Mrs.
Dean: Would my hon. Friend expect primary care trusts to
ensure that the foundation trusts they have contracts with provide the
right sort of care for people with autism?
Phil
Hope: Yes. The Bill does not apply to foundation trusts
for the reasons that I have just given—wider policy and so
on—but if a PCT is contracting with a foundation trust, as I
said earlier, the obligation of the PCT as an NHS body to ensure that
it is carrying out its statutory duties is, therefore, handled through
the contracting process. I emphasise that NHS foundation trusts have
more autonomy in the system, which is why the Bill cannot directly
apply to them in the way that it may apply to other NHS
bodies. 3.30
pm Subsection
(2) of new clause 4 will ensure that the commissioning role of local
authorities and the NHS is properly covered by the Bill—that is
exactly the point that I was making to my hon. Friend the Member for
Burton. Commissioning is not readily recognised in law because the duty
to provide services in legal terms goes wider than just direct
provision of those services. The duty also covers cases where the
organisation on which that duty lays arranges for a third party to
provide the services—fundamentally that is what commissioning is
about. I feel that I am repeating myself, but I want to get it on
record. I am delighted that the third sector plays an important part
here, along with other bodies, and we are committed to supporting such
initiatives. It is important to find a way to make it explicit that we
recognise the need for clarity around the extent of the Bill.
Therefore, we have to express the concept of commissioning that is
recognisable in law. The wording in the
subsection, “arranging
for the provision of
services”, is
how I propose to do that. It puts the concept of commissioning into
statutory language, and I commend the new clause to the
Committee. In
my earlier remarks, I mentioned the work that we are commissioning the
Social Care Institute for Excellence to do, to publish guidance on best
practice and give people more choice and control. I think I said that
it will be issued this spring. I should have said next spring, and I
apologise to the Committee for that slight slip. Having described how
we will put the concept of commissioning into the statutory guidance, I
commend new clause 4 to the
Committee. New
clause 5 is largely self explanatory, and there are only one or two
points worth mentioning. After my efforts during the discussion on new
clause 4 to specify that the Bill will not apply to Wales, the
Committee may be slightly confused about subsection (1), which refers
to “England and Wales”—I know I was. I reassure
the Committee that that is merely a technical legal requirement. An Act
cannot extend to an area smaller than the whole of England and Wales,
because they are a single legal jurisdiction. We can, however, ensure
that the Bill will apply only to England, and we have done so in new
clause 1, which specifies that the autism strategy will cover only
adults in England. As I have already explained, the definitions of
“local authority” and “NHS bodies” in new
clause 4 refer to English bodies only. I hope that that is
clear.
Mrs.
Gillan: The joys of devolution. Will the Minister confirm
that Wales has its own autism strategy? The strategy is a good
document—a good way of moving forward. It is not often that I
praise the devolved Welsh Assembly Government, which is a
Labour-Plaid
Administration, but in this case, I think that the
Welsh Assembly Government and the Welsh Assembly have already done some
good work and I commend
them.
Phil
Hope: I agree with the hon. Lady, who I know speaks for
the Opposition on matters relating to Wales. Wales has its own
strategy, which it is pursuing, and it is important that we continue to
learn from the experiences in both England and Wales to ensure that
both jurisdictions—devolved institutions—learn the best
from each
other. Mr.
Russell Brown (Dumfries and Galloway) (Lab): The Bill
refers to England and Wales. If it is successful, as we are hoping it
will be, there are at least two of us here in the Committee who will
make others north of the border aware of what can be
achieved.
Phil
Hope: I will not be drawn into any more debate about
devolution, and whether the Scottish Parliament will take the matter
forward. I hope that we are all learning from each other in our
endeavours to do our best for people with autism.
Subsection
(2) of new clause 5 takes the unusual step of determining the
Bill’s commencement in advance. Normally, that depends on the
laying of a commencement order no fewer than two months after Royal
Assent is obtained. In this case, however, the Bill will automatically
come into force two months after being granted Royal Assent, rather
than being dependent on a separate commencement order. I am sure that I
do not need to spell out the significance of, for example, activating
the deadlines for the publication of the strategy and issuing the
guidance. The
purpose of amendment 42 is to ensure that the Bill’s long title
accurately reflects the Bill’s content, assuming that the
Government’s new clauses are accepted by the Committee and that
the existing clauses are removed. I hope that I have sufficiently
outlined the purpose and effect of the new clauses, which constitute an
alternative to the Bill as currently
drafted. As
I understand it, Mr. Gale, I must now speak to original
clauses 4 to
9.
Phil
Hope: Thank you. Having commended the alternative Bill, it
will come as no surprise that I do not support clauses 4, 5, 6, 7 and 9
of the Bill as currently drafted. I support clause 8, the money clause,
which will remain as part of the Government’s alternative Bill.
