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Dr. Andrew Murrison (Westbury) (Con): I congratulate my hon. Friend on the Bill; it represents a positive step forward. I, too, am concerned about coverage. Those who work in further education make a big contribution in this regard, and I suspect that, in the old days, such provision would have been covered by the Bill, because FE came under the remit of local government. That is no longer the case now that its funding comes from the Learning and Skills Council, whose many problems we have heard about in recent months. Does she feel that FE should be covered by her Bill? Perhaps it is, and I have missed it. It would certainly be a serious omission if it were not.
Mrs. Gillan: My hon. Friend raises a point that has gone through my mind, but this is not an all-encompassing, catch-all Bill. I am afraid that there are lots of areas not covered by the Bill that, in an ideal world, I would have liked to cover. Unless my interpretation of my own legislation is incorrect, I do not believe that further education is specifically covered in the Bill. However, there is a possibility that the Minister may address the matter, because access to education and skills is extremely important for any adult with autism. Indeed, one of the major problems that we are seeking to address is the transition from childhood to adulthood, alongside trying to identify that swathe of individuals hidden under the surface who fail to get any help or support at all. I hope that the Minister will be able to address these points. I suspect that if I had attempted to introduce an all-encompassing piece of legislation, it might not have got as far as this stage.
I was talking about the statutory guidance, which covers the assessment of the needs of adults with autism. This represents a crucial step forward, as a proper needs assessment by suitably qualified professionals is the gateway to appropriate and effective support. I would like some reassurance from the Minister that the assessments will be person-centred—I do not like that term, but it does express the meaning—and that they will be carried out by professionals with an appropriate level of autism-specific training.
A vital part of the strategy’s success will be the timing and scope of the consultation. The Minister of State, the hon. Member for Corby assured us that the dates announced were the latest ones, and that he expected the strategy and the guidance to be issued much sooner than the timetable indicated. I am aware, however, that they will be staggered, and not released in tandem. Will the Minister outline in her speech the timetable for the publication of the documents? Ideally, there should not be too large a gap between the two publications. In addition, will she assure me that, if there is to be a separate consultation exercise for the statutory guidance, her Department will seek the views of all stakeholders, and not just local authorities and NHS bodies, as stated in the Bill?
Another issue of timing involves the review of the strategy, and the question whether it should be revised if it does not produce the intended results. In Committee, the Minister of State said that he did not wish to make a time commitment in relation to when such reviews might take place. His reasoning was fairly acceptable, but questions remain about what might trigger such a review. Will the Minister outline how the success of the strategy will be monitored, and what indicators would trigger a review?
Will the Minister also commit to naming an individual in the Department of Health with responsibility for the success or failure of the strategy? A clearly identified person in an official post covering this area would give the assurance that continuing attention will be paid to the outcomes for people with autism. One of the problems that the families of people with autism face is that, when they try to address an issue with a Government Department, they are unable to track down an individual with a title, a post or a name to whom they can direct their questions. Their case seems to disappear into a spongy area in the Department to be handled by whoever is the latest official to deal with it. I hope that the Minister will be able to give me some reassurance on that point.
Liz Blackman: I absolutely agree with the hon. Lady about having someone in the Department of Health with that specific responsibility. Will she pay tribute to the Department, however, for having such a dedicated person in place at the moment? Let us hope that that continues.
Mrs. Gillan: Absolutely. The hon. Lady’s point is taken. The trouble is, however, that everything changes. I am looking for continuity, security and stability in this area, because a constant state of flux is good for neither man nor beast.
A further remaining concern relates to ensuring the commitment of all the relevant Departments. I am sure that the Minister will agree that joint working across the Departments is essential for achieving an effective strategy for people with autism. What measures does her Department intend to put in place to ensure, for example, that the Department for Work and Pensions plays a full and active part in developing and implementing the relevant parts of the autism strategy?
Finally, the ultimate success of the strategy and statutory guidance will depend not only on their content but on how well they are implemented, as my hon. Friend the Member for Daventry (Mr. Boswell) said. I would like the Minister to guarantee that the implementation plan will be consulted on as part of the strategy consultation; if not, will she outline the steps the Department would be prepared to take to develop the plan to ensure that it is robust and practical?
Adults with autism are much more likely to experience mental health problems, bullying and unemployment, and to be reliant on family or the state for support. We must put that right, so that the needs of people with autism receive proper attention. They deserve the legal footing that could flow from this legislation, not least to redress the position that has resulted in the outcomes of so many being so poor.
I realise that others might want to contribute to the debate, so I will draw my remarks to a close. Better data and information collection at the national and local level has an important part to play in improving outcomes, as does better access to diagnosis and support. If the Bill becomes law, the information collected under it will have the potential to improve our understanding of the support needs of adults with autism, to raise expectations on local services and to ensure that professionals who work with people with autism are properly trained to understand their problems.
To conclude, each and every person deserves the best possible chance to make the most of their talents and fulfil their potential, as I have said before, including people with autism. As was illustrated by the National Audit Office report, by not providing adequate support to people with autism, we are wasting not only large amounts of taxpayers’ money, but human talent and lives. I hope that the Bill will act as a catalyst for change. I am very proud to have been able to continue other people’s work and introduce this legislation by working with people across all sides of the political divide and in the best interests of our society and community.
