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Another early move by the group was the launch of its 10-year manifesto in 2003. We were operating then from a pretty low base, but the 2008 “Half way there?” mid-term review makes it clear that there has been progress, although much more in terms of services for children with autism than in terms of adults. There have been one or two green shoots in that regard, however. For me, the most welcome announcement came last year when the Department of Health announced an adult autism strategy and the creation of a senior autism advisory post within the Department to keep the focus constant. I pay tribute to the Under-Secretary of State for International Development, my hon. Friend
the Member for Bury, South (Mr. Lewis), who was a Minister in the Department of Health at that time and who fought very hard to get that full-time expertise.
We have heard this morning some shocking statistics on adults with autism, such as that 63 per cent. say their needs are not met and only 15 per cent. are in full-time work, out of an estimated population of 300,000. We all know from having met people on the spectrum in our surgeries and communities—and, indeed, in our families—of the entire further dimension of the thousands of adults out there in the country who are in their 20s, 30s, 40s, 50s, 60s and way beyond who have never been diagnosed.
I welcome the strategy—and particularly the announcements alongside it from my hon. Friend the Minister, and the proposed process to achieve those outcomes that will make a difference—and so does the NAS. The strategy sits alongside other announcements that feed into the process. I know this has been mentioned several times, and that the Minister will cover it when he winds up the debate, but I want to say that the prevalence study must go ahead as we have to get a grip of the quantity issue.
Publishing the good practice commissioning guidance in April is also a very good step. However, a note should go with it to every authority and NHS body saying that a strategy with teeth—however it arrives—is coming down the track, and that this guidance should not just be stuck on a shelf; people should actively get on with it. The National Audit Office study on the extent of existing services and how they meet the needs of adults regarding health, social care, employment and carers is timely in the context of this process.
The scope of the strategy itself has to be broad enough to deliver the service——which is currently not being delivered in a comprehensive way——that we want to see. I want my hon. Friend the Minister to assure me on this issue and to be guided by those whom he asked to define the boundaries. The question of scope is extremely important; it can be narrowed but it cannot be widened, so let us have everything of concern in that remit as we go forward.
Nobody has said very much today about the process that the Government intend. When I spoke to the Minister privately on seeing this debate coming up, I was particularly interested in the question of who was going to be guiding the process. The external reference group is incredibly impressive. It consists of the chief executive of the NAS, Mark Lever; parents; people with autism; local authorities; mental health services; the voluntary sector and academics. The group needs to be as wide as that because we have to have that expertise in this process. Autism is a hidden disability and the issue is as much about culture as it is about practice and making practice work.
Reference has been made to Jobcentre Plus. The steering group is intergovernmental and will include the Departments of Health, for Children, Schools and Families, and for Work and Pensions—the latter will cover Jobcentre Plus—and, again, Mark Lever. The range of consultees needs to be extremely wide, and there must be a place for Members of this House in the group. It is crucial that they are part of the consultation.
We have identified some of the issues on which improvement is really needed. Data collection is crucial. There is the question of people falling into the gap—of
52 per cent. of people with particularly high-functioning autism being told by mental health and learning disability teams that they do not fit the bill. That is shocking.
Martin Linton (Battersea) (Lab): Does my hon. Friend agree that it is important that local authorities be encouraged to collect information not only on the number of adults with autism, but on their actual needs?
Liz Blackman: Absolutely, and that brings me nicely on to training.
Training is also a central part of the approach. However much we manage to improve services for adults with autism, training is absolutely key and must be delivered—both initially and ongoing—in professional development. We are talking about GPs, psychologists, psychiatrists, social care workers, mental health services, Jobcentre Plus—I could go on but I am not going to as I am mindful of the time. Part of the issue is the huge cohort of people who remain undiagnosed and who need to get support within the system.
