SOCIAL SECURITY A proper income for the disabled
In 1969 Mr Heath laid down, in a passage that was clearly not meant to be mere window-dressing, the principles of his own approach ta social welfare : The natiori we want to build depenas on free enterprise, on a prosperity that is based on the earnings, the savings and the' efforts of a free people; and a free people who are strong but who are determined that our nation shall be judged by what it can do for the weak as much as by the opportunities it can give to the vigorous. We as a nation must be judged by our treatment of the elderly, by our attitude to the disabled, by the conditions in our hOspitals, and particularly in our mental hospitals, and by the shelter we can afford to the homeless and the badly housed, These are noble sentiments. Further, the paragraph — from Mr Heath's speech to his party's conference in Brighton — was curiously prophetic of certain major problems his Government would face and try to tackle. The Pensions Bill will attack, according to the Government's principles and lights, the problem of provision for the elderly; while the Housing Bill has, in part, and again according to the Government's principles and lights, attacked the problem of homelessness and inadequate housing provision. We do not pretend that either piece of legislation is wholly adequate, or that some of the criticisms made of both are without force. But in both cases an attempt has been made. For the disabled and the mentally ill, however, far too little has been done; yet, both the disabled and the mentally ill are the victims of circumstances completely beyond their control and should therefore be cared for by the community, according to both the principles of the welfare state and the principles of the Conservative Party as laid down by its leader.
Of all the pressure groups which harry government—especially the social welfare pressure groups — none is more mature, more influential, more considered in its actions, than the Disablement Income Group. The sole purpose of the group's existence is to procure monetary compensation — an income — for anyone who. through disablement, is unable to lead a normal life. This income, the Disablement Income Group believes, should be available in two forms, a taxable pension for loss of earnings, and a tax-free allowance for extra expenses. The struggle for a national disability income, as the group points out in its new critique of the Government's pension scheme, goes back to the seventh century, when King EtheIbert laid it down that certain forms of disability should entitle the sufferer to compensation. The disablement lobby is no tiresome newcomer in the field of social provision: it has its roots deep in the past. Further, it can be distinguished sharply from other and similar kinds of pressure group like, for example, the Child Poverty Action Group — which seeks to persuade government to take more eflective and large-scale action for the relief of the poor — in that the citizens on whose behalf the Disablement Income Group campaigns can by no stretch of the imagination be regarded as at fault for their plight. It can be argued that his poverty may be to some extent the fault of the Aai n , poor individual. His disablement, however, is a. con'Tfi flicted by chance or accident on the disabled indivionv' cannot be considered to be the result of his own actaied. Age, too, is an inflicted condition; but it can be anti,c`,1-011 Thus it is the purpose of the Government, according to Itflated White Paper Strategy for Pensions — which will be legisf the upon this autumn — so to arrange matters that the bulk °000 provision for old age will be made by the worker, thrstead rel is with the broader aspects of government socia in private pension schemes,, during his working lifetifne of, as heretofore, by the state through National Insurance on. tills tributions. The Disablement Income Group favours,dict scheme in principle, though it alters the whole basis on l We pensions have been provided in Britain in the past. Its 1f3te bled strategy, and particularly with the fact that the disa excluded — as they have been in the past — from the °,,PtiefilY tion of the national pensions system. "A social se't policy," says their policy document Creating a Natior1,6„0111 ability Income, "which fails to treat invalidity constnild with retirement and widowhood is unsound, discriminatc" must be amended." in alveli It is important to note and emphasise the principle - in this statement, for it is one which underpins the W`"itio state, and the Disablement Income Group seeks to aPPILiple that group in the community which it represents. The PrP'35 3 affirms that it is the responsibility of the communYliealtil whole to provide, in matters of security, income ano care, for those of its members who cannot provide f°r (11))' selves. It is a principle broadly accepted by both parties Poor successive governments, though some sections of the .ciciod munity resist its implications. There is, however, a sot/5,110P principle as well, one which the Government's proPoseLl' sions legislation expresses : that it is the responsibiovi' government to compel citizens by legislation to make hrefore sion for future disability — the disability of old age "itierlt that particular disability occurs. The present GovernisiO judges that this act of compulsion towards private 10v od is necessary because of the huge demands social Welf0e35 health care make on the resources of the communiti„nel# whole: these dictate that as much as possible should be aulfnuf people for themselves, and that only the irreducible Mirl:nioll of the unfortunate should be provided for out of °— resources.
The financial burden of physical disability Was oatiticfr recognised in the Government Social Survey's report on 'i911, capped and Impaired in Great Britain, which appeared in 006 Only laundry expenses and prescription charges were:41.11%134, among the costs which bear heavily on disabled PeoP,Ic.,blO when the attendance allowance — to assist those01—pd people who needed constant attendance — was introclucAv 1971 the amount — £4.80 — was ludicrously small anLver, kind of problems covered ludicrously limited. It does, 1107:10 provide the basis of the tax-free expenses allowance for liii stittite'anlement Income Group have been campaigning. It con8, no step whatever towards providing a national dis ke Y inc°ine, as part of the provisions of the National Insur;osessystem. Nor is there any sign that the Government pro Uire to tackle this problem in the radical spirit which is lieril;re remain two major developments in the field of care. ttos 1,8t is Alfred Morris's Chronically Sick and Disabled Pero' c4re 'ct, which places a number of responsibilities for the eco of the disabled on the shoulders of local authorities. The 6ohilild is the Local Authority Social Services Act (the Seeare Act) which reorganised the whole system of welfare rove at local authority level. In the offing, further, are the :nirient's proposals for reforming the structure of local cien'rntnent itself, so as to secure greater dispatch and effikeacY in the work these authorities have to do. The two , Peo:illres we have, and the one to come, will affect far more lotl'te than those who are disabled. But the three together will ti less have an enormous impact on the lives of disabled sens. While it is true that the structure created following ter]. °wii eebohm report will probably require several more years to 971 oso e d and work at maximum efficiency, and while it is [ted rtet true that a number of local authorities are dragging their t1i1 °II the implementation of the Morris Act, it is nonetheless all iljase that all these pieces of legislation together constitute aj°I. improvement in the situation of disabled people.
