs of socks. My informants say that Mr. A. and his father "appear to be very intelligent people." I need not ask any hon. Member of this House what he thinks about the plight of a man in that condition getting 39s. a week.
Mr. B is aged 55. He has been crippled with arthritis and rheumatism, particularly in his back, for a number of years. He lives with his wife in what my informant describes as a "dreadful cellar of a condemned house" for which he pays 6s. a week. He receives £3 5s. National Health Insurance for himself and his wife. The only supplementation they have received from the National Assistance Board was 35s. for trousers and jacket. My informant says:
I am sure they would be very worthy people if circumstances could have been different.
That poor soul carried his cross long enough. Since I had this report the poor man has passed away.
Mr. C, aged 57, has chronic bronchitis and severe high blood pressure and is incapable of doing even handicraft work because he cannot hold his head in a lowered position. He has not worked for five years and will never work again. He receives £3 5s. National Health Insurance for himself and his wife. The only supplementation received from the Assistance Board was for one sheet at a time when Mr. C. was in bed for a long period. My informants add that Mrs. C. is an excellent manager. Obviously, to maintain two persons in that condition for £3 5s. a week, one needs to be an excellent manager.
In my opinion, the three cases which I have cited are typical of hundreds and hundreds of such cases, which exist particularly in the industrial towns. It ought to be somebody's responsibility to do very much more than is now being done for them. I hasten to add that I have no complaint to make about the National Assistance Board officers in my constituency. I want to make it quite clear that, immediately I called their attention to these cases, certain steps were taken to improve the position as outlined in the report which I have quoted. It is equally true that since that date a certain improvement has been made in National Assistance scales.
I am sorry that the Minister of Pensions and National Insurance and his Parliamentary Secretary are not here now. I should have thought that they would have stayed to hear much more of the debate than they did. It certainly should be somebody's job to ensure that these appalling conditions do not exist for a moment longer. I am sure that every hon. Member would agree with that. I know that it may well be said that the National Assistance Board officials have powers to make discretionary grants and it is on this point that I want to direct a question to the Minister.
On what basis are these discretionary grants made? These investigators in their reports to me on these three cases, clearly establish beyond contradiction how utterly inadequate the allowance has been for the replacement of clothes and sheets. What is done in these cases of unfortunate people who obviously have been homebound for many years? It surely should be somebody's job to ensure that proper provision is made whereby sheets and articles of clothing are replaced within a reasonable period of time. Quite obviously, this poor man whom I have mentioned, struggling about the house on his knees, needs replacement of clothes very much more often than a normal person. It is equally obvious that the income which goes into the house is utterly inadequate for the need.
Where then lies the fault? Between 1945 and 1950, the Labour Government prided themselves quite rightly upon laying the foundations of the Welfare State. We did an enormous amount of work and I had always understood that it was the intention that the National Assistance machinery was designed to ensure that people of this kind who were badly in need could be dealt with properly and systematically. Everybody who is familiar with this kind of work knows that there are large numbers of people who, hard-pressed though they are, hesitate to go out of their way to make appropriate applications from time to time. It is not right to leave the initiative with these people. It should be somebody else's job.
It may be said that this is the responsibility of the local authorities' welfare committees, but is that the case? My experience is that there seems to be no proper liaison between these welfare committees and the National Assistance Board and National Insurance office and other parties who are interested. There is no proper co-ordination. We have now in Birkenhead a chairman of the welfare committee who is particularly keen on her job and who is trying to get things done to help these disabled people; but is it not the experience of all who are engaged in local authority work now that welfare committees are almost the Cinderellas of local government?
The hon. Member for Bury and Radcliffe referred to circumstances as they are today, and I thought that he subscribed to the view that the welfare committee is by no means the main committee of a local authority. How right he is. He expressed fears of what will be the position of welfare committees in the future when the block grant is in operation. It seems to me that the chances are that the position will worsen and not improve. The time surely has come when there should be far greater liaison between the welfare committee of the local authority and all the other interests concerned to ensure that proper care is given to these shocking cases which exist in far greater number than most of us imagine.
There is another aspect of this problem of which I expect all hon. Members have had experience similar to mine. This is the sort of letter which hon. Members so frequently receive:
I am in a predicament. I am in great anxiety. I am a registered handicapped person with the Birkenhead Welfare Department and I have been advised to write to you. My disability was caused by osteoarthritis of both hips and knees, with the result that I can only move a few yards at a time with difficulty and have been unable to go out for almost two years now. My anxiety is caused by being unable to obtain accommodation without stairs. The owner of this house where I have rooms at present has given me notice that she is selling this house and going to live in Wales on retirement from work, and I am completely at a loss to understand or to know what is to happen to me. My age is 54 years.
I have checked the facts in this letter with the town clerk. He confirms absolutely what the writer says and adds:
Her disability prevents her doing any further service as a nurse. She has nowhere to live and will shortly be required to leave her temporary accommodation.
Everybody's sympathy is with a case like that.
Here is a woman who has been nursing other people for the greater part of her life and, at 54, she finds herself physically handicapped with no relatives and nowhere to go. What is the poor soul to do? The local housing authority will only say, "How many points has she? Has she a sufficient number of basic points and enough balancing points?" If she is not on the top of the list of points, she is out. What then is the poor soul to do by way of getting accommodation? Hon. Members knows perfectly well how virtually impossible it is for a handicapped person like that to obtain private accommodation.
The only remedy for people of that kind, obviously, is for the Government, in conjunction with the local authorities, to take such steps as will enable a local authority to provide suitable accommodation. Is it not far better that the Government, with the local authority, should utilise their financial resources to provide this housing accommodation? These people do not need much room. They can be comfortable in a couple of modern rooms where there are no stairs. That accommodation can be provided easily these days.
Unless those things are done between the Government and the local authority, the handicapped people have no chance. Therefore, I beg the Government to take up this matter with the local authorities and give assistance to the local housing authorities. They can say with truth that they have done something for the aged people by asking local authorities to go out of their way to provide accommodation. The condition of the totally disabled, however, who are unable to work now and are quite unlikely to work again, is just as pressing and urgent. The local authorities will not do it because their points' schemes do not allow for cases of this kind, and they say that the Government will give them no financial help. That is true, since the general housing subsidies were abolished by the present Government, and so the local authority gets no financial assistance in providing such accommodation.
What is to be the end for such cases? I suppose at the worst the poor soul I have mentioned will struggle on and on until she goes into an institution where it costs £8, £9, £10, £12 or £14 a week to maintain her. Surely, it would be better if she could be on her own somewhere, satisfying to herself and costing far less?
The disabled have no highly organised pressure croup to deal with the Treasury. It is a shocking state of affairs. One could talk on this question all day. There is, for instance, the type of person who is disabled but is able to carry on some job. I know dozens of cases. I could almost recite them by heart. They have either to pay for a taxi in which to go to work or they have to get somebody else to take them. In either case they incur expenditure. Yet when we asked for £100 as an allowance from Income Tax to be given to them to meet this expenditure, it was turned down by the Government.
These are the practical things a live Government should be doing if they mean seriously to help the disabled. If the Motion on the Order Paper today has done nothing more than focus attention on this urgent problem, it was well worth putting down.
It is a considerable pleasure to me to join with those who have congratulated the hon. Gentleman the Member for Lowestoft (Mr. Edward Evans) on, first, his good fortune in the ballot, secondly on the Motion that he selected for debate, and, thirdly, on the way in which he presented it to the House. I will not follow the case book of the hon. Gentleman the Member for Birkenhead (Mr. Collick) because I am sure he will appreciate that each one of the cases requires detailed knowledge and examination which is far better left to my hon. Friend the Parliamentary Secretary to the Ministry of Pensions and National Insurance.
