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Lord Ashley of Stoke asked Her Majesty's Government: How many people in the United Kingdom are both deaf and blind, and how many of them have communication guides. The Parliamentary Under-Secretary of State, Department of Health (Baroness Cumberlege): My Lords, since there is no universally accepted definition of deafblindness, it is not possible to give an accurate figure of the number of deafblind people. The numbers of communicator guides for people who are both deaf and blind will depend upon the local authority's assessment of overall needs.

Lord Ashley of Stoke: My Lords, is the noble Baroness aware that I have been told of the Government's actions in this field? I refer to launching the good practice guide last year, funding the voluntary associations and the work of local authorities in setting up schemes. However, those actions are hopelessly inadequate. Some deafblind people are still quite isolated. Only 16 out of 400 local authorities have set up the schemes. That is a disgraceful neglect by many local authorities.

Will the Government press all local authorities with deafblind people in their areas to set up one of the essential communicator guide schemes? Will they ask local authorities to identify all the deafblind people in their area and to set up a form of record? We do not know how many deafblind people there are, where they are, or what problems they have. That is not good enough. Will the Government press local authorities to assess needs and to make adequate provision to add some quality to the lives of deafblind people?

Baroness Cumberlege: My Lords, I have a lot of sympathy with much of what the noble Lord says. However, as regards resources for social services, local authorities are receiving a 4.5 per cent. increase in cash for next year. They are receiving extra money for community care. New money will amount to £325 million. It will be the third year running that that money will be ring-fenced so that it has to be spent on community care.

It is for local authorities to set their priorities. We do not do that for them. But we expect them to provide appropriate care and support for the most vulnerable and disabled people in their communities and for their carers.

Baroness Hayman: My Lords, does the Minister accept that not only are the schemes greatly valued by the people who use them, but they can also be very cost effective in preventing the need for residential or nursing home care, in particular for elderly people suffering from that dual disability? Will the noble Baroness consider positively encouraging local authorities to implement the schemes and to disseminate good practice in this area?

Baroness Cumberlege: My Lords, the Government have a number of programmes which encourage local authorities to have greater awareness of those people who have dual disabilities of, I think that we would all agree, an horrendous nature. We work closely with the directors of social services. There are some programmes to raise awareness of the needs of this group of people. But in the end it is for local authorities to decide whether an investment in one area is cost effective in saving money in another. We have to rely on their local discretion.

Lord Dean of Beswick: My Lords, local authorities being what they are, irrespective of their political persuasion, does the Minister appreciate that we shall have an unbalanced service? Some people in some areas may be well looked after, and some ignored, depending on the priorities of the local authority. Can the Government cut across that imbalance by deciding on a specific subsidy made available to local authorities for this purpose only and for no other? I believe that were such a system introduced assistance would reach most quickly the areas of greatest need.

Baroness Cumberlege: My Lords, the noble Lord having been a councillor, as I was for many years, will know how jealously local authority members guard their autonomy and their rights in setting local priorities. We recognise that there are parts of the country where needs are very different from other parts. Therefore as far as possible we have been going away from setting quotas or rigid policies, leaving it to the local authorities to spend the money as they think fit.

Lord Harris of Greenwich: My Lords, is it not rather odd that we do not know how many people are both deaf and blind? Will the Minister's department undertake some form of research programme to find out what the numbers are?

Baroness Cumberlege: My Lords, it is very difficult; the degree of disability varies according to the person. Therefore we have not set a rigid definition. Clearly it is up to local authorities to know the needs of their populations. We encourage them to keep local registers where they think it appropriate.

Lord Ashley of Stoke: My Lords, does the Minister agree that local authorities could provide her with a definition without any problem at all? That is no difficulty. Is not the situation very odd? The Minister assures the House that more money is forthcoming and says that it is a matter for the local authorities, and yet hundreds of deafblind people are isolated and not being helped. We cannot fob the problem off on the local authorities, many of whom are negligent. The Government can speak of autonomy, but they can influence the local authorities. If the Minister so chooses she can intervene and persuade local authorities. The Government do that in relation to other matters. Why cannot they do it in relation to deafblind people?

Baroness Cumberlege: My Lords, we fight shy of doing that in relation to other matters. The noble Lord will recognise that there are many, many demands on local authorities. We acknowledge that, and that is why we have given them increased cash for this coming year. It is really not up to central government to set local priorities; it does not work--I know; I have been on the other end. Such an approach merely gets caught up in red tape. It is inappropriate. It is quite right that local authorities should judge priorities in their own areas.

Lady Kinloss: My Lords, what guidelines are there to encourage local authorities which co-ordinate their communication guides to share the information with local authorities which do not use them? Does the Minister agree that at least some elderly deafblind people could benefit from conductor guides and other support services to retain their independence and perhaps live in their own homes?

Baroness Cumberlege: My Lords, we are working with voluntary organisations and also the Association of Directors of Social Services to ensure that local authorities are much more aware of that group of people. There is evidence that the profile of that group is being raised. We will also put out a circular on the registration of deaf and partially hearing people in the next couple of months. We hope that that will also encourage local authorities to become more aware of the needs of this particular group of people.

Lord Molloy: My Lords, is the Minister aware that when I was leader of a London local authority we saw to it that, in addition to our councillors and aldermen, representatives of deafblind people attended our council meetings so that, before the meetings took place, we could ensure that the points they wished to raise became its subject-matter and subsequently the policy of the local authority?

Baroness Cumberlege: My Lords, it is up to local authorities to run their meetings as they choose. I hope that they do work with voluntary organisations. Clearly those organisations have a lot of knowledge and wisdom to give.

Lord Carr of Hadley: My Lords, might it be possible for the Government to make use of the local authority associations to circulate information about best practice among their members? It is a less direct way of influencing them than the interference which she rightly fears.

Baroness Cumberlege: Yes, my Lords, in November 1995 we set out good practice guidelines in consultation

with local authorities and the voluntary organisations relevant to this particular sector. The document was entitled, Think Dual Sensory. I gather that it had something of an impact.
 

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