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15 Oct 2002 : Column 291—continued
10.16 pm
The Parliamentary Under-Secretary of State for Health (Ms Hazel Blears): I congratulate the hon. Member for Buckingham (Mr. Bercow) on raising this extremely important issue on the first day back after the summer recess. That is an indication of how important the matter is to increasing numbers of families throughout the country who have to cope with the severe problems experienced by children with a whole range of autism spectrum disorders.
As the hon. Gentleman said, autism is a complex and distressing condition for those directly affected by it and for their families and carers. The pressures can be immense. Children with autism often lead isolated lives; their social and communication difficulties place great stress on their families. I acknowledge the tremendous contribution made by families and carers in these difficult situations. It is clearly the responsibility of Government, nationally and locally, to put in place good, effective support services. Without their carers and families, the lives of these children would be much worse.
The hon. Gentleman acknowledged that there have been difficulties in this area for many years. The number of children who have been diagnosed with autism has increased recently, but it is primarily a result of better diagnosis and assessment that we are beginning to see the extent and scale of the problem. In years gone by, autistic children were almost the forgotten children with the hidden problem. We are beginning to uncover how great the problem is for communities.
The hon. Gentleman is right that the Government have taken a number of positive and practical steps. I accept that although much has been done in this area,
there is a great deal more to do by all Government agencies—social services, education, local authorities and the voluntary sector. They need to pull together and put in place a package of support on which families, carers and children can rely.The main issues that parents have raised concern early diagnosis, early intervention and early support. The evidence is that the earlier these matters are addressed, the better the long-term outcome is for the children and their families. Parents want quick and easy access to statutory and voluntary services. No one party has a monopoly on the provision of these services. It is important to ensure that a variety of diverse providers can meet the needs of these children. Parents also want straightforward, readily available information. They sometimes find themselves in a maze of different assessment, processes and organisations and do not know where to turn.
The overarching issue is about multi-agency planning and assessments. We talk, perhaps a little glibly, about joined-up thinking and services, but I can think of no better example of an area in which lack of integration means poor services for the families concerned.
I will deal with the three specific issues that the hon. Gentleman raised, but I should like to set out the way in which the Government are trying to introduce quality and rigour into the area. It is necessary to have a decent legislative framework, which has not been in place in the past. The Special Educational Needs and Disability Act 2001 strengthens the support given to parents of children with special educational needs. In the past, finding a way through the legal process has often been a minefield for parents. I speak as a former local authority education lawyer, so I know the difficulties that parents have struggled with there.
We also introduced the Carers and Disabled Children Act 2000, which gives people greater flexibility. The introduction of direct payments starts to give people more choice about the sort of services that they want provided. The inspection and regulatory standards of the Care Standards Act 2000 are very rigorous, enabling us to get some quality into the system. The Children (Leaving Care) Act 2000 supports all children with disabilities, including those with autism and deals with some very vulnerable children indeed.
We have a legislative framework, but that will work only if it is underpinned by practical action for families on the ground in local communities. Therefore, we have the quality protects programme, which is a major programme to help children in general, but is also targeted on children with disabilities. I am pleased to be able to say that the grant directed at children with disabilities was #15 million last year, it is #15 million this year, and next year it will double to #30 million, so it is a significant investment for such children.
This is about trying to get greater integration of family support services—trying to integrate children with disabilities, including autism, into mainstream leisure and cultural activities. The hon. Gentleman mentioned children having life skills as well as education and having a chance to participate in the things that other children take for granted, which is extremely important. This is also about trying to ensure that people have key workers—one person to whom they can go, who can give them a gateway into the whole range of services that are available.
I have some practical examples of things that are happening under the quality protects programme, which are very encouraging. I will highlight a couple. In Cornwall, #1 million has been set aside to develop autism and Asperger's children's services. There is a five-bedded bungalow to provide respite care and transitional support and to ensure that parents can get a break from a tremendously stressful situation.
In Windsor and Maidenhead, a one-stop shop has been set up for children with disabilities, with a particular focus on children with autism. Again, it is trying to bring the agencies together so that parents are not pushed from pillar to post, trying to seek the most appropriate service. There are also early diagnosis, speech and language therapy, physiotherapy and occupational therapy, which are all designed to give children the extra step up that they need so that they can try to participate.
