Autism Bill

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Mrs. Gillan: I understand the Minister’s difficulty. Following the statement he has just made, anybody looking at the Committee proceedings, or interpreting the Bill when it is enacted, will see that it was the clear intention of Parliament that the foundation trusts should also be included in it. I hope that that satisfies the hon. Member for South Thanet.
4.15 pm
Phil Hope: My hon. Friend the Member for South Thanet brings great experience to the Committee, having served as a Health Minister himself in the past. He made an important point about young people in transition. I cannot pre-empt what the guidance will say about out of area placements. Clearly, that possibility exists, because the issues he raised are covered by the guidance in subsections (b), (c) and (d). As we go through the process of delivering guidance on those issues, he will be able to find a way of ensuring that his concerns about out of area placements are covered.
My hon. Friend the Member for South Thanet made an important point about definitions of autism. We all know that there is a debate about which conditions should be included under the umbrella of the autistic spectrum. We know, too, that there is professional disagreement on matters of diagnosis and the classification of conditions, which is why we think it would be inappropriate for Secretaries of State—in effect, lay people—to include the definitions in primary legislation. We want to include those in the strategy—the range of symptoms, the spectrum that the strategy embraces and the needs for which support and services must apply. We can keep the strategy under review, and as developments and new thinking occur, and as conditions become identified, we have the flexibility to revise the strategy, as we debated earlier, to embrace the matters that my hon. Friend raised.
Dr. Ladyman: My amendments were only ever intended to be probing. I never expected the Minister to put the definition in the Bill. Governments never do that, whether it is a good or a bad idea. However, I want the definition to be included in the guidance and be part of the process of review, so that there is clear guidance for the people who make decisions about whether a person is on the spectrum of disorders. I particularly want the Minister to use the words and state that it is his intention that the Bill will include people who are symptomatically autistic rather than what a future scientist might define as autistic.
Phil Hope: In the good practice guidance, “Autistic Spectrum Disorders”, which the Department for Education and Skills and the Department of Health published in 2002—my hon. Friend might even have been the Minister at the time, I am not sure—we listed the conditions that might be considered to be on the autistic spectrum: Asperger’s syndrome, atypical autism, Kanner’s autism, childhood disintegrative disorder or Heller’s syndrome, high-functioning autism, pervasive developmental disorder not otherwise specified, and semantic pragmatic disorder. We made it clear in that guidance, and I hope that that gives the hon. Gentleman the assurance that he needs. In future guidance, we can address the approach that he described. We made it clear that it was a tentative list. We stated exactly which disorders should be included in the spectrum. How broadly the spectrum extends is controversial and still debated. The importance of revising guidance to take into account the approaches that he argues for gives us that opportunity. I know that he wants me to use particular words now in Committee. I fear that I will not be able to satisfy him in that regard, but I can say that he has made his point eloquently. When we publish the strategy and the following guidance, he will be able to press his points.
Dr. Ladyman: I want to reiterate my point. The Minister has given the list of disorders that we currently consider to be on the spectrum. I will have a little bet with him—some time in future, scientists will identify a genetic link to some of those disorders. Equally, one or more of those conditions may not have that genetic link. I do not want people with those disorders to fall outside the scope of the Bill, simply because we discover a genetic link to three quarters of the disorders.
Phil Hope: I understand my hon. Friend’s point. I think that we both want to land in the same place—this is about how we get there. We do not want to risk excluding particular people by being too definitive in the Bill. However, through the strategy, which can be regularly revised, we may be able to embrace and include people who, as yet, are not identified. We want to arrive at the same place, but we want to get there in a slightly different way.
Phil Hope: The hon. Lady reinforces the point that I made to the hon. Member for Daventry about the value of reviewing the guidance and the strategy on a continual basis to respond swiftly to changes of that kind when we need to develop new approaches. The hon. Member for Tiverton and Honiton raised the issue of mental health services, which I think I covered earlier. Mental health trusts will be listed in the Bill, as new clause 4(1) states:
“‘NHS body’ means...a National Health Service Trust”.
That includes mental health trusts, and I made a point about foundation hospital trusts earlier. The hon. Lady made a point about misdiagnosis and individuals with complex needs or a variety of needs. I hope the guidance that will flow from the Bill, and which will specifically include issues arising from diagnosis, will cover that point when the time comes.
I want to put on record our thanks to my hon. Friend the Member for Burton, who is no longer in the Room. She is at a meeting about complex needs—I think that I was supposed to be there too, but never mind. She has been a great champion for autism in her role as chair of the all-party group. We have other former chairs here, and we all know that all-party groups in this House play a highly significant role. They allow hon. Members from both sides of the House to have a shared purpose across party lines and to join organisations representing particular groups in which they have an interest to introduce proposals. I want to congratulate the all-party group on the work that it has done. I think that I have covered all the points made in our debate.
Question put and agreed to.
New clause 1 accordingly read a Second time, and added to the Bill.