I want, however, to refer to a point made earlier by the hon. Gentleman the Member for Barking (Mr. Hastings). Before I proceed to his point, I think it is reasonable to express the observation that every hon. Member has a broad and general interest in the training of handi- capped people. Many of us have specific interests in certain sections of this training and of the welfare and work of handicapped people, sections to which our attention is directed by circumstances, profession and particular interests. I am in the position of having a particular interest in my capacity as chairman of the Mental Health Sub-committee of the Middlesex County Council, to which authority the hon. Member for Barking referred in such kindly and glowing terms for its work in the mental health field.
Mental health committees cover two particular factors. They cover work for those who are mentally sick and also for those who are mentally defective. Often in this House we have opportunities of discussing the welfare and rehabilitation of those who are mentally sick—that is, of recent months. For this reason I wish to draw the attention of the House for a short while to the question of the habilitation of the mental defective. We have agreed generally in this discussion that the function to which we are now directing our attention is to give economic consequence to the work which we are trying to train handicapped people to undertake. If we fail to do this with a large number of them, the value of the effort is greatly lessened.
This must be the direction we are trying to follow in our work for the mental defectives. I join with the hon Member for Barking in his plea for early diagnosis, which is so much a preliminary of the training. Obviously, the earlier one can diagnose the complaint the earlier one can set to work on training and equipping the person to fulfil some useful function in the future.
There is one other factor, the parental attitude. It is extremely important, where mental defective children arrive in a family, that the parents should be instructed and encouraged to meet the problems they will have to face. Their problems are vastly different from those of parents of normal children, as I am sure hon. Members will know from cases in their own constituencies. We shall fulfil a valuable function if we can encourage local authorities to work on early diagnosis and on aiding parents to realise what may be the limits of the capabilities of their children, and that they must make the best of those children within such limits.
I mention these points because, in training mentally defective children to take a limited place in society and in industry, the job starts right from the beginning and right from the diagnosis. Where the parental attitude is right, where the local authority has been able to develop the parental approach, there is often an opportunity for the child to go to what is called an occupation centre.
I want to express the view that "occupation centre" is a wholly misdirected name, a name which is out of keeping with the subject of our debate. It implies that the child goes there for nothing but occupation, whereas the object of the system must be for training and a form of education, though certainly not education in the accepted sense. As circumstances have changed, as training is improving, it seems to me that it would be reasonable to change the title, and I hope that my hon. Friend the Parliamentary Secretary to the Ministry of Health will give consideration to this point.
In some authorities there are opportunities for graduation from the simple occupation centre to which children are first taken and, as the hon. Member for Barking said, in some authorities opportunities are given for the older children, particularly older boys, to go to a special type of training school and to acquire certain abilities. For example, in Middlesex there is a training school which employs some of the children in wood-chopping. Chopped wood is used in county council establishments, and, therefore, this training fulfils an economic purpose. There is also training in gardening and in simple assembly jobs.
In this, as with every other branch of disablement, which we are endeavouring to expand—the occupational side, the training side, and the work side—there must always be the requirement for a job to do. The plea that we must put up on this occasion is to industry as well as to the Government, as was suggested earlier by the hon. Gentleman the Member for Shoreditch and Finsbury (Mr. Collins), that industry could reasonably easily, if it examined the situation, supply jobs involving simple operations which could be put out to occupation centres and training centres for adult mental defectives.
Again, as the hon. Gentleman the Member for Barking mentioned, there is a commercial job of cardboard box manufacture being carried out in the Middlesex area. I hope that there will be considerably more opportunity coming from industry for the employment of people in sheltered workshops of this kind. I hope, too, that in the mental health field there will be further development in due course, for those cases where it is most suitable, of industrial hostels.
There are many cases where mental defectives, being sheltered and protected to a certain extent, can find a job in the community provided that they are assisted with their money and feeding problems, and matters of that kind. There are many jobs in industry itself which they could undertake if the diagnosis is early enough, the parental attitude is right and the training is also right. There they could then fulfil a useful and economic service and become nearly a part of the normal community.
I conclude by welcoming this Motion and by repeating my hope that industry will find many more jobs of a suitable kind which it can pass outside its own boundaries and its own shops and put economically into sheltered workshops.
In utilising his good fortune in the Ballot to introduce this Motion, I feel sure that my hon. Friend the Member for Lowestoft (Mr. Edward Evans) has done a very real service not only to the disabled and the services with which we are concerned, but in focusing attention upon this particularly human aspect of the work of the Government Departments which have responsibility for disabled persons.
Government Departments in general are so often regarded as soulless, impersonal institutions that it is well to be reminded from time to time that they are not merely and exclusively sidelines of an aloof and remote bureaucracy, but have a very definite responsibility for a human service of this character. The work, in particular, of the Ministry of Labour in this field is one of the outstanding marks of the tremendous transformation which has taken place in that Ministry from pre-war days, when it was very largely dismissed—and was to a large degree very unpopular—as little more than a dole-paying agency, and has translated itself into an essential social service Ministry and an essential instrument of the Welfare State.
This is a change which, as was said by my hon. Friend the Member for Lowestoft, owed a great deal to the inspiration of a very distinguished holder of the office of Minister of Labour, the late Ernest Bevin, aided by an enlightened administration and staff. That Department was only too keen to embrace the opportunity of undertaking work of this kind.
Nor should the work of the Ministry in this field be dismissed as a mere incidental sideline of its main function. We should be wrong if we did not recognise that these services are of tremendous consequence and concern to a very substantial section of the community. It has already been said that we do not know the exact size of this problem. We know that there are about 750,000 people who are on the register of disabled persons, but we also know that that is only a part of the problem. I hope that the Parliamentary Secretary will be able to give a promise that that part of the Piercy Committee's Report which directs attention to the need and desirability of assessing this problem more accurately will be treated by the Government with some practical steps by way of research.
It is my experience of disabled people that the last thing they desire is pity or patronage. I am firmly convinced that what they need is practical help, means to recovery to the extent that physical recovery is possible in their individual cases, and; above all, means of securing a basis and assurance by which they can learn to live with their disability and learn to be able to take a part in society, with the satisfaction of knowing that they are making a real contribution to their own self-esteem.
Nothing is more devastating to a disabled person than the feeling that he is useless to society, useless to his family and perhaps to himself. I feel that we have done right today to devote time to this subject. Surely it is a demonstration of something of our human civilisation that we should indicate that society is really concerned to provide the means whereby its disabled members can make a very real contribution to their own recovery and welfare and above all the restoration of their self-esteem.
The Piercy Committee has made a very wide and comprehensive review and should like to pay tribute to its work. I do not make any complaint that it spent an adequate time on the job, whatever may be said about the delay, since the Report was published, on the part of the Government. It was a comprehensive Report and it is gratifying to find that the Committee finds that the services which are provided for the disabled are comprehensive and well-established. There is no doubt that what has been done, and done very well indeed, has been of tremendous benefit to those concerned.
We should be failing to take this opportunity if we did not pay tribute to the work of the officials of the Ministries responsible and those concerned in associated Ministries for the sympathy, understanding and tact which they have brought to bear on their task.
I agree with my hon. Friend the Member for Lowestoft that there is no ground for complacency on this issue. It has already been illustrated in this debate, by hon. Members better equipped with personal experience than I am, that there is need for close examination of the necessities which have not yet been fully met in this field. I want to draw attention to one or two somewhat disquieting features in the Report of the Ministry of Labour for 1957. I think that the whole burden of this debate has been to indicate not merely that existing services should be maintained but that there is a need for an expansion in various directions.
I am concerned to note one or two features of the Ministry's Report which would seem to indicate at least the possibility that we are not even maintaining the service that we had previously, that there is some slackening, some going hack. For example, one is surprised to note that the sharp decline in the number of registered disabled people continued during the year 1956. It dropped from 818,500 in 1955 to 785,000 in 1956, and I think that we ought to pause and ask what is the significance of that change. Is it really due to the diminution in the total number of disabled people in the country?
If medical science and the prevention of accidents have reached the stage where it is really making inroads upon the total number of disabled people, I am sure that we shall all welcome that fact. I am not, however, convinced by any available evidence that such is the case. I should expect to find, quite naturally, a reduction in the number of ex-Service disabled by the mere passage of time. Analysing the figures, however, one observes that the reduction is just as sharp in the other category of disabled.