When we are trying to do something that will affect so many people’s lives and that shows the House of Commons at its best, I think it is a shame that there are no hordes of journalists in the Press Gallery here to see what the House really does for this country. I see a sole, single, lonely journalist up there, perhaps reporting on these matters. He is to be congratulated, and it is a great shame that more people outside the House do not concentrate on the good that we do as a group in it rather than on the subjects covered in newspapers today. I am proud to commend this Bill to the House.
10.12 am
Liz Blackman (Erewash) (Lab): I start by putting it on the record that I was wrong on Second Reading not to wish the Bill to go into Committee. I felt at that time that the strategy and process announced by the Minister of State, Department of Health, my hon. Friend the Member for Corby (Phil Hope) was correct—that we should just get on with it and move towards delivery as soon as possible. However, much water has passed under the bridge since 27 February, when the Bill had its lively, very knowledgeable and somewhat tetchy debate on Second Reading. The crux of the tetchiness was the point I have just made—about deciding the right way forward to achieve our common aims. Between then and 13 May, massive consensus broke out, and what we have before us now goes a very long way to meeting all our sincerest wishes. The Bill now goes further and is better than the original.
I hugely congratulate the hon. Member for Chesham and Amersham (Mrs. Gillan). As my hon. Friend the Member for Burton (Mrs. Dean), chair of the all-party group said, we would not be here or have come so far, had the hon. Lady not chosen to introduce a private Member’s Bill on autism. Behind the scenes, my hon. Friend played a vital part in discussions in progress. She is a modest person and would blush to hear it, but I pay tribute to her.
Mrs. Gillan: I omitted to mention the hon. Member for Burton (Mrs. Dean) in my speech, although I had her name written on my post-it notes. I apologise and would like to acknowledge the enormous amount of work that she did. I am sorry that she cannot be here today, but I know that she is busy in her constituency.
Liz Blackman:
I also pay a huge tribute to the hon. Member for Tiverton and Honiton (Angela Browning) for her promotion of this cause. As I said on Second Reading, she was for many years a lone voice in the House, trying to improve services right across the spectrum. I also offer huge congratulations to the Minister of
State on responding so comprehensively and enthusiastically to the challenge. It was a great moment when he moved the clauses in Committee.
I am pleased that the hon. Member for Chesham and Amersham decided that it was right to focus on the adult strategy and transition in this particular vehicle. I am also pleased that she has been reassured by the Department for Children, Schools and Families that it is committed to promoting and improving services for children. Nevertheless the statistics for the adult autistic community remain dire, shocking and stark, and that reflects variable practice, to say the least, and bleak prospects for so many. It is worth repeating those statistics: 63 per cent. of adults with autism say that their needs are not met; a third have mental health problems; 40 per cent. carry on living at home; and only 15 per cent. are in full-time work. Moreover, 67 per cent. of local authorities and 77 per cent. of primary care trusts do not collect data. It is scarcely surprising that the National Audit Office found that a good diagnosis, particularly of high-functioning autism, would save the taxpayer many millions. Equally unsurprising is its finding of the high level of frustration experienced in accessing services by so many adults with autism.
The key question—and the reason we are all here—is how we make our expectations translate into reality in order to secure improved services and improved outcomes for the autistic community. Well, as we know, the process has already begun irrespective of our disagreements along the way. We all endorse the practical framework set up to consult on the strategy—the external reference group, which reflects the range of stakeholders and is chaired by Mark Lever, the chief executive of the National Autistic Society.
Four main pillars have been identified: health; social inclusion, embracing employment, to which I will return; choice and control; and training. What makes the Bill so novel is its explicit requirement that the Government must produce a strategy. It requires the Government to improve services for adults and sets a clear time limit— 1 April 2010, so I hope we do not meet it, as the expectation is that the strategy should be completed by the end of the year. The limit merely allows flexibility and will be kept under review.
The statutory guidance is to be consulted on and issued by 31 December 2010. We hope that the interval between the strategy and the guidance will be as small as we can make it, as the hon. Member for Chesham and Amersham said. The statutory guidance will apply to local authorities and NHS bodies—including mental health trusts, which is vital. We had an interesting debate in Committee on how binding the guidance will be on foundation trusts. Because of their autonomous nature, it will not be binding, but a primary care trust contracting with such a foundation trust will still need to ensure that its statutory duty is fulfilled through the commissioning process, so there are some safeguards in the system.
Clause 2 covers all the crucial points that we in the all-party group have argued for over many years. Improving these services will be a challenge. Diagnosis will have to be done by suitably qualified people, and it may need to be done, as the hon. Member for Tiverton and Honiton argued on Second Reading, out of area. Diagnosing high-functioning autism and Asperger’s syndrome is
much more tricky and difficult than diagnosing classic autism. As I said, that group is often hidden from services.
