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That is a good thing, but this is not only a question of implementation. We must also continue the momentum that has already started and been seeded in various Departments. That is as important as using legislation as a framework to drive things forward.

Liz Blackman: Absolutely, but it is all part of the same package: implementing something is a moving process and training is at the heart of that.

I am very proud to be speaking here today in support of a Bill which, if properly implemented, will make a huge difference to so many people and, crucially, their families and carers as well. I wish it well.

10.40 am

Angela Browning (Tiverton and Honiton) (Con): I begin by joining other speakers in thanking and paying tribute to the many Members from all parts of the House who have played their part in bringing this Bill to fruition as it receives its Third Reading today. I must also pay particular thanks to my hon. Friend the Member for Chesham and Amersham (Mrs. Gillan), who is a true friend to me. She has worked tirelessly on this subject. She chose it, having finished No. 1 in the private Member’s Bill ballot; I have been a Member for almost 18 years, and I have never even got into the top 20, so she was right when she said she felt as though she had won a lottery. She could have chosen many other subjects, but she chose to promote a Bill on autism. I believe that she will be remembered for many great things in her parliamentary career, but this will certainly be one of her most memorable achievements. Its impact will be felt long after she has left the House, and it will benefit many people and their families.

I also want to pay tribute to the two Ministers who have brought the Bill through to this stage. Although it was a battle in the beginning, it turned out all right in the end—and it turned out better as a result. There was cross-party support and Members from different parties worked with each other, and although there were some tough negotiations—as my hon. Friend knows only too well because she was part of them—there was also good will and a desire to do something good. I am sure we have achieved that in this Bill.

I shall try today to break a personal record by making a shorter speech on autism than I have made before—the House will be relieved to hear that—but as the Minister
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is in her place I want to flag up a few key points. The National Audit Office report came before the Public Accounts Committee on Monday, and three Departments were represented at the session. I requested for them all to be asked to come back and report on progress in a year’s time, because there is a lot of compatibility between the NAO report and what the Bill intends to achieve. Having listened to the three departmental representatives, who included a permanent secretary, I now think that the Department for Work and Pensions has a long way to go to get up to speed. I will not go through all the issues that were addressed as we discussed them in Committee, but I must stress that getting people into training and employment is essential.

The hon. Member for Erewash (Liz Blackman) has been a great advocate in this House for the need to address the autistic spectrum, and I congratulate her on the work she has done over many years. She said she thought I was a lone voice, but when she joined the House I did not feel that I was alone any more. It is good that so many MPs now not only talk about autism, but are able to handle constituency casework in a way that makes a difference for people with autism. The hon. Lady made the point that when we see that done well—and it gladdens the heart to see it done well—it seems simple to do, and that that is how it should be done everywhere. The PAC listened to the three speakers at the session we held on Monday afternoon, and there was a noticeable change in view: not only was there understanding, but there was a recognition that we must implement the changes being proposed.

I want to raise three points. The first of them is about the statementing process for children in education. We must be very careful that statementing in relation to autism does not neglect those children on the autistic spectrum who do not have a statement of educational needs. There are many of them and, over recent years, the statementing process itself has changed and the criteria have changed, and the people on the more able end of the spectrum, particularly the Asperger’s group, are less likely to be formally statemented, although their needs may be understood and known in the classroom. When people in that group enter the transitional period between leaving school and going into further education or training and ultimately—we hope—into employment, it is important that they are not excluded purely because they have not had the insurance policy of a statement and because there is a rationing system in place that addresses only those with a statement of educational needs.

John Bercow (Buckingham) (Con): First, may I apologise for my tardiness in coming to the Chamber this morning? What my hon. Friend says is absolutely right, and does she agree that it is not only a question of children without statements but who are on the spectrum—perhaps with Asperger’s—being vulnerable, but that there is a very real sense in which they can be more vulnerable than anyone else for precisely the reason that she offers: that they do not have what she calls an insurance policy and what I call the comfort blanket or safety valve of a statement? My son is on the spectrum. He has high-functioning autism and he is very fortunate to have a statement, but I have lost count of the number of children I know who are similar to him but who do not have that protection.


