That such a titanic debate should have ended so that I could have my Adjournment debate gratifies me immensely.
The plight of many disabled people, whether they be in Sheffield, south Yorkshire or any other part of the country, is literally heart-breaking. The struggle to live with dignity is hard enough for ordinary working people but if one is crippled and handicapped, life can be a living hell, and there are many such. Those who are confined to wheelchairs are disadvantaged and dispossessed in a way that would horrify us if ever we had to face such a misfortune, and there are many thousands of such people, many more than most people are aware.
We are a little inclined to take such people for granted, although I think that we do not know that we are taking them for granted when we do so. We look on sympathetically, we are glad that we are not like that, and we pass on. Generally, most of us do very little about it, but there is much that we can do, and we have a National Health Service that can and must be put to great use in the service of such people.
Like everyone else, I have watched good people pushing other folk around in wheelchairs, and I have watched people struggling who, through age or ill health, should never have to perform that task for their loved ones. How many times have we all felt a pang of compassion at the sight of an elderly man or woman trying to push another elderly person in a wheelchair when they are obviously unfit to be doing that? We have the sick pushing the crippled, and often the elderly sick pushing the elderly crippled.
Surely, it is obvious, in this day and age, when technology can put men on the moon, and plan weapons of unimaginable horror, that we should use the money and the technical skill to ensure dignity and mobility to disabled people. Many of the people who are confined to a wheelchair are virtually prisoners in their homes. I can give an example of this.
In Sheffield, there is a woman called Ivy Peters, who is 82 and is crippled. She spends all her days sitting in a high chair, making soft toys and other handicrafts to help patients in the city hospital, despite her own ailments. She has been completely crippled since 1979, and since her husband died four years ago, there has been no one to push her manually-operated wheelchair. The only respite to her daily routine is a daily visit from a district nurse, and a weekly trip to a nearby day centre for the elderly. She says:
I can't stand up because of the pain. I can't get my manual wheelchair out of the hall because I can't manoeuvre it through the door, so all I do is just sit in this chair. To me, it is living hell.
If it were only Ivy it would, in all conscience, be bad enough, but she is only one among many thousands. Surely our priorities are wrong. By rearranging our priorities it is possible to provide, under National Health Service prescription, a battery powered wheelchair to all those who need them, provided that we use money for that purpose. These poor people, already deprived and disadvantaged by being crippled, are a thousand times more deprived by the national restriction upon powered
wheelchairs which in many cases compels them to spend their lives imprisoned in their own homes. As Mrs. Kath Savage in my Sheffield constituency, who is leading the campaign, says:
I don't think the people who make the rules appreciate how degrading, frustrating and depressing it is to have to rely on someone else to take them everywhere.
This lady, Kath Savage, ought to know, for she is both disabled and determined: disabled, at 48 years old, for some years by rheumatoid arthritis and determined to end this misery for all similarly disabled people as well as for herself. Recently she came down to London in her wheelchair, which is not battery powered, with another lady who is similarly disadvantaged, Colleen Ford, pushed by Kath's husband and the co-ordinator of the Sheffield branch of the Spastics Society, a lady called Marlene Seedhouse.
It was reading and hearing about their efforts which brought me into this struggle and almost shamed me into doing what I could to try to help. There are many people trying to help. As a result of the campaign, large numbers of people are helping these poor folk. For example, the Sheffield Star began a campaign to help them under the general title "Power to the People". It highlighted their plight, and letters came flooding in from all over the country.
Local Members of Parliament began to ask questions and I put down an early day motion asking for battery powered wheelchairs to be provided for all those who need them. It soon attracted 108 signatures and I hope that we shall obtain more signatures. Sadly, those signatures are largely confined to members of my own party, except for one or two Ulster Unionists who added their signatures because so many people in Northern Ireland are losing limbs. Therefore, Kath Savage and Colleen Ford were pushed in their wheelchairs through the corridors of power and met the all-party parliamentary committee for the disabled which promised to help them.
