My Lords, I too join in thanking my noble friend Lady Anelay for initiating this debate. But before we start advising other countries what they should do to improve services for disabled people, perhaps it would be wise to examine our own recent past and how we failed even in the 1970s and 1980s to provide adequate services for disabled people. In particular, I shall illustrate this by describing the pitfalls in providing services for those who need artificial limbs and wheelchairs.
Prime Minister Thatcher realised that something was radically wrong with these services, so I was asked to chair a national inquiry to find out exactly what it was. Our committee found that there was no shortage of money in the provision of this service but the management was deplorable. First, the attitude to disabled people showed arrogance and a lack of respect, as well as incompetence. The artificial legs with which disabled people were fitted very often simply did not fit, were painful to walk on and were hopelessly out of date in design. The commercial firms were given cost-plus contracts with no system for controlling the cost. The plus should have been limited to 4% but in some cases was as high as 16%. But we were told that it was all above board and that the contracts went out to tender. When we attended these tendering occasions for wheelchairs, one company tender was £119, another was £120 and a third was £121. Does that not sound suspiciously like a cartel?
I was fortunate in having on our committee outstanding members including the late Lord Hussey and the noble Lord, Lord Griffiths of Fforestfach, but the trouble was that we were outnumbered by civil servants, who tried to block almost every idea we put forward. We called them the congenital snag hunters. We therefore sacked them and went on to produce a report that was critical of the civil servants who had run the service for many years.
When it was presented to the senior civil servant, a knight of the realm, no less, and Permanent Secretary, he was very angry—in fact, he was white with rage. He told me that my report would be buried. He went on to say, “Most of the reports done by people like you we put on the shelf and they collect the dust”. I replied, “Never mind my report, though I spent a lot of time doing it; what are you going to do about disabled people?” He shrugged; that was my signal to go to Prime Minister Thatcher and tell her exactly what was going on. You can imagine what she said: “What are the names of these people?” When I told her, she was surprised. It is a regular feature that senior bullies and abusers are deferential to those above but abuse those below. Our report was implemented and improved services for several million disabled people.
What advice could one give to developing countries seeking to offer a good service for disabled people? The person at the top—the senior person in charge—must have the right attitude; they must be competent, free of arrogance and understand the meaning of “service”. It goes without saying that corruption must be eliminated because that undermines government departments and services all round. In the end, our report was a success story but we had to fight tooth and nail to get it implemented. I have illustrated all these problems so that developing countries may be able to avoid them. They should have senior people at the top who believe in service and are neither arrogant nor incompetent.