It is true that in a period of full employment there would be less and less incentive voluntarily to register as a disabled person, but when the Minister of Labour, in his Report, draws attention to the fact that during 1956 there was a slackening of demand for labour, which had its impact on the placing of disabled people in employment, I should have expected some reversal of the tendency for a decline in voluntary registration of this character.
I hope the Parliamentary Secretary will be able to tell us that some investigation is being undertaken, or can offer some assurance about this disquieting factor. Is it, for example, due to a lack of adequate publicity on the part of the Ministry and the associated Departments as to the services which are available to disabled people? If so, I hope that the Parliamentary Secretary will tell us what the Government propose to do in respect of the recommendations on publicity in the Piercy Report.
Another feature of the Ministry's Report for 1956 which is disquieting is that the number placed in employment during that year totalled only 89,000 compared with 114,000 in 1955, a drop of 25,000. We cannot pass that over as a matter of no concern. It is true that it is related to a smaller register, but even if one analyses the figures and feels satisfied that the reduction in the number of registered disabled is justified by reference to understandable facts, one still arrives at the fact that the unemployed disabled represent nearly 5½ per cent. of the number on the register in 1956 compared with little more than 4½ per cent. in 1955. That is an indication of some slackening in the work of the Ministry. At all events, it warrants inquiry and investigation.
One notes in the same Report a decrease in the number who have been completing their courses at industrial re- habilitation units. The reduction is from 8,300 to 7,801. The same tendency is noted in respect of the numbers who completed vocational training. There are several indications of that character in the Ministry's 1956 Report which call for a measure of reassurance from the Ministry.
Could it be, for example—I make no positive assertion; I raise the question because I think it proper and relevant to do so—that this is, in part, because the Minister has been wielding the economy axe in his Department over the last two years? He has been aiming at a reduction in staff of about 2,000 over the Ministry as a whole. The Parliamentary Secretary will recall that at an earlier stage I pressed his right hon. Friend to explain what the consequence of the reductions would be. While he was anxious to assure me that there would be no reduction in standards through these economies. I do not feel at all reassured when I observe figures of this character in relation to the work for disabled people. I hope it will be appreciated that when one talks in terms of reducing staff and of closing local offices it may well be that, almost imperceptibly but, nevertheless, significantly, the work for disabled people is beginning to be affected.
Turning to the Report of the Piercy Committee, it is true that the Committee does not consider it necessary to recommend any tremendous increase in financial provision or expenditure except in regard to certain welfare services undertaken by local authorities. An adequate comment about that has already been expressed on both sides of the House: what are local authorities to do in this matter in view of the Government's proposal of a block grant? I do not imagine for a moment that the Parliamentary Secretary will be able to reply to that point. Indeed, I feel that one of the most regrettable features of the debate is that, while the presence of Ministers of the Departments primarily concerned has been welcome, we have not seen a representative of the really important Department, the Treasury.
Whatever may be said of the Piercy Committee's suggestion that what is required is not necessarily a great increase in expenditure, there can be no doubt that, with rising costs, and for the purpose of maintaining existing services and entertaining anything in the nature of the expansions of the service which have been urged on both sides of the House, increased financial provision will be required. I hope that that will not be forgotten, for no amount of platitudes and expressions of good will will overcome the need to make adequate provision from national resources to meet necessities of this character.
I wish to refer to one or two recommendations by the Piercy Committee. One or two of them have some bearing on the question of the financial ability of the spending departments concerned to meet the recommendations. In recommendation No. 7 the Committee:
…recommends that the larger share of what can be spared from the national resources for capital development for rehabilitation in the near future should be on the hospital side, but that some important existing industrial areas without industrial rehabilitation units should be supplied with them…
I think I am right in saying that the Ministry attaches some importance to an expansion of this kind of provision.
I believe the Minister has it rather dearly in his heart to establish two such units at Aintree and Perivale. I hope that the Parliamentary Secretary will be able to tell us what is happening to those projects, and whether it is a fact that so closely is the Minister's Estimate to be out under the Chancellor's present directives that it is impossible to carry on with them.
I now pass to the importance of ensuring an adequate staff, an adequately trained staff and a staff of a sufficiently high level to undertake this essential work in the Ministry of Labour. The Committee in my judgment, quite rightly—has rejected the idea of a specialist service for the D.R.O.s. I think it is right in its view that those who are chosen for this work should possess an aptitude for it that they should not necessarily be in a specialist grade but can best be chosen from persons who have an all-round knowledge and acquaintance of the work of the Ministry and can see the whole thing in perspective.
The Piercy Committee recommends that the Ministry
…should take steps to secure that its methods of selection are such as to ensure that in all disablement resettlement officer
appointments the fullest consideration should be given to the officer's suitability and inclination for this work.
I hope that the Parliamentary Secretary will be able to tell us something about that and what progress he has been making in his explorations into this subject.
It is true that, while one can readily draw from the existing ranks of the officers any person for this work without setting up a specialist class, none the less it is essential to ensure that those who undertake the work are not assigned to it arbitrarily merely as part of their rota duties, but are selected in the light of their willingness and ability to meet the peculiar requirements of a job of this character.
Recommendation No. 25 refers to the desirability of extending training courses. I believe—the Parliamentary Secretary will be able to assure us—that that is already being undertaken by the Ministry and to that extent we can welcome the development. I want to refer to staff in this connection. It is not good enough that a disablement resettlement officer, who has to undertake close collaboration and co-ordination with officials in the hospital service, at a very high level in many cases, and who has to undertake negotiations and explanations of policy and of services available, should be of the rank which is often the case in the Ministry of Labour.
For instance, the resettlement officer in a city like Cardiff ranks as a mere Grade V officer, which is not sufficient. The post should warrant a much higher grading. After all, one cannot carry great weight and influence with a high authority in a hospital if the hospital authority is conscious that he is dealing with only a relatively junior official of the Ministry. The Piercy Committee stresses the importance of more coordination and consultation, and hospital authorities ought to be able to feel assured that they are dealing with people of comparable rank.
I have stressed that much of the debate has been in the direction of urging upon the Government the desirability of an extension and expansion of existing services. We need not delude ourselves into thinking that this does not inevitably mean increased financial provision. We are now in a period of an attempt by the Government to restrict Government expenditure. I shall not enter the general debate about the efficacy or validity of the Government's general policy on that, but it is imperative, when we approach the subject of economy, that we should appreciate that if sacrifices have to be made they should not be made by disabled members of the community. They are the last who should be called upon to suffer for anything which is wrong with the economy.
After all, it would be not only bad humanity but unsound economics, for in the end what is being done is good humanity and good economics, and from that point of view this subject demands a much higher priority in the scheme of things of financial provision than it has had hitherto. I hope that the Parliamentary Secretary will be able to assure us that at least he and the Ministry of Labour are putting up a good fight with the Treasury to ensure that there shall be adequate provision for these services in the future.
It is a great pleasure to be able to follow the hon. Member for Walthamstow, West (Mr. Redhead), as I once tried my best to prevent his being here. On this occasion we find ourselves very much more in agreement than we were on wider issues on that earlier occasion.
I do not want to speak in great detail about the wide range of subjects which the debate has covered. I congratulate the hon. Member for Lowestoft (Mr. Edward Evans) on introducing the subject, which has produced much detailed information which can only be of use to the Ministries concerned.
Two themes run through the Report of the Piercy Committee and the debate and I want to underline them. The first concerns the feeling, expressed by nearly everyone, that the treatment of this problem must be regarded as a continuing process—we are looking at every single stage from an accident or disablement at birth right up to the time when people may be able fully to participate in life. The second theme in the debate and the Report has been the need for more consultation among authorities which have some responsibility for rehabilitation.
I want to make only two points. The first concerns the need to spread informa- tion about the services as widely as possible among the various services, the medical profession, to which the hon. Member for Barking (Mr. Hastings) referred, industry, and local authorities, where practices appear to differ, and among the disabled themselves and their families. The spreading of information about services available to the disabled is perhaps the most important thing to come out of the debate.
