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27 Feb 2009 : Column 518

What themes will the adult statutory guidance cover? Will it cover only the Department of Health, or will it be broader? The Welsh Assembly issue has already been raised in an intervention, so I shall skip that.

Perhaps the most important matter is transition. Many of us have experienced cases of local authorities, of all political persuasions, failing on transition. Some authorities, which deliver well on children’s services, have no provision for proper transition. As my hon. Friend the Member for Blackpool, North and Fleetwood (Mrs. Humble) pointed out, they can fail even at the basic level of sharing information within departments. What will the guidance do about transition? Will it bring about the sort of change in regime that ensures that there is no longer a chasm between child and adult services?

Mrs. Humble: My hon. Friend and I agree that there needs to be communication between children’s services departments and adult social care departments, but we need more than that. Children’s services departments have developed appropriate services for many children with autism, but one of the problems facing adult social services departments is that the services are not there for them to purchase and offer to adults with autism, so another outcome that we want from the legislation is the building up of such provision.

Andrew Miller: I fully understand that and respect my hon. Friend’s expertise. Transition is fraught with difficulties, which arise largely because local government, like central Government, has a silo structure. We have to avoid that. Support for an identified client of social services or educational services should travel with them, irrespective of their age or which part of the service deals with them. By focusing services on the individual client, we can ensure that bureaucratic obstacles do not get in the way.

Angela Watkinson: May I recommend to the hon. Gentleman the excellent ROSE project—realistic opportunities for supported employment—which is run by Havering college of further and higher education? The project does exactly what he is describing, by enabling students with autism and other conditions to enter supported employment. They move from education into the adult world and, over a period in which support is gradually withdrawn, become independent in the workplace.

Andrew Miller: I am not familiar with that project, but it sounds like the kind of thing that needs to be developed throughout the country. It also fits with the observation that the hon. Member for Buckingham made about the Government’s apprenticeship programme. There could be a role for organisations in the third sector that can help that kind of transition to take place. That is quite an important area to consider.

Mention has been made of the cost. When my hon. Friend the Minister is arguing his corner and seeking resources for his Department in order to deliver the commitments that the House collectively expects him to deliver, irrespective of the vehicle, he needs to make it clear to the Treasury that, as has been said, doing nothing would impose some extraordinarily high costs on us all. Mention has been made of the book that Professor Knapp wrote, “The Economic Consequences of Autism”. We need to make it statutory reading
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among Treasury boffins, so that they fully understand why resources need to be directed towards my hon. Friend’s Department to ensure that delivery occurs properly.

Mark Durkan: My hon. Friend is suggesting that when the Minister makes the case to the Treasury for those resources—resources that he says the whole House would want—he should make certain arguments. Is not the best way for the House to amplify the Minister’s arguments to give the Bill its Second Reading and then test the issues further in Committee? That would allow the Minister to make a compelling case to the Treasury and others about the priority that the House attaches to the issue and its proper resourcing.

Andrew Miller: I totally agree with that. Clause 8, which refers to expenses, says:

and so on. If the Bill were enforced properly, there could be a net saving to society, by removing the burdens that are placed not only on the criminal justice system but on a range of Departments.

My hon. Friend the Minister will have found, when he has tried to negotiate for clauses to go into a Bill, that there is always pressure from those in the Treasury who say, “We can’t have that because of the cost.” Here, there is prima facie evidence from the work of Professor Knapp to demonstrate that the enormous cost to society could be reduced if we managed our services better. So I am making a plea to the Minister not to be suckered into a discussion with the those in the Treasury about how much these measures will cost, and instead to convince them that the work of Professor Knapp and others adequately demonstrates why this would be a wise thing to do, financially.

John Bercow: The hon. Gentleman and I have worked together on a number of issues over the years, and I am listening to his contribution with respect. What is more, he and I are partners in the House of Commons tennis team, so he knows that I intend him no slight or discourtesy, but may I, in all conscience, appeal to the hon. Gentleman, whose credentials I do not doubt, to conclude his remarks soon, to give others a chance to contribute and the Minister an opportunity to respond to the points made by other hon. Members in their short speeches?

Andrew Miller: Actually, I am about to conclude my remarks, so the hon. Gentleman does not need to appeal to me, either as a tennis partner or as anything else. He is a very good tennis partner, as the Minister knows. There is cross-party co-operation in all sorts of areas, which sometimes surprises the public. I have even played tennis with the Leader of the Opposition—

Madam Deputy Speaker: Order. I think that we have heard enough about who partners whom in what game.

Andrew Miller: Yes, I—

Mr. Greg Knight (East Yorkshire) (Con) rose—


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Andrew Miller: No, I am sorry. I will not give way. I can see that the right hon. Gentleman—the drummer in the band—is going to lead me astray, and I want to conclude now.