In my opinion, everybody who enters the fray learns how improved the quality of life can be for the disabled once they receive battery powered wheelchairs. This has stirred the conscience of many people. I wrote to the Minister for Health, who in his reply said:
We have however recognised for a long time that, while it is necessary to bear the financial constraints in mind, the range of wheelchairs supplied by the Department requires to be reviewed. We are keenly aware of the strength of feeling among some wheelchair users that it does not provide them with the kinds of wheelchair they would like to have. For this reason, we have asked Professor Ian McColl, who is chairing an inquiry into the services of artificial limb and appliance centres, to give particular attention to this matter. I know he will be interested to see the leaflet and I will draw it to his attention.
We are very grateful that people who are dedicated to helping these folk have moved more deeply than hitherto into the fray. However, it is not enough. I was told in a recent letter from Mrs. Savage that many disabled people and associations are writing to Professor McColl who chairs the working party review of wheelchairs. Support from all corners of the country has become tremendous and is heartening a wide group of these people, many of whom are sending us letters. One or two who have got the chairs tell us how the whole quality of their life has been changed. Of course, these chairs are for internal use and the ones they use outside still have to be pushed.
I understand that the Chartered Society of Physiotherapy is supporting our campaign. A network of disabled people are interested in this small debate which is taking place very late. People have let us know that they are watching to see what will result from the debate. Therefore, I hope that something of worth emerges from it.
All those devoted people who spend their lives pushing their loved ones around with such splendid unselfishness and care will also be giving us a great deal of attention because their lives are rendered miserable by the hard work they have to do, especially when they are getting older. Wives and husbands have to push their life partners around at a time when they are not feeling well enough to do it.
I was reminded only today by thy hon. Friend the Member for Barking (Ms. Richardson), who takes an interest in this for obvious reasons as well as her own humanity, that more women are looking after sick and elderly relatives than are looking after their own children. That statistic came out recently. We would be helping not only the disabled but those selfless people who look after them.
In answer to a series of questions put down to the Department of Health and Social Security the Minister said that the Department does not provide battery-powered wheelchairs for outside use. Why in heaven's name does it not? Other expenditure could be cut so as to provide wheelchairs for these poor people. Let us hope that the working party reports soon and recommends both indoor and outdoor battery-powered chairs for all who need them. Compared with the cost of such horrific things as nuclear weapons, Trident submarines and so on the amount that would be needed would be trivial to ensure that these poor people have one of the necessities of life, a wheelchair.
We cannot afford not to do this. There is a growing demand among these people and among many who are humane enough to realise that so far they have walked past and not taken much interest in the subject. It is our duty to help change the quality of life for our suffering fellow citizens and to restore to them some of their lost human dignity.
I have one more question from a wheelchair-bound mother, aged 45, who lives in the pit village of Maltby in south Yorkshire. Among other things she said:
I think every disabled person has the right to a powered wheelchair. My wheelchair is no good to me without someone pushing it because I am not strong enough to maneouvre it on my own. The national campaign for powered wheelchairs is a wonderful idea and I'm going to work very hard to make it a success.
I hope that the Minister, who is a compassionate man, will do his best to let us have some hope for people who need these wheelchairs so urgently to alter their quality of life and give them more human dignity.
It is with perhaps more than the conventional courtesy that I congratulate the hon. Member for Sheffield, Hillsborough (Mr. Flannery) on having chosen this subject for the Adjournment debate. It is of great interest to everybody concerned with the welfare of disabled people with severely restricted mobility. Certainly we in the Government share that concern and interest. Of course, because of our direct role in the provision of services for disabled people, more direct than with most other parts of the Health Service, we feel a particular responsibility.
I should like to spend a moment making clear that role and putting into the perspective of the whole wheelchair and appliance service what the hon. Gentleman has said. The wheelchair service is one of the services provided through artificial limb and appliance centres in England. It is, as I said, unusual among health services for disabled people. Like the artificial limb and eye service, the provision of appliances for war pensioners and the provision of motor cars and three-wheelers for those who remain eligible for them, is the direct responsibility of the Department of Health and Social Security rather than one discharged by the health authorities, and in that sense I have a direct and personal interest as the Minister with particular day-to-day responsibility for the artificial limb and appliance centres.
