The 1970 chronically sick and disabled persons act – fifty years on

Abstract

The 1970 Chronically Sick and Disabled Persons Act was the first legislation for all disabled people in Britain and seemed to promise comprehensive services and more inclusion in society. With the fiftieth anniversary of the Act in May 2020, many of the problems the Act was meant to remedy remain, such as inadequate housing and lack of basic services. Disabled people in Britain today also face exclusionary practices and hate crimes. The need for comprehensive services is now especially important because UK governments since 2010 have curtailed disabled people’s benefits. In 2020, UK disability services are subject to cuts and poor implementation which back track on the promises of the 1970 Act. Arguably, a system of universal services would attract much needed political support and give vital assistance to disabled people.

Keywords:

• benefits
• disabled people
• 1970 Chronically Sick and Disabled Persons Act
• services
• welfare state

The CSDP act

The welfare state settlement of the 1940s largely excluded disabled people who did not receive war pensions or who were not injured while in employment. The development of services for disabled people was slow in the 1950s, but the conviction that the welfare state would expand to further include them became widespread, and there was public indignation about their welfare (Webster 1988). The 1959 Mental Health Act raised anti-institutional sentiment and brought attention to the welfare of all disabled people. So too did Peter Townsend’s The Last Refuge (Townsend 1962), a study of life in institutions for disabled and elderly people. By the early 1960s, there were some services for disabled people in every local authority in England and Wales (Brown 1971). By the end of the decade, both major parties, the media, and the public were aware that the welfare state settlement had neglected disabled people.

The Act began as a private member’s Bill created by Alf Morris, Labour MP for Wythenshawe, who had familial experience with disability and poverty. The Bill faced widespread opposition within government because of potential costs, superfluity with existing legislation and practice, and the idea that benefits, not services, were the best way to address the welfare of disabled people. Media coverage of the Bill, however, gave the Labour government no choice but to accept it at a time when the welfare of disabled people had become a policy and political issue (Topliss and Gould 1981). Medical advances and an ageing population meant more people were becoming disabled. There was also political pressure exerted by the Disablement Income Group and other groups for and of disabled people (Oliver 1986).

The Act included many new statutory responsibilities for disabled people. It instructed local authorities to be informed of all disabled people in their jurisdiction and listed a range of services that they could provide. Other terms dealt with vehicles, suitable housing, public access building adaptation, education for mentally and physically disabled children, and considerations for children and elderly poor people (DHSS 1970). Expectations for the Act were high, as Mary Greaves, honorary spokesman for the Disablement Income Group, said, ‘As a disabled person, the importance of this Bill is the underlying philosophy: the integration of the disabled person into society’ (Morris and Butler 1972).

The CSDP act in the 1970s

Local authorities were tasked with compiling a register of all disabled people in their jurisdiction. With the pervasiveness of need, however, some local authorities did not attempt registers because identifying and providing services for all disabled people seemed impossible. By 1973, one-half of local authorities had attempted some sort of survey, but these surveys often underestimated the number of disabled people and their needs (NFRCD 1973, Brown and Bowl 1976). Local authorities were to provide a range of services – including meals, telephones, home adaptations, assistance with holidays, and practical assistance in disabled people’s homes – but there were obstacles to providing them. Some local authorities were slow to compile registers and thought that they could not provide services until all disabled people were accounted for. For those local authorities that completed accurate registers, the scale of need revealed made offering comprehensive services too costly in finances and in personnel (Hampton 2016).

As a private member’s Bill that went against concurrent thinking about the welfare of disabled people – selective benefits for extraordinary need – the Act never received the financial support of central government. The money resolution granted to local authorities was not earmarked for disability services and could be spent as local authorities pleased. With high inflation in the 1970s, local authorities often did not provide services and items that disabled people could not afford. Beginning with the 1976 Priorities in Health Care, the emphasis on ‘community care’ meant the withdrawal of the state and a focus on non-statutory welfare (DHSS 1976). Many of the services created under the Act were cancelled in the late 1970s.