The same applies to needs assessments. Transition planning of relevant services is vital, and I am pleased that the Bill includes that. The all-party group has just completed a report on transition and has made a number of recommendations to the Government. Some are more relevant to the Department for Children, Schools and Families, but many are relevant to other Departments, including the Department of Health.
One of the report’s main recommendations is:
“Guidance should require Directors of Children’s Services to maintain a database of the numbers of children with autism in their area and share this information with Adult Services.”
I think that that commitment has already been made. It also recommends:
“Guidance should require that Directors of Children’s Services and Directors of Adult Social Services co-operate to review and plan services for young people with autism on a regular basis, including those children with complex needs in out-of-authority placements.
The Government should extend the duty on local authorities to ensure that a multi-agency person-centred transition plan is developed for each pupil with autism who receives support at School Action Plus from the age of 14, in addition to those with a statement of SEN.
The disabled children’s services national indicator (N154) should be extended and young people’s views gathered in a survey so that there is a specific focus on transition against which local areas can be measured. Any future review of the local government performance framework should address the needs of disabled young people during transition to adulthood.
The Government’s learning disability employment strategy should address the needs of young adults with autism, including Asperger syndrome, in line with Public Service Agreement 16.”
Mr. David S. Borrow (South Ribble) (Lab): Does my hon. Friend share my concern about the difficulties that some young adults with autism face when, having settled into employment and sorted out their lives, a disruption in the workplace throws all the good work that has been done to the four corners of the earth? Stable, steady employment that could have gone on for several years, and the stable, steady life that would have existed for those years, can be lost because of a change of manager, or another change within the workplace, that disrupts the regular pattern. Young adults with autism find that particularly difficult to manage.
Liz Blackman: I agree. The culture of the workplace is a key factor in getting young people with autism into employment and keeping them there. It is a real challenge to shift that culture. I shall say more about employment in a moment.
There are four more recommendations on the report’s list. I want to read them into the record because transition is a crucial process. If we get that right, we are far more likely to get adult services configured in a way that secures good outcomes. The report continues:
“The Government should ensure that all children with autism have opportunities to undertake meaningful work experience in Year 10.
The Government must ensure that disability support advisors at further education colleges and universities have autism training.
The Department for Work and Pensions should ensure that Connexions provide information to all young people with autism on Employment Support Allowance and Disability Living Allowance.
JobCentre Plus should ensure that all transition plans include young people’s employment goals and outline the work support programmes available to them.”
Those are all relevant recommendations, and I hope that the Government will give them serious consideration and implement them.
The hon. Member for Chesham and Amersham mentioned strategic planning. Some 74 per cent. of local authorities do not have a commissioning strategy for adults with autism. We are starting from an extremely low base, and that will be one of the biggest challenges to shifting the culture.
On training, I welcome the wider definition of relevant services caught by the National Health Service Act 2006 and the Local Authority Social Services Act 1970. Extending the definition’s scope is helpful. However, 80 per cent. of GPs told the NAO that they need more training and only 29 per cent. of local authority staff who are responsible for needs assessment have training in high-functioning autism. As has been said, Department for Work and Pensions staff are not caught within the definition of relevant services.
On jobs, we cannot underestimate the importance of trying to support people with autism, in particular those with the high-functioning condition, in getting meaningful employment. Whether one has a disability or not, employment is crucial to how people live their lives and feel about themselves. It gives an immense feeling of self-worth. Jobcentre Plus staff are not covered by the definition of relevant services. In particular, disability employment advisers and personal advisers, and also health care professionals involved in work capability assessment, are not caught by it and are not required to have training. We need buy-in from all relevant Departments to make a difference. The DWP must take ownership of relevant parts of the strategy. I hope that the Minister will give us some comfort on how we are going to ensure that other Departments play their part.
Employment has to be a top priority. There are brilliant examples of young and older people with autism who have been happily placed and are settled in their work. I met a young woman at an event the other day. She has high-functioning autism but is immensely talented in IT. She works for BT, where she is supported extremely well, and told me about Goldman Sachs, which also does sterling work in embracing young people with such skills and in supporting them in the workplace. The shopping centre at Meadowhall in Sheffield has a good reputation for doing the same thing.
On local leadership, some time ago the all-party group took evidence from people in local authorities who had specific responsibility for autistic people’s services. One individual—I think from the authority of Sussex; if I have got it wrong, I apologise—was incredibly good. He had seized the agenda by getting all the stakeholders together and making the system work. The services for adults in that authority were far better than in many others.
As I said on Second Reading, we can have a Bill, a strategy, statutory guidance and all the rest, but it will not make a ha’p’orth of difference if they are not implemented. Implementation is complex, but has to be
driven from the centre and from local leadership. We need to see sight of the implementation plan, sooner rather than later, in the strategy. The whole strategy needs rigorous, detailed monitoring.
Mrs. Gillan: Does the hon. Lady agree that it is not just the implementation that is important; it is also continuing the momentum in other Departments where there has been partial awareness of the strategy and partial implementation of it? One of the things that I have been hunting for in the NAO report is that since November 2005 the Department responsible for disability employment advisers, the DWP, has been taking on updated training so that the advisers are more aware of the needs of people with autism. The figures for Great Britain are that
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