This rather odd arrangement, looked at against the background of the Health Service as a whole, reflects the historic development of this part of the service. The wheelchair service had its origins in the centrally administered provision of wheelchairs to ex-service men after the first world war, and although this provision was extended to civilians when the NHS was created in 1948, the service continued to be run by central Government. In 1953 the responsibility for the wheelchair service passed from the Ministry of Pensions to the Ministry of Health, and it subsequently became that of the present Department.
Running the wheelchair service in England is a big task. Apart from the headquarters organisation at Blackpool and a central store at Heywood, the Department has 25 centres and sub-centres through which wheelchairs are provided. The service is staffed by the whole-time equivalent of more than 600 medical, technical and administrative staff, and there is a network of more than 100 approved repairers who provide services under contract to the Department.
The expenditure on the wheelchair service in 1983–84, costed on a commercial basis was about £32.25 million. The rate of growth of the service—this point is not always appreciated—has been impressive. In 1954 there were only 17,000 wheelchairs of all kinds on loan. By 1974 there were more than 10 times as many, and today the figure is about 410,000, and over 160,000 wheelchairs of all types are issued every year.
I hope, therefore, that it will be common ground between us that this is a service in which provision has expanded dramatically over 20 or 30 years and which has gone a long way to meet the needs of the people with whom we are concerned.
The historic development of the service and the rapidly growing demands made on it have been important factors in determining the limits which have had to be placed on the range of wheelchairs it provides. As the number of wheelchair users has grown, so their constitution and needs have changed. From being a service designed for young disabled ex-service men, the wheelchair service has become one providing to a large extent for older people. Indeed, we believe that one user in four — this corresponds with some of the cases that the hon. Gentleman mentioned—is over 80 years of age.
Initially, wheelchairs were provided for a group of men who could be expected to use hand-propelled wheelchairs without assistance. Today, a great part of the ever-increasing demand is, as we see it at present, for simple, mainly non-powered chairs for occasional use by elderly people when they are accompanied by able-bodied persons. Much of the energy and resources which have gone into the development of the wheelchair service have of necessity, therefore, been devoted to coping with the demand for wheelchairs of a fairly basic type.
Despite this, the service has developed its range of wheelchairs impressively. It currently offers over 250 variant models of non-powered wheelchairs. There are some 50 variants among its powered wheelchairs for indoor use, and there are two basic versions of a power-assisted outdoor wheelchair for attendant control. About 80 per cent. of these chairs are made to departmental specifications, and the rest are the proprietary designs of manufacturers, though the balance is now beginning to change. The Department also supplies a range of accessories, modifications and adaptations to suit individual needs, and custom-built wheelchairs are supplied where there is a medically established requirement.
I nevertheless recognise that, as the hon. Gentleman made clear, there are many disabled people who feel that the service is not fully meeting their needs. There are a large number of powered and manually propelled vehicles which could be added to the range if our resources were unlimited. There are younger wheelchair users who are urging us to provide chairs especially designed for sporting purposes, not powered chairs, but very much more manoeuvrable chairs, and chairs with different characteristics from the standard DHSS wheelchairs.
There are others who suggest that we should provide some of the newer and highly sophisticated non-powered wheelchairs; for example, those which enable the occupant to rise from a sitting to a standing position and to work at a bench or kitchen worktop. There are those, like the hon. Gentleman, who emphasise what they see as the need for powered wheelchairs for outdoor use or for use indoors and outdoors. The range of that sort of chair on the market has grown significantly in recent years. Some will climb kerbs, and some incorporate features normally found in a motor car; for example, lights, a horn and traffic indicators. There is also a range of so-called scooters generally based on three wheels, over which are mounted a platform with a control column and seat.
The cost of extending the Department's wheelchair service into these areas is something which, frankly, it is difficult to calculate. It is not known how many people might be eligible for or want wheelchairs of such kinds, but a conservative estimate would probably put the figure at several thousand pounds and again might correspond with the response to the campaign that the hon. Gentleman reported.