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Angela Browning: My hon. Friend has devoted a lot of time to, and developed a lot of expertise in, this topic and related subjects, and he is absolutely right. It is very important that the practical application of what we are legislating for today does not lead to silos being created and to the exclusion of the very people who need help the most, but who are not able to articulate that.

The second issue that I want to flag up is to do with social services assessments. I shall be writing yet again to Devon county council this week—I have lost count of how many times I have written to it about this—because yet again a social worker has told a mother, “We cannot assess or do anything for your Asperger’s child because they probably have an IQ of over 70.” The mother has now pursued the council to such an extent that it is going to do an IQ test. However, if the council finds that the IQ is over 70, which for an Asperger’s child it probably will be, that will be its get-out clause for saying, “Sorry, not learning disabled, so we can’t do anything.” Department of Health circulars have been issued telling people not to exclude Asperger’s children in this way. I have a copy, which I shall send to Devon county council. I shall also send it the text that the permanent secretary at the Department of Health gave to the PAC on Monday afternoon, showing that that is not how councils are meant to treat Asperger’s children. Somehow, however, when such circulars get sent out, they end up getting put in a filing cabinet and, conveniently, the information does not trickle down to the practitioners on the ground: the social workers, the educational psychologists and so forth. For some reason, they are unaware of this advice. I will deal with Devon county council, but—

John Bercow: I would rather be on your side!

Angela Browning: I am grateful to my hon. Friend for that remark. I am so weary of having to keep writing the same thing over and again. I ask this of the Minister: when the new information goes out, which will be after I have retired from this place, will she please make sure that it does not fall victim to what I call “the filing cabinet syndrome” so that it never sees the light of day, because that involves a great disservice.

I made a final point on Monday to the permanent secretary at the Department of Health, but I will repeat it now. I have raised two separate debates particularly about Asperger’s syndrome and mental health services. We know—my hon. Friend the Member for Chesham and Amersham gave the statistics—that the whole spectrum of autism, including Asperger’s syndrome, is not of itself a mental health disorder, but people with Asperger’s can develop mental health problems. After all, if any of us had that syndrome and we had struggled to be like everybody else in society—to make friendships, to form relationships, to get a job, to cope independently with life and to communicate with people, because it is a communication disorder—and by the time we reached our early 20s we got nowhere, we would all develop very serious depression and mental health disorders. Such a development is quite common and, as has been expressed, it arises because of a lack of basic facilities and support. Some of the support required is fairly low budget; the National Audit Office report shows how spending a little can save a lot. The problem is that a bit of spending in one Department may mean that a lot is saved in another Department, so inter-departmental interests emerge—again, we are talking about the silo effect.


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If we are to serve this population properly, we need to ensure that when they need mental health services, they not only get the right ones but they are supported so that they do not end up with a mental health problem on top of the autism. Once those two things become entwined, it can be difficult to find a psychiatrist who can actually unravel what is a mental health symptom and disorder from what is Asperger’s behaviour in crisis. Very few people in this country can disaggregate the two behaviours and not only diagnose them, but, if necessary, medicate appropriately for them.

I have been involved in two debates in this House on people who fall foul of mental health. When they fall foul of mental health, all too often—these are not rare occasions—people with autism, particularly Asperger’s syndrome, are misdiagnosed with conditions such as schizophrenia and are then medicated for schizophrenia, but the medication does not work. Why would it work for someone who does not have the condition? Such people work their way down through a catalogue of different, very strong drugs, trying them out to see whether they have an effect. By the time they reach drug number five, their brain is scrambled. I have seen at first hand the results of what happens when artistic people with high IQs, who at one time could do the most wonderful paintings, are misdiagnosed and drugged with five highly powerful drugs—they end up with scrambled brains; I can give no other description.

