Draft programme for government and draft budget

A Law Centre (NI) response

January 2008

1.  Introduction: About Law Centre (NI)

1.1  Law Centre (NI) is a public interest law non-governmental organisation.  We work to promote social justice and provide specialist legal services to advice organisations and disadvantaged individuals through our advice line and our casework services from our two regional offices in Northern Ireland.  We provide a specialist legal service (advice, representation, training, information and policy comment) in five areas of law: mental health, community care, immigration, social security and employment to almost 500 member agencies.  Members include local Citizen Advice Bureaux, independent advice agencies, local solicitors, trade unions, social services, probation offices, constituency associations of local political parties, libraries and other civic organisations.  

2.  General Comments

2.1  We welcome the opportunity to comment on the draft Programme for Government, Budget and Investment Strategy and will focus our comments primarily on the Programme for Government and the Budget. 

2.2  We welcome the echoing of the commitment by the British Government to reduce child poverty by 50 percent by 2010 and eradicate it by 2020.  We are also encouraged by the inclusion of a further target for the elimination of severe child poverty by 2012, which is the first target of this kind in the United Kingdom.  We are concerned, however, that anti-poverty did not appear as a key theme within the draft Programme for Government and that there was no mention of the recent anti-poverty Strategy.  Co-ordinating a cross-departmental approach will only be successful if anti-poverty is a consideration of all the work of each department and this does not appear to have been the case thus far.  Moreover, it already appears that the Government in Britain is unlikely to meet the 2010 target in England and Wales.  In England and Wales greater strides have been made towards developing comprehensive wraparound child care than in Northern Ireland.  Affordable, high quality childcare is essential if parents are to enter the workforce yet neither DEL nor DSD has a childcare database when advising lone parents and other parents about support for returning to work.  As a result the Programme for Government needs to address the issue of childcare provision urgently. 

2.3  We support and endorse the Executive’s over-arching aim ‘to build a peaceful, fair and prosperous society in Northern Ireland, with respect for the rule of law and where everyone can enjoy a better quality of life now and in years to come.’  However, we are unsure that the draft Programme for Government and the supporting budget is able to best meet this aim. 

2.4  We also welcome the development of a Charities Commission.  We participated in the consultation process regarding the Charities Order and believe the Commission will make a positive contribution to our community and voluntary sector. 

2.5  We note that the Programme for Government is a brief and concise document containing little analysis of the priorities and themes contained therein.  It is clear that this is an economically focused Programme for Government and budget with the priority area of ‘growing a dynamic, innovative economy’ receiving much of the attention. 

2.6  We are concerned by lack of balance within the draft Budget with the economic context given 13 pages of analysis while only two pages of comment are devoted to the social context.   We note the comments that ‘sustainable economic growth and increased prosperity will provide the opportunities and means to enhance quality of life, reduce poverty and disadvantage, increase wealth, health and wellbeing.’  However, economic growth of itself is only part of any strategy to tackle poverty and improve health and well being.  Sufficient social investment must go alongside the promotion of economic growth.

2.7  There is a very real concern that there are insufficient resources allocated within the draft Budget to support the measures and aims outlined within the draft Programme for Government.  This raises considerable alarm regarding how realistic or sustainable the promises made within the Programme for Government are. 

2.8  Our comments are divided into our five priority areas of specialist legal advice as specified below.

3.  Mental Health

3.1  Despite many assurances by both the Transitional Assembly and the Assembly that implementing the recommendations of the Bamford Review of Mental Health and Learning Disability and the development of mental health and learning disability services and support was a priority it was disappointing that mental health and learning disability were given only a brief mention in the draft Programme for Government.  While the commitment that ‘by 2013 anyone with a mental health problem or learning disability is promptly and suitably treated in the community and no-one remains unnecessarily in hospital’ is commendable, as previously mentioned it remains to be seen whether the funding allocated to mental health in the draft budget is able to deliver on this aim. 

3.2  We are advised by the Department of Health, Social Services and Public Safety (DHSSPS) that its highest priority bids were submitted for services for people with mental health and/or a learning disability.  Information received from DHSSPS states that bids of some £17million, £29million and £48million were submitted across the Comprehensive Spending Review period.  However, we note from the draft budget that only some £4million, £7million and £18million are available for mental health and learning disability.[1]  This is a significant reduction from the bids made and we are concerned that the funding offered will have little impact on urgently needed plans to overhaul services in these fields. 

