Care Services Minister Ivan Lewis MP answered your questions live online on the Disability Agenda website on 1st March 2007 from 10 - 11 a.m. You can read the transcript below.
Welcome to today's live discussion. Please take the opportunity to ask your questions.
Question 1 Submitted by: Liz
Why is so much money wasted on beaurocracy, when I need something I have twenty professionals telling me that I need it... and then 6 months have passed before I recieve it... I have been disabled since my twentys and have more experience than somone out of college for 1 month to 20 years who does not know my condition????????????
Answer by Care Services Minister Ivan Lewis MP :
I think the answer to that is that it is variable from area to area. Some areas you have one lead professional to ensure you are the main contact. That is not happening everywhere. The main answer is to put more power and control in the hands of disabled people and in some cases carers. That means the money is put into services and not bureaucracy. I think also an important element is a move towards individual budgets and self assessment.
Comment by Bert Massie:
I picked up the idea you said about one person being in control of this and this was going back to the Warnock report of 25 years ago. So often we know the answers but it is not happening on the ground.
Reply to Comment by Care Services Minister Ivan Lewis MP
The point is that obviously the difficult bit is that some people are disabled adults and some with interest in disabled children. Some families tell us that alongside respite care, this notion of having one person to be the person that can take them through the bureaucracy and get them to the right process. That equally applies to disabled adults and anyone requiring social care.
Question 2 Submitted by: Linda Hoggarth
How can independence, well-being and choice be achieved by disabled people when local authorities are having to make savings of many millions of pounds per year, resulting in reduction of funding to individuals, closure of services and a general feeling of concern as to how service changes are being planned?
Answer by Care Services Minister Ivan Lewis MP :
First of all, this government has tripled by next year the investment in the NHS. Spending has increased year on year in an unprecedented way. Alongside that there are demographic realities we have to face up to. People are living longer. There was a report from the Alzheimer's Society which illustrated that point. Also disabled people are now having full lives in a way that wasn't the case previously. Alongside of that, I still don't believe we are gettting the best value for money from the money spent in the NHS and in local authorities. We have a long way to go to get the best use of those resources. Alongside that, the contribution the voluntary sector makes, there is a question about making the best use of resources. Equally we mustn't be in denial about the combination of demographic changes, greater levels of public expectation and demand mean we need a new settlement for social care which reflect the realities of a changing world. What is the state's responsibility, the individual's and families.
Question 3 Submitted by: sally cooper
When I met my husband he already had his disability ,I had two young children from a previous marriage. When discussing his care needs and possible care packages with social services I quickly realised that as his 'partner' it was assumed i would also become 'carer' even though this was against his and my wishes . why do services assume the people living with a disabled person will become carers , carers should at worst just fill in the shortfall of care support and not services offering to only cover what carers can't. My husband wishes to be totally independant of me with regards to his care , do you feel this is his right under the new ideals for independant living?
Answer by Care Services Minister Ivan Lewis MP :
Yes. I believe that we need to be careful with this one because there are many family members who would want to be carers and would be offended and angry if the government denied them that right. Equally there are others who don't feel it is appropriate to fill that role and no presumption should be made by services that either they or the person with the disability should fill that role. No assumption should be made by professionals of that.
Comment by Bert Massie:
I think Sally would welcome that reply. But am I right that the law gives the duty to the local authority to provide a service but not to provide it themselves, and therefore if a wife can provide the care, they do not have to provide it themselves.
Reply to Comment by Care Services Minister Ivan Lewis MP
I assume the legislation is framed because many of the services are provided by the voluntary sector or indeed the private sector and not directly by local authorities. However, I still stick to my view that whilst Bert is right that professionals make that assumption, that is inappropriate.
Question 4 Submitted by: Nick Danagher
In order to achieve recommendation 4.3 of the 'Life Chances' report, is it not essential to place a duty on local authorities to fund the development of user-controlled Centres for Independent Living, or at the very least ringfence funding for that purpose?
Answer by Care Services Minister Ivan Lewis MP :
The first thing to say is that we now have a high-level group in the Department of Health project which is responsible for making this happen. The commitment stands for the date of 2010, which I think in every locality there should be a funded user-led organisation. There are a variety of ways that we need to set about achieving that. Therefore, ringfencing money specifically for that purpose is not consistent with policy, but there are a whole range of means we have to make sure this happens, including funding, guidance and inspection and regulation.