tbeAll, socially vulnerable groups, but particularly the old and abled, suffer from the physical characteristics of modern ur:tY — the kind of housing we have been creating since the tp,, the kind of urban and suburban .sprawl which has grown partt,he kind of environmental planning which has taken place, PIN,le,ularly in the late 'fifties and in the 'sixties. The type of Cal society which we have been creating assumes the qlori‘e, Physical fitness and vigour of each member of the corntY. It is not built to consider the very young, the old, the the otherwise disabled, nor even the poor. Planning has, ottt „s_imPIY, gone ahead without a social conscience, or withII ed Surricient intelligent concern for interests other than those ire couproPerty developers, motorists, shopkeepers and some to Q:1,cil housing tenants. tie il' course, it is true to say — and fair as far as it goes — $i With vast leaps in medical knowledge, and with the growbotharticulacy of social welfare pressure groups, we have been ir seie" Prolonging lives and awakening the national social con/ Oi4 nee to hitherto unconsidered kinds of need. These factors ;les explain and excuse, if they do not justify, the inadequat40 c'f. provision for the vulnerable. We have now become r tried! aware of need; and we have now greatly improved 9( Of dl.cal and other skills and devices to ease the consequences cotiilsablement if not to remove them. Has the time therefore ical? for a great leap forward in provision, both financial and h jii cI .r.l'he Disablement Income Group proposes : $ '11 t,e $ '11 t,e benefits payable for total or partial loss of earnings (such list,7vandity benefit and special hardship allowance) should be conWhether or not the disability was caused by industrial injury. I ■rsitsgehe benefits payable because of the higher cost of disabled living 40t,., as attendance allowances) should be the same whether or Ie disability was caused by industrial injury. extra benefit payable to those injured at work and desigas compensation for the impairment of their power to lead iVrial life should be kept to modest proportions. kchelbc)clY should be outside the scope of National Insurance in a serious event as invalidity. Work.411. dicapped children who are unable to work when they reach birttl'Ing age should become entitled to an invalidity pension as a 'I11. h r People in the labour force who contribute fully to National ktrabce schemes, cover against invalidity should be put on the dill:?P' footing as cover against industrial injury — i.e. it should s be available. 'arried women who are housewives or who, if employed, are only contributing for cover against industrial injury should be covered against invalidity on their husband's insurance in the same way that they are insured for a retirement pension.
Each one of these proposals is reasonable and fair. The programme as a whole puts the disabled on the same footing as the retirement pensioner or the industrially injured. There can be little argument against doing that, or against accepting the same responsibility for the disabled persons that we accept for the old (whether or not it is judged that the responsibility to the old is adequately discharged).
It would still be only another beginning, a further step towards the creation of a more fair society. The mentally ill, the fourth concern of Mr Heath in his 1969 speech, are still treated shamefully. Scarcely a week passes without some further revelation of scandal at a mental hospital, some further case of bullying or unnecessary suffering, some other account of harshness endured, necessarily without understanding, by people unable to look after themselves. There have been a series of inquiries into specific abuses. Each time another scandalous situation is revealed Sir Keith Joseph promises — and undertakes — another investigation; and now we are to have a kind of hospital service ombudsman to keep an eye on things. This demonstrates goodwill, and there has been an impressive unanimity on the part of both the Government and the Opposition in keeping these problems out of the field of political controversy. But nothing adequate has been done. The politicians and civil servants in the Department of Health and Social Services feel they have neither the time nor the staff to undertake a full review of mental health provision in this country, and they have consistently dragged their feet in response to demands for a full public inquiry, let alone a Royal Commission. The demands for a public inquiry should now be met. There can hardly be any doubt that an inquiry would reveal a staggering inadequacy which is nation-wide, and that this revelation would lead to irresistible demands for largescale and expensive reform. But, again, this is no excuse for continuing with the present piecemeal approach. By the professions of their own policies and philosophies, both the Government and the Opposition are committed to accepting respossibility for the mentally ill, as for other vulnerable members of the community.
We have said little about the poor. The duty of society and of government towards those whose capacity to live a normal life is impaired by physical or mental abnormality or disorder is cleaner and sharper than and, in a way, different in kind from, our duty towards those who suffer purely economically. Even if we allow that poverty is a cultural and environmental, as much as a financial, condition it is still the case that the first step in tackling poverty must be a financial one. It is moreover one that raises all sorts of unanswered economic questions; questions more difficult, in many respects, than those concerning disablement or mental illness. Nonetheless, all governments have a duty to the poor, a duty which must be discharged, and which is now being discharged inadequately.
The good that has been done by this Government since the last general election has been considerable—but it has been a multitude of small goods, a multitude of piecemeal activities, and of patching and mending. Even meeting the Disablement Income Group's proposals, and acting on the results of an inquiry into mental health provision—dramatic though the difference these actions would make to the groups concerned — would still be only partly adequate. This is to some extent because of the crushing burden of modern social and health responsibilities, and the enormous cost of making provision which is even remotely adequate. In another and deeper respect, however, it is because our concepts of social direction and purpose have become fudged and uncertain. We lack an overall concept of need that fits these problems and concerns and states the public obligations the rest of us owe to the vulnerable and needy members of our public community.
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