As I have said before—this will probably be the last time that I say this in this House—if a cardiologist misdiagnosed someone’s heart condition and misprescribed in that way, they would be sued, and it is outrageous that this country’s mental health services, particularly those in the provinces, away from the centres of excellence in the bigger cities and towns, have not got the expertise to treat people with autism not only with dignity, but in a way in which they deserve to be treated. I say to the Minister that I hope that the outcomes and the practical application of this Bill will ensure that we do not treat people with autism like that any more—it is criminal; there is no other word for it.

I am grateful to the House for this opportunity to speak, and I look forward to seeing in practice, out there among the autistic community, the outcome of this wonderful Bill.

10.43 am

Annette Brooke (Mid-Dorset and North Poole) (LD): I congratulate the hon. Member for Chesham and Amersham (Mrs. Gillan) on introducing the Bill, on the vast amount of detailed work that she has undertaken and, in particular, on her tenacity. Excellent joint working has been done across the parties and with the Government, and she has brought certain skills to that: her good humour, her diplomacy, her negotiating skills and much more. All that has brought us to the point that we have reached today.

I also congratulate the hon. Member for Tiverton and Honiton (Angela Browning), who has obviously made an enormous contribution. It began long before I joined this House, but I have been very much aware of what she has done. In addition, she has been connected with quite an important organisation that serves my constituency, although it is not located within it: the Wessex Autistic Society. It is a great honour to follow
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her. She has brought reality to what we are discussing today and shown us just how serious some of the shortcomings are in the services for children and adults with autism. We are aware of those shortcomings and we have lots of statistics on them, but by talking about the misdiagnoses and what actually happens—the breaking up of people into little bits—we identify what we are about today: we are trying to remedy that situation.

The Liberal Democrats supported the Bill on Second Reading and made it clear that we wanted to have further discussions in Committee. We wanted to do everything we could to support that process, as we felt it could only be beneficial. We did not want to rely just on the Government’s promises, although I am sure that the motivations behind those were good. We needed to ensure that the Bill had more bite in order to ensure that we made progress.

I also congratulate the hon. Member for Erewash (Liz Blackman), who was gracious in expressing that we are rather pleased with this Bill—that is important. Although I played a very small part, I will have some pride in it if we are able to say that we have really changed matters. I congratulate the Ministers who have been involved, because a great deal of work has been done to reach this position, and the large number of organisations that have been involved—I should at least mention the National Autistic Society. I am sorry that I only managed to attend two Committee sittings out of three. The one that I missed was the crucial one, but I have, of course, read the Hansard record in great detail so I hope that I am fully au fait with everything. That was a very important sitting and involved the unusual situation where the promoter of the Bill proposed that her clauses be deleted and replaced by Government clauses.

John Bercow: The hon. Lady has rightly paid gracious tribute to the NAS. I am always conscious that there are unsung heroes and heroines who are actively working and deploying all their skills behind the scenes to secure our objectives. Therefore, rather than confine myself to paying tribute to the NAS, I am inclined to invite her to pay particular tribute to its chief executive, Mark Lever, to Amanda Batten, to Beth Reid and, last but by no means least, because she is a precocious talent, to Ellen Broomé.

Annette Brooke: I thank the hon. Gentleman for his intervention; I am very pleased to support it, although I am rather conscious of all the people whom we are not mentioning. Thus, I shall not go too far along that line, except to say that my unsung heroes include the support groups that I meet in my constituency, one of which is for adults with autism and Asperger’s and another of which is for parents whose children are at school and have such conditions. Their needs are very different, and that brings home to people the real battle that parents have all the way along the line. I wish to echo the earlier point that parents’ greatest fear is what will happen when they die—that never fails to touch my heart—and we know that we have to make things better for that reason.

May I return to the new structure of the Bill? I think that I shall refer to this Bill—and later, to the Act—many times, because it contains a great deal of detail. I have been told so many times that a certain thing is not suitable to go in a Bill when the discussion has been of
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what the guidance should include, but this Bill creates a precedent that will be incredibly useful across the board. I give notice of the fact that next time I am on a Committee I shall have this Bill in my pocket, because it is excellent. It is just what we need on this particular subject.