I will outline my reasons for opposing the substance of the Bill as
currently
drafted.
Mrs.
Gillan: I would like to inform the Minister that I intend
to recommend to the Committee that clauses 4, 5, 6 and 7 be replaced by
the new clauses. If members of the Committee agree with that intention
at this stage, that will allow me to short circuit a rather long
explanation from the Minister. I therefore hope that my intervention is
of
use.
Phil
Hope: I seek your guidance, Mr. Gale. The hon.
Lady makes an excellent suggestion that saves me from having to explain
why we do not want to include original clauses 4, 5, 6, 7 and 9 in the
Bill.
Mrs.
Gillan: On a point of order, Mr. Gale. If I
recommend that we should accept the new clauses, what is the mechanism
to substitute the Bill’s clauses as they currently stand with
the new clauses? Will you confirm that I need only to recommend the
withdrawal of clauses 4, 5, 6, 7 and
9?
The
Chairman: The principle is fairly straightforward. We will
shortly debate new clause 1, which will give members of the Committee
the opportunity to comment on that, as well as on new clauses 2 to 5,
which are grouped with it. In other words, there will be a general
debate on all the Minister’s proposals. Those new clauses will
then be moved formally, voted upon and, I imagine, in the light of the
sentiments that have been expressed,
carried. Thereafter,
because the Bill has been read a Second time, the Chair must put the
original clauses to the Committee. That system is again quite
straightforward. Members may wish to comment on the original clauses,
which will then be put to the Committee and, I imagine in the light of
what the hon. Member for Chesham and Amersham has said, negatived. In
other words, the whole Committee will vote against them. Since clause 8
is necessary as a money resolution I imagine it will be left in,
although it is not for the Chair to determine that. Furthermore, one of
the amendments relates to an existing clause, and it will also be
called, but not
yet.
Dr.
Ladyman: On a point of order, Mr. Gale. It
might simplify things for the Committee if I say that I am fairly
confident that I will be able to make my points on amendment 41 in a
debate on the Government’s new
clauses.
The
Chairman: That would be perfectly in order when we come to
it. The hon. Gentleman just needs to not move his
amendment.
Phil
Hope: In light of your guidance, Mr. Gale, I
will not speak to clauses 4, 5, 6, 7 and 9 because there is consensus
across the Committee. I will simply say that I will not support the
original clauses for the reasons that we have just
discussed.
Mrs.
Gillan: I have listened to the Minister very carefully and
I think that the whole Committee will see what a long way he has come
in meeting the demands of this private Member’s Bill with the
new clauses that he has tabled today. Therefore, I will take the
unusual step of recommending to the Committee that we vote in favour of
these new clauses.
I also want
to say that, in all my years as a parliamentarian, I have never seen a
Minister and his team of officials respond in such a courteous and
rapid fashion to a subject that I believe needs to be remedied through
legislation. He should be rightly proud of moving the new clauses
today, because it shows Parliament at its best. We have seen a problem,
identified the needs of a very large group of people and their families
in our society and we are acting together to try to bring some
alleviation and common sense.
The Minister
is really responding to years and years of work by individual Members
of Parliament to whom I have paid tribute before—we all know who
they are. I am absolutely delighted to recommend to this cross-party
Committee that we accept these new clauses.
If
we do accept them, we have to vote against many of the original clauses
in the Bill, and I am very happy to do so. They are imperfect vehicles.
They are imperfect vehicles because the Minister has gone further than
I or the National Autistic Society and the 14 other charities that have
been advising me have asked for. He has met their needs and demands at
every step of the way. There is obviously some fine tuning to be done
and I hope that there will be room for that on Report and Third
Reading.
New clause 1
is key to this strategy, a strategy that has already started. I know
that the fact that the consultation has begun is delighting an awful
lot of people right across the country. They will be delighted that the
Minister and the Department are making progress.
New clause 1
confirms the strategy for meeting needs. I think that all of us on the
Committee know the sort of complex needs that are identified and
required by people with autism. I have been particularly touched by
some of the incidents that I have observed and by some of the
discussions I have had with the professionals working in this area. The
smallest intervention can make the largest difference in
somebody’s life. Alternatively, it requires a group of very
dedicated and very well-qualified professionals to deal with the more
complex
needs. Rather
than delay the Committee, I will just pick out certain aspects of the
new clauses. I am very pleased with the responses. It is extraordinary
that the Minister has put a date in subsection (3) of new clause 1. I
was particularly worried that this Bill, like many other pieces of
legislation, might not reach the statute book, may not be enacted or
may fall foul of all the bureaucracy of political timetables. Indeed,
that was also the fear outside this House. However, new clause 1(3)
states that
“The
autism strategy must be published no later than 1 April
2010.” That
is a real step forward because there is no room for misinterpreting
that date.