The second point concerns the need to make the maximum use of voluntary organisations, some of which give very skilled training. I stress the part which can be played in the spreading of information by the general practitioner. He has a unique part in drawing together many factors in the treatment of the disabled. I am thinking particularly of the stage when a patient emerges from a hospital or residential unit of some kind and begins to return to normal life. I am thinking of some of the less seriously disabled. If adequate medical supervision and medical interests are not available at those key moments, there is a danger of recession and deterioration and loss of confidence by the patient which could result in the patient returning to hospital and presenting a much more serious problem in future.
There are obviously very many cases where the finest possible standards of consultation and of bringing the G.P. into the picture have been evolved and scrupulously observed, but we know of others where, partly because of overwork and partly because of other factors, that has not been done. Much is to be gained from stressing the importance of this subject in the training of the medical profession.
I have a tentative suggestion to make to my right hon. Friend the Minister of Labour about information in industry. Here again the Piercy Committee stresses that some firms, particularly the larger ones, do a great deal of work on their own in this sphere. Anything which my right hon. Friend can do by publicising what is done by the large firms and by some of the smaller ones will be helpful. That is a suggestion which would not cost money but which would certainly help in some cases.
Voluntary organisations can be of especial importance in rural areas. The hon. Member for Birkenhead (Mr. Collick) said that there were many disabled people in his constituency. Obviously there are areas, however, where the disabled are separated by miles of countryside and where they are very scattered. We will not be able to build for those cases a "welfare organisation on the doorstep," of the right pattern, unless the general practitioner is informed when one of his cases leaves hospital so that he is able at once to inform the appropriate welfare officer.
To effect that there should be a link between the local authority organisation and the hospital organisation so that each could refer to a particular village and know that there was a suitable voluntary organisation working there which might be of use as a contact for getting that disabled person in touch with the welfare authorities. That is particularly the case where the patients concerned are married women with families to look after.
I say that because it very often happens that the person concerned is a woman with a home to which she wishes to return, maybe with children in the household. Because her work is in the home, she tries to—or is almost forced to—get back into full-time activity before she is absolutely ready for it in a way which, maybe, would not be forced upon a man who goes back to his work in the factory of a good employer, where some provision would be made to lighten his work in the early stages.
I suggest that voluntary work in this sort of case could be of very great value, and that anything that local authorities can do to train voluntary organisations in what is needed and to encourage them to see the need in this sphere is so much the better.
Finally, I should like to say that, as always in any field of medical work, prevention is better than cure. Thinking again in terms of industrial accidents, I suggest that good management and supervision, good machinery and adequate safety regulations properly observed, can play as big a part in this problem as anything else.
In view of the fact that the time is approaching when speakers from the two Front Benches will take over. I propose to address to the House only a few sentences, so as to enable the hon. Member for Exeter (Mr. Dudley Williams), who has been sitting here very patiently, to say a few words.
I rise to summarise the impressions which I have formed as the debate has proceeded. I join with others of my hon. Friends who have expressed gratitude to my hon. Friends the Members for Lowestoft (Mr. Edward Evans) and Shored itch and Finsbury (Mr. Collins) for having given us the opportunity to discuss this matter today.
Further, I think it would be the wish of some of my hon. Friends that I should also say on their behalf that we appreciate too the great interest of the Minister of Labour himself and of his Parliamentary Secretary. We believe that the fact that we are political opponents is no reason why we should withhold due tribute to people whom we know have a deep interest in matters of this kind. What we have said from this side of the House in this debate today has not been meant as a form of criticism but as a means of strengthening their hands in anything which they may endeavour to do in the future on behalf of the handicapped people about whom we have been talking.
Some of us have lessons to learn from these people who are severely handicapped. We find that some people are born into our society with physical handicaps, while others are citizens who have suffered severely through a disaster such as that which we have recently experienced here in London in the railway accident. In fact, all sorts of things can account for people suddenly becoming physically handicapped. When I say that we have something to learn from them, I refer to the way in which these people accept the disabilities which have been inflicted upon them.
I shall never forget the occasion when I had the great privilege of conducting thirty blind people around this building. I brought them into this Chamber, and I said, "We are now standing by the side of the Speaker's Chair." They immediately started to put their hands round the Chair. I brought them to the Table, and they began to feel round the side of the Table, and they could see through their fingers. They said. "This really is a wonderful building." They said things about this building which many of my own constituents who are able to see have refused to recognise. One of the lessons which I believe we can learn from these pople is contained in the way in which they are ready to try to overcome their handicaps.
They do not ask for sympathy from us, and that is one thing we must remember. They ask for just what this Motion says. They simply ask us to give them help, to provide them with the means and facilities whereby they may be trained so that they can earn their own living. These people do not want to assume but to enjoy the sturdy independence which we always associate with them as one of the natural instincts of our race.
There was a reference in the debate, I believe by my hon. Friend the Member for Lowestoft, to the percentage of disabled workers employed by the Dock Labour Board. It is by pure coincidence that I have been dealing recently with a case of this kind sent to me from my constituency in Bristol by the dockers at Avonmouth.
I have tried to make some independent inquiries—independent of any officials of the Dock Labour Board—about this matter, and I have been advised that it is not easy to incorporate the maximum percentage of disabled dockers in this class of work. Nevertheless, it should perhaps be possible for the Minister or his Parliamentary Secretary to make some further inquiries about what really does happen in connection with the employment of disabled persons in the docks to see whether we can do something further to increase the amount of employment available to them there.
There is very much more which one would wish to say, but in deference to the time factor and in order to give the hon. Gentleman for Exeter the opportunity to say a few words. I will now resume my seat.
The emphasis which the hon. Member for Bristol, South (Mr. Wilkins) placed on the fact that I must say only a word or two makes me wonder whether he was thinking about the various debates which have taken place up in Committee up- stairs. I assure him that I do not propose to take up as much time as on those occasions when we have been discussing various Bills.
I shall take only a minute or two.
I was glad that the hon. Gentleman referred to the presence on the Front Bench of my right hon. Friend the Minister of Labour. I felt that it was appropriate that those remarks came from the Opposition benches, because the hon. Member for Walthamstow, West (Mr. Redhead) seemed to think that we have not had a fair cut of the cake where Ministers are concerned this afternoon.
I think we have done rather well. At one time, I saw four Ministers on the Front Bench, including the Minister of Labour, and also one of the Lords Commissioners of the Treasury, when there was a rather smaller number of hon. Members on the other side of the House, though that was probably due to the fact that it was lunch time. I think we have done very well indeed to get a member of the Cabinet to listen to this very important debate. I am sure that any calls for additional expenditure for the disabled will be adequately represented by the Minister of Labour in the Cabinet at the right time.
I should like to say a few words about the remarks made by the hon. Member for Birkenhead (Mr. Collick), who, I am sorry to say, is not in his place at the moment. He referred—with, understandably, some emotion—to handicapped people in his own constituency who were living in very grim conditions and upon very limited incomes. I would have shared his indignation if the same sort of cases had been brought to my attention, but I could not follow his argument that his relations with the local office of the National Assistance Board were happy. Mine would not have been in those conditions.
As I understand, in those cases the Board was aware of the situation. It had given allowances for sheets, and such things, and I believe that one man received an allowance for some trousers. The officers of the Board must have known the limited incomes which were going into those homes. My experience is that on those occasions the officers of the Board do not hesitate for a moment to provide financial assistance. There are people living on far too low an income, and who are not receiving National Assistance, but that is because their cases have never been brought to the attention of the Board's officers. My experience is that when they hear of such cases they act to the limits of their statutory power.
The hon. Member also criticised the Government for not making it possible for local authorities to build houses for disabled people living on such limited incomes. He was not quite fair to the Government in that respect because, as I understand the position, if such an individual is moved into a council house the rent of which exceeds that which he had been paying for his previous accommodation, the National Assistance Board will help with the additional rent. It is not fair to say that any action of the Government has made it impossible for such persons to live in council houses. Any additional expenditure in which they are involved is covered by regulations relating to the activities of the Board.