I have asked my hon. Friend the Minister a series of specific questions, which are key to determining whether either the Bill, in its current form or with amendments, or statutory guidance based on the Local Authority Social Services Act 1970, can deliver what the House expects him to deliver. I hope that he will take on board all the points that have been made by colleagues on both sides of the House, and ensure that the House takes a leading position—it would be a leading position, because not many countries have really taken on board the needs of people on the autistic spectrum—so that we can say that we have done this by working together and with the National Autistic Society in the interests of people on the spectrum and their parents and families, as well as of the whole of society.

12.13 pm

Anne Milton (Guildford) (Con): I congratulate my hon. Friend the Member for Tiverton and Honiton (Angela Browning), who has worked tirelessly throughout her time in Parliament to introduce measures to support children and adults with autism. Parliament, and Members of Parliament, attract a lot of criticism these days, but the work that she has done is a shining example of what still can be done by this place to improve the lives of others.

I also congratulate the National Autistic Society on all its work, and the many other charities that are involved in this area. The “I Exist” campaign is one of many that has contributed significantly to raising awareness and achieving some of the changes that are needed. Of course, I also congratulate my hon. Friend the Member for Chesham and Amersham (Mrs. Gillan) on introducing the Bill. I know how hard she has worked, into the small hours, preparing for today and gathering the cross-party support that we have seen.

Autism is different, because there is no other condition of such complexity that affects so many, and about which so little is still known. We have heard many statistics today, but one of the most striking was the figure of 2 million. It referred to the 2 million people who are affected by autism, including the parents, the siblings, the carers and the families. No one who is unaffected can truly understand what these people’s lives are like: the wide yawning gap they fall through between learning disability and mental health when autism is neither of these. For some parents caring for children with autism, there are no holidays and no time off—just 24-hour care every day of every week. This private Member’s Bill provides an opportunity to make that better.

Shortly after I was elected, I met some parent carers locally who were looking after children with profound disabilities. They felt angry and let down and were utterly exhausted. With the help of Carers Support Guildford and Carers Support Waverley—I pay tribute to their work—we set up a group locally. Carers Support was fantastic; it had an open day last year and intends to repeat it. It provides an opportunity for parents to drop in and meet some of the local charities and statutory services, attend workshops and meet other parents. Not
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all these parents have children with autism, but many do. Despite the best efforts of charitable and statutory services, many are isolated, lonely and struggling on their own.

The Bill would change all that. It would combat the lack of information about children and young people with autism. It would give local agencies obligations to include their needs when they plan their services. It would ensure that services around transition—a crucial area as children move towards adult-focused provision—are maintained seamlessly. For young people—and not just those with autism—this period is a trap door through which many fall, as hon. Members have mentioned today. The Bill would ensure that the needs of adults with autism were truly recognised. In a word, it would give people—children and adults—a chance for a good quality of life: the physical and mental well-being that most of us take for granted.

I would like to highlight a few important issues for the Minister. The section 7 agreements, much debated today, have not worked for people with Asperger’s. The 2006 Department of Health guidance requires local authorities to nominate a strategic lead or team on autism, but only 39 per cent. have done so—in other words, more than half have failed to do so. The costs due to loss of income from employment and the direct costs to families are estimated at £27.5 billion, as my hon. Friend the Member for Chesham and Amersham mentioned.

Another statistic to pick up is that, because of the lack of support, a third of adults with autism suffer from severe mental health problems. My hon. Friend the Member for Tiverton and Honiton referred to the 8 per cent. who commit suicide. If we drill down into the repercussions, they are truly dreadful. People with autism not only lack support, but suffer from mental health problems—severe mental health problems—on top. We then need to turn our attention to the fact that people with mental health problems have significantly worse physical health. What this third of adults lacking support face is a spiral of deteriorating mental and physical health, dreadful misery, hardship, loneliness, poverty and isolation, sometimes ending in suicide.

I pay tribute to the hon. Member for Burton (Mrs. Dean) and the all-party parliamentary group. I hope that she will decide to support, not block, this Bill. She failed to explain in her interventions why she objects to the Bill going into Committee. The bottom line is that it will be on the record and easy to see who wanted the Government commitments examined with the Bill as a vehicle and who blocked the Bill and walked away from scrutiny of the Government.

The hon. Member for Mid-Dorset and North Poole (Annette Brooke) covered many points and the hon. Member for South Thanet (Dr. Ladyman) raised the interaction between people with autism and the police, pointing out that the Bill fell short in some ways. I think that my hon. Friend the Member for Chesham and Amersham accepts that, but this is precisely the point. The Committee stage would offer all of us the opportunity to work through the detail and add and subtract in order to get the very best possible services. A Committee stage could only add to services. It would take nothing away. There really is no downside.