Undoubtedly, the Bill has been a catalyst for the Government introducing their raft of proposals, and today we have the opportunity to put those proposals on a statutory basis. Most of my time in Parliament is spent talking about children, so I just wish to refer briefly to children with autism before I get on to discussing what is now the main part of the Bill. I was pleased when early on the Government committed to amending the children and young people’s plans through the Apprenticeships, Skills, Children and Learning Bill, which placed a new legal duty to ensure that local areas collate and share data on disabled children as part of their CYPP needs assessment and include children with autism in their plans for children’s services. We also have a commitment that the statutory guidance that accompanies the regulations will state that autism must be specified as a specific category. The announcement of further funding for the Autism Education Trust to improve services commissioning is also welcome. All those commitments go beyond what the original Bill covered, and are very pleasing. Although the Bill is a big step forward, there is much more to be done, and much to be improved, in children’s services. We know from the parents we talk to about the gaps that remain, and the situation must be reviewed and monitored.

Children’s services have improved over the years, but the situation remains dire for transition and adult services, with woeful gaps. It is so important that we have reached this point today, and at least made a start in addressing the dreadful gap in services. I was pleased to serve on the cross-party panel of MPs that was established to conduct hearings on services for disabled children. What we heard, loudly and clearly, was that parents felt that they had got through the school years only to have to start all over again with the transition to adult services. We heard again and again that successful transitions could be achieved only by parents literally screaming for the services that they needed.

The problems include inadequacy of transition planning, lack of communication between children’s and adult services, and a lack of co-ordination between different services and agencies. We have referred to the National Audit Office report, and I wish to cite more statistics from it. A quarter of parents surveyed in 2006 felt that transition support was co-ordinated. In other words, 75 per cent. did not think so. Only one in three parents felt that Connexions’ knowledge of autism was adequate.

The lack of assurance of support when a statement comes to an end has been a problem for so long. We know where the gaps are and what is needed. We know that we need multi-agency assessment at the right time, transition plans to be developed with families, and appropriate goals set.

I add my congratulations to the hon. Member for Burton (Mrs. Dean), which I hope the hon. Member for Erewash will take on board, and the all-party parliamentary group on autism on its recently published inquiry and report on transition into adulthood by young people on the autism spectrum. The key points identified include effective and timely planning; realistic but stretching
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expectations; the need to enable young people to reach their full potential, because we have had too much waste in our society for so long; effective joint working across services; and a key contact. I am very keen on the latter point, because when parents and young adults are engaging with a raft of services they need to have just one person to talk to and to liaise with. Other key points include furthering the understanding of autism by training for all professionals involved; accessible information for young people and their families; and appropriate funding. The key recommendations from that report and inquiry will be timely for the consultation on the strategy and the statutory guidance on the Bill.

The amended Bill will put 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. It will provide a huge opportunity for progress in meeting the needs of adults with autism. The new clause goes beyond what was originally proposed, and the statutory guidance will cover all the crucial aspects, including access to diagnosis; needs assessments; transition planning; strategic planning of support services for adults with autism; and local partnership and co-operation.

On diagnostic services, I recently received a representation from a unitary council in the south-west. It said that in the council’s area

Many families may be unable to take that step—

David Howarth: Similar situations occur in many parts of the country. Even in Cambridge, where one would expect a higher level of service, many parents find that the only way in which they can get a diagnosis is to take part in academic research projects. That should not be how it works.

Annette Brooke: I thank my hon. Friend for that intervention, and that is why I am so pleased to see the level of detail in the Bill. The changes that need to take place will not come about without the detail that I mentioned earlier.

On the issue of data collection, the National Autistic Society survey found that 67 per cent. of local authorities and 77 per cent. of primary care trusts do not collect any data on adults with autism. It is clearly a crucial starting point to determine the scale of the problem. I concur with the hon. Member for Chesham and Amersham that we need to be sure that we go the whole way—that we do not just work with the people we know about, but reach out and identify those who have not been identified before.


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