The implementation of whatever measures are decided on is crucial. We can have a Bill, translated into an Act, and we can have regulations. We can have clause 7 and statutory guidance but both can be flouted simply because of ignorance, or because of lack of understanding and leadership in the organisations that we want to push this agenda forward in order to improve services for adults with autism. I wait with bated breath to hear what the Minister has to say, but I think that the outcome of the process could be more wide-ranging and robust than could be achieved by going into Committee at this point. However, I shall listen carefully to what the Minister has to say.
The strategy needs to be carefully thought through and it needs time to do its work. It also needs to be brought out within a reasonable amount of time and to be given teeth. It needs to be resourced, ambitious and long term.
12.35 pm
Mr. Oliver Letwin (West Dorset) (Con): I want to make an extremely brief speech. The debate today has not actually been about the Autism Bill, and I have not yet heard anybody who suggests that it is anything other than a very good idea. The subject of the debate has been about whether the Bill is necessary, about the Minister’s claim in his letter, to which I referred in an earlier intervention, that
“Legislation could make delivery of change more difficult”,
and about whether the Minister has a better method of doing it through statutory guidance. His claim is that there will be statutory guidance, that there will be money behind it, as detailed in his letter, and that it will be a more effective method.
First, there is no evidence that such a method will be more effective. My hon. Friend the Member for Tiverton and Honiton (Angela Browning), who has a long record of interest in these matters, is extremely clear, as I have been from my constituency activities, that the existing statutory guidance often produces no effect. Why not? Many of those on the ground do not know that it exists. My hon. Friend pointed out that if it is invoked in court, it is effective, but the problem is that the Department conspires through inaction to allow it not to be known by many of those on the ground. That would probably also be true of further statutory guidance.
Secondly, and more importantly, there will probably never be any statutory guidance or, if there is, it will probably take a very long time. Why do I say that? I accept that I am being slightly more rebarbative than some of my colleagues, who have been very generous to the Minister, but I have some personal experience of this in the recent past. I spent some hundreds of hours on the Sustainable Communities Act 2007 and we negotiated extensively with a parallel and equally admirable and well-intentioned junior Minister. The officials in the Department were extremely resistant to the Act and a series of documented assurances were reported in Hansard, each of which has been falsified. In particular, an assurance was given that a detailed spending assessment would be produced for all the money spent by central Government in every locality in Britain. That has not been produced. Not only has it not been produced, but a total travesty of that assurance has been produced. Are the Government embarrassed? Not in the least. Where is the junior Minister? Somewhere else. What is the Secretary of State saying? Nothing. She will not attend meetings or answer questions.
To quote an earlier intervention during a speech by a Labour Member, “cast-iron” guarantees were given but they have been falsified in practice. Does that and can that apply to the present case? Certainly it can. We have the evidence of the prevalence studies, which have not happened. No mention of them is made in the Minister’s letter. There is no explanation of why the prevalence studies have not happened.
The fact is that the junior Minister does not have the capacity to deliver, the Department shows no sign of the will to deliver and—this is my main point—however well-intentioned the Minister, the Secretary of State and the Secretary of State for Children, Schools and Families are, the Government have all sorts of other priorities. I do not blame them for that. We are in the midst of an enormous national crisis.
Only one person matters in this Government. It is usually the case that the one person who most matters in a Government is the Prime Minister, but in this Government only one person matters and that is the Prime Minister. We have had neither sight nor sound of the Prime Minister’s being involved in this matter, and I would not expect that, because he is concerned with a major national crisis. The idea that the junior Minister can stand at the Dispatch Box and guarantee to the House that provisions including the expenditure of significant sums of money, legislative time and his Department will be delivered is plainly ludicrous. We do not know whether they can be delivered and the Minister does not know whether they can be delivered.
I now come to my fourth and final point. The truth is that if the Government as a whole were genuinely signed up to delivering what the Minister says that he wants to deliver, they would allow the Bill not only to go into Committee, but to come out of Committee and to become an Act. All it does is seek to deliver the same things as the Minister says that he wants by other means to deliver. Nothing about the Bill would prevent the Minister from issuing statutory or other guidance if he wished to do so once the Bill was an Act. The only basis that the Minister has for trying to prevent the Bill from becoming an Act is the statement in his letter that
“Legislation could make delivery of change more difficult”.
