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Adults with Autism
3.34 pm
Angela Browning (Tiverton and Honiton) (Con): I beg to move,
That leave be given to bring in a Bill to impose duties upon the Secretary of State and certain organisations involved in health and social care in respect of support for people aged 18 and over with autism; and for connected purposes.
I declare an unremunerated interest as a vice-president of the National Autistic Society.
Autism is a lifelong condition, yet from the lack of support available to adults with autism and the lack of knowledge of their needs, people could be forgiven for believing that that is not the case. I am using the term “autism” now and in the Bill to refer to all adults on the autism spectrum, including those with Asperger’s syndrome and high-functioning autism.
At this point, however, I should like to deviate from what I intended to say to welcome strongly the Government’s announcement on 8 May in which they set out a number of actions in relation to adults with autism. Those actions include increasing the Department of Health’s capacity to work on the issue by employing a full-time autism specialist and by having one of the Department’s officials working specifically on autism, as well as undertaking research into the number of adults with autism. I believe that that is a real step forward and that those measures have the potential to make a real difference to the lives of people living with autism.
I am introducing the Bill, though, as there is still an imbalance between the increasing recognition of the need to provide support to people with autism and the action taken to meet that need. That discrepancy is highlighted in the recent National Autistic Society’s report “I Exist”, which details the experiences of adults with autism and the action taken by local authorities and primary care trusts in relation to autism. The report reveals that almost two thirds of adults with autism do not have enough support to meet their needs and that more than nine in 10 parents are worried about their adult son’s or daughter’s future when they are no longer able to support them.
I will come back to more of the findings of that report as I discuss the clauses of the Bill, but first I should like to read out a quote from the mother of an adult with autism, which I found particularly moving. She said:
“My daughter has quite calmly said that when we die, she plans to kill herself because she knows she will be completely alone and unable to care for herself. She weeps on a daily basis because she is so scared of the future. There is nobody to help her manage her daily life, and more importantly, who will love her when we’re gone?”
I believe that the duties in the Bill would be instrumental in transforming the experiences of such adults and enabling them to achieve fulfilled and independent lives.
I should like to make it clear that, when I refer to independent living, I am using the definition that the Disability Rights Commission used:
“all disabled people having the same choice, control and freedom as any other citizen—at home, at work and as members of the community. This does not necessarily mean disabled people
doing everything for themselves, but it does mean that any practical assistance people need should be based on their own choices and aspirations”.
So what change is required? Well, we still do not know how many adults there are with autism in the UK, and that lack of information has a negative impact on the planning of services. More than three quarters of primary care trusts do not keep a record of how many adults with autism there are in their areas and 86 per cent. of local authorities say that if they had more information about the number of adults with autism in their areas, it would help them with their long-term planning.
The Government now intend to support a study of the number of adults with autism. That is why I am not calling for that today, but it is important that action for adults does not wait for that study to report and that that research is reinforced by action locally. Therefore, the Bill would also require local authorities and NHS bodies to identify people with autism in their areas and maintain a register of the numbers, which should also include carers.
In addition, the Bill proposes placing additional duties on local authorities and NHS bodies, because despite recent Government guidance to tackle the inaction by local services, it is apparent that not nearly enough is being done to support people.
There is a lack of clear responsibility for autism at a local level, and that needs to be addressed. First, there is currently no responsibility for autism at a senior level. The director of adult social services guidance published by the Department of Health in 2006 attempted to tackle that in part by stating:
“Local authorities shall ensure that the DASS draws up clear lines of responsibility, within his or her staff team for managing the needs of all adult client groups,”
with autism defined as one of those client groups, yet only 39 per cent. of local authorities say that the requirement has been met. A duty on local authorities and NHS bodies to appoint a senior-level person or team with responsibility for autism is essential if the situation is to improve.
Secondly—this is closely linked to the previous point—in the majority of local authorities there is uncertainty about which team provides support for people with autism. As autism is a developmental disorder, not a learning disability or a mental health problem, many adults with autism, particularly those with Asperger’s syndrome or high-functioning autism, are passed over by both teams, receiving no proper help from either. More than 60 per cent. of adults with Asperger’s syndrome or high-functioning autism say that they have experienced problems when trying to receive support from their local authority or health services. Of those, 52 per cent. were told that they did not fit easily into mental health or learning disability services.
That is perhaps unsurprising, given that nearly half of local authorities say that they do not have a process in place to manage how people with autism who do not fulfil the learning disability or mental health criteria receive support. As one local authority said,
“service silos means ASD doesn't fit. ASD falls between service areas”.