In the few minutes that remain at my disposal I want to refer to the war disabled. Most people still do not realise that the majority of registered disabled people consist of ex-Service men injured as a result of war. I believe that their number is about 436,000 out of a total of just under 800,000 disabled persons. I hope that my hon. Friend will be able to confirm that there has been no falling off in the treatment of war disabled persons.
I believe that everyone in the House would agree that they deserve special treatment, because they did something which many of us were lucky enough not to have to do. I therefore hope that my hon. Friend will be able to confirm that since the Ministry of Pensions has been merged with the Ministry of National Insurance no representations have been made from organisations such as the British Legion about any falling off in the standard of treatment for these men and women.
In the course of the last twelve months one case has been brought to my attention which led me to believe that there was a tendency, in some places, to treat these people a little less generously than they were treated by the Ministry of Pensions alone, and I hope that the Minister will use his influence to see that that situation is not allowed to worsen.
The part of the Report which struck me was paragraph 259, which refers to the King's National Roll Scheme, which was introduced after the First World War to encourage employers to take a percentage—I believe that it was 5 per cent.—of war disabled people into their employment. If they did so they got the right to put a badge on their notepaper, and this right was greatly prized by many employers. It is now not so easy to obtain such a badge, because there are now only 123,000 people—I say, "only." but it is a rather ghastly figure—who are still registered as disabled as a result of the 1914–18 War. There are now not enough of these men to go round.
In those circumstances, I wonder whether my hon. Friend can say whether there is any likelihood of extending the scheme to include those persons who were disabled in the Second World War. I understand that the scheme now operates only in respect of those disabled in the First World War, and I would have thought that it ought to operate in respect of the second. I should also have thought that a similar scheme could be devised for firms employing people who have been disabled in industry, or have been born with various disabilities. I wonder whether attention could be given to that proposal.
I do not propose to say much about the employment of disabled people in industry. I think that the subject has been adequately covered by various hon. Members this afternoon, some of them with much more experience than my own. In my own constituency we have a considerable interest in this problem, because we have the St. Loyes College, which deals with the training of disabled people and which does wonderful work in enabling them to lead a normal life. We also have a large orthopaedic hospital which assists disabled people to follow their normal trades.
I agree with those hon. Members who wish to see Remploy maintain its position, although I am convinced that what the disabled people want more than anything else is to be able to take their place among normal people. They want to be able to stand on their own feet. As the hon. Member for Bristol, South said, they do not want sympathy. They have got much more "guts," if I may use that word—I believe it is now accepted in the House, Mr. Speaker—than normal people. All they want is the equipment and the opportunity to train themselves so that they may take their position in life as near to normal as possible. Although there is a case for sheltered factories, and so on, I am sure that the tendency should be to enable these people to take their position alongside normal people doing the same job.
I am sure the hon. Gentleman will bear in mind that 14,000 people have been trained by Remploy. There are now 6,200 in the employment of Remploy, and the difference between those two figures is represented largely by people who, because they were trained by Remploy, were eventually able to go out into open industry.
I am aware of the point that the hon. Gentleman makes. As I say, the tendency should be to move in that direction.
My last point relates to children and the facilities that are offered to them to enable them to overcome disabilities with which in many cases they were born. Again, I have a particular constituency interest in this problem, because in Exeter there is the Royal West of England School for the Deaf, a wonderful school which concentrates on training children who were born completely deaf to take their normal place in society. Anyone who has been to that sort of school and has seen how it is run cannot come away without feeling extremely humble. The care and affection that is shown to those children by their teachers is quite out of this world. I have been told that the whole of one term is sometimes spent in teaching a child how to say six words, the child, being stone deaf, putting a hand on the teacher's chest and feeling the vibrations so that eventually he can mouth the words.
I hope that my hon. Friend will be able to say that there is no question of any cheeseparing where that sort of institution is concerned. When the children grow up in places like that, and eventually leave, they are as near to normal as makes no difference. They can lip-read and understand what is said to them, and they are able to speak quite normally by the time they have finished their training. I hope that it will be possible for my hon. Friend to say that there is no question of any hold-up of finance from the Government for such institutions.
I should like to add my congratulations to the hon. Member for Lowestoft (Mr. Edward Evans), who introduced this subject. I am sure it is the feeling of the whole House that this has been a most constructive debate.
It is not often that one can claim that the most interesting debate of the week took place on a Friday, but I think that today the House has been at its very best. It must be a source of great satisfaction to my hon. Friend the Member for Lowestoft (Mr. Edward Evans) who for over fifty-one years has given of his life to this work, that today his words were as vital a contribution to this subject as the actions and practical work which he has done for disabled people over those fifty-one years.
My hon. Friend the Member for Shoreditch and Finsbury (Mr. Collins), who seconded the Motion, has also done great work in this respect. A little later I will comment on the propositions which he put forward.
In reviewing the range of this vast subject one is at a loss to know how to put it all together in the course of one speech, especially when so many hon. Members from both sides of the House who have contributed to the debate are outstanding experts in one or more of the phases of work for the disabled. For my part, with my limited knowledge gained through work at the Ministry of Labour, concerned more with the care of the disabled and rehabilitation, I do not propose to range over such issues as those mentioned by my hon. Friend the Member for Birkenhead (Mr. Collick), who made a very graphic and moving speech, except to say that when we think about bringing people back into industry we cannot include in that category the type of people to whom he referred. They are obviously people who need practical examples of sympathy in the sad position into which they have now descended. I want to support his claim that local authorities should be given greater scope in relation to such people. He suggested that they should have greater scope in the provision of housing and in their general ability to help these people to live a fuller and more comfortable life.
On this issue I must join with him, with my hon. Friend the Member for Walthamstow, West (Mr. Redhead) and several other hon. Members, including one hon. Member opposite, who have referred to the new situation which will be created for local authorities when the Government's proposals for a block grant come into operation. We must ask the Parliamentary Secretary what is to be the position of local authorities in this respect. We know from the details of the 1944 and 1948 Acts that it was always our conception that local authorities would play an ever-increasing part in the care of the disabled. The picture is by no means complete. Local authorities are required to do certain things only in respect of the blind. As yet there is no requirement upon them in respect of the deaf, the spastics and people of that sort. We hoped that we were moving into those categories.
At this very time, however. I believe that local authorities are to be severely handicapped in the work which we hoped they would do. If the Parliamentary Secretary cannot today give us some assurance on this matter, or if indeed the Government have not appreciated the implications of the block grant in this respect, I hope that at least the Minister will look at the matter again in order to be able to assist local authorities in playing a far more important part in work for the disabled than they have been able to play up to the present.
Many hon. Members have referred to industrial rehabilitation. Rehabilitation services in this country are indeed a fusion of voluntary effort and State assistance and represent the best instincts of large numbers of enthusiastic workers, working on an entirely unpaid basis, plus the desire of the whole community to provide finance necessary for such important work. The development of such services started a long while ago. It was, perhaps, during the First World War that we saw efforts made to bring a really comprehensive service into operation.
In modern times, however, we think in terms of the Tomlinson Committee and the 1944 Act. It was very proper of my hon. Friend the Member for Lowestoft to pay a tribute to the work of the late George Tomlinson as well as to his Minister, the late Ernest Bevin. We remember with the greatest affection the wholehearted way in which George Tomlinson threw himself into this work. I am sure that many thousands of disabled people will remember for the rest of their lives the work which George did on their behalf.
Today, we think in terms of the 1944 Act, for it was Section 3 of that Act which regulated our present courses of industrial rehabilitation for persons over the age of 16 who, while not in need of medical treatment, need rehabilitation treatment to fit them for employment or to make use of vocational training.
Before turning to the physically disabled, there are one or two categories of people whom I should like to mention. One remembers, for instance, that under the Employment and Training Act, 1948, courses were made available to able-bodied unemployed. I should like to know from the Parliamentary Secretary whether these services are being used.
