House of Commons
Friday 19 June 2009
The House met at half-past Nine o’clock
Prayers
The Second Deputy Chairman of Ways and Means took the Chair as Deputy Speaker (Standing Order No. 3).
Mike Penning (Hemel Hempstead) (Con): I beg to move, That the House sit in private.
Question put forthwith (Standing Order No. 163).
The House divided: Ayes 0, Noes 45.
AYES
Tellers for the Ayes:
Mike Penning and
Mr. Tim Boswell
NOES
Austin, Mr. Ian
Baldry, Tony
Baron, Mr. John
Borrow, Mr. David S.
Bottomley, Peter
Brooke, Annette
Browne, Mr. Jeremy
Browning, Angela
Bryant, Chris
Burns, Mr. Simon
Chope, Mr. Christopher
Coaker, Mr. Vernon
Cormack, Sir Patrick
Crabb, Mr. Stephen
Cunningham, Mr. Jim
Fallon, Mr. Michael
Fitzpatrick, Jim
Gidley, Sandra
Gillan, Mrs. Cheryl
Goodman, Mr. Paul
Harper, Mr. Mark
Howarth, David
Jones, Mr. Kevan
Keeley, Barbara
Keen, Ann
Kirkbride, Miss Julie
Lammy, rh Mr. David
Mackay, rh Mr. Andrew
Mann, John
Mates, rh Mr. Michael
McCarthy-Fry, Sarah
McIntosh, Miss Anne
Milton, Anne
Mole, Chris
Murrison, Dr. Andrew
Newmark, Mr. Brooks
Osborne, Mr. George
Rosindell, Andrew
Ruddock, Joan
Shaw, Jonathan
Simmonds, Mark
Skinner, Mr. Dennis
Swayne, Mr. Desmond
Thomas, Mr. Gareth
Ward, Claire
Tellers for the Noes:
Mr. Dave Watts and
Kerry McCarthy
Question accordingly negatived.
Autism Bill
Consideration of Bill, as amended in the Public Bill Committee.
9.45 am
Mrs. Cheryl Gillan (Chesham and Amersham) (Con): I beg to move, That the Bill be now read the Third time.
Mr. Deputy Speaker, I cannot tell you how delighted I am to move Third Reading. Reaching this stage is a landmark, and our having done so is due not only to me, as the Member who had the privilege of promoting the Bill, but to the House of Commons at its very best. This has truly been a cross-party effort involving those on the Conservative, Government and Liberal Democrat Benches, and I am delighted that Members of Parliament have come together to try to introduce a Bill which we hope will make a great difference to so many people’s lives throughout our country.
The hon. Member for Portsmouth, North (Sarah McCarthy-Fry) is in her place, although she is no longer responsible for part of the subject area that the Bill covers. I am grateful for the attention to detail that she showed, and for her undertakings in her previous role, to which I shall refer later. She has rapidly moved through the ranks and ended up at the Treasury through sad circumstances, but I know that her competence will be put to good use in that Department and I am sure that hon. Members of all parties wish her well, not least because of the detailed attention she gave the Bill.
Mike Penning (Hemel Hempstead) (Con): Before my hon. Friend praises more Members from across the House, may I pay tribute to her work in taking the Bill through its passage—something which is, as she said, a tribute to the House? She has followed on from the fantastic work of my hon. Friend the Member for Tiverton and Honiton (Angela Browning), who previously promoted such a measure. The work of my hon. Friend the Member for Chesham and Amersham (Mrs. Gillan) in bringing proceedings to an excellent conclusion should be acknowledged on the record.
Mrs. Gillan: I am grateful to my hon. Friend for his generous remarks, but it really has been a team effort.
Mr. Tim Boswell (Daventry) (Con): The congratulations expressed to my hon. Friend, as well as to my hon. Friend the Member for Tiverton and Honiton (Angela Browning) and to Government Front Benchers, are well deserved. However, will she reflect on the fact that, although we can legislate here—that is what we do—introducing mere legislation, even with all-party and Government support, to issue guidance is insufficient in itself? Implementation is critical, especially in respect of training and promoting awareness in a community beyond those who directly care for people on the autism spectrum. That is hugely important—perhaps she will comment on it—because unless people understand what is involved, they will act insensitively and many of the advantages that we are trying to secure today will be lost.
Mrs. Gillan: My hon. Friend is right. I refer him to clause 2(5)(f), which specifically covers
“the training of staff who provide relevant services to adults with such conditions”
in the guidance that the Secretary of State issues. That provision is included for the reasons that my hon. Friend outlined.