Question 5 Submitted by: Olivia Hogman
What, in your opinion, is the future potential of Lord Ashley's Disabled (Persons Independant Living) Bill?
Answer by Care Services Minister Ivan Lewis MP :
I think much of what is in the bill in terms of the principles the government has already signed up to and believes in, the bottom line though for any government is it has a responsibility to consider the financial implications of any law it puts on the statute book, for two reasons; one, there will always be finite resources, secondly, it would be irresponsible to make commitments that in reality cannot be fulfilled.
Comment by Bert Massie:
Do you think there is merit in the argument that what the government tends to do is look at the cost of a bill but does not look sufficiently at the cost to the public purse? The argument being the government is spending money anyway. In the example of carers, they have to be provided and the money is from the public purse. If carers are not supported, they often become disabled and the public purse has to pay, whereas if the government looked at the cost of not providing that, it might be a very different figure.
Reply to Comment by Care Services Minister Ivan Lewis MP
I agree with Bert, when you consider the cost, you also have to consider the benefits and therefore any decision you make on any piece of legislation needs to be balanced. I think we've indicated a willingness -- I have committed to meet with Bert and colleagues to look at the bill and see whether we can make progress.
Question 6 Submitted by: Mary E. Powell
Bed blocking in the NHS is frequently caused because elderly people have no where to go, cannot care for themselves and have no one to care for them. Better pay for carers whether or not family members would release the NHS blockage. What so you think?
Answer by Care Services Minister Ivan Lewis MP :
I think, very bullishly, that bed blocking used to be the norm in this country. We used to have a winter crisis in the health service every winter. I am proud of the fact that in my view, this is now the exception rather than the rule. That is partially because of the extra money in the system. We always talk negatively about things, but this is partly due to significantly improved relationships between local councils and the NHS locally, focussing on this particular issue of hospital discharge. However, I also believe that, irrespective of this, carers, whether family members or relatives, should receive adequate support to enable them to fulfil their caring role. This is why we introduced the annual carer's grant in 1999 to every local authority, why we announced last week the New Deal for carers, and why there is now a statutory right for carers to request flexible working from employers and we are legislating to give many carers new pension rights.
Comment by Bert Massie:
I think people will welcome the changes. But we have had cases reported to the DRC of people who stayed in hospital for weeks longer than was necessary or they wanted because they could not go home, and yet the government resists introducing lifetime homes, which would not cost the government anything. Why does the government resist the policy because the building lobby does not want them to do it?
Reply to Comment by Care Services Minister Ivan Lewis MP
I personally would be willing to have a look at this because I don't know a great deal about the argument. We are doing a review of community equipment because the service is in many parts of the country unsatisfactory. Based on the work done so far, I am very optimistic that this will lead to major improvement.
Question 7 Submitted by: Karen Adams
There have been hints that the Comprehensive Spending Review contains good news for disabled people and carers alike. Could you tell us more?
Answer by Care Services Minister Ivan Lewis MP :
It is more than my job's worth, Karen. But it is worth people knowing how the comprehensive spending review works because for many outside government, it is a mystery. What it is, is a negotiation between the treasury and each of the spending departments about the amount of money which will be spent on their respective areas of responsibility over the next few years. These discussions are based on the overall amount the economy can afford, political and public priorities, plus changes which are occurring in society, such as the new challenges of demography, advances in medicine and science, global warming, security at home and abroad. One encouraging element of this CSR process is that Anne McGuire has encouraged a cross-government view of the needs of disabled people. I can honestly say today that no decisions have yet been made about the allocation of resources.
Question 8 Submitted by: Diane
I agree with Liz about the number of Experts there are who tell you what you need. With 3 disabled youngsters, why do I have to keep repeating myself over and over to numerous people and STILL have to wait for things to be done?
Answer by Care Services Minister Ivan Lewis MP :
I spent much of my life before I went into parliament working in the social care sector working with children and people with learning disabilities and their families. Therefore I am very familiar with this reality for many parents of disabled children. Only recently I met a parent of an autistic young man in my constituency that said two things that will strike a chord with many people. "I am the expert on my son, no-one else. Why do I have to shout before anyone listens?" I believe that one of the specifics that the current review of services to disabled children and their families will address is this question of too many professionals and not enough action.