In the present phase of relatively full employment, we should consider the mental effect on people who are unemployed for any length of time. The knowledge that when so many other people are able to get employment, they themselves cannot get it, must do something frightful to their own thinking. The sort of inferiority complex which can be generated under those conditions can be appreciated only by those who have suffered. I should like to know, therefore, whether much work is being done concerning that provision of the 1948 Act.
The second category I wanted to mention arises from the first recommendation of the Piercy Committee, to which a number of hon. Members, on both sides, have already referred. The suggestion has been made that an inquiry should be conducted to ascertain how many persons receiving sickness benefit for longer than six months could be assisted to return to work if suitable facilities for rehabilitation or resettlement were made available to them. One recalls that the Minister has given to the House figures showing the time lost from causes of this kind. It is easily the biggest amount of industrial time that we lose from any one cause. If we could know whether efforts are being made already to implement the suggestions of the Piercy Report in that respect, the House would be grateful.
An hon. Member on the Government benches talked of the work which larger firms have been doing of their own volition in providing workshops for rehabilitation. I know some of the good work that has been done in that respect. Perhaps the Parliamentary Secretary can tell us whether there have been any suggestions emanating from that source which are now commonly adopted in rehabilitation workshops by the Ministry of Labour and whether there has been any spread among private employers of this very worth-while job of indulging in rehabilitation work in their own factories. Certainly, I agreed with the hon. Member when he pointed out the need for a gradual return to industry. Those of us who know something about returning under piece-work conditions to compete against the clock and all the rest, which may be all very well for a man who is 100 per cent. fit, know that it can have a most depressing effect upon men who have been away and who have to return to industry under those fully competitive conditions. I hope that some publicity can be given to that very important aspect.
I am told by hon. Friends of mine, especially those from the mining areas, that there are still numbers of disabled people quite unable to obtain employment in open industry, but who are not deemed to be sufficiently badly disabled to justify their being given covered employment. Regarding the point made by the hon. Member for Walthamstow, West about the number of placings falling away, we know that there are not so many vacancies. It could be that we are setting too high a standard for work in covered industry. As the number of placings the Ministry is making is falling away, perhaps we should realise that people who are not now considered sufficiently disabled to warrant covered employment cannot hope to get employment in open industry, now that conditions are more competitive.
There have been many references to the work of the disablement resettlement officers. These people are the key to so much of this work. I was thinking, as I listened to hon. Members on both sides, that it could be perhaps that by the very nature of their work they are the ones who need rehabilitation. Events are moving at such a terrific pace in industry that a preconceived idea of what a man's functions may be, derived from the fact that he may have gone through a course of training some years ago, may be completely out of focus. Therefore, if the Parliamentary Secretary could give more information about the work of these officers we should be very grateful.
I had a complaint from one of my hon. Friends, who is a lawyer, who told me a week or two ago that he was concerned with a case in Wales where a man sustained a skull injury as a result of which there was temporary mental derangement. There is no facility for people like that to be accommodated either by the Ministry or by any voluntary association. They are obviously not cases for a mental hospital.
I suggest that, in its modern sense, rehabilitation ought not to be a process which aims at attuning one's thinking to being for example a lift attendant or a car park attendant, worthy though such occupations may be. Resettlement today should have a far closer relationship to, for instance, technical training than to jobs carrying little or no responsibility. Even jobs which a few years ago were deemed as heavy employment now centre round one's capacity to read a graph instead of to swing a hammer. One can think of vast sections of the chemical, steel, and engineering industries in which today there is perhaps a far greater opportunity and facility for a physically disabled person to acquire a responsible status.
It is because of that kind of change that I believe our approach to rehabilitation and resettlement must now undergo a most revolutionary change. Change in the sphere of rehabilitation and resettlement must be at least as rapid as, and indeed should seek to anticipate changes in, methods of production.
For many years past this has been a subject which has aroused our emotions. I think we have now reached a stage at which the problem must be determined intellectually rather than emotionally. So many hon. Members on both sides of the House have rightly sought to show that disabled people do not want pity, but that they want the chance to get back in the mainstream of life, with work among other employed people. The time has gone when their usefulness is restricted, or can be regarded as being restricted, to certain rather irresponsible sorts of work. Despite their physical disabilities, their mental attributes are right enough, and tit them for more responsible employment.
Indeed, many of them, because of their physical disabilities, develop mental attributes which are better than those of many of the able bodied. One could give many illustrations to show that. Although this is still a comparatively young subject, it is so advanced now that should the day come when our thinking of rehabilitation becomes static, that is, the thinking of those of us who have to try to decide these things, that will be the day when we ourselves ought to get out altogether.
Remploy has been a very great, imaginative experiment. It has enabled us to take the disabled from the scrapheap—that, I think, was the expression I used a moment ago. Its size is such that sonic 6,200 persons at the moment can hope to find employment with Remploy. In the absence of Remploy no work of any type could he found for them. Although it is right that Remploy should be efficient, for my part I would deplore any attempt to assess its value simply by the balance sheet. I do not think that Remploy, being of the nature it is, can be judged by expectations of a certain percentage of production, or by comparison with production in open employment.
We have heard on many occasions of the competition—I think that is the right word, for it certainly was when I was at the Ministry of Labour and National Service—for work for Government Departments between Remploy, the Home Office on behalf of prisoners, and so on. I was very interested in what my hon. Friend the Member for Shoreditch and Finsbury had to say about that. It was, I thought, the basis of a very good, new conception of how we should manage this. Time forbids me to go much further with that now, but I hope that the Minister will consider what my hon. Friend said.
It was originally intended that the company should establish some 130 factories to provide employment for about 13,000 seriously disabled persons. The House will remember that about mid-1949, 56 factories were operating and others were nearing completion. Then it was felt we were making too rapid progress with them and that the very rapidity itself was endangering the whole project, so that in July, 1949, the then Minister announced a slow-down in these developments, deciding to limit the company's programme to some 90 factories to employ some 6,000 people. These factories were all in operation by March, 1952.
It seems to me that we have now forgotten what the object of that exercise was. It was undertaken only because it was felt, for administrative reasons, that the whole development of Remploy was getting out of phase. It seems to me that, instead of looking upon that limitation as temporary only, a temporary standstill of operations for a short period, we have tended to regard it as permanent, instead of a pause while we prepared for a new spring forward from the point we reached in March, 1952.
This has a relationship to the complaints one hears of seriously handicapped people being now unable to get employment either in Remploy or in open employment. I hope the Minister will consider that again, to see whether there are, as it is complained there are, very many disabled people who are now being victimised because of the circumstances I have described. I should like to see a survey of the position made, not in the light of knowledge that only 6,000 can be accommodated but in the light of the needs of the disabled.
Under Section 29 of the National Assistance Act, 1948, local authorities gave a great deal of assistance to the Ministry. Now that we are contemplating a new approach to industrial problems, and the advent of automation. I am sure that the Ministry will feel that it requires the services of every type of organisation to lend a hand, but I still think that the local authorities, of their very nature are bodies which can play a considerable part in assisting the disabled. In that respect the block grant is not helpful. If it was the case that the Government overlooked the implications of the block grant and its effect upon the work of the disabled, I hope that the Minister will take up the matter with his colleagues in the Cabinet in the hope that assistance can be given to the local authorities.
I feel that the Ministry of Labour is now developing into a Ministry far and away different from that which we contemplated in the pre-war days of heavy unemployment. I feel, with the particular affection that I have for the Ministry, that it is now the key Department which can usher in a new conception of the full and proper life which disabled people can lead if they are given the necessary facilities. I believe that many thousands are now grateful for the work that the Ministry has already done.