I have yet to understand on what basis such an assertion could be made. As my hon. Friend the Member for Guildford (Anne Milton) said during her excellent speech, there is no evidence that legislation will make the delivery of change more difficult. Indeed, there is every reason to suppose that legislation will make the delivery of change easier. Why? Because there will be better understanding on the ground of what is required; the Government will be subject to a stronger requirement to enforce what is required; and, in the final analysis, it will be easier for people to take cases to lawyers and the courts, because what is required will be clear in primary statute.
The facts are that the Minister has no argument, no effective jurisdiction and no guarantee, he cannot offer the House a guarantee and he has no logic to back him up, other than the logic of trying to make sure that the Government are not constrained to do the things they say they want to do. There is therefore no reason for the House to believe that they will do those things better without the legislation than they will with it. I hope that my Conservative colleagues and others in all parts of the House who share our ambitions will support the Bill, which my hon. Friend the Member for Chesham and Amersham (Mrs. Gillan) has rightly introduced.
12.41 pm
Mrs. Joan Humble (Blackpool, North and Fleetwood) (Lab): Like many others, I begin by congratulating the hon. Member for Chesham and Amersham (Mrs. Gillan) on choosing this important subject for her private Member’s Bill. I also congratulate my hon. Friend the Member for Burton (Mrs. Dean), the chairman of the all-party group on autism, and its previous chairmen, my hon. Friends the Members for South Thanet (Dr. Ladyman) and for Erewash (Liz Blackman), both of whom have contributed to the debate.
The all-party group, of which I, too, am a member, has done an amazing amount of work in recent years, especially in producing the autism manifesto and now in continuing to press the Government to make the improvements that the group has identified, with the support of the National Autistic Society. The NAS has played a key role in raising awareness of autism and of the need to proceed with that agenda.
I also congratulate the Minister and his colleagues on the many initiatives introduced in recent years and especially his new announcements in response to the Bill. As Mark Lever, chief executive of the NAS, says in his letter, the measures set out by Ministers cover all aspects of the Autism Bill. So why are we still here debating the Bill? We are debating it—I say to the right hon. Member for West Dorset (Mr. Letwin) that I intend to discuss the Bill—because we are determined to get it right this time. That is why we making our comments in this debate and why we are seeking reassurances from the Minister.
We know from our constituency experience the difficulties encountered by many families who have children with autism, especially if those children are adults, in accessing appropriate services. I know it also as a result of the work that I did with my right hon. Friend the Member for Coatbridge, Chryston and Bellshill (Mr. Clarke) on the parliamentary hearings on the review of services for
children with disabilities. Children with autism and their parents came to us and explained the problems they had encountered at a series of levels, from getting the initial diagnosis through getting the health care and support they needed and then getting appropriate education provision. Above all, they described the real problems with the transition from children’s services to adult services. We need to get this right, because, as other speakers have said, although there are examples of good practice, gaps in provision remain and we have to fill them.
Mrs. Gillan: I thank the hon. Lady for her kind words. Unfortunately, the Minister has just left the Chamber, but does she agree with me that it is about time that we heard from him, so that he can put the promises on the record and subsequent speakers can challenge what he says? The Minister has said that we can put the debate to bed and not send the Bill to Committee, so is it not about time that we heard him give those guarantees in this Chamber, so that the remaining speakers can start to undertake the scrutiny that I want to take place in Committee?
Mrs. Humble: Much as I admire and respect the hon. Lady for introducing the Bill, I think that I might annoy some of her colleagues and mine if I suggested cutting short the debate. She has all-party support, and everybody in the Chamber feels as passionately as she does on the subject of the Bill. As one of its sponsors, I want to ask some questions, and I hope that somebody is making notes or will at the very least tell the Minister what my questions are when he comes back into the Chamber, because I want some answers, too.