The structural disadvantage that adults with autism frequently experience is a major factor in poor outcomes, and many adults’ problems go unaddressed. The Bill therefore requires local authorities and NHS bodies to establish and publish a route by which all persons with an autism spectrum disorder may access assessments and any resulting care.
Thirdly, there is a worrying absence of references to autism in many strategic planning and commissioning documents produced by local bodies. Commissioning strategies should include the requirements of people with autism. To bring that about, it is essential that local authorities and partner NHS bodies have regard to the requirements of people with autism in their area when undertaking joint strategic needs assessments. Many areas are still to publish their joint strategic needs assessments, but it is clear from those that have done so that many assessments do not cover adults with autism. That is not acceptable.
Fourthly, the Bill would require local authorities and NHS bodies to secure sufficient training about autism for staff who are in regular contact with people on the autistic spectrum, and those involved in assessment. It is of great concern that more than 70 per cent. of local authorities do not believe that care managers receive sufficient training about autism either in their initial professional training or as part of their ongoing professional development. That is perhaps unsurprising, given that more than three quarters of local authorities do not have an autism training strategy at all.
Some 98 per cent. of local authorities and 100 per cent. of primary care trusts say that the Government could provide them with more guidance and assistance to support adults with autism, so there is near-universal demand for more support. From that it can be concluded that there is a recognition that existing work and initiatives have not gone far enough. The Bill therefore calls on the Secretary of State to ensure that there is regional support to assist local authorities and NHS bodies in taking forward good autism practice. The Bill intends to address the inactivity in relation to autism, particularly locally. It is time to recognise that it is unacceptable for adults with autism to continue to be socially excluded. We know what change is required; we now need action from local services to make that change happen.
Bill ordered to be brought in by Angela Browning, John Barrett, Roger Berry, Mr. Tom Clarke, Mr. Geoffrey Cox, Michael Fabricant, Mrs. Janet Dean, Mr. Frank Field, Mr. Bernard Jenkin, Anne Main and Mr. Andrew Turner.
Adults with Autism
Angela Browning accordingly presented a Bill to impose duties upon the Secretary of State and certain organisations involved in health and social care in respect of support for people aged 18 and over with autism; and for connected purposes: And the same was read the First time; and ordered to be read a Second time on Friday 17 October, and to be printed [Bill 111].
Orders of the Day
Human Fertilisation and Embryology Bill [Lords]
(Clauses Nos. 4, 11, 14 and 23, Schedule No. 2 and any new Clauses or new Schedules relating to the termination of pregnancy by registered medical practitioners)
Further c onsidered in Committee [Progress, 19 May].
[Sir Alan Haselhurst in the Chair]
3.46 pm
Mr. Iain Duncan Smith (Chingford and Woodford Green) (Con): I beg to move amendment No. 21, page 9, line 10, leave out paragraph (b) and insert—
‘(b) after “father” insert “and a mother”.’.
The Chairman of Ways and Means (Sir Alan Haselhurst): With this it will be convenient to discuss the following amendments:
No. 12, page 9, line 10, after ‘parenting’, insert
‘and a father or male role model’.
No. 22, in clause 23, page 19, line 6, leave out from ‘(2)’ to end of line and insert—
‘after ‘father’, insert ‘and a mother.’.’.
No. 13, page 19, line 6, after ‘parenting’, insert
‘and a father or male role model’.
Mr. Duncan Smith: I shall speak to amendments Nos. 21 and 22, which are in my name and in the names of right hon. and hon. Members in all parts of the House. I should explain why, in the amendments, we have gone slightly further than the debate with the Government over whether the word “father” should be in the clause. We propose to retain the wording “a father” and add “and a mother”.
In the Government’s consultation, they received an overwhelming amount of correspondence from the public in favour of a reference to fathers and mothers. More importantly perhaps, clause 54(2)(c) refers for the first time in the Bill to gay couples acting as fathers, and I believe that in the interests of balance, there should be a reference to mothers. We propose to amend the Bill accordingly.
Since 1990 there has been a huge amount of research on the effect of absent fathers, demonstrating an increasing understanding of the importance of the role that fathers play in the home. That is not to suggest that if a family breaks up and the father leaves, that is simply bad for the children: research that we published recently, which was drawn from more than 3,000 evidence sessions, showed that the effect on those broken families is remarkable—75 per cent. of the children are more likely to fail at school, 70 per cent. are more likely to succumb to drug addiction, 50 per cent. are more likely to have serious alcohol problems, and 35 per cent. are more likely to experience some form of unemployment or welfare dependency.
