Disabled and Chronic Sick

Part of Prayers – in the House of Commons at 12:00 am on 15th March 1968.

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Photo of Sir David Price Sir David Price , Eastleigh 12:00 am, 15th March 1968

I am sure that the high tenor of the speeches so far shows the debt which the House owes to my hon. Friend the Member for Moray and Nairn (Mr. G. Campbell) for raising this subject. After some of the events of last night, when we see in the papers that there is concern about gold and the general position of the economy, it is particularly appropriate that we should take time to recognise the position of a considerable section of our community.

I should like to reinforce the point made by my right hon. Friend the Member for Ashford (Mr. Deedes), when he said that we should expect an increase in the numbers of chronic sick and disabled in our community over the years, and I want to suggest some of the reasons why that will be so.

The first is the natural rise in the population. The second is better surgery, better drugs and better nursing. Let us pay tribute to what has been done by the medical profession and the pharmaceutical industry. Many people are alive today as chronically sick who owe their continued survival to drugs.

Thirdly, I believe that the increase to be seen in the Ministry of Health figures for mental disorders suggests that the number of people deemed chronically sick due to this cause is likely to rise. At least, we should be prepared for it. With the advances in psychiatry and par ticularly the pharmacological therapy of mental disorders there is hope, on the other hand, that many mental disorders which we are unable to deal with at the moment will be treated successfully in a few years' time. It is a balance of the two, but certainly we should prepare for an increase. We need not this morning go into long analyses of why it is so—the stress and strains of modern life, and so on—but we should recognise that this is a growing problem.

Then there are the disabilities of old age, to which the right hon. Member for Llanelly (Mr. James Griffiths) has referred very movingly this morning, as he always does on such occasions. We must recognise, however, that as we improve our medicines and general geriatric care in the hospitals we shall get more people at the top age end of the population who will come into this category of disabled or chronic sick.

My own special interest and experience of the disabled and chronic sick relates to paraplegics. Like all hon. Members I have had in the course of my duties examples of most of the categories we are now discussing, but if I harp rather more on paraplegics than on other categories within the terms of the Motion it is simply because it is paraplegics of whom I have most experience.

In paraplegics we have a very good example of the problem that the Motion raises—that of identifying the total number. I have asked Parliamentary Questions, and have always been told that the Ministry does not have the full figures. It knows how many have been through its hospitals to a certain date, but not the total number, the breakdown of the number, the degree of disability caused by their paraplegia and the cause of the paraplegia. In order to get improved treatment and care we must be able to identify the source of the disability and chronic sickness.

As the House knows, I am rather an enthusiast for statistical analysis. I suggest to the Ministers present that the proper use of the computer enables us to handle large quantities of figures in a meaningful way. One therefore hopes that those Departments represented on the Government Front Bench this morning, all of which use computers in their normal administration, will use them also for forward-thinking and model-building as to how the services should work.

In the identification of the disabled and chronic sick, it is interesting to note that the blind are identified by the source of the disability. With the Forces pensioner or the Industrial Injuries pensioner identification is made by the occupation in which the person became disabled or chronically sick. I should like to see right through the community of the sick and disabled identification done in both ways—by occupation and the nature of of the disability or sickness.

A number of categories are not recognised in the whole provision of our services, particularly in the cash benefits. Here, I agree very much with what the hon. Member for Bedwellty (Mr. Finch) said. First, there are those who have become disabled or have contracted chronic sickness outside their employment. It is very difficult to explain to a man why if he falls off a derrick used in the construction of a power station he gets full Industrial Injury benefit, but if outside that works he falls and sustains a similar injury he gets only sickness benefit—or supplementary benefit, if necessary. I shall not go into the figures now because I appreciate that all hon. Members present know them far better than I do, but, as a broad generalisation, I would say that the difference is a factor of two.

The second category comprises housewives with injuries or disease contracted outside gainful employment. It is not very easy for me, for reasons that are obvious, to speak about this category, but let me give one example. At Stoke Mandeville I met a woman, the wife of a small farmer, who is now a spinal paraplegic in a wheelchair. I suggest that her injury is as serious to her family as if her husband had the injury; we all know the key rôle played by any wife but particularly the wife of a small farmer. Here, I may say that I support very strongly the campaign being run by the Disablement Income Group. I believe it to be absolutely right.

Then there are the adults who have been disabled since childhood, the disabled children and the pensioners whose ability to look after themselves is diminished by industry or disease. As the hon. Member for Bedwellty pointed out, the impact of disability falls on the whole economic life of the family. It is true to say that a disabled member of the family means a disabled family, because the disablement reduces or eliminates the earning power of the disabled person and can reduce or eliminate the earning power of other members of a family. Particularly, it can cause extra expense: in fact, I know of no case where it does not cause extra expense. But I add at once that a disabled family can be just as happy and purposeful as any other family. One of the things that are so important for the disabled or the chronic sick is to make them feel that they are, as they are, normal members of the community.

