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7 Mar 2007 : Column 500WH—continued
“springs from hearts in the right place”.
Many of us have at some time been seduced by the theory of inclusion, which seems so nice and reasonable and politically correct, but there is clear evidence that it does not work for every autistic child. Many parents know that inclusion is not appropriate and that that policy is failing their child. We need to make available to every autistic child the form of education that will give them the most effective learning environment. We should support inclusion, but only where it is in the best interests of the child and is the parents’ choice.
I draw attention to the National Autistic Society’s superb efforts to assist people in the UK with autism. In May 2006, it launched its first ever education campaign, “Make School Make Sense”. Its research found varied outcomes for children with autism, such as 20 per cent. of them being excluded from school and 67 per cent. of those excluded children being excluded more than once. It also found that only 30 per cent. of parents are satisfied with the understanding of autism in their children’s school and that 66 per cent. of parents believe that their choices have been constrained by lack of provision. There is difficulty in accessing professionals such as speech and language therapists even when such support is identified in a statement as being needed. The results of the research led the NAS to call for three things: the right school for every child, the right training for every teacher and the right approach for every school.
Stephen Pound: The hon. Gentleman has touched on an extremely important point about the broad range of the autism spectrum—what is appropriate for one child often is not appropriate for another. Does he think that there is a role for external agents such as educational psychologists to take decisions, given that parents are understandably sometimes incapable of objectively regarding their sons and daughters?
The autism spectrum is so long and wide that a child’s behaviour can sometimes be identified under another heading such as attention deficit hyperactivity disorder or as a behavioural problem. Does the hon. Gentleman think that an objective external body could take such decisions? If so, what would its role be? I am thinking particularly of educational psychologists who are employed in local education authorities.
Mr. Scott: Of course, there has to be a role for an external body, but I emphasise that parents are with their children on every day of every week—it can be hard to be objective in those circumstances. There must be professional help, but in unison with the parents, not ordained from on high.
There should be a statutory duty on local authorities to secure a range of SEN provision centrally and it should be properly funded. NAS research found that more than 50 per cent. of such children are not in the kind of school that their parents believe would best support them. That recommendation was endorsed by the Education and Skills Committee report on SEN last July. It is not unreasonable for a parent or child to expect some form of SEN provision in their area, whether it is a special school, specialist support or a resource base in a mainstream school. Where provision
is absent, long journeys to school can have adverse consequences on a child’s ability to concentrate and on the time spent with their family. In some cases, the sheer cost of travel can be a problem.
It makes sense for local authorities to work together to assess and plan provision for children with autism and all forms of SEN. Similar suggestions were made in the autism spectrum disorder good practice guidance produced by the Department for Education and Skills. What is the Minister going to do to encourage co-operation between local authorities and others to develop the range of provision for children with autism?
Given that autism is thought to affect one child in 100, every teacher should expect at some stage to teach a child with autism. There have been welcome recent developments on teacher training. For example, SEN co-ordinators must receive SEN training and must be qualified teachers, and there are autism resource packs for every teacher. There is also an inclusion development programme that includes autism.
The need for improvements in teacher training was made all the more clear by a recent survey by the National Union of Teachers, which found that 44 per cent. of teachers are not confident in teaching children with ASD and that 39 per cent. are not confident in identifying children with ASD. Some 76 per cent. said that the lack of professional development in this area is a barrier to teaching children with ASD. All mainstream schools must be autism friendly so that as many children with autism as possible can be educated in mainstream schools.
NAS campaign research found that children with autism often miss out. Almost half the parents of such children in mainstream schools say that the school is not adequately accessible. Almost half such parents say that their child has not been able to take part in activities before or after school, where they are provided. I must add, however, that in many areas there is no such provision. The NAS “Make School Make Sense” campaign encourages schools and local authorities to make improvements for children with autism. What works for children with autism tends to work for all children. Examples of good practice include providing quiet space, having peer support such as a buddy system or circle of friends, and having visual timetables.