Notwithstanding some good intentions, the Act did not guarantee any standard of provision. Borsay (2004) said that services did expand under the Act, but with lofty expectations, it was condemned as failing to help most disabled people – estimates on the percentage of disabled people who received practical assistance ranged from 8% to 27% (Knight and Warren 1978). The mid- and late 1970s were a time of increasingly negative attitudes toward statutory welfare. With the Act and the disability benefits of the mid-1970s, disabled people were viewed as never having it so good. This perception was incorrect, as the Act mostly failed to deliver important services or the intangible benefits of respect and inclusion.

The CSDP act in 2020

The last decade was a time of growing hardship for disabled people including massive government cuts, the bedroom tax – a measure that reduced benefits for some tenants in social housing – and stringent tests to qualify for inadequate benefits. With the liberalisation of British society in 1960s, the Act was passed at a time of improving attitudes toward disabled people and faith that the welfare state would continue to expand to address needy groups. Today, there are hate crimes against disabled people including harassment, intimidation, cyberbullying, physical assault, sexual assault, and alleged fraud and withdrawal of services (Healy 2020). With current government and public attitudes, and the traditional unwillingness of government to spend on disabled people, new or improved benefits are very unlikely in the near future. Services are now vital as disabled people experience, amongst other problems, food poverty, a pay gap with non-disabled people, and comparatively poor opportunities and outcomes in education and employment (Bulman 2017). Services for people with mental health conditions are also important, as the evaluation of eligibility for benefits often does not account for mental health conditions. Since 2010, local authorities have struggled with funding cuts, and this has not only affected services, but also direct payments to disabled people (Graby and Homayoun 2019). These payments give disabled people freedom to obtain services to meet individual need and to make up for the services not offered after fifty years of the Act.

In 1970, the Act seemed to many to promise universal disability services. While discussion of disability during the 2019 General Election campaign focussed on benefits, there was also the idea of universal care, and Labour had announced plans for free personal care for people over 65 in need of special assistance (Butler 2019). Governments can cut or restrict expenditure on services for disadvantaged groups without significant political consequences, but universal services are available to the wealthy and the middle class, meaning higher quality and better protected services. Paid for by general taxation, universal services would lessen the burden of increasing costs: this is especially important for severely disabled people living alone and without care because the introduction of Universal Credit included the cancellation of benefit supplements for severity (Butler 2020). The NHS is free at the point of delivery and addresses ailing people without consideration of their wealth and employment, and universal services might mean that care would be delivered in a similar way. Both the NHS and statutory welfare for disabled people provide assistance at acute times but are perceived very differently by government and the public (Ryan 2019). The Act was often poorly perceived because local authorities created rigid qualification criteria for services. The NHS is protected by public esteem and its political consequences, but like the Act in the 1970s, disability provision today is subject to cuts and poor implementation with general acquiescence.

In 2020, the historical experience of the Act is telling. The Act contained no definition of need, and there was no legal recourse against local authorities for disabled people who did not receive services. A national standard of local authority disability services and a statutory duty to provide them are needed. The Act did not require that the number of people with knowledge of disability issues should be increased on local authority committees. Today, the greater involvement of disabled people and disability organisations in the planning and implementation of services is needed as first argued by disabled writers in the wake of the Act (Barnes 1991). The Act required local housing authorities to design and allocate homes for disabled people, but this provision was largely unfulfilled, and many disabled people could not afford to purchase a private home. The current government must act based on the consultation on mandating higher accessibility standards for new homes that began last year. Access to housing is fundamental to better health and employment prospects for disabled people – and the reduction of isolation and loneliness – especially when increased rents and local authority tax are consuming a large portion of low incomes.

A sea change in attitudes is needed. In 2017, Britain was found in violation of the United Nations Convention on the Rights of Disabled People. The rights of dignity and personal freedom, as the Act seemed to promise and failed to deliver, are amongst the least definitions of rights. Yet, they seem unattainable today in a culture of scrounger hunting and disdain for disabled people. Britain has traditions of thinking that improving the welfare of disabled people must protect the interests of non-disabled people and that disability benefits and services must have an economic return to compensate for their cost. In 2020, there are attitudes and traditions worth abandoning.

Disclosure statement

No potential conflict of interest was reported by the authors.