Question 9 Submitted by: s sassoon
Why is there so little practical help outside of the family available to teenagers to help them with independent living eg training on lifeskills, road safety etc. The onus is so much on parents so that they cannot work full time or in some cases at all with disabled children. the children will be adults all too soon and we do not want to create a dependency when it is best to try to assist when they are still developing.
Answer by Care Services Minister Ivan Lewis MP :
This is a very valid point. One of my top priorities since I got this job is to get government, across departments, to take seriously the whole question of transition from being a child to a teenager to being an adult. Again, I hope in the near future people will start to see a clearer direction from government about the whole question of support at those different transitional stages in a young person's life.
Question 10 Submitted by: David Morris
As a personal assistance user with what would be considered high support needs and also professionally involved in strategy and policy around social care and independent living, I am very aware of the stress and pressure many PA users have to go through if they wish to move from one authority to another as I'm currently attempting this. Do you think that it is right that the level of support an individual may receive with exactly the same needs can be different dependent on their postcode ?
Answer by Care Services Minister Ivan Lewis MP :
The honest answer to that is that if you have a devolved system of any public service, of course you can specify, and we do specify, national minimum standards. However, if you really believe in the rights of local government to make decisions which are focussed and relevant to the rights and needs of their communities, then you will always have these tensions. Therefore, the debate about equity versus localism is a very live debate and one that remains unresolved.
Comment by Bert Massie:
Minister, it seems to me one of the issues is people who have high support needs represent a problem to the authority. When someone has such needs, the authority has to find money. Some countries in Europe solve this by setting a set amount which a local authority must find towards a person's needs, but beyond that, money can come from central government. The issue here is that a local authority can give a more accurate assessment, because beyond a certain amount it will fall to state budget, but the local authority has no interest in overassessing. There could be a partnership that would get round this postcode lottery. This is soluble if we decide to solve it.
Reply to Comment by Care Services Minister Ivan Lewis MP
I have said very openly in the last few weeks that there is a need for a new settlement in social care because of demographic change and rising public expectations. This is one issue that should be considered as part of the development of that new settlement.
Question 11 Submitted by: Parin
On Independent living, how does the government choose to give elderly individuals residing in their children's homes some form of equity. My mum has had an assessment for a disabled facility in my sister's house, the Council 'forced' a specific design to her requirements which left my sister with a lot more expenses. It turns out that the DDA 1995 & 2005 do not provide her with any remedy, nor does ot provide my sister the main carer any remedy to ask for assistance to meet mum's needs. What does the government plan to do to give old persons rights and respect for choosing to live independently, even if it is in the homes of their relatives and/or children? Currently the disability legilsation fails to give them such rights unless they are residing in their own home/house. Regards parin
Answer by Care Services Minister Ivan Lewis MP :
In a world where people are living longer and want to stay in the community, this is an issue which will become of growing significance. The DRC will be in touch so the minister can look at this in more detail.
Question 12 Submitted by: Andrew Hatton
What action do you plan to ensure that neuro diverse adults like me, with conditions like dyspraxia, dyslexia, AD(H)D, Asperger's Syndrome, can receive, assessment, acceptance, and support from all parts of the NHS, rather than, ridicule, rejection and dismissal?
Answer by Care Services Minister Ivan Lewis MP :
I am really concerned to hear that you feel the system treats you in this way, Andrew. It is one of the reasons why I recently, possibly for the first time ever, published guidance to the NHS and local government on best practice in terms of adults with Asperger's Syndrome and autism. Of course, what will matter is the way the NHS and local government applies this guidance in the real world and on the ground. If you would like a copy, I can make sure we send you one and I would be very interested to hear your feedback as to whether this addresses your concerns.
Closing comments by Bert Massie:
That is our final question, the minister has to leave. I would like to thank the minister for spending so long with us. I would also like to thank all the people who contributed to the debate. We would like to take more questions, there are more being given to us, and we will feed them to the minister's office. We close this webcast and thank you very much.