New Clause 2

Guidance by the Secretary of State
‘(1) For the purpose of securing the implementation of the autism strategy, the Secretary of State must issue guidance—
(a) to local authorities about the exercise of their social services functions within the meaning of the Local Authority Social Services Act 1970 (c. 42) (see section 1A of that Act), and
(b) to NHS bodies and NHS foundation trusts about the exercise of their functions concerned with the provision of relevant services.
(2) Guidance must be issued under this section no later than 31 December 2010.
(3) The Secretary of State—
(a) must keep the guidance under review, and
(b) may revise it.
Brought up, read the First and Second time, and added to the Bill.

New Clause 3

Local authorities and NHS bodies: duty to act under guidance
‘(1) This section applies to guidance or revised guidance issued under section [Guidance by the Secretary of State] to a local authority or an NHS body.
(2) Guidance or revised guidance is to be treated as if it were general guidance of the Secretary of State under section 7 of the Local Authority Social Services Act 1970 (c. 42) (local authorities to exercise social services functions under guidance of Secretary of State).
(3) For the purposes of guidance or revised guidance—
(a) an NHS body is to be treated as if it were a local authority within the meaning of the 1970 Act (see section 1 of that Act), and
(b) the functions of an NHS body mentioned in section [Guidance by the Secretary of State](1)(b) are to be treated as if they were its social services functions within the meaning of that Act (see section 1A of that Act).’.(Phil Hope.)
Brought up, read the First and Second time, and added to the Bill.

New Clause 4

‘(1) In this Act—
“adult” means a person who is aged 18 or over (and, accordingly, “child” means a person who is under the age of 18);
(k) in relation to an NHS body, means health services provided for the purposes of the health service continued under section 1(1) of the National Health Service Act 2006 (c. 41);
(l) in relation to a local authority, means services provided in the exercise of the authority’s social services functions within the meaning of the Local Authority Social Services Act 1970 (c. 42) (see section 1A of that Act).
(2) In this Act references to the provision of services include references to arranging for the provision of services (and references to services provided are to be construed accordingly).’.(Phil Hope.)
Brought up, read the First and Second time, and added to the Bill.

New Clause 5

Extent, commencement and short title
‘(1) This Act extends to England and Wales only.
(2) This Act comes into force at the end of the period of 2 months beginning with the day on which it is passed.
(3) This Act may be cited as the Autism Act 2009.’.(Phil Hope.)
Brought up, read the First and Second time, and added to the Bill.
The Chairman: We shall now work through the original clauses, which, as I understand it, the Committee will need to negative. The clauses may be debated. I shall put the clause stand part in each case. If any hon. Member wishes to speak to any of the clauses, they may do so. I shall put the clause stand part question at the end, when it will be up to the Committee, but to make sure that we get it right, I shall endeavour to indicate what the Committee wishes to do.

Clause 1

Duty to record and provide information on the number of children with autism
Question proposed, That the clause stand part of the Bill.
Mrs. Gillan: In the course of negotiations, the Government and the Ministers involved, who are present, have given the reassurances that we need and, indeed, made some great steps forward. I do not intend to speak at length or at all on clauses 1 to 3, if that is any help to the Committee.
The Chairman: That is clearly helpful to the Committee. If the hon. Lady wishes to make any all-embracing remarks in relation to clauses 1 to 3, I am perfectly happy to allow her to do so.
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