I ask the Minister and the Parliamentary Secretary, however, to consider the fact that industry, which at one time could not possibly take 1 per cent. or 2 per cent. or 3 per cent. of disabled people is now entering a new, modern phase in which brawn is no longer the main requirement, and useful, responsible, indeed almost managerial employment can be found for the physically disabled who, very often, because of their very disabilities are all the better equipped for the job in that they have concentrated on mental studies. The day of these disabled has now come. Given proper facilities and rehabilitation, and resettlement viewed in the light of technical accomplishments and education, there is no reason why a far greater percentage of physically disabled people than has been the case hitherto should not acquire managerial status and highly responsible work.
The House should not be satisfied until that kind of status is achieved by the largest possible number of the disabled. My hon. Friend the Member for Lowestoft will have earned our gratitude by raising this subject today and if all this can be done for the disabled it will be a great monument to the fifty years of hard work which my hon. Friend has done on their behalf.
First, I want to thank the hon. Member for Lowestoft (Mr. Edward Evans) for choosing this subject to raise in debate. The hon. Member told us that this was the first Ballot that he had ever won. He is one up on me in that respect, but he has had longer membership of the House. Friday the 13th was a lucky day for him, and it was lucky for us in his choice of this subject.
No one in the House could have been a more appropriate person to raise this matter, and I know that we should all like to pay tribute to the fifty years of work that the hon. Member has done on behalf of the disabled; and we know that it is work and not just speeches. Some of us are aware that we do more speaking than working.
We have also been fortunate in the other hon. Members who have spoken, and particularly in the hon. Member for Shoreditch and Finsbury (Mr. Collins), who seconded the Motion. This has been a splendid debate, notable for speeches based on long experience and specialised knowledge. As the hon. Member for Newton (Mr. Lee) said, this has been the House of Commons in one of its best moods, showing its knowledge and interest in a great human problem.
In moving this Motion, the hon. Member for Lowestoft said that its wording might present me some difficulty. Let me say at once that the difficulty is not serious. He also made it clear that he did not intend the second part of the Motion to be interpreted narrowly, as referring simply to the contents of the Bill mentioned in the first part of the Motion. Rather he meant the words as a call to the Government to base all their future plans for work for the disabled on the recommendations of the Piercy Committee and of other bodies concerned in the welfare of handicapped workers.
On that interpretation, I can willingly welcome and accept the Motion on behalf of the Government and I assure the hon. Gentleman that the Government will continue to press on, wherever possible, with the implementation of the Committee's recommendations subject only— and this cannot be disregarded, however much we would like to do so—to the urgent need at present for economy. In doing so, we shall take full account in the future, as we have done in the past, of voluntary organisations and other bodies interested in these problems.
For example, and to take up a point mentioned by the hon. Lady the Member for Devonport (Miss Vickers), we shall consider with interest the report to which she referred. It would be wrong for me to give her an undertaking that we will delay all action until that report is received, and I am sure she would not ask us to do so, because it depends on when the report appears.
I cannot give a firm date. It is in the course of preparation and I can assure the hon. Gentleman that it will be introduced as soon as possible. It will be introduced in plenty of time to go through all its stages in this Session without, I hope, any undue inconvenience to hon. Members.
I want to say something about the Bill itself. As I think the House understands, it is to be a Measure to amend the existing Disabled Persons Employment Act. It will be designed to effect certain changes in that Act recommended by the Piercy Committee. Although I am sure it will be a valuable Bill, I want to make it clear that it will not be a major one. The recommendations of the Piercy Committee in this respect which need legislation are both few in number and comparatively minor in substance. It is a cause for satisfaction that there were only a comparatively few small amendments which need be suggested to the legislative framework. The Bill will cover all these. Briefly, they are as follows.
First, there will be two small alterations in the registration scheme for the disabled. Secondly, there will be a transfer of the statutory responsibility for supervising local authority schemes for sheltered employment from the Health Departments to the Ministry of Labour. Thirdly, there will be a reduction of the minimum age for the industrial rehabilitation and training of the disabled from the age of 16, at which it now stands, to the school-leaving age.
Now let me turn from the Bill to the much wider subject under discussion. I was glad that the speeches today have stressed so strongly what I am sure should be the first and over-riding objective in all our work for the disabled, namely, providing them with opportunities for active, gainful employment. As has been said today, disabled people do not want charity. Nowadays, thanks to modern developments in treatment, rehabilitation, training and employment, the majority no longer need charity. Most men and women do not want to sit at home and receive a pension, even if that pension could be adequate enough to provide them with the reasonable comforts of life. Their most intense desire is to work, not only so that they can feel themselves independent but also so that they can contribute to the economy of the community in which they live.
I feel sure that the curse of disablement—far greater in most cases than the bearing of pain or the burden of the injury or handicap—is to feel oneself set apart from one's fellows, and the extent to which we can remove that feeling of separation is the measure of our success.
So, while we must, of course, not neglect to provide financial means of support for those for whom we still find it impossible to provide employment, our main objective for development in this field must be to extend even further than we have done already the chances of useful employment for every type of disabled person. The second main objective mentioned in this debate is the one of prevention, so that we have as few disabled and handicapped people as possible.
I think that it is perhaps worth putting on record in this debate the progress that has already been made. Of course, that progress started, as so many hon. Members have said, with the great development and application of medical knowledge and treatment, and we owe a great deal to advances in that way. There is also the growth of rehabilitation and training of disabled people for employment. The Piercy Committee commented favourably on the arrangements for this and recommended only minor changes.
Since July, 1945, almost 50,000 disabled persons, including blind, have been trained under the Vocational Training Scheme and have been placed in the employment for which they were trained. In recent years, these successful placings have averaged no less than 91 per cent. of the total trainees who have completed the course. That is a tremendously encouraging figure and it does great credit both to the disabled people themselves and to the skill of those who have trained them.
The final stage of our work after treatment, rehabilitation and training is the actual placing of disabled people in employment. Success at this stage is, of course, all important. The rest of the work goes for nought unless we do succeed at this stage. I am sure, therefore, that we are right once again to pay tribute to the skill and determination both of the disablement resettlement officers of the Ministry of Labour and also to the placing officers of the various voluntary associations to which reference has been made. I was glad that the hon. Member for Lowestoft mentioned so warmly this latter class. I can assure him that we value their work and shall do our best to continue to co-operate closely with them.
It is also true, and ought not to be forgotten, that the work of placing could not have been so successful, however skilful placing officers, unless it had been matched by growing interest on the part of the employers and their willingness not only to have disabled workers, but, in many cases, to make special and individual provision for them. Some of the individual cases, which have come to my knowledge since I have been in my present position, of employers who have made quite large alteration and provisions in order to take on a particular person are a great credit.
I think that the success of what we have achieved is shown in the figures of employment. A striking fact is the decline in the number of severely disabled unemployed—Section 2 cases—in need of sheltered employment. In 1946, the number in that class was nearly 13,000. By 1954, it had been reduced to half that number, and since June, 1955, it has never risen above 4,000. The figure for October of this year at 3,640 was the lowest October figure since 1945, and almost the lowest for any month since the registration scheme came into operation. In November, there was a slight seasonal increase to 3,702, but the November figure is still 200 below the July, 1955 figure. At that time employment was very high indeed, and July is always, of course, the low trough of unemployment every year. Since the latter date, July, 1955, the employment conditions have not been so easy as they were. That makes it all the more encouraging to find that the severely disabled have more than held their own in this period.
I assure the hon. Members for Walthamstow, West (Mr. Redhead) and Newton that the fall in the size of the register of disabled, any change in the number of placings or any change in the throughput of our rehabilitation units is not caused by any Departmental economies that we may have had to make. I assure the House that in making these economies we have had very specially in mind the needs of the services for the disabled, and we have watched the position extremely carefully. The hon. Member for Newton queried whether we set too severe a standard of disability for inclusion in Section 2 of the register. I do not think he expects me to give any judgment on that at the moment, but I can assure him that the position will be watched.
I turn now to Remploy. Before I talk about Remploy, for which the Ministry of Labour has special responsibility, I think we ought to recognise that it is impossible to talk about the employment of severely disabled people without thinking of the work done not only by Remploy but by local authorities and voluntary organisations in providing sheltered employment. Undoubtedly, all of them have made a most valuable contribution to the reduction in the number of unemployed severely disabled people.