The Minister
may like to hear that I am particularly pleased because when I was a
junior Minister I did a great deal of work on a report about the
position of women. We were running up to the 1997 election and my
permanent secretary told me that I could publish the report but could
not publish its conclusions. I felt that it was far from a political
report; it was a report that was of interest to women generally. I did
not want that to happen again, with any political timetabling, to a
subject that is so important. That is why I was delighted to see that
date of 1 April included in new clause 1.
We talked
about the need to keep the reviews moving on and the general power. I
think that a named individual, or a couple of named individuals within
the Department, is still the way forward, because there is a need to
know where to call. All the information I have received shows that many
people do not know where to go. They do not know where the final
arbiter is; they do not know where the contact point is. The Department
could move towards having a very transparent interface with the outside
world by ensuring that those people are clearly named. I think
the Minister has given that undertaking, which I am delighted
about. 3.45
pm Subsection
(6) seeks to consult widely and not limit participation. That is, of
course, something that we all welcome. It is also a response to the
requests from the
National Autistic Society and the people advising
it. I am glad to see the ingenious way that parliamentary counsel has
dealt with the fact that the strategy consultation has already been
launched; that is a common theme throughout the Bill. Drafting counsel
has moved so rapidly—much more quickly than most of the lawyers
I have come across—and has come up with some quite good ways of
putting into legislation what we required from the original Bill.
Likewise, subsection (8) deals with that particular
issue. On
guidance, I am delighted with new clause 2(5) and its paragraphs,
because it reflects a particular request from the National Autistic
Society. It is the basic shopping list, but it allows somebody to go to
the shops and buy a few extra things. We know that there will be
other items, and the list covers that. The real triumph is that
subsection (5)(d) meets the requirements. The transition with which it
deals has caused so many problems and such heartache. To read
“planning in
relation to the provision of relevant services to persons with autistic
spectrum conditions as they move from being children to
adults” will
gladden the hearts of so many people outside the Committee that it is
hard to say what the effect will be on people with autism and their
families. New
clause 3 is absolutely right. It gives section 7 guidance. I am
grateful for subsection (3)(a), because that is a good device for tying
in the NHS. I congratulate the lawyers on their ingenuity on that
particular piece of drafting.
On new clause
4, I need reassurance that the list under “NHS body”
covers mental health trusts. I think that is a given, but it is of
particular importance because so many people with autism fall between
the mental health trusts, the adult services and disabled services, and
that is where I need reassurance from the
Minister.
Dr.
Ladyman: May I emphasise the need for reassurance on that
point, because of course some of the mental health trusts will be
mental health foundation trusts and, therefore, will be excluded from
the statutory
provision?
Mrs.
Gillan: I am grateful for that intervention because that
is exactly the point I was going on to make. I am looking for comfort
from the Minister on that as well.
The Minister
gave an excellent explanation of new clause 5. Again, I am particularly
pleased to see—I was not aware of this until the clauses were
tabled—that the Bill is not going to fester on the statute book
and never be enacted. Much of our legislation is not discussed in
detail, and much of it does not see the light of day and is overtaken
by other legislation before it has been allowed to breath or has been
tested; it is obsolete before we get there. This Bill will come into
force as an Act two months after Royal Assent, if it gets through the
rest of its parliamentary stages—it still has a long way to go.
I am particularly keen for the new clause to go
through. On
co-ordination between the devolved bodies, there is no doubt that
devolution is here to stay in the United Kingdom, no matter what
one’s view of its success. I hope, however, that there will be
co-ordination between the four nations of the United Kingdom on their
strategies and how they learn about dealing with autism. That is
particularly important. The Minister and I were at a
reception last week, which I think many members of
the
Committee attended, at which the head of the
Northern Ireland autism strategy spoke. Northern Ireland has been
making progress in this area, and I would like the four nations to move
together. That is not a matter for legislation, but I hope that there
will be a sub-committee somewhere in the Department of Health that
brings together the four relevant Ministers from the Governments in
Wales, Scotland, Northern Ireland and Westminster so that there is a
good exchange of information. That will be important, particularly at
official level, because we are not operating in isolation, we are all
part of the same United Kingdom, and as a Unionist I would like us all
to benefit from
that. I
do not wish to delay the Committee any longer—I want to give
other Members the chance to speak if they so wish—but it might
help if I reaffirm what I intend to do. As the Bill’s promoter,
I intend to recommend that at this stage the Committee accepts the
Government amendments so that we can move the proceedings on. I have
detected in this Minister a real determination that the Bill become an
Act, and if that is the case I do not want to hold up the proceedings
for too long because that will mean so much more to those with whom I
have been dealing throughout the progress of the Bill—the
National Autistic Society and the other charities, and of the course
the families and individuals affected. Once again, I commend the
Minister and thank him and his officials for all the work that they
have so rapidly done, and I ask the Committee to accept the Government
amendments.
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