I think we agree that more needs to be done to help to secure a better education for children with autism, and I hope that this debate will help to move matters in that direction. I have met many families in my constituency who rightly want to do what is best for their children, and I am sure that all hon. Members have similar experience. Let us start to help them.
4.15 pm
The Minister for Higher Education and Lifelong Learning (Bill Rammell):
I genuinely welcome this debate and the efforts that the hon. Member for Ilford, North (Mr. Scott) has made to bring these important issues to the public’s attention. As a constituency MP, I have dealt with these matters on behalf of parents, and I know how challenging it can be to deal with a child who has special educational needs, particularly one with autism. I recognise the hon. Gentleman’s
commitment to this issue, and that of other hon. Members. The hon. Gentleman is particularly concerned for his constituents, but I cannot comment in detail on the individual cases that he discussed, as I did not have advance notice of them.
The significance of this issue has been highlighted by the NAS “Make School Make Sense” campaign. The Under-Secretary of State for Education and Skills, my hon. Friend the Member for Gloucester (Mr. Dhanda), was pleased to speak at the parliamentary launch of that campaign back in May. Other hon. Members spoke forcefully at the launch about the pressures that having a child with autism can put on families. Like many MPs, I know from my constituency work how desperate parents can feel when trying to ensure that their children get what they believe to be the right provision. We acted to help parents under our early support programme by publishing our popular guidance for the parents of autistic children. However, more needs to be done.
Before I go any further on the issue of autistic children, I shall respond to some of the points that the hon. Member for Ilford, North raised and make some general comments about SEN. For the record, this Government have never had a policy of closing special schools, per se. Indeed, local authority expenditure on SEN has increased from about £2.8 billion to £4.5 billion over a period of five years. Since 2001, the percentage of children with statements who are educated in special schools has increased by 1 per cent., and local authority expenditure by school shows a 50:50 split between special schools and mainstream schools. I welcome the fact that the hon. Gentleman encouraged his colleagues not to start a party political battle on this, especially given that many more special schools were closed under the Conservative Government than under this Government.
The hon. Gentleman talked about the construction of schools. Clearly, the opening of new schools is a matter for local authorities and for voluntary and independent providers, but we will—this directly addresses one of his points—produce guidance on the reorganisation of SEN provision. That will rightly promote a range of provision, including special provision.
The hon. Gentleman also raised the crucial issue of equipping teachers and teaching assistants with the skills and experience to deal with children with special needs. That is a key part of the programme that the Department is developing.
Stephen Pound: I entirely concur with the points that the Minister has just made, as I am sure everyone will. What does he have to say about training people in mainstream education to assist with early identification? I constantly come across cases in which teachers have concerns but do not have sufficient training to identify them in a manner that would be recognised by professionals in the field. Is there any generalist training?
Bill Rammell:
My hon. Friend’s point is exceedingly important. We are prioritising training for teachers in respect of children with special needs, and we are also prioritising the role of special educational needs co-ordinators so that they can work within a school.
Early identification is crucial so that children get the direction and support that they need.
As hon. Members will know, autism is a spectrum condition. We talk about autistic spectrum disorders because people with the condition range from those with severe learning disabilities and challenging behaviour to intelligent people with Asperger’s syndrome. Individuals on that spectrum have a unique profile of need. For example, a young person with Asperger’s may also have behavioural or mental health difficulties. That spectrum of difficulties, which requires input from a number of agencies, makes autism an exemplar condition.
As autism is a spectrum condition, children on the spectrum need different types of provision—in mainstream schools, in units attached to them or in special and autism-specialist schools. It is crucial that we make it clear that that variety is available, which is precisely why our policy is to encourage a spectrum of provision to meet that spectrum of needs. Indeed, the good practice guidance on autistic spectrum disorders, which we published in 2002, promoted that spectrum of provision. We know that schools, local authorities and the regional partnerships that we fund have used that guidance to help deliver and develop that provision. We continue to support that policy for both children with autism and those with special educational needs in general.