3.3  The low level of available resources especially in years one and two means that most of the improvements will not be able to be implemented until the end of the three year funding cycle in 2011.  Given the high awareness of the drastic problems within mental health and learning disability services in Northern Ireland and the commitment publicly made by the Transitional Assembly to implement the Bamford recommendations it is unacceptable for there to be a further delay in the implementation of key changes to better services and support for people with mental health issues and/or a learning disability. 

3.4  We are concerned at the clear inequality in the allocation of resources to mental health and learning disability services in Northern Ireland when compared to recent increases in funding by the British Government.  The allocation of funding for mental health and learning disability as detailed in the draft budget amounts to a rise in funding in years one and two of less than 1 percent.  In stark comparison from 2000-2006 the British Government have invested an average 6.6 percent per annum rise in mental health spending with 11.8 percent of the NHS budget allocated to mental health.  In Northern Ireland despite a higher prevalence of mental health issues compared to Great Britain, only 8.4 percent of the NHS budget is allocated to mental health.[2]  There are clear inequalities therefore in relation to the resourcing available for mental health services.

3.5  One of the other major concerns that was highlighted by the Bamford Review is the lack of an adequate number of trained mental health staff in Northern Ireland.  Without an appropriate workforce many of the desired recommendations made by the Bamford Review cannot be implemented.  Currently in Northern Ireland the workforce is 500 below the number of community mental health staff recommended by Bamford.  Essentially this draft budget will equate to little or no support in the community for a significant number of people with mental illness.  Yet the draft Programme for Government and Budget both refer to the need to extend and strengthen the range of services available in the community so that people get immediate support and are spared inappropriate hospitalization but the funding is simply not there to back up this aim. 

3.6  As previously commented in is clear that this is an economically focused Programme for Government and Budget yet the economic advantages of dealing with Northern Ireland’s drastic mental health problems seem to have been ignored.  An estimated 80 million workdays are lost each year to stress, depression and anxiety.[3]  Furthermore, not addressing mental health problems in the workplace cost business and the public sector an estimated £9 billion each year.[4]

3.7  One in six people in Northern Ireland will suffer from a medically identified mental illness at any one time[5] and research indicates that the history of sectarian violence in Northern Ireland continues to have a serious impact on the mental health of individuals.  Recent research has found that almost a tenth of Northern Ireland’s working population is claiming benefits for mental health.[6]  Northern Ireland has significantly more people claiming benefits for mental health related illness than any other region in the United Kingdom.  If mental health services were given the priority they deserve this would have a significant impact on the Northern Ireland economy, reducing the number of people on benefits and increasing the market economy. 

3.8  The British Government seems to have accepted the economic arguments and are investing significant funding to provide an additional 10,000 psychotherapists over the next 10 years as part of the Pathfinders Programme.[7]  Its aim is to provide timely access to psychotherapy to enable people who are in receipt of benefits for mental ill health to get the help they need and therefore return to work faster.  Northern Ireland could learn much from this model.  While the draft budget will support the recruitment of about 30 additional psychotherapists this is still a long way off meeting the identified need for talking therapies in Northern Ireland. 

3.9  The Bamford Review was extremely wide ranging and established clear links between legislative reform, service delivery, promotion of wellbeing and the need for social inclusion for those with mental health issues or a learning disability.  Our legislation is not fit for purpose as it currently stands, unlike recent legal reform in England, Wales and Scotland.  Without adequately recognising the importance of the Bamford recommendations and providing resources for their implementation the programme for Government is squandering a vital opportunity.

3.10  The recommendations of the Bamford Review offered new hope to those with mental health issues and/or a learning disability.  The draft Programme for Government and Budget does little more than quash that hope.  As it stands the draft Programme for Government and Budget if implemented will, we fear, result in a continued loss of momentum and further prolong the struggle of service users, families and carers who had hoped that the Bamford Review would herald a transformation of services and provide the support which is so urgently required.  We would call for a reconsideration of the allocation of funding for mental health and learning disability in Northern Ireland to ensure this does not occur. 

4.  Community Care

4.1  We welcome the aim within the draft Budget to give older people ‘a strong independent voice’ and the statement that the Office of the First Minister and Deputy First Minister is ‘committed to ensuring an enhancement of rights for older people and to making a real difference to their day-to-day lives.’ 