I pay great tribute to the Minister of State, Department of Health, the hon. Member for Corby (Phil Hope). He is not with us today because he has a vital duty to perform in his constituency, so I am delighted that the Under-Secretary of State for Health, the hon. Member for Brentford and Isleworth (Ann Keen), is here. I am sure that she will do an excellent job today. The Minister of State did not start off entirely supporting the Bill, but, my goodness, he has got behind it. He has done a first-class job in his current ministerial position, which I am glad he continues to hold, because I hope that he will supervise the legislation, if we are fortunate enough to get it through the House today and through the other place in due course.
The Bill has the potential to deliver the crucial improvements needed for the approximately 500,000 people with autism in the UK, who have been neglected for so long. It is the culmination of a great deal of work by many people. The effort that has gone into the Bill is a testament not only to the determination and dedication of many of my colleagues in the House, on a cross-party basis, but to a large number of people outside. I have paid tribute to those people in previous speeches, so perhaps they will forgive me if I do not name them today, but the National Autistic Society and all the other charities that have been involved have done a first-class job on behalf of the group that they represent.
I would like also to thank the Members who supported the Bill and those who served on the Public Bill Committee, which shows what we can achieve when we work together. Lastly, before I get to the substance of the Bill, I would like again to thank my hon. Friend the Member for Tiverton and Honiton, who has been a champion on the issue. The Bill builds on her earlier ten-minute Bill and—to sound just a small sour note—resulted also from the Government’s failure to respond or to fulfil their promises on autism in the past. To be truthful, the Bill is really her Bill, which, because I won a lottery, I have been fortunate enough to present.
Autism was long overdue serious consideration, as outcomes for both children and adults were consistently so much poorer than those for people who do not have autism. A recent report by the NAS found that 40 per cent. of children with autism had been bullied, that 27 per cent. had been excluded from school and that 42 per cent. reported that they had no friends. In addition, 70 per cent. had a psychiatric condition accompanying their autism. For adults, the picture is even bleaker. The NAS estimates that 63 per cent. of adults with autism do not receive enough support, while 82 per cent. of parents or carers of adults with autism say that their child needs daily support just to live independently. Only 15 per cent. of adults with autism are in full-time work and 75 per cent. do not have any friends or find it very hard to make friends, while 40 per cent. of adults with autism still live with their parents. We currently fail both children and adults with autism in this country.
Mr. John Baron (Billericay) (Con):
I am sure that my hon. Friend would also agree that there is grave concern among parents of children and adults with autism. The
same report to which she has referred suggests that 90 per cent. of parents worry greatly about how their children will survive and cope in society when they leave school or university, particularly given the statistic, which she rightly pointed out, that only 15 per cent. of adults with autism are in full-time work.
Mrs. Gillan: That is absolutely correct: the figure is 15 per cent. However, as my hon. Friend knows, and as I know from meeting many adults with autism, their potential is far greater than that. With a small amount of assistance and the correct support, we can allow them to fulfil their potential and live their lives. That is what we should be doing in this country. I hope that the Bill, if it becomes an Act, will give this and future Governments a framework to concentrate on what needs to be provided to that very deserving group of people.
Angela Browning (Tiverton and Honiton) (Con): Following on from that point, it is true that parents worry about their children’s education and ability to live independently, as they go through the various developments and cycles of life. However, as a parent, I think—I hope that I would speak for many parents—that the biggest fear is: “What happens when I die?” That has to be addressed.
Mrs. Gillan: That is probably the most moving part of my encounters with families with children who have autism. The terrible fear of someone who has a child with a disability of any sort is about what will happen to that child when they are no longer around to give it the sustenance that it needs. That is why I hope that this framework legislation will provide a platform from which Governments can ensure that local authorities and other services are structured in such a way as to give greater reassurance to people in that situation.
Liz Blackman (Erewash) (Lab): Does the hon. Lady not also agree that it is people with high-functioning autism who are the most hidden from services and that their parents have a great deal more to worry about? If someone has classic autism, it is blatantly obvious. We might argue about the quality of the services for them, but at least they have been identified. That is why it is so important that the Bill translates into reality.
Mrs. Gillan: The hon. Lady makes an excellent point. The problem is like an iceberg: we can see the tip, but we cannot see the vast swathe underneath. If people do not have immediate parental back-up, they will at some stage reach a crisis. So many commentators outwith this House are preoccupied with expenses and money, but perhaps they would like also to register the fact that unless we make that help available, it will cost the taxpayer a great deal more money to deal with those individuals in crisis. I count the cost in human terms and think what a loss to our society it would be if an individual did not receive the support that would enable them to fulfil their potential when their parents are no longer there.
Autism does not really fit in with many of the structures, and certainly not with local authority service structures. The problem is exacerbated by a lack of understanding of autism among the health and community care professionals, particularly those providing assessments. The resulting exclusion from services can result in an
increase in support needs in the long term, with 33 per cent. of adults having developed mental health problems because of a lack of access to services.