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Mr. Letwin: Will my hon. Friend briefly address, in the course of this powerful sequence, the Minister’s claim in his letter that

Is she aware of any respect in which this legislation could make delivery of change more difficult?

Anne Milton: That is an interesting point, which I had intended to discuss later. I can see no way in which proceeding with the Bill would make anything more difficult, and I hope the Minister will take account of that in his response.

The hon. Member for South Thanet said that he wanted cast-iron guarantees. The only way in which to secure such guarantees, and to secure the very best for people with autism, is to give the Bill a Committee stage. The hon. Member for Ellesmere Port and Neston (Andrew Miller) referred to the criminal justice system, and pointed out that section 7 orders were effective only if enforced. Along with the hon. Member for South Thanet, who asked for those cast-iron guarantees, I do not doubt the Minister’s commitment. It is not that I do not trust him or what he says; I just feel that unless the Bill goes into Committee we will not maintain the impetus or secure the legislation that is needed, because section 7 orders simply are not good enough.

The details of the Government’s proposals need to be examined properly. As we have heard today, debate on them is crucial, and can only enhance the services that are eventually provided. We need an opportunity to go over every detail of the proposals, and to flesh out precisely what they will mean for a child or other person with autism.

In his letter to all Members, the Minister said that he would launch a consultation on a strategy on services to support adults with autism, that it would have bite, and that he wanted outcomes to be delivered. He said that the strategy would include statutory guidance, which would, however, be subject to consultation and assessment of benefits. I note that slight qualification. Let me say this to the Minister: do not hold back. Join the cross-party consensus on the Bill, and let it go into Committee so that it can be examined in detail. I am not sure that any statutory guidance will work, and I hope that today’s debate has raised doubts in the Minister’s mind as well.

The Government have nothing to fear if they have nothing to hide. They should welcome the opportunity that the Bill gives them. If they do not support the Bill, we have to ask why. What exactly is worrying them? Why do they not welcome the opportunity to put their proposals on record and showcase them in the open in Committee? My fear is that they are allowing politics to get in their way and are playing a rather shoddy political game because they cannot bear the fact that the Bill has been introduced from the Conservative Benches. That would be a terrible shame, because I see no reason at all for them to block it. My hon. Friend the Member for Chesham and Amersham—backed up by some generous observations from the hon. Member for Somerton and Frome (Mr. Heath)—has gone to great lengths to demonstrate that this is a cross-party issue. It is not about politics; it is about people with autism.

I ask the Minister to put aside his politics. I ask him not to block the Bill and sell people with autism short, but to put his shoulder to the wheel, welcome the Bill
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into Committee, and do what is right for the people with autism whom it aims to serve. I ask him not to make this into a fight, but to use his energies to join us all—including his Labour colleagues—so that we can make a real difference.

12.24 pm

Liz Blackman (Erewash) (Lab): I have huge regard for the hon. Member for Buckingham (John Bercow), and I promise him that I will not speak for very long.

I congratulate the hon. Member for Chesham and Amersham (Mrs. Gillan) on choosing the Bill, running with it, and putting a real Government focus on all the issues that it raises. I also hugely congratulate the hon. Member for Tiverton and Honiton (Angela Browning). I suspect that, before I came to the House, she was a lone voice on autism. We have made significant progress over the past few years, however, and she has particularly flagged up the issue of people on the autistic spectrum who happen to be adults. That is what I also wish to focus on. There are two reasons why. First, I am a Parliamentary Private Secretary in the Department for Children, Schools and Families, so I cannot stray too far—I am merely moonlighting from the Minister today. Secondly, I recognise that there is a long way to go in respect of adults with autism, as I stated when I had the honour to second the Loyal Address.

It is worth putting on the record that there has been progress and that the agenda has moved forward, especially since the setting up of the all-party group in 2000 by my hon. Friend the Member for South Thanet (Dr. Ladyman), who has spoken in this debate and to whom I pay tribute. From the outset, the group has received invaluable support from the National Autistic Society. Rightly, every Member who has spoken has paid tribute to it, and I do, too; its skills, knowledge, encouragement and utter professionalism are second to none.

One of the first steps the group took was to survey Members. I recall the feedback from that, and it was quite shocking. A significant number of Members in the year 2000 had not even heard of the word “autism”, and quite a few of those who had heard of it had no idea what it was. I recall that a Member—who is still a Member, and actively campaigns on a range of disabilities—asked me at one of the first meetings: “Can it be cured?” We were on—and we remain on—a learning curve. Although autistic spectrum disorder has been known about for some time, it has only come under the spotlight, and therefore been a little more understood, relatively recently.


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