Slough has a new in-borough autism service, which is situated in the early years centre, so it is very connected with education, ensuring that children can be diagnosed and get access to services early, which is what parents want. So, the quality protects service is a practical programme that is actually making a difference.
The hon. Gentleman mentioned diagnosis and having multi-agency assessments. He is aware of the NIASA—national initiative on autism: screening and assessment—guidelines. I am pleased to be able to tell him that Dr. Gillian Baird, the secretary of NIASA, has been appointed as a member of the disabled children's external working group, which is working on the children's national service framework. Clearly, her views and the work that she is doing will be fed into that NSF, which is very practical. Rather than having guidelines in isolation, they will form part of an extensive programme under the NSF and there is a clear focus on that.
Secondly, the hon. Gentleman raised multi-agency assessments. He asked whether we would issue guidance to local authorities to say that all the agencies should come together to undertake the assessment. There must be nothing more frustrating for families than having to tell their story time and again to a multiplicity of individuals. I am delighted to be able to say that we have already issued statutory guidance under the quality protects programme. This is about moving from service-led assessments to looking at the child—putting the child at the centre of the assessment and asking what he or she needs, rather than what is the boundary of our agency, and what contribution we can make. That is quite a culture shift for some services—saying that this is the child's pathway or journey. It is similar to what we are trying to do in the national health service by asking what is the patient's journey. We are working out how to configure services to meet the needs of the child.
Mr. Bercow: The Minister is dealing very thoroughly with my questions. Does she agree that it is important that a child should have an alternative between, on the one hand, education in a mainstream school but in social isolation, which is what Christian currently endures, and inclusion in a special school in an atmosphere that may not be suitable? Surely there should be a spectrum of choice and opportunity, just as there is a spectrum of disorder.
Ms Blears: That is exactly the situation that we are trying to work towards. We want to provide services that are more flexible and responsive, which look and feel different and actually are different from those that we have been used to. We have embarked on that journey—we have to get from where we are now to where we want to be. Multi-agency assessments that ask what the child needs and trying to challenge services to configure themselves so that they meet the needs of that child will take some time, but that is very much the direction of travel. Those services will be valued and will make a difference to the long-term outcomes for children.
The third issue that the hon. Gentleman raised related to education and training, which are absolutely central. If we are to have early diagnosis and intervention, we must ensure that such issues do not go unnoticed for years and years. I am delighted to be able to tell him that in July the Department of Health and the Department for Education and Skills published some good practice guidance—exactly what he highlighted. It was produced by the autism working group, so we are very much in tune with our partners. The group was made up of experts and practitioners on the whole spectrum of autism disorders.
The document provides guidance on raising awareness and improving understanding of the disorders and draws on good practice throughout the country. It asks local education authorities and schools to keep their provision under review and to audit it, to provide monitoring and quality evaluation. If the provision available is not of the right quality, it will not have the impact wanted by parents and families. That guidance has been issued, so I am pleased to give the hon. Gentleman those reassurances.
In addition to the legislative framework that we have set up and the practical measures on the ground, a third important aspect is the children's national service framework. Whenever we talk about a specific service, it is crucial that we try to connect it to the rest of the machinery and the existing organisations; otherwise we end up with specific programmes for specific parts of the community. That is not the way to obtain sustainable mainstream provision that meets the needs of a whole range of people in our community. Sometimes, it is necessary for projects to pump-prime and kick-start things, to get innovation going and to set up pilots. However, the needs of children with autism are increasingly and equally important in the general thrust of the children's national service framework. They are very special children but they should be included in our mainstream thinking rather than being on the outside as Xspecial" children.
Under the national service framework, there will be a series of exemplars for the design of optimum service. I am pleased to tell hon. Members that one of the exemplars will focus on children with autism, so there should be some good work arising from that to show what a good service for those children should look like.
The hon. Gentleman is right to say that in the past services for children with autism have been extremely poor and that families have often been left in isolation to cope on their own. We all acknowledge that.
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