Hon. Members who are familiar with the Bill will see that it has gone through quite a metamorphosis since Second Reading. I want briefly to set out why and how it has changed. When the Bill was first introduced, it required local authorities and their partners to take a strategic approach to meeting the current and future needs of children and adults with autism in their areas. Following the strong commitments and the undertakings on data collection and provision for children given by the hon. Member for Portsmouth, North when she was a Minister with responsibility for schools and learners, the clauses relating to children were removed from the Bill. She made commitments on behalf of the Government, including one to amend the children and young people’s plans—the CYPPs, the key strategic planning tools for local authorities—in the Apprenticeships, Skills, Children and Learning Bill.
There will now be a new legal duty to ensure that local areas collate and share data on disabled children as part of their CYPP needs assessments, and they will also include children with autism in their plans for children’s services. I hope that the Minister will nod at me—I know that convention means that she cannot intervene, but she made a bold commitment on ensuring that the statutory guidance accompanying the regulations will state that autism must be specified as a separate category. I look forward to seeing those provisions enacted later this year in a separate piece of legislation.
The Exchequer Secretary to the Treasury (Sarah McCarthy-Fry) indicated assent.
The Parliamentary Under-Secretary of State for Health (Ann Keen) indicated assent.
Mrs. Gillan: I see both Ministers nodding, which I will take as confirmation of what will be going through.
In debates, and in meetings with Ministers and officials, I was pleased to achieve a broad consensus on the need for legislation and further action, so that people with autism receive the quality of support that they deserve. The clauses relating to adults now look quite different from those in the original drafting, but they are completely in keeping with the spirit of the original Bill and in many instances go well beyond what was covered in the first draft. The statutory guidance covers all the crucial parts, including—I am pleased to say this, because there was a strong feeling among the charities supporting the Bill that these things needed to be included—access to diagnosis, needs assessments, transition planning, strategic planning of support services with adults with autism, and local partnership and co-operation.
The Bill now places a duty on the Secretary of State to introduce a strategy for improving outcomes for adults with autism, accompanied by statutory guidance for local authorities and NHS bodies. If the Bill becomes law, it will be a catalyst for huge progress in meeting the needs of the country’s adults with autism. The NAS and other partner organisations, such as TreeHouse, that have been involved with the Bill have been pleased with this positive approach, and have warmly welcomed the new, amended Bill that I am presenting today on Third Reading.
I have a few remaining concerns, however, on which I should like to seek reassurance from the Minister, together with any further details that she might be able to give me, especially on implementation, which will be the next stage if the Bill becomes an Act. The first issue relates to data collection. The Minister has recognised the importance of data collection to enable organisations to identify and meet the needs of people with autism. Given that the National Audit Office’s recent report on autism found that identifying and supporting people with Asperger’s syndrome or high-functioning autism would save the public purse many millions, I would be grateful if she could reassure me that the proactive measures needed to identify those adults will be put in place, and that those measures will not have to rely purely on making better use of existing data. In addition, I would like reassurance that a particular focus will be placed on identifying adults with Asperger’s syndrome who are not already known to the services. Will she also confirm that the definition of people on the autistic spectrum will specifically include those with high-functioning autism and Asperger’s syndrome?
The second issue relates to strategic planning and joint strategic needs assessments, or JSNAs—hardly a snappy title that rolls off the tongue. These are the key strategic planning tools for the local authorities, but at the moment, more than two thirds of local authorities have no commissioning strategy at all for adults with autism, and only 21 per cent. of all JSNAs include any mention of the needs of people with autism. Can the Minister reassure me that the statutory guidance will specify that JSNAs have to take into account the needs of people with autism?
Another concern relates to identifying which professionals are relevant to autism. The Bill covers all health and social care staff, and that is welcome. However, other staff who play a large part in supporting adults with autism are not covered—notably those involved with employment matters, including Jobcentre Plus staff. Will the Minister confirm that professionals who have a particular responsibility for supporting adults with disabilities will receive an appropriate level of training, be it in the field of social care, employment support or another relevant field? I think I see the Minister nodding. That would go a long way towards reassuring people that, at last, the real needs of people with autism were beginning to be considered across all levels.
David Howarth (Cambridge) (LD): I congratulate the hon. Lady on getting this far with her excellent Bill. I have one small concern about coverage, to which I hope she and the Minister will be able to respond. It relates to housing. The definition of a local authority in the Bill rightly refers to the upper tier, which is the tier that deals with social services. However, I have come across many problems in my constituency involving the housing needs of people—especially adults—with autism. In a two-tier area, housing is dealt with by the lower tier—the district council. I would like some reassurance that planning for housing will also be part of the process.
Mrs. Gillan: That is a very valid point; I have come across that issue as well. I hope that the Minister will be able to give us that assurance, because an indication of that intention at this stage would ensure that that issue was encompassed by the Bill.
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