Mr. Pelling: That guidance is extremely helpful to schools but, from the figures that my hon. Friend the Member for Ilford, North (Mr. Scott) postulated earlier and the response that I have had from secondary schools in my area, it seems that there is a tremendous lack of confidence that schools can deal with pupils with the condition. Is the problem a lack of confidence or a lack of qualification and ability on the part of teachers to provide the best support?
Bill Rammell: I shall come later to the specific issue of parental views on what is happening in the system. Although I would be the first to recognise and acknowledge that there are real challenges for some parents and some young children, the overall figures show that there is much greater confidence in and support for the system than is sometimes suggested. I certainly acknowledge that we need to do more.
It is not only encouraging that there is a spectrum of provision for a spectrum of needs, which is the right approach; it also fits in with what parents want. The report for the “Make School Make Sense” campaign noted that, taking parents’ views as a whole,
“the answer is not mainstream or special, but both. When given a theoretical choice, parents are fairly evenly split between mainstream schools, special schools and resource bases in mainstream schools as the best option for their child.”
Often, quite rightly, it is parents who do not get the option that they want from whom we hear, but there is a wider variety of views in existence.
Although there is still a way to go, the range of provision that we want is developing. For example, based on visits to 150 English local authorities, the Department’s team of SEN national advisers has reported that many authorities are developing
specialist resourced provision in mainstream schools and that most of that new provision is for pupils with autism or behavioural, social and emotional difficulties.
Hon. Members may be aware that Ofsted has reported that additionally resourced provision is particularly successful in achieving high outcomes for pupils academically, socially and personally. For example, there is a successful autism unit at Beal high school in the constituency of the hon. Member for Ilford, North. It is featured in the online version of our good practice guidance, as is Hatton special school, also in his constituency.
It is not just in the maintained sector that provision is expanding. In the past few years, new autism-specialist provision has opened in the voluntary and independent sectors and is part of a spectrum to which local authorities can give parents access. We encourage local authorities to work co-operatively with those providers, as they can sometimes provide the solution.
Do such welcome developments mean that there are no problems with educational provision for children? Clearly not, and a number of the difficulties that the hon. Gentleman highlighted underline that fact. It is true that the parents of children with autism, like those of other children with SEN, do not always get the school that they want, and it is a concern that the number of appeals registered in 2005-06 at the special educational needs and disability tribunal was higher for children with autistic spectrum disorders than for those with any other type of SEN. Most worrying of all is the finding of the Office for National Statistics that 27 per cent. of autistic children have been excluded at some point and that most of those—23 per cent. overall—have been excluded more than once. That is a concern.
Worrying though those findings are, it is not possible to argue that we have a general crisis in provision for children with autism, although we do need to deal with the problems. It is always helpful to hear about individual cases of the system not working which are identified by MPs, but we need to see the wider picture. As of January 2006, some 39,000 children with autistic spectrum disorders were being supported at schools in England, and of those the great majority—almost 30,000—had SEN statements. That means that they have resources available for their education over and above what is normally available in mainstream schools, and that their parents have a better chance of getting the school that they want for their children. As I have said, not all parents get the school that they want, but local authorities, for example, can and do fund provision in autism-specialist voluntary or independent schools. A recent report by the Audit Commission found that the majority of children placed in non-maintained or independent special schools with fees paid by local authorities had autism or behavioural, emotional and social difficulties.
Of the 760 appeals relating to autism cases that SENDIST dealt with in 2005-06, 318 were withdrawn and 155 conceded. Of the 287 decided, 162 involved appeals about the school that the child should go to. Appeals to the tribunal are not the only barometer of parental satisfaction but, when compared with the 39,000 children being supported by schools, such figures do not suggest that children are routinely not receiving the educational provision that they need.
When that is the case it is right that we focus on it, and one issue that we consider is parental support and parental advocacy to local authorities. However, we are not facing a picture that uniformly shows a system that is not delivering.