The research highlights the fact that fathers bring something more profound to the parenting process, which has for too long been taken for granted. In some cases people are determined that it should not be discussed. One set of evidence published as recently as 2007 by the Joseph Rowntree Foundation states:
“Maternal ‘inputs’ are not consistently correlated with indices of their children’s development once they enter secondary school, whereas paternal ‘inputs’ are so correlated. Indeed, there is an indication that teenagers’ sense of self-worth is predicted by the quality of their play with their fathers some 13 years earlier.”
The report goes on to say that that
“has demonstrated links between parental reports of father’s involvement at the age of seven and lower levels of later police contact as reported by the mothers”.
Obviously, that makes the strong and profound point that the effect of fathers on both sexes during the teenage years is important.
Something of which I had not been aware came from the research that we have conducted in the past two and a half years, and I should like to put it before the Committee. It is simply this: the effect that absent fathers have on young girls too. That issue is often forgotten. We always hear of the effect of a father’s absence on young boys in respect of the whole issue of role modelling and giving them a stable beginning. However, in Britain we have some of the highest levels of under-age sexual activity, particularly among young girls, and there is very strong evidence to suggest that the effect of an absent father is to distort that further. That is because young girls more often learn empathetic and non-conditional love—something important and profound—from their fathers. They learn that it is possible to have a relationship that does not necessarily involve sex. We all know about the pressures that a young girl is under from young boys at such a time, and her relationships may have to countenance sex at an early stage. From most of the studies, it is clear that the absence of a base from which to understand how far such relationships need to go has a huge effect on such daughters.
The studies that we have been considering show consistently that such girls lose out in a way that we have not understood or even talked about enough. We know all about how sons need stable father figures who give them decent modelling, such as going out to work and having a creative relationship with the mother; however, the absence of a father is as significant for a daughter as for a son. The evidence on young daughters is also absolutely critical.
Mr. George Howarth (Knowsley, North and Sefton, East) (Lab): I am very grateful to the right hon. Gentleman. I apologise for intervening so early in his speech, but he was moving on to another point.
Although I accept as an ideal a great deal of what the right hon. Gentleman says, does he not accept that there are bad fathers, and that bad fathers can have a bad influence in some circumstances? The picture is not always as rosy as he paints it.
Mr. Duncan Smith:
It is far from rosy, and I am not trying to paint a picture in which the simple arrival of a father makes a huge difference, regardless of what has happened with him. There are plenty of very bad fathers out there; there are fathers who are absent but
arrive at particular periods and cause mayhem. We know about that. In many of the areas that I spend a lot of time visiting at the moment we see much of that. We also know about the problems surrounding those who are loosely described as stepfathers, but whom we might call “friendly father arrivals”. Such men are not related to or involved with the child, and levels of abuse can follow—not sexual abuse necessarily, but violence, possibly against the mother. As the right hon. Member for Knowsley, North and Sefton, East (Mr. Howarth) knows, violence against women is at very high levels and rising.
We know all about those problems. I am not trying to paint some incredibly rosy picture. However, my point is that, on the whole, the absence of fathers has a detrimental effect on children; the vast majority of fathers are more likely to be positive influences if they are connected to and held to the family for various other reasons.
Dr. Evan Harris (Oxford, West and Abingdon) (LD): May I bring the right hon. Gentleman from the general to the specific? We are dealing with the duty on clinics when they consider applications from lesbian couples and solo parents. Does he consider that lesbian couples with children are broken families, to some of which he attached the litany of concern that he rightly has? If he does, what evidence does he have that children with lesbian parents are going off the rails?
Mr. Duncan Smith: I do not consider them to be broken families. We do not have enough data to understand exactly what the nature of the outcomes is—I shall come back to that point in a second.
We know that absent fathers have a detrimental effect on their children. That is found up and down the income scale—the percentage effect is exactly the same for people living in Chelsea as it is for people living in difficult parts of Lambeth. It is not about whether the families are broken—I used the word “broken” because they are without a father. Cohabiting and gay couples are slightly different. I shall deal with the subject of gay couples in a moment, and I hope that that will explain a little more to the hon. Gentleman.
Mr. Gerald Howarth (Aldershot) (Con): I wonder whether my right hon. Friend is aware of the study carried out by the Office for National Statistics about six or seven years ago? It found that the incidence of behavioural disorder in 11 to 16-year-old boys was up to three times higher in households where there was a single parent or where the parents were cohabiting than it was in those households where the parents were married. That is a real issue, facing our people day to day in our streets and cities throughout this land.
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