The Remploy Report for the year ended March last was published a few weeks ago. I know that hon. Members have seen it and that many of them have studied it. It seems that, under the energetic leadership of the Chairman, Sir Alec Zealley, the board of Remploy is making strenuous efforts to increase production and sales and to improve Remploy's trading position. In view of what the hon. Member for Newton said about getting into the habit of thinking of the present size of Remploy as permanent, I think we must realise that the key to Remploy's future expansion lies in increasing production and sales, and it is the ability to produce and sell the right things which is the key factor and the one to which the energy of the hoard is turned at the moment.
Remploy has had, and is having, considerable success. There has been a restricted demand in some trades, especially the furniture trade in which Remploy has had large stakes. In spite of this, total sales for 1956–57 showed an increase of more than £200,000 on the previous year, and rose above £3 million for the first time in the company's history. It is hoped by the management that the figure for the current year will be even higher.
There has also been an encouraging rise in the value of output per disabled worker, and mechanisation and improved methods of work are being introduced wherever possible. Therefore, I feel that the position of Remploy is improving and that the new reorganisation, to which the hon. Member for Barking (Mr. Hastings) referred, is having some effect.
My hon. Friend the Member for Bury and Radcliffe (Mr. Bidgood) implied that Remploy might be employing too high a proportion of able-bodied people. I can assure the House that this is something that we shall watch, but I feel that there is nothing in that charge. Remploy would not have made the progress that it has made had it not employed a minimum number of able-bodied people for certain types of supervisory and management work and also a certain percentage in some of the heavier forms of production on which it has embarked. Were they not there, the scope of industry in which Remploy could participate would be limited.
I cannot leave the subject of Remploy without stressing what I believe to be very important, that every year about 250 men leave it for open employment. Even if the total numbers in Remploy stay rather static, if we take those who leave its employment plus normal wastage, there is a constant flow of new recruitment into Remploy. Indeed, in the twelve months ended last July, no fewer than 781 severely disabled people were placed in Remploy factories.
I want to turn to those parts of the Piercy Report other than those with which I dealt in relation to the proposed
Bill. The debate in June gave me a chance to give a first progress report and I want to bring that up to date, although, of course, it is still only an interim and not a final report, because progress is still being made. I have to stress that it is not possible for the Government to ignore the present need for economy, but, having said that, we should also bear in mind that the Piercy Committee itself said, in paragraph 341 of its Report:
…there may be a danger in assuming too readily that more effective services can be brought about solely, or even mainly, by increased expenditure…
Therefore, while, naturally, many of us know of directions in which we would like to spend more money, we must also recognise that there is great scope for important and constructive work based on the Report and room for steady progress on the Committee's recommendations by administrative and other action without large additional expenditure.
In general, I am sure that the hon. Member for Newton and my hon. Friend the Member for Tonbridge (Mr. Hornby) were right in saying that one of the important things we have to do—and I think it arises from the findings of the Piercy Committee—is to spread information about services which are available and about the practices in some firms and in some institutions, so that they are all more widely known.
I want to come to the first recommendation of the Piercy Committee, the one which asks that an inquiry should be made to find out how many people receiving sickness benefit for more than six months could return to work if suitable facilities for rehabilitation and resettlement were available. I am glad to tell the House that this recommendation has been accepted and that plans for making the inquiry have been completed and that the investigation will start in January.
Now I come to the hospital and medical services and the most important recommendations dealing with physiotherapy, establishment of resettlement clinics and rehabilitation centres for regional hospital boards, better information and even persuasion for the medical profession generally, and so on. This, of course, is not a subject for direct Government action, but, as I told the House, my right hon. Friends the Minister of Health and Secretary of State for Scotland intend to circulate advice to the hospital authorities. They have had a lot of other things to consider and the Royal Commission on Mental Illness and Mental Deficiency covers some of these subjects as well. The circular has not yet gone out, but I am informed that it is likely to be issued in the near future and that it is intended to give advice on all these points.
Now I come to industrial rehabilitation. Here, I have to give the House what, to me, is somewhat disappointing news. In view of the economic situation we cannot undertake at this time to proceed with the additional I.R.U.s, to which reference has been made, nor can we go forward at once with the comprehensive rehabilitation centre. There is also much planning work to be done for the latter. This is now proceeding so that if it is possible to go ahead, when the financial position allows, it will not be held up by need for much consideration.
There are two recent developments in the services rendered by the I.R.U.s which I want to mention—the assessment of suitability of candidates for Remploy was one matter on which the Piercy Committee suggested we might embark. We have done so on an experimental basis and we have got satisfactory results. We are now extending the practice to a larger number of I.R.U.s. The I.R.U.s are also assisting the Youth Employment Service in a number of places by giving two to three day assessments to a number of handicapped young people recommended by youth employment officers. I hope that that goes some way in the direction stressed by the hon. Member for Lowestoft.
Now I come to the important subject of welfare services. Of course, I realise the importance attached to this by the Piercy Committee and by hon. Members who have spoken in the debate. The recommendation about the Exchequer grant is still under consideration and a decision has not been taken.
There is not time to renew again the arguments about the respective merits of the block or special grants. All I can say is that the decision whether an allowance should be made is under consideration and has not yet been taken. In any case, the Minister of Health is to issue, early in the new year, a circular to local authorities on the group of the Piercy Committee recommendations dealing with further and better provision of welfare services.
My right hon. Friends will take the opportunity to urge those authorities which have not yet adopted welfare schemes to do so. The percentage of local authorities which have various forms of approved welfare schemes is now high and has been growing, and the publication of the Piercy Committee's Report has had a stimulating effect in this direction.
On the question of appliances and other aids, the Minister of Health will be including references to recommendations Nos. 14 and 15 of the Piercy Report in the circular to local authorities to which I have just referred in connection with welfare services. In addition, the Ministry of Labour is planning to publish a booklet on work aids, and the Ministry of Health also has in mind the publication of a booklet on personal aids for use in the home. The hon. Member for Lowestoft mentioned publicity on television, and I will look into that.
I will certainly keep that point in mind.
There is one other important point about the training of disablement resettlement officers. I can tell the House, on the subject of training, that not only do we accept that recommendation but that we are now ready to put it into practice. The training period is to be extended from four days to one month for all newly appointed disablement resettlement officers who spend more than only a very small part of their time on work for the disabled. These new training courses will be something much more than just a lengthening of the old four-day courses. They will include training on the job, practical exercises, visits and lectures on various aspects of rehabilitation and resettlement.
The hon. Member for Shoreditch and Finsbury spoke of Government contracts. I noted the specific suggestions made by the hon. Member, and I assure him that I will see that they are fully studied. The Government are anxious to increase the volume of contracts allocated to priority suppliers, if possible, and the Ministry of Labour is having discussions with the Treasury and other Departments at this moment.
There are, of course, a large number of points in this field, and, as the hon. Member for Newton said, the difficulty is to gather them all together. I could go on a great deal longer, but I have tried to cover as much as I could in the limited time available. I know, however, that I have left out a number of points, not only some of those mentioned today but others which have not been mentioned, but which are still important. I hope hon. Members will forgive me, but I can assure them that all the points made in the debate will be personally noted and considered.
There will always be a need for more work on this subject. It is, of course, true that on some points people complain of a lack of action and press for more urgency, but I think that the record as a whole is a good one, and that this Government, like those which have preceded it, together with all the other organisations who are active in this field, can take credit for what has been achieved. That does not mean that we shall be complacent. I agree that we must not be complacent and that the opportunities of the future are very great—that is the spirit in which we shall continue our work.
That this House welcomes the intention of Her Majesty's Government to introduce a Bill to improve the arrangements for the industrial rehabilitation, training and resettlement of disabled persons; and urges Her Majesty's Government to base its proposals on the major recommendations of the Piercy Committee and of other bodies concerned with the welfare of handicapped persons.