Mrs. Gillan: The hon. Lady is absolutely right that we would not want to prevent any colleagues from making a contribution, but the fact is that the Minister could make his contribution now, and then the debate could continue, because we have until 2.30 pm. That would not insult colleagues on either side of the House; subsequent speakers would like to have the chance to question the Minister on the subject. The hon. Lady and I should press the Minister to speak in this debate as soon as he possibly can.
Mrs. Humble: I am sure that many colleagues on both sides of the Chamber want to make points that the Minister could then address—
Mrs. Humble: They include, I think, my hon. Friend, to whom I am about to give way.
Mr. Dismore: I am grateful to my hon. Friend. There is an hour and three quarters left for debate today, so there is plenty of time for all Members who wish to speak to do so, and for the Minister to respond to all the questions asked. If the Minister were to speak now, it would mean that those who spoke afterwards would not get answers to their questions. If the hon. Member for Chesham and Amersham (Mrs. Gillan) plans to move a closure motion, as I suspect she does, I hope that she does not do so prematurely, and that those of us who wish to speak have the opportunity to do so.
Mrs. Humble: That comment is for the hon. Member for Chesham and Amersham (Mrs. Gillan), rather than for me.
Mr. Deputy Speaker (Sir Michael Lord): Order. Perhaps I can be helpful. It might be sensible if, rather than getting into the mechanics of the debate, we carried on discussing the Bill.
Mrs. Humble: As always, I am grateful for your advice, Mr. Deputy Speaker. I intend to address the purpose of the Bill. There are three main areas: information gathering, the delivery of services to people with autism, and the transition to adult services. The Government have already addressed many of those issues, but clearly there is still some way to go. We do not have a national register of people with autism, and even if one were set up, it would be extremely difficult to maintain. As hon. Members have said, some people, especially some people with Asperger’s syndrome, are never diagnosed, and so are never included in any information. However, we ought to make the effort.
Some effort has been made; a variety of organisations have attempted to get statistics through epidemiological studies or surveys. More efforts are now made by local authorities to try to collate information via schools. However, we need to do more, so I welcome the Minister’s announcement—I am pleased to see that he is back in the Chamber—that he will address those issues, and I welcome the Department of Health’s £300,000 investment in the prevalence study, which will give us some sound information. The information is wanted not just to satisfy the needs of statisticians, but to enable us to develop appropriate services to meet the needs of people with autism.
The excellent House of Commons research paper on the subject gives an account of the range of existing statutory support for people with autism. There are few references in legislation to the needs of people with autism, but through guidance, the Government have made sure that legislation applies to people with autism, or people with autism spectrum disorders. I note that there is guidance on how direct payments and individualised budgets for people with an ASD can be used. That will be an interesting way forward, because if people on the autism spectrum—or their carers or family, in certain circumstances—are given control of budgets, they will have a say in the sort of services that they want. If a theme has run through the debate, it has been the paucity of services for adults. If, through individual budgets, new services can be developed, it will certainly help to plug the gaps that we have all identified.
As has been mentioned, standard 8 of the national service framework for children also has an autism spectrum disorders exemplar, which illustrates how children with an ASD are to be covered by the NSF. The Department of Health has made special reference to children with autism in its document “Healthy lives, brighter futures: The strategy for children’s and young people’s health”. The document was accompanied by a practice guidance note for local authorities. In spite of that, however, there are still gaps in service.
The hon. Member for Mid-Dorset and North Poole (Annette Brooke) said that she wanted a named person to offer advice to families, and she knows that I have campaigned long and hard for a key worker system for children with disabilities. The guidance note that I mentioned referred to the need to
“Ensure each young person and their family/carers are supported by a single ‘trusted adult’ contact who will liaise with services, support, the young person and their family/carers.”
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