I suggest that the reference point for looking at any improvement in cash benefits, services or the provision of after care is the cost of hospitalisation because at the end of the day if disabled or chronically sick people cannot cope or get worse they end up in hospital. I have made some inquiries in the Library, and as far as I can discover the average national cost of a person in an orthopaedic hospital is £38 a week. I gather that that figures does not cover the capital cost of the facilities, but if I am wrong I hope that I may be corrected.

Let us take £38 a week as our reference point. We could do an awful lot with that amount. Let us cut it in half and say £19. There is an awful lot we could do with that. Our aim should be to get as many as possible of our disabled and chronic sick out of hospital and back into the community. The reasons are worth repeating. First, it is better for the disabled person. Second, and in the shadow of the economic crisis, it is cheaper for the community. Third, as the right hon. Member for Llanelly pointed out, many disabled or chronically sick people can contribute to the economy—but they can also contribute to society.

Fourth, I beg the House to agree that we should do everything we can to avoid the creation of ghetto communities of disabled and chronic sick, circumstances in which the remainder of society feel "We are doing right by them because we put them there in their little ghetto, their little community." We want these people as integral parts of the community. A blind man or a disabled child is every bit a normal member of the community as any of us here present.

What needs to be done is, first, to define the problem, but to define it in numerate terms, not sweeping generalisations, and, second, to adopt a total programme aimed at getting as many of the disabled and chronically sick out of hospital and into their families. We must also recognise, however, that a number of them do not have families to go to, and we want to see some sort of community to which they can go without its being an institution or a ghetto—a home and a base from which they can operate in the community because they lack families.

Thirdly, there is accessibility. To anyone in a wheelchair this is a particular problem. I pay tribute to what the right hon. Member for Leeds, West (Mr. C. Pannell) did when he was Minister of Public Building and Works by sending circulars to local authorities, but I do not think the response from local authorities has been very good. I wonder how many people realise that when a person lives permanently in a wheelchair he is living in a two-dimensional and not a three-dimensional world. A kerbstone is a real obstacle to get over. You, Mr. Speaker, will know that in the City of Southampton a great effort has been made over the years to ramp some of the kerbstones in the main shopping streets. This is not very difficult for a local authority to do. The same applies in the building of council houses and council flats. If it is done on the drawing board, it does not cost a penny more of ratepayers' money to build the houses or flats so that those with wheelchairs can live in them, but if it is not done then and the building is done in the traditional way, to convert it costs a great deal of money.

We also have to develop further the employment opportunities for the disabled and the chronic sick. I agree entirely with all that has been said about that. There is the matter of disabled incomes. This has been well canvassed by the Disablement Income Group. There is nothing I need add other than to say that when we relate back to the £38-a-week hospitalisation we might take a rather fresher look at the claims of disabled income groups.

I do not know how many hon. Members realise that many local authorities are extremely helpful to disabled drivers by giving them parking privileges. Those privileges do not extend across the boundaries of other local authorities. It is a question of each local authority doing right by its own disabled people. But we are a small country and in London there is a large number of boroughs. One has to go only a few hundred yards down a street to cross a boundary and find that there the privileges cease to apply. It would be a simple thing for the Government to give paraplegics a laissez-passer for parking. I would limit this to anyone who has received a disabled person's car or a grant towards the conversion of a car. I leave that thought with the Minister.

There is also the availability of therapeutic physiotherapy and remedial treatment. One of the difficulties experienced is that although we have a number of physiotherapy departments in hospitals it is often difficult for a patient attending such a department to park his vehicle. If we want to make paraplegics more independent we should make it possible for them to drive to a hospital, to get into a wheelchair and go into the hospital and to come back again. If there is nowhere for them to leave their cars the whole point of the exercise is lost.

There is the question of equipment. I should like to believe that I could take a year off with a good engineer in order to design better baths for the disabled. Then there is the question of recreation and leisure. Here I pay tribute to the work of Sir Ludwig Guttman and the paraplegic centre at Stoke Mandeville. I hope that his work for spinal paraplegics can be extended. Then there is the availability of information to the chronic sick and disabled. This is scattered around. It is obtainable by way of something from the Ministry of Health, something from the Ministry of Social Security and something from this or that society or local authority. It should be brought together in one place. I agree with the right hon. Member for Llanelly about local offices, but I want this to be supported by simple literature made available in handbooks for disabled.

I agree with my right hon. Friend the Member for Ashford and the right hon. Member for Llanelly that we need a change in the total approach to the disabled and chronic sick. To use a bit of contemporary management jargon, we need a total concept of techniques which would cut across the traditional demarcations between Departments and between central and local government. If we can change from the demarked management principles of the Pharisee to the total concept of the Samaritan we shall do right by the disabled and chronic sick in our community.