4.2  The extension of free public transport during 2008 to everyone aged 60 and over is welcome and recognises the important of equality and social inclusion.  There are some concerns, however, regarding the uptake of and access to public transport in rural areas which will need to be considered. 

4.3  We were disappointed that despite the passing of a unanimous motion within both the Transitional Assembly and the Assembly for the introduction of free personal care as a priority it has not formed part of the Programme for Government or been provided for in the draft Budget.  OFMDFM state in the draft budget that it wants to support the most vulnerable in society, which must include real tangible benefits to those most at need; older people, children and the disabled.  The provision of free personal care would be a significant step forward in achieving this aim.  We would welcome further information regarding the review of free personal care which was due by the end of October 2007 but has not yet been completed or made public. 

4.4  We are pleased that the language within the draft documents reflects a shift in priority from a previous focus on ‘ill health’ to a wider sense of promoting ‘wellbeing’.  This change is very welcome; however, more detail on the preventative care agenda for older people would have been welcome.  The health promotion activities which are referred to in the draft Budget focus on screening exercises, which relate primarily to preventing the effects of disease or illness once found, rather than promoting wellbeing as a whole which could prevent disease or illness from occurring  in the first instance. 

4.5  We note that as with the bids for mental health and learning disability DHSSPS bids for primary and community care services were well above what was allocated in the draft budget.  DHSSPS state that bids of £26million, £41 million and £89 million were submitted but only expenditure of £3million, £7 million and £19 million are funded by the draft Budget.[8] 

4.6  While the allocated funding will enable the provision of additional respite packages to support carers of people with a physical or sensory disability the limited funding will mean that additional funding for services for carers including respite care for those dealing with highly dependent adults with complex needs will not be available.  Furthermore, proposals to improve care services by expanding the range of services and responses to older and vulnerable people will not be taken forward and long waiting times for care packages will continue. 

4.7  There are an estimated six million carers throughout the UK,[9] and over 185,000 carers in Northern Ireland.[10]  Respite care is vital to ensure that everyone in the family is equally and fully supported.[11]    Many carers are the sole care giver(s) for their family member and 8 out of 10 families provide more than 15 hours of care every day.[12]  Such a high level of constant and intensive care without pay or holidays, places an enormous burden on the carer(s).  Without adequate respite care a carer’s own physical and mental health is at risk as the endless pressure of providing care takes its toll.

4.8  The Carers and Direct Payments Act (Northern Ireland) 2002 gives carers the right to request an assessment of their individual needs and places an obligation on Trusts to meet the needs of carers as assessed, including the need for respite care.[13]  The Act contains a duty to provide the services required yet no extra funding was earmarked to meet the requirements of the Act.  It is disappointing that yet again funding to ensure carers receive their statutory right to an assessment has not been forthcoming.  A knowledge based economy, as supported by the draft Programme for Government, Budget and Investment Strategy, will still require the support of caring professions; the status of these jobs must be acknowledged and raised.

4.9 From an economic point of view, in keeping with the main theme of the draft Programme for Government and Budget, the work of carers saves the UK economy approximately £57 billion a year.[14]  Furthermore, estimates from 2005 indicate that carers in Northern Ireland are missing out on almost £4 million in unclaimed benefits[15]  We would urge the Executive to consider the economic advantages gained by the commitment of individuals becoming carers in Northern Ireland and reconsider the allocation of funding to ensure that carers receive the support and services they so desperately require.  Moreover, greater support for carers is likely to reduce the call on primary health care and the need for institutionalised and residential care alternatives. 

4.10  While the Budget recognises a hugher number of working age population until 2024, there is no mention of the commensurate rise in older people.  For example, by 2023 the number of people over 65 will exceed the number of children, a rise which will only continue.  Given the fact that there is currently a default retirement age of 65, the Executive will need to look at the practicalities of what is needed in terms of investment and infrastructure for an ageing population. 

5.  Social Security

5.1  We generally welcome the commitment by the Department of Work and Pensions to provide more support to people on Incapacity Benefit and we are encouraged by the principles behind the Governments package for welfare reform as contained within the Welfare Reform Act and mirrored in legislation passed by the Assembly.  However, we have considerable concerns regarding the outworking of some of the proposals within the Act namely the introduction in 2008 of a new Employment and Support Allowance (ESA) as referenced in the Programme for Government.