What I have said does not mean that we are in any way complacent. Previous reports have suggested that about 70 per cent. of parents of autistic children are satisfied with the education that their children are receiving, although one report from Brunel university in 2005 pointed out that that is only after some parents have fought for the provision that they want. As both an Education Minister and a constituency MP I know that there are concerns about the degree to which parents have to fight, through schools and local authorities, and we need more help and support through better training and better recognition of the spectrum of disorders.
Of course, if 70 per cent. of parents are satisfied, 30 per cent. are not. Frankly, that is not good enough and we know that there need to be improvements. As I said to my hon. Friend the Member for Ealing, North (Stephen Pound), improving teachers’ skills to provide for children with autism is important, which is why autism will be one matter on which we will focus in our inclusion development programme, which is aimed at providing practical help for teachers in the classroom. It is also why our autism working group is taking up a recommendation from the NAS and developing an autism pack for schools.
We also recognise the importance of supporting parents in contributing to the education and development of their autistic children. That is why, through the Department’s children, young people and families grant programme, we are supporting the TreeHouse Trust to work with parents’ groups campaigning for improved autism services. We are also supporting the NAS to extend its “help!” programme, which assists parents with such things as guidance on educational rights and accessing services and benefits.
We know that much good is being done and that there is much good provision across the country meeting the special educational needs of children with autism. We also know that more needs to be done to ensure that all autistic children get the provision that they need. We will continue to work with our partners in schools, local authorities and the voluntary sector to meet that important and significant objective.
North Yorkshire and York PCT
4.30 pm
Hugh Bayley (City of York) (Lab): This year, North Yorkshire and York primary care trust received a 9.5 per cent. increase in funding—an additional £69 million—taking the total NHS budget for the county to £870 million. The NHS in North Yorkshire has never been better financed, yet the PCT is predicting that it will end the year with a £35 million deficit, and York Hospitals NHS Trust anticipates a £2 million or £3 million deficit.
We face a paradox. NHS patients are being treated better and more quickly than ever before, but a small number of patients—250 so far, according to York’s local evening paper today—with non-urgent conditions have been refused treatment. It is not necessary to remind the Minister that the 250 patients who have been refused treatment, not the hundreds of thousands of patients who received treatment, hit the newspaper headlines. I do not deny that the Government must reduce the deficit, but they must not deny patients necessary treatment while doing so.
My first point is that my constituents in York pay the same taxes and national insurance as everyone else, and they are entitled to the same access to NHS care. On my birthday on 9 January, I asked the Minister:
“The national health service is based on the principle that care is provided on the basis of patients’ clinical needs, not their ability to pay, so will the Minister reassure the House that the rights of patients in north Yorkshire will be protected, despite the PCT’s deficit, and that they will retain access to the same range of NHS treatments, and experience the same waiting times, as NHS patients from other parts of Yorkshire and the Humber.”
I was pleased to hear the Minister’s reply. He said:
“I agree with my hon. Friend and I congratulate him on adopting a constructive approach towards the difficult financial circumstances that his PCT faces.”—[Official Report, 9 January 2007; Vol. 455, c. 143.]
I expect the Government to honour that commitment, under which the PCT must change some of its current policies. In December, I met the chief executives of the Yorkshire and the Humber strategic health authority, Margaret Edwards, the North Yorkshire and York PCT, Janet Soo Chung, and the York Hospitals NHS Trust, Jim Easton in my office in York. My hon. Friend the Member for Selby (Mr. Grogan) also came to the meeting.
During that meeting, I asked the strategic health authority to produce regular information for each PCT in the region showing patients’ access to NHS services in those PCT areas. The chief executive wrote to me in February saying that she had discussed the matter with the NHS information centre and asked it to develop some meaningful indicators. I call on the Government to ensure that that work goes ahead and that the indicators are published soon and regularly. They will reassure MPs and, most importantly, the public in areas with deficits that NHS standards in those areas are not falling below the standards in other parts of the country.
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