More than 10,000 powered wheelchairs are already issued every year for indoor use or outdoor use with an attendant, and over 18,000 are on issue at any one time. The average cost of an indoor-outdoor powered chair for occupant control is well in excess of £1,000, so it is quite possible that the cost of what the hon. Gentleman—and, indeed, the campaign — is urging could be several million pounds, without taking account of the costs of a repair service.
The cost of extending the service to the other kinds of wheelchair that I have mentioned—for example, for the more active younger users or those who require the more sophisticated kinds of chair with the self-raising capacity — would be considerably greater. Although I do not want in any way simply to put the emphasis on costs, that is obviously one of the points that any Minister in any Administration would have to bear in mind.
I should also remind the hon. Gentleman that a large number of people who need a wheelchair are also in receipt of a mobility allowance or a war pensioner's mobility supplement. If they choose to do so, they can use their cash benefit to buy a wheelchair outside the Department's range, and they can seek the help of the organisation Motability, which I am sure will be familiar to the hon. Gentleman, in obtaining one on favourable terms. It is not the case that the mobility allowance is tied to expenditure on a car, for example, or, indeed, that the activities of Motability are tied to help with the provision of a car. The Government meet the whole of Motability's administrative costs, this year to the tune of some £425,000, and that is something that we are glad to do in view of the way that it can help disabled people to turn their mobility allowance cash into a vehicle or, as I have suggested, a wheelchair on the road.
However, I accept that that is not a complete response to the aspirations of disabled people and those who, as the hon. Gentleman has done this evening, seek to represent their interests. It is for that reason that we are doing a number of things.
The most important is the one to which the hon. Gentleman referred and, indeed, on which he has corresponded with Ministers, that is, the setting up of the independent working party under the chairmanship of Professor Ian McColl to study all the services provided through the Department's artificial limb and appliance centres. That working party has already undertaken a fundamental analysis of the structure and costs of the wheelchair service, and is evaluating its effectiveness and the options both for evolutionary development and for more radical change.
One of the matters to which it is paying particular attention is the range of wheelchairs available through the service. We expect to receive the working party's report by the summer and, when it is available, we shall obviously give careful consideration to any recommendations that it may make.
In addition to the recommendations of the working party, we are looking to the efforts being made within the Department itself to increase the efficiency and cost-effectiveness of the wheelchair service, which would be of obvious relevance to any proposals to extend it still further. Economies are being achieved by measures such as the introduction of the computerised stock control system, which allowed stocks at the central store to be reduced by some £2·5 million in the second half of 1984. Internal studies, for example of the storage operation, together with several independent studies commissioned by the working party, are providing a basis for other economies that may in due course enable improvements to be introduced into the service without increasing its overall cost.
In a broader sense, I should also mention the work that we have set in hand to improve the information base for future planning of services and benefits for disabled people. The valuable pioneering survey of the disabled that Amelia Harris carried out some 15 years ago did not attempt to identify groups of people with specific wheelchair needs. We hope that in the new survey of disabled people, on which work is currently in progress, it will be possible to include questions that go some way towards identifying numbers and kinds of potential wheelchair users, because that would help us in the planning that we would wish to consider.
More immediately relevant to the subject raised by the hon. Gentleman is the attention that the Department is giving to the possibility of commissioning an evaluation study of the powered outdoor wheelchairs that are on the market. The questions that need to be addressed in such a study are being considered at the moment, and it is proposed to seek outside expert advice in drawing up possible terms of reference for such a study.
Whether the Department's range of wheelchairs may be extended to include occupant-controlled powered wheelchairs for outdoor use is something about which I cannot, as I hope the hon. Gentleman will understand, give a firm undertaking here and now. Indeed, it would be quite wrong for me to attempt to anticipate the report of the McColl working party, in view of the work on which I commented a moment ago.
I should like to repeat to the House, and particularly to the hon. Gentleman, who has taken a close and valuable interest in those matters, my assurance that we very much understand the pressure that the hon. Gentleman has reflected and very much sympathise with the problems for people with severely restricted mobility — problems which underly the debate. When we study the working party's findings, we shall bear carefully in mind everything that the hon. Gentleman has said today and the other efforts that he has made to advance that important cause.
Question put and agreed to.
Adjourned accordingly at eighteen minutes to Four o'clock am.