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8 Jan 2003 : Column 291continued
Mr. David Tredinnick (Bosworth): The hon. Lady kindly asked me to support her in this debate, and I am happy to do so. I suggested to her and the Minister that there are three key issues here. There must be better co-ordination among the agencies at county level. Secondly, there needs to be better evaluation of the existing treatments, particularly dietary treatments and assessments of the effects of vitamin C, vitamin B6 and magnesium and some of the specialist treatments. Thirdly, given the hon. Lady's eloquent plea on behalf of her constituent and the work that has been done on both sides of the House, does she agree that the Government should now take a more direct interest in these problems?
For the last 3-4 years he has presented his parents with severe problems with regard to sleep disturbance and the parents are getting to the limit of their tolerance. I have referred him twice in the last 12 months to CAMHS and to the Tree House . . . and according to Father there have been no appointments coming forth.
In this situation, the family and primary medical care services need help and assistance from secondary care units and it is completely unacceptable that this service is absent or lacking in the Stockport area."
Where does this lead us? First, early diagnosis is clearly needed. Secondly, support, like the Early Bird and Help services from the National Autistic Society and Portage, which is available through some local authorities, needs to be there to support and educate parents immediately the diagnosis is made. Parents need the support to help them help themselves.
Thirdly, the family needs a named person to assist them to access the package of services required by the family. Local authorities should establish a clear route for families to access support. Services and support at an early age will increase the person's likelihood of living independently when older and contributing positively to the community.
Fourthly, the child needs to be educated in an environment that is autism-aware and responsive to the needs of individual children. There needs to be recognition that those with Asperger's syndrome who are not learning-disabled nevertheless have significant needs.
Fifthly, transition planning should be in place in a timely fashion. All Connexions personal advisers should receive training in autism spectrum disorders. Joint Department for Education and Skills and Department of Health guidance should be issued to social services departments highlighting their responsibility to all young people with ASD during transition.
A great deal is happening in Stockport. Some 146 young people are on the award-winning disability database. It is run by a friend of mine, Elaine Mounter, who received a XGetting the Message Across" award in the House of Lords before Christmas. That work is excellent, but she tells me that families still fear the lack of respite care and the transition to secondary and further education. Too often, they are sent out of area, which costs more and leads to the statutory agencies battling it out over who payswhile the family waits. There is too little supported housing. The voluntary agencies cannot meet all the needs for respite and short-term care. Supported leisure activities or activity-based breaks can prevent the crisis that happens when the family is worn down by the condition of autism.
The National Autistic Society tells us that current services for disabled adults are not designed with autism in mind. People with ASD fall between learning disability and mental health teams. Only 38 per cent. of adults with ASD receive a community care assessment and of those only 45 per cent. receive the services specified as needed. People with Asperger's but without a learning disability are unlikely to receive a service.
The NAS wants the Department of Health to produce statutory guidance on the social care needs of people with autism spectrum disorders. It wants a named senior manager in each local authority to be responsible for the commissioning and delivery of services to that group. Only 10 per cent. of adults with ASD are in paid employment, while 24 per cent. do nothing, or help around the house. The Department for Work and Pensions should provide a national employment support scheme tailored for people with ASD.
The NAS says that there should be explicit recognition that people with ASD are eligible for the whole range of disability benefits and consideration should be given as to how they can be supported into work without risk to their benefits. Forty-nine per cent. of adults with ASD live at home with their parents. They need help with meals, housework, paying bills and personal care. Only 3 per cent. of adults with Asperger's syndrome live fully independently. The NAS wants local agencies to collaborate to provide a range of sheltered housing and supported accommodation in each local area, designed specifically for adults with autism spectrum disorders.
I have used up more than my share of the time for the debate, but I am grateful to the House for listening with such keen attention. I very much hope that the Minister will be able to tell us that something will be done to co-ordinate the services. They are undoubtedly available in bits, but it is impossible for families to access what they need.
The Parliamentary Under-Secretary of State for Health (Mr. David Lammy): I congratulate the hon. Member for Cheadle (Mrs. Calton) on raising such an extremely important issue. The debate comes shortly after a year in which all of us tried to raise awareness of autism in our constituencies. That is an indication of the importance of the issue for carers throughout the country and the hon. Lady spoke eloquently in bringing to the attention of the House the circumstances for the parents of Alexander, her constituent.
Autism is a complex and distressing condition both for those directly affected by it and for their families and carers. Children and adults with autism often lead very isolated lives. Their social and communication difficulties often put great stress on their families.
I acknowledge the tremendous efforts made by families and carers who support children and relatives with autism. The Government are committed to giving them more support. We accept that in the past there have been frequent delays in the diagnosis and identification of the condition. There has been too little family support and services have been dogged by fragmentation. Like me, Members will know from their constituency casework that carers of autistic children and adults sometimes find themselves in a maze of different assessment processes carried out by different agencies and that they often do not know where to turn for help. The starting point must therefore be to provide services and support in ways that suit children and adults with autism and their families. Adults and children with autism want early diagnosis, intervention and support from agencies, as the hon. Lady suggests: agencies that speak to each other and that make their families' lives easier. They want straightforward, readily available information and access to local community facilities and activities.
The Government are responding to that context and those concerns by ensuring that our policies and programmes reflect those issues. Where needed, the Government have brought in new legislation. The Health Act 1999 introduced a Xduty of partnership" making it clear that co-operation between health and social services is no longer an optional extra. The Special Educational Needs and Disability Act 2001 strengthened the support given to parents of children with special educational needs. The Carers and Disabled Children Act 2000 introduced direct payments for carers. The Children (Leaving Care) Act 2000 supports disabled young people leaving the care system. I acknowledge that we started from a poor baseline, and it will take time for those Acts to bed in and to address a patchy picture across the country. More needs to be done within the Department, and I hope that I can address that in moving forward. One of the most important aspects of that is the children's national service framework, which I hope will bring together coherently much of that to which the hon. Lady referred for children with this condition.
As the hon. Lady mentioned, one of the key issues for children with autism is to provide early intervention and early support. The evidence is that the earlier support is given, the better the long-term outcome is for the children and their families We are therefore taking a close interest in the work of the national initiative for autism screening and assessment, which she mentioned. We have appointed Dr. Gillian Baird, the secretary of NIASA, as a member of the disabled children's external working group, which is helping us develop the children's national service framework. That will build on the Xduty of partnership" in the Health Act 1999 and set national standards for the health service and social services to work in partnership with education and other agencies.
The national service framework will include exemplars setting out how the NSF should be implemented for particular groups of children. It will show how families should receive multi-agency early intervention and support based on their needs. We have already announced that one of those will be on services for children with autism. Dr. Baird is leading on this area of work and is actively involved with the interested voluntary sector groups, such as the National Autistic Society and the Parents Autism Campaign for Education. The NIASA guidance will inform that work. The bottom line is that we hope that the NSF will raise the game in this area for children and families with autism.
The children's NSF will build on the work of the Government's XQuality Protects" programme, which focuses on improving children's social services. Under XQuality Protects", #60 million over three years has been allocated since April 2001. That has been earmarked for spending on services for disabled children and their families, which has provided more family support services, particularly home-based short-term breaks and sitting services. Nearly every single XQuality Protects" management action plan gave details of how local authorities were improving services specifically for children with autism and their families, including providing services such as the Early Bird service and Portage services that the hon. Lady mentioned. For example, Surrey, the Wirral, Reading and Windsor and Maidenhead have all introduced new Early Bird schemes to support children with autism. Sutton, Tameside and Thurrock have introduced new Portage schemes, and Somerset and Southampton are planning and developing new key worker support services.
The XQuality Protects" money will double next year from #15 million to #30 million. However, I recognise that much more needs to be done to ensure that all autistic children and their families receive high-quality support from social services, from education and from the health service wherever they live. That is why, as I said, we will publish the children's national service framework later this year, and I hope that it will drive up standards throughout the country.
I turn now to special educational needs. Children with autism are also benefiting from the improvements and resources that we are promoting to meet special educational needs. The hon. Lady rightly points out that, as a result of the Special Educational Needs and Disability Act 2001, local education authorities and
We are backing our drive to improve provision for those children with significant resources. For example, this year's SEN standards fund is supporting expenditure of #91 million. The hon. Lady mentioned in particular the training of teachers and others in autism awareness. She will be pleased to hear that in-service training is one of the main activities financed by that fund. Guidance from the Department for Education and Skills recommends autism training as an area that LEAs may want to support. We are also making available smaller grants to encourage innovative developments in special educational needs. The SEN training and development fund for 200203 aims to
Last July, my Department and the DFES published good practice guidance for schools and LEAs on supporting pupils with autism. The guidance is based on the key principles that underpin good provision, including early identification and intervention, family support, and partnership and co-operation with other agencies. The autism working group, which developed the guidance, included not only officials from the Department of Health and the DFES but experts and practitioners in the field, including the