5.2 This new income related allowance will replace Incapacity Benefit and Income Support paid on the grounds of incapacity for new claimants.  The Act divides claimants for the new ESA into two groups: (i) those who are assessed as being capable of participating in work-focused interviews and activities, the Work Related Activity Group, and (2) those who are assessed as being ‘severely functionally limited’ who will not have to participate in such activities, the Support Group.   It is likely that the majority of claimants will have to take part in work-focused interviews and work related activities in order to qualify for the full benefit rate

5.3  We remain concerned that sufficient thought has not been given to the particular needs of people with mental health issues and the proposals for required participation.   This concept of compulsory participation shows little understanding of the fluctuating and, at times, unpredictable nature of some mental health problems.  Nor does it take into account the fact that claimants with mental health issues may feel unduly pressurised to sign up to Action Plans they may be unable to fulfill rather than risk a reduction in their benefit.[16] 

5.4  The ESA places a large degree of responsibility on Personal Advisers to assess whether a person is complying with their Action Plan.  Personal Advisers are able to waive or defer work-focused interviews in certain circumstances.  In the first stage of the evaluation of the Pathways to Work pilots, however, Personal Advisers expressed concern that they had little understanding of the issues affecting people with mental health problems and in some cases were even fearful of them.[17]  Considerable training will need to be available to Personal Advisers prior to roll out of the new scheme in October 2008.  Again, we are concerned that the draft Budget does not allow sufficient funding for staff training purposes.  Yet it is vital that Personal Advisers working with people with mental health issues have a good understanding of the particular difficulties they may face and of the possible impact on their health of enforced participation in this new scheme. 

5.5  One area where much can be done to positively encourage people back to work would be an overhaul of earnings rules for means-tested and health related means-tested benefits.  Existing rules though improved remain complex, difficult to understand and underutilised.  Many people interested in returning to work on a part time basis initially are deterred by the labyrinthine arrangements that apply to incapacity benefit.  For other benefits, for example income support or income based JSA the earnings rules have not changed in nearly five years.

5.6  We are aware that the regulations to govern the outworking of the ESA are still being developed and welcome further information when draft regulations are available for comment; in particular the rate of payment of ESA and its relationship with other means tested benefits.  Further information on the long term proposals to migrate existing incapacity benefit claimants is important. 

6.  Employment

6.1  The aim within the Programme for Government of focusing on the economy is welcomed as we acknowledge that a healthy economy can help facilitate the development of the peaceful, fair and prosperous society desired by the Assembly.   However we note that an innovative and productive economy does not guarantee a fair society that promotes social inclusion, sustainable communities and personal health and well-being.

6.2  We applaud the stated goal of raising employment levels within Northern Ireland but would have appreciated a more focused statement on how this will be achieved.  One of our concerns is that the assertion that this is a time when the potential for economic growth is at its greatest may given the recent problems, particularly within the financial sector over the ‘credit crisis’ be somewhat overly-optimistic. Current economic thought seems to suggest that the next 18 months may be difficult for the economy of the UK as a whole and we have seen nothing to suggest that Northern Ireland will fare any better.  Indeed given the stated dependence on the US economy and the depths of projected losses in the US economy over the sub-prime lending crisis it could be argued that the Northern Irish economy may be more exposed than other parts of the UK. 

6.3 Similarly while we welcome the goal to ‘address problems of economic inactivity and ill-health among the working age population and promote greater employment opportunities in rural areas and disadvantaged communities.’ We are clear that the drive to target economic inactivity and ill-health should be through positive incentives and not through sanctions which could lead to those unable or unsuited to work being forced into employment or destitution if benefits were removed.

6.4  A further concern is that the goal of providing the conditions for enterprise and industry to flourish could, if pursued through a process of de-regulation lead to a climate where rights of employees become diminished.  To this end we would suggest that in line with developing a high skilled and dynamic workforce the Programme should also pursue high class employment rights to ensure the employees within Northern Ireland enjoy protection from employer mal-practice. 

6.5  We would suggest that among other measures to ensure this the Assembly should commit to the creation of an employment Appeals Tribunal as part of Tribunal Reform as well as implement measures to target Age and Equality discrimination.

6.6 We are very concerned that the measures set out in the programme lack detail.  The Programme for Government appears to be a list of aspirations.  There needs to be more detail on how the Executive is going to protect the rights and ensure that the projected economic boom that will bring much wealth to a few individuals will also benefit society more broadly. Indeed we note there seems to be no reference in the document to how to ensure the proceeds of this growth will stay in Northern Ireland.  There are no details on how the Executive intends to accurately distinguish between those who can be supported back to work and those who cannot, no plan articulated in detail on how measures that will require extra resources will be delivered against a backdrop of a reduction in government resources.

7.  Immigration/Migrant Workers

7.1  We welcome much of the sentiment within the document on immigration and race relations, however, we are concerned at the lack of detail on how these aspirations will be delivered.  Particularly we would like more details on how the Programme will deliver more integrated communities, reduce hate crime or help those who come to Northern Ireland for employment and in the process boost the Northern Irish economy especially against a background of reducing budgets over the next three years and beyond.

7.2  Unlike in England, Wales and Scotland where local authorities manage education, social services, housing in one place here in Northern Ireland there is less immediate scope for coherence. This can exacerbate the lack of co-ordination of services for migrants.  There must be changes to work practice adopted by public services to co-ordinate their response to the needs of this group.  

7.3  We would have expected within the goals for developing the economy some recognition of the impact of migrant workers on key Northern Irish sectors such as agriculture, food processing, health care and hospitality along with measures to facilitate the integration of these individuals into Northern Ireland.  Key among such measures would be, we would suggest, funding for ESOL courses, clarifying the rights of migrant workers to access healthcare and putting in place services such as access to education for dependent children that would allow migrant workers to settle within Northern Ireland bringing further benefit for the economy and increasing the contribution the Northern Irish government would receive through taxes. 

7.4  We are concerned that the commitment to promote tolerance, inclusion and health and well-being, contains no measure aimed at promoting racial equality, no measure to tackle racism, no measure to promote the integration of the growing migrant community in Northern Ireland and no mention at all of services for those who are in Northern Ireland either seeking asylum or as refugees.  There is much that the Assembly could do to tackle these issues, but hoping that a rising economy will solve all problems is not sufficient.  As many wealthy societies show without direct intervention, the most vulnerable in society are unlikely to benefit from the general affluence.  One firm step would be to ensure that all those resident in Northern Ireland have access to health care and that all children in Northern Ireland have access to education. 

7.5  Similarly the Government should fund directly measures to reduce levels of racism across Northern Ireland.  It should be a firm goal of this Government for Northern Ireland to not be depicted as the ‘race-hate capital of Europe’.  While promoting integration within government requires work across a number of departments, a cross departmental approach is more likely to provide value for money.  As noted above funding ESOL courses will allow those entering Northern Ireland to integrate faster, Northern Ireland has the opportunity to benefit from the skills of these individuals and the dynamism they bring. This would send out an important message in contrast to elsewhere in the UK where funding for language courses has been cut.

7.6  It is also the case that more should be done to care for children who arrive in Northern Ireland seeking asylum.  In May 1999, Amnesty International dubbed unaccompanied child refugees the ‘invisible of the invisible’.  Eight years on, there is no doubt that unaccompanied asylum-seeking children represent one of the most unseen, marginalized and vulnerable groups of migrants. 

7.7  Unaccompanied children seeking asylum are often some of the most difficult cases facing carers.  Often these children have seen or experienced, war, torture, imprisonment or the loss of loved ones.  For these reasons unaccompanied children seeking asylum deserve the highest levels of care.  Part of this process must include the ability to feel secure in the place they have settled, be it with a foster family or in care.  Currently the response from social services is uncoordinated with levels of service variable. The Government should work to ensure that the service it provides to these children is efficient and of a high standard.

7.8  The commitment to promote tolerance, inclusion and health and well-being in the document is particularly weak on details of delivery. The programme for government is from 2008 onwards and greater detail must be available for this work to proceed next year.  It appears that apart from ‘trickle-down’ benefits from optimistic projections for the economy Government has made no plans to reach out to the migrant communities in Northern Ireland.  There are significant issues that should be addressed, which we touch on above, that appear to have been entirely overlooked. In particular the executive should endorse the enforcement, research and information action plan produced by DEL through its work with the voluntary sector and statutory agencies.

8.  Conclusion

8.1  Law Centre (NI) welcomes the opportunity to respond to this consultation.  We trust you will find our comments helpful.  If there is any further way in which we could contribute to this process we would